OPINIONS

What should a General Surgeon in Govt hospital do if the anaesthetist refuses to help for emergency LSCS?

Tuesday, April 21, 2015

by Dr M C Gupta

Dr M C Gupta, a doctor turned lawyer, provides medico-legal opinion on what a surgeon in a government hospital should do if the anaesthetist refused to help him for an emergency LSCS (lower segment caesarean section).

Dr M C Gupta

Dr M C Gupta

Dr Gupta holds an MD (Medicine) from All India Institute of Medical Sciences (AIIMS), an LLB from Delhi University and LLM from Kurukshetra University. He has served as a faculty member at AIIMS for 18 years and as professor and dean at the National Institute of Health and Family Welfare. Currently, Dr Gupta is a practising advocate with health and medical law as the area of special interest. He is a member of the Supreme Court Bar Association and Indian Law Institute.

You Ask:

I am a Surgeon in a Govt hospital in Uttarakhand. I had to perform an emergency LSCS because no obstetrician was available (the post is vacant). The anaesthetist refused to assist me by giving anaesthesia on the ground that I am not an obstetrician. As per my knowledge, an MS General Surgeon is qualified enough to perform Obstetric procedures in case of emergency. What should I do?
– Dr Pranam Singh Pratap, Roorkee

Dr Gupta Responds:

1—An emergency life-saving surgery can be performed even by an MBBS in the absence of a specialist provided this is, as far as possible, explained to the patient/relatives and informed consent is taken.

2—In Surinder Kumar (Laddi) and Anr. V. Dr Santosh Menon and Ors. 2000; (III) CPJ 517, the Punjab State Consumer Commission held that there is no bar against an MBBS performing a Caesarean section merely on the ground that the doctor does not have a qualification in Gynae-Obs.

3—According to AP Medical Council:

“What can an MBBS Doctor do:-
(1) He can do all the Minor Surgical Procedures for which he is trained in MBBS Course and Housemanship.
(2) He can do Deliveries and its related procedures as trained.
(3) He can do National Programmes like Tubectomies & Vasectomies.
(4) In emergencies if a qualified surgeon is not available in the near vicinity as a life savings measures he can do first aid and a Surgical Procedure based on his experience.
(5) He should not do Elective Major Surgical procedures and the care should be taken to refer to a nearby Hospital where a Surgeon / Gynaecologist is available.”

http://imaapstate.blogspot.com/2010/12/can-mbbs-doctor-do-surgery.html

4—If it was life saving / emergency surgery, the anaesthetist, by withholding his services, committed a breach of the MCI Code of Ethics Regulations, 2002.

5—You may take the following actions:

i)—You may complain to the State Medical Council against the anaesthetist under
Regulation 1.7 of the Indian Medical Council (Professional Conduct, Etiquette and Ethics) Regulations, 2002, which reads:
“1.7 Exposure of Unethical Conduct: A Physician should expose, without fear or favour, incompetent or corrupt, dishonest or unethical conduct on the part of members of the profession.”
ii)—You may complain to the State Health Department against the anaesthetist.

iii)—You may complain to the District Appropriate Authority set up under the Clinical Establishments Act, 2010, which has been extended to Uttarakhand—

http://www.thehindu.com/todays-paper/tp-national/tp-newdelhi/uttarakhand-doctors-to-protest-against-regulation-of-clinical-establishments/article4816042.ece

iv)—If the patient / relatives ask you as to whom they can complain in the circumstances, you may inform them that a complaint can be made by them to:

a)—State Medical Council (SMC) against the anaesthetist.
b)—District Consumer Forum against the hospital and the anaesthetist.
c)– District Appropriate Authority set up under the Clinical Establishments Act, 2010, against the hospital.
d)—Director, State Health Services.
e)—Police complaint, if so advised legally depending up on the facts of the case.

Dr M C Gupta (Former Professor and Dean)
MD (Medicine), LLM
Advocate (Delhi Bar Council No. 857/2001)

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2 Comments »

Comment by shailendra jain
2015-04-30 09:38:44

Dear editor

I would be happy if you kindly give following answer _through legal expert.

Our is 1000 beded hospital with D N B in all specilities and all aquipments. presently we are having superspecilities in all the deparment. However majority will retire and no new entant.
1. Will MD medicine and MS gen sur head the superspecility department. The designation at senior level we will give SR Consultant surgery but allow them to work in department/ They were in the superspecility as an assistant to Superspecilist. Can they head independently without super specialist. What kind of surgery they can do. Can MD Medicine do the Angiography and plasty., surgeon can he do glioma removal and traumatic.
2. In and around of town we have AIIMS, many hospitals and have facility for refer also. It is Public sector hospital.

3. What about out sourcing. cardiologist come from Delhi does procedure and goes away same day. The MD medicine follows the patient. We have encountered the complications. No medico legal

4. same for other. What is the administrative medico-legal responsibility.

Pl advise

With regards

 
Comment by Amir Baluch
2018-07-05 15:39:43

Really informative and helpful post for the doctors. This shares lots of information regarding anesthetist. Please keep sharing this type of helpful blog with us.

 
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