‘Golden hour’ wasted before man’s death, private hospital to pay Rs 43.36 lakh to family

“No proper treatment was given to the patient during the Golden hour period. Over and above the same, the corrections or over writings on the dates, manipulations and time, is adding fuel to the fire regarding the delay…the Golden hour period was wasted by the opposite parties (hospital, its doctors and employees) due to their negligence,” the commission said on August 20.

According to the complaint, N Devender Rao developed symptoms of a brain stroke after lunch at his home in Warasiguda, Secunderabad, on March 22, 2013. His family said he was taken to the hospital’s Secunderabad branch between 1.30 pm and 2 pm before he was shifted to its Jubilee Hills facility.

Delay in treatment

The commission found discrepancies in the records concerning his arrival and subsequent treatment and noted that the hospital had not produced the original emergency records from the Secunderabad branch, making it difficult to establish the patient’s condition and treatment there.

Rao was shifted to the hospital’s Jubilee Hills facility. The commission said that the entries appeared to have been made before his recorded admission time and noted overwriting and corrections in dates and timings.

A case-sheet entry at around 6 pm stated, “Patient not thrombolysed as patient beyond window period.” The drug chart showed that Clexane, a blood-thinning medicine, was given at 6:30 pm, while the entry for fluids given through a vein at 6 pm was struck off. The commission noted that, apart from Dolo, the records showed little medication being given until later that evening, with the first medication recorded at 7:13 pm.

It further held that the corrections and overwritings added to concerns about delay. Taking the reported onset of symptoms at around 1:30 pm into account, it concluded that the golden-hour period was wasted by the opposite parties due to their negligence.

Comorbidity defence called an ‘afterthought’

The hospital argued that thrombolysis was not performed because Rao had several serious medical conditions, including hypertension, diabetes, coronary artery disease and chronic kidney disease, besides a history of previous strokes and right internal carotid artery occlusion.

The commission, however, was not persuaded by this explanation. It noted that the contemporaneous case sheet did not record that thrombolysis had been withheld for the reasons later cited by the hospital. The commission said the explanation surfaced only after the allegation regarding loss of the golden treatment window was raised and described it as an “afterthought” to meet the allegation of delay.

The commission separately criticised the manner in which Rao’s medical records were maintained. It noted that the CT scan and coagulation reports had not been filed and that virtually no record was available before it for a substantial period between March 28 and October 17, 2013. It awarded Rs 1 lakh as compensation for “Shabby maintenance of records”.

The commission calculated the family’s loss-of-income claim at Rs 40.11 lakh based on Rao’s salary, a deduction towards personal expenditure and the applicable multiplier. It additionally awarded Rs 1 lakh towards loss of estate. His wife was awarded Rs 50,000 and his son and daughter Rs 25,000 each towards loss of consortium and paternal affection. Another Rs 1 lakh was awarded for record maintenance, along with Rs 25,000 towards costs, taking the total monetary award to Rs 43.36 lakh.

Takeaway

The order highlights that hospitals must provide timely treatment during a medical emergency and maintain complete, accurate medical records. Delays during the critical “golden hour” and inconsistencies or gaps in treatment records can have serious consequences in a consumer complaint.

Aggrieved consumers may contact the consumer helpline in their respective states (Telangana: 0771-2582902) or call the National Consumer Helpline at 1915 for assistance.

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