Doctors speak about the early signs that the patients and their families can look out for immediately after surgery.

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news Health Saturday, January 11, 2020 - 17:22

It had only been a day since 24-year-old Priya delivered her baby through C-section on December 27, 2019. While she was yet to recover from the surgery, she started showing certain worrying symptoms: she was not lactating enough and she vomited whatever she ate. Eventually, she started becoming disoriented and even showed signs of memory loss. It was later found that the doctors who performed the C-section allegedly left a cloth inside the body cavity, which caused blood infection and ultimately, her death.

Priya’s death is only one of the many instances of medical negligence. In 2018, in a similar incident, a private medical college in Uttar Pradesh’s Mathura allegedly left a needle in a six-year-old boy's head after surgery for a head injury. He was discharged and given medicines. But the boy soon started complaining of pain. It was soon found that there was a sharp object in his head.   

In recent times, there have been many instances when either a surgical item is left behind in the patient’s body after a surgery or a wrong injection is administered to the patient. These have led to permanent deformities in some, and in other cases, the death of the patient.

With conversation around medical negligence and holding doctors accountable for their actions growing louder, TNM spoke to a few doctors to understand if negligence or lapse by surgeons can be spotted early.

According to Dr Kavitha Lakshmi Easwaran, a Senior Obstetrician and Gynaecologist at Motherhood Hospitals, there are distinct signs, or something out of the ordinary, that the patients and families can look out for immediately after surgical procedures. “The first conspicuous sign would be a rise in body temperature since the infection process would have started. This will be followed pain beyond what can be addressed by painkillers,” she explained. 

Patients could also show other signs that are symptomatic of medical negligence. These signs differ from case to case and are based on the types of procedures undergone by him/her, Dr Kavitha added.

“For example, if a foreign object is left behind in the abdomen, the patient could also show symptoms like constipation, obstruction of bowel movements and distention of the abdomen, among others,” she said.

According to Dr B Asokan, Dean, Coimbatore Medical College and Hospital, post-surgical complications arise due to various factors, including anaesthesia. Hence, having a set list of symptoms that could point to a possible mistake in the surgery may not be prudent, he added.

“Even with anaesthesia, the symptoms and recovery process differ considerably based on the site of operation, type of anaesthesia etc,” he pointed out. 

First 48 hours crucial

Every patient is different, Dr Kavitha said. And that is why, the first 24 to 48 hours after the surgery is the most crucial period for observing discomfort, if any. “When we say fever and pain, the patients’ families might not really notice anything different since most patients tend to develop these illnesses immediately after a surgery. But when these symptoms persist for over 20-24 hours, then it must be investigated further,” she said. 

Though latest technologies might have made it marginally easier to address the flaws in such procedures, Dr Asokan noted that the problem becomes serious when the doctors and duty nurses fail to spot the abnormality. “Most symptoms become noticeable or pronounced only when the presence of a foreign body has caused an infection. That is why it often gets too late to address the problem, especially when regular checks are not made by doctors. Hence it becomes all the more necessary that the duty doctors keep a careful eye on the patient in the initial days after surgery,” he said. 

Patients have right to question

Highlighting the difference between other professions and a surgeon, Dr Asokan said that it is difficult for a surgeon to go back and correct the error since it might have been too late for them to realise it. “This is why, whenever surgeries are performed, the entire surgical team has to be extremely careful and cautious.”

Dr Kavitha concurred and said that in spite of stringent internal checks in the operation theatre to prevent errors, mistakes do happen, albeit rarely. “Even if the patients miss these signs, the doctors on duty must be able to notice that something is off,” she added. 

When pointed out that many negligence cases are detected after they become serious due to the lack of constant post-operative monitoring by the medical team, Dr Kavitha said that it is the patients' rights to question the doctors and ask them to be more attentive. "It is the primary responsibility of the doctor to make sure that he or she has done the right thing for the patient," she explained.