Good morning. Two negligence cases today: one hospital lost, the other won, and in both the paperwork decided it. What Round 2 did to Pathology last year, and the worst air in India on Thursday, which wasn’t in Delhi. If your ward has a turning chart that nurses fill in every shift, hit reply and tell me how you made it stick.
— DR. ADITYA SETH, EDITOR-IN-CHIEF
01 · THE LEAD
MEDICOLEGAL
Her file never mentioned a sore. Her children found them the night she got home.
A 71-year-old with fever was admitted by her physician the day he saw her, treated conservatively, and stayed alert and sitting up throughout. By the morning after discharge, photographs of the sores were on his WhatsApp, and on the family’s account he scolded his staff for not turning her. The hospital wrote a prescription and sent a staffer to dress the wounds at home, free, four or five times. They never closed. Her death summary, signed on the hospital’s own side, blamed the sores.
At the Hoshiarpur district commission, the hospital said it had turned her and kept her on an air mattress, and that its notes, silent on any sore, proved she left without one. The commission started with arithmetic. Four advanced sores cannot form between a morning discharge and bedtime, so they began in her first two or three days on the ward, and she lay there two or three more with nobody noticing. Then it asked for the paper behind the turning and the mattress. The free dressings, sent as goodwill, also found their way into the judgment.
WHY IT MATTERS
Chart every turn with a time and a name; a protocol nobody wrote down was treated as one nobody followed.
Look at the pressure areas on discharge day and write down what you found, even when you found nothing.
Check two lines on your indemnity policy: the name on it, and whether its year covers the date of admission.
02 · MEDICOLEGAL
He blamed a femur nail for his varicose veins. It took 18 years to say no.
Twenty-three years ago, a road accident brought a man to a private hospital in west Delhi with a severe head injury (GCS 6) and a comminuted femoral shaft fracture. The team waited nine days for the head injury to settle, then nailed the femur. More than three years later, AIIMS was treating him for varicose veins and cellulitis, and he took the hospital to consumer court for Rs 10 lakh, saying the leg was now useless. The district commission took almost 15 years to throw the case out, and the state commission has now agreed. Nothing on record tied the operation to his veins: his AIIMS notes treated the leg as a skin and vein problem and advised no operation, and in all that time he never asked for a panel of specialists to review his care.
03 · DOCTORS
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Doctors
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A resident spent his evening on her IV. She spent it worrying about dinner.
He was a first-year anaesthesia resident leaving a late OT; she was about 60, still waiting outside, sent for a difficult IV. All four limbs were swollen, her veins were thrombosed or extravasated from repeated pricks, and she had refused a central line. Two ultrasound-guided attempts missed, and she began insisting she had to leave. Most of us would have written “not cooperative”. He and his senior stopped and asked what was so urgent. There was a 30-year-old son at home, so they asked the obvious question.
04 · NEET PG
Three in four government Pathology seats came back for Round 2 last year
No other branch we’ve counted lost a bigger share. This year’s Round 1 closed government Open seats at rank 46,664, just 811 short of last year’s final cut-off, and EWS and OBC have already gone past theirs. Most of the 809 government seats went to ranks between 20,001 and 50,000. Round 2 runs 6 to 14 November, and the piece works out where each category could close if last year repeats.
The other ten, ordered by the best rank that chose each: Medicine · Radiology · Dermatology · Orthopaedics · OBGY · Paediatrics · Surgery · Ophthalmology · Anaesthesia · ENT.
05 · AIR QUALITY
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AQI · THU 5 NOV Faridkot read 989. Delhi, at 550, missed the worst eight. All eight are in Punjab and Haryana, six of them in Haryana, on AQI.in’s live India ranking. Karnal, home to EndorphinMD, was third.
Other metros: Ahmedabad 220, Kolkata 216, Pune 171, Mumbai 168, Hyderabad 112, Bengaluru 84, Chennai 78. Every bar here is past 300, where AQI.in’s Hazardous band begins. At that level the US EPA advises everyone to avoid outdoor exertion, and people with heart or lung disease, older adults and children to stay indoors. The × figure is PM2.5 against the WHO 24-hour limit of 15 µg/m³. Readings are US-scale AQI from AQI.in; India’s CPCB index stops at 500, so its numbers won’t match. |
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