Subash Chandra Pathak, 28, of Soaltee Mode, Kathmandu was taken to the emergency section of the hospital around 9:30 p.m. after a motorcycle accident at Kalimati. Doctors discharged him after initial treatment but he lost consciousness at home and was pronounced dead on arrival back at the hospital after midnight. [break]
The autopsy showed his ribs had fractured and pierced the lungs. The victim´s relatives claim that doctors at emergency were negligent and therefore missed such a serious injury.
The report says the patient was conscious with no signs of vomiting and oral and nasal bleeding at the time of arrival. It also mentions a cut on the left hand and a 4x1cm size wound below the left armpit.
Doctors then did some blood tests, urine tests, ECG and X-ray of the hand, elbow and wrist before discharging him but didn´t do a chest X-ray, ultrasound of the abdomen or CT Scan that are normally done in road accident cases.
Relatives claimed, and Emergency Department head Dr DP Singh conceded, that the doctors didn´t treat the wound under the armpit despite mentioning it in the report.
“Had they been careful about the wound under the armpit and not overlooked it, they might have known about the fractured ribs and injured lungs,” Roshan Pathak, the victim´s cousin said.
Head of department Dr Singh was surprised how doctors missed such a big wound.
Dr Harihar Wosti, who conducted the autopsy, said, “Such multiple rib fractures should have been clinically detected without any tests and a chest X-ray should have sufficed”.
Director of Bir Dr Buland Thapa and Dr Singh argued that the ribs may have been broken while trying Cardiopulmonary Resuscitation (CPR) after the patient was returned to the hospital and said death may have been caused by something else. But Dr Wosti said, “CPR doesn´t fracture over 10 ribs, with some of them broken at three places.”
Other doctors also said emergency doctors overlooked the fact that the patient had low blood pressure of 90/60 and a high pulse rate of 120/minute, indicating he may have internal injury. But Director Dr Thapa argued that alcoholic intoxication--the victim was returning from a party--also results in low blood pressure and high pulse rate.
The hospital has formed a five-member committee to investigate the incident. “The committee includes a doctor from the victim´s family,” Dr Thapa promised.
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