TREATMENT of Mrs Bhadra Ray, wife of Mr R.K.Ray (From 15.11.09 to 30.11.09)
At around 2130 hrs my wife Mrs. Bhadra Ray got up from the Sofa in the Drawing Room and went to the toilet. She brushed her teeth and before she could come out, she slipped in the toilet and hurt her right wrist. Contacted our family friend Dr Kulkarni at 2200 hrs. He advised to place some ice and apply Dharasona lep for the night and to consult him the next day morning..Next day morning, i.e on Sunday at 0739 hrs, Dr Kulkarni on hearing that there was no reduction of pain or swelling in the night, advised us to proceed to Leelavati Hospital and reach positively by 0900 hrs as Dr Shreedhar Archik, an Orthopedic doctor will be available for consultation in the hospital till 0900 hrs. Accordingly we reached Leelavati Hospital and met Dr Archik. He advised X-ray of right hand wrist both AP and lateral. The X-ray confirmed breakage of right wrist in to broken pieces.
Dr Archik also advised that the O.T of Leelavati Hospital is fully booked till Wednesday and only one slot is available on Monday 16.11.09 between 0700 and 0800 hrs. On his advice, booked the O.T in the hospital by paying Rs 1000.00 for above period and carried out tests like CBC, Sr Creatinine, Electrolytes, Random Blood Sugar, Liver Profile, HIV I & II, HCV antibodies (Elisa), HBSAg (Elisa), X-ray chest and ECG. All tests were completed except X-ray chest. The Doctor advised tablet Racipers and tablet Nimulid to be taken once in the morning and once at night. Same was bought from the Hospital Chemist. Subsequently, we went back home at 1145 hrs on 15.11.09.
Came back to Leelavati Hospital after taking Dinner at home before 2000 hrs as the Doctor recommended ‘Nil by mouth “after 2000 hrs., view operation at 0700 hrs on the following morning. Got the paperwork completed and she was admitted in Room no 805 at 2123 hrs on 15.11.09 .The Casualty Dept of the Hospital informed the Park site Police Station of the accident at about 2315 hrs on 15.11.09 from the Direct line Telephone of the Casualty Dept of Leelavati Hospital. The Inspector Mr. Gaekwad from Park site Police Station came to visit the Hospital and met us in Room No 805 in the Hospital at 0130 hrs on 16.11.09 .He took our statement. As my wife’s hand was bandaged, she could not sign but gave her thumb impression on the statement written in Marathi. Also she was asked to give her thumb impression on a blank paper.
The chest X-ray was done at 2230 hrs on 15.11.09. She was taken to Operation theatre at 0615 hrs on 16.11.09 and was brought back to the room at around 1015 hrs. She was given some water at 1200 hrs, Coconut water was given at 1300 hrs and Khichdi was given at 1430 hrs. After that normal food was restored.
During her stay she was administered medicines and injections as prescribed by Dr Archik. She was discharged at 1100 hrs on 17.11.08. As she was advised to take Bonista Injection, contacted the person as described by Dr Archik and bought one month stock of Bonista for Rs 10154 on 18.11.09 and started administering 8 units daily at 2200 hrs.
Dr Archik wanted the patient at his clinic at 1900 hrs or at OPD of Leelavati at 1330 hrs. for removal of bandage on the righr hand. The timings of The visit to clinic was more appropriate. We went o0n 20.11.09 The Doctor took out the bandage and got an X-ray done. He assured healing is going on in proper way and prescribed Betadine ointment and microspore tape and advised us to change the dressing every day after cleaning by Betadine lotion. The medicines were bought from a shop in AmrutNagar; close to our residence at 2230 hrs. Hence did not get a proper receipt for purchase of medicine at Rs 181.60
On 23.11.09, the patient complained of severe abdominal pain and watery like loose motion. Also the urine was reddish. Contacted Dr Archik at 0800 hrs on 24.11.09 and informed him. He advised on 24.11.09 to land Urine sample for analysis and call him with the report. The urine sample was given to Hiranandani Hospital on 24.11 .09 and report received at 1830 hrs. Doctor could be consulted at 2100 hrs on the same day. He advised to stop Voveran tablets and prescribed Ceftum 5oo grs twice a day for 7 days. This was bought from Noble Medicals for Rs 2071.49.The tablet CCM prescribed by Doctor for three times a day got over on 29.11.09.Hence new tablets bought from Noble Chemist for Rs 691.32. The ceftum got over on 1.12.o9 and as advised by Doctor, did a urine routine culture on 2.12, 09 and found no occult blood and pus cell less than 5.
The next visit to Dr Archik was made on 3rd December. He opined all is well and advised next visit on 17.12.09
The Springs were removed on 17.12.09.The Doctor advised the patient that there will be lot of pain and prescribed some pain killing tablets .the patient has to bear it. An X-ray was done on 17.12.09 .We were asked to come next after 15 days. Hence we went on 30.12.09.Doctor’s Assistant took out the external fix and advised Physiotherapy (5 Exercises) and advised Tablet IMSTREEL 1 to 3 times a day on S.O.S basis. To be reviewed after 15 days.
Hence met Doctor on 19.01.10.The patient complained of too much pain. He advised T.Benzaday (15) 0-0-1, Tab Naprosyn 750 0-0-1 and Tab Omez FF (40) 0-0-1 for 15 days. When asked about the deformity of the hand, Doctor opined that nothing can be done, by performing Physiotherapy the patient should learn how to to use the hand for normal function. All the rods were removed on that day but no final X-ray was done. The Doctor was asked that the hand does not reflect a normal hand with so much swelling on one side but the Doctor assured “My job is over, now you have to get used to it. It cannot be any better. Her wrist is broad that is why it is shifted.
The file containing all treatment details and the two X-rays done at Dr Archik’s clinic was given to Dr A.C Kulkarni, our family friend and who suggested us to go to Dr Sreedhar Archik, to advise. We were told by him that nothing much can be improved. Dr Archik also indicated that there is no need to go to him. Hence we concentrated on physiotherapy (5 Exercises) prescribed by Dr Archik
As the pain was persistent, we went to Dr Hemant Patankar on 31.03.10.He wanted the last X-ray done by earlier Dr Archik. We said he did not take any X-ray after removing the external fix. Then he guided us to take X-ray from Dr Madhu Bal’s Diagonistic Centre. Both A.P and lateral X-ray of right hand forearm was done at Dr Bal’s clinic for Rs 300.We returned with the X-ray plates and seeing the X-ray plates, Dr Patankar said, it is complicated, the earlier fracture has not healed. Will require Surgery to rectify the defects. Doctor’s fee of Rs 500 was paid.
On 02.04. we met Dr A Thakkar. He also said the earlier fracture exists and fresh surgery is required.By now the patient was very nervous, having suffered at wrong hands from Mi Nov 09 till April 10.She insisted we go to the Orthopedic who had fixed her ankle when it broke a few years ago. Doctor’s fee of Rs 500 was paid.
Same day 02.04, we met Dr Palekar. On his insistence once more Digital X-ray from nearby Piramal Diagonistics, same was done for Rs 300.00.He also opined a re operation to set it right. He was also paid his fee of Rs 600.00
Finally we met Dr Sreedhar Archik with new Xrays on 06.04.10..He was now agreeing that the fracture has not healed and it can be rectified by a new surgery. The Patient did not agree and when Dr Archik was told that the patient is not agreeing the same combination of Leelavati Hospital and Dr Archik, Dr Archik nodded and said I understand. He took Rs 500.00 and wrote as under
“No FUP (Although patient had gone every 15 days till 19.01.10), however the fracture has collapsed & recent X-ray shows a frank non union and radial shortening.
Can’t do ADL easily & has weak grip.
Adv Surgery 2 Options (1) fix #C locked comp plate and do Darrach at same time use ulna as BG.
(2) Wrist Arthrode sis Carracci’s
Relevant tests were done at Nidan, Ghatkopar for Rs 3120.00 and at L.H Hiranandani Hospital for Rs 1710.00.The patient was admitted to Saifee Hospital, Charni Road on 10.4.10 for fracture right wrist. She was operated on 11.04.10.Dr Palekar said as the fracture was more than five months, the ligaments around the fracture are all destroyed and hence restoring all movements of the wrist was difficult. Even if it is restored, the patient will get pain at all times due to the damage the wrist has inside for last five months. He advised wrist fusion. For this Doctor had to take some bones from the patient’s right waist. The dressing was renewed on Monday 12th afternoon and the patient was discharged from the Hospital and brought home on Tuesday at 1100 hrs.
The patient was very weak. She could not walk from the bed to the toilet. But with home care and good nourishment, she started walking alone from 17th morning. Till such time the patient was not allowed to walk alone.
The Hospital charged Rs 1, 10, 673.00, The Doctor charged Rs 45000 including Rs 5000 for attendance at the hospital for two days and the Anesthetist charged Rs 10, 000.00
The medicines prescribed has been purchased for next 30 days as per the discharge card. She was taken to the Doctor on 23rd April at his chamber. The Doctor took out the old dressing of both right hand and right waist from where the bone was taken for wrist fusion. The wound on the waist was healed up. The Doctor told the patient that she can now take bath without any precaution. Only the right wrist to be kept dry. The new dressing of the right fore arm was done and soft plaster was put after removing the two halves heavy plaster. The Doctor took Rs 4000/-towards his fee and cost of plasters etc and told us to visit him on 15th May.
On May 15 the Doctor removed the plaster, cleaned the hand and advised not to take heavy weights, not to put any pressure for at least two more months as the bone is still very soft. He requested us to revisit him on 15th June with a Digital X-ray of the arm. Following are suggested:
(1) As is evident from above, the patient is suffering for last six months with acute pain, unable to use her right hand impairing her eating and dressing and making her dependant on other people. As is evident fron later inspection of Doctor Palekar, the normal operation of hand can not be restored as the ligaments are either dead or destroyed permanently. The patient must thus be compensated adequately.
(2) The Director of Leelavati Hospital should ensure such Doctors are not allowed to practice there, as similar lapse on the part of the Doctor will bring bad name for the Hospital. It can be vrified whether the Doctor operated himself or allowed his junior to operate. This, if true, will be very serious offence.
(3) Understand Dr Archik does a lot of Knee replacement. When he can not undertake a simple operation of correcting a fracture and patient goes through such trauma, will it be prudent to allow Dr Archik to continue his practice?
Submitted for favour of Scrutiny. Papers or Photograph of hand can be submitted on request'