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Surgeon admits to mistakenly removing womans kidney, but denies negligence

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Dr KK Aggarwal    22 September 2018

Morning MEDtalks with Dr KK Aggarwal 22nd September 2018

Dear Colleague

Here are two links for videos to watch. Share them with your colleagues and friends.

  1. What is FDC?https://www.youtube.com/watch?v=tGv6BRIG8UA
  2. TEDx Video: Doctor-patient relationshiphttps://www.youtube.com/watch?v=i9ml1vKK2DQ

Surgeon admits to mistakenly removing woman’s kidney, but denies negligence. A South Dakota surgeon admitted to mistakenly removing an Iowa woman’s healthy kidney but denied that he breached the standard of care, according to the surgeon’s response to a lawsuit filed by the patient. The surgeon acknowledged in an answer to lawsuit that right kidney was removed instead of an adrenal gland and an associated mass. The patient developed stage 3 kidney disease after her October 2016 surgery.

The patient said she wasn’t told about the mix-up until after she was released from the hospital. The surgeon had known on the day of the surgery that he hadn’t removed the adrenal gland because he was notified by pathology department. But the surgeon said the patient was provided with the information on the day of her surgery. Patients medical records also indicated “a very superiorly located right adrenal gland,” which was near the large lobe of her liver. The surgeon team said they did not breach the standard of care by removing the kidney, failing to remove the adrenal gland and failing to admit the mistake. They also deny that Knapp suffered damages.

The question is whether it was an error of judgment or a negligence. Well, it could easily be an error of judgment.

Here is another study adding to the evidence for benefits of exercise. Compared with those who are physically inactive, adults who routinely engaged in light to moderate physical activity prior to a stroke or TIA are twice as likely to experience a mild event rather than a moderate or severe one. The finding that even light physical activity, as recommended by WHO can have a positive impact in reducing the severity of a future stroke is both new and surprising (Neurology, Sept. 19, 2018).

Avoid using a phone, tablet, or computer screen well before bedtime. A study from the University of Houston College of Optometry published in the journal of Ophthalmic & Physiological Optics has examined the blue light harms of digital gadgets. According to the study, blue light emitted from digital devices could be a reason for increased sleep dysfunction. Participants in the study who wore short wavelength-blocking glasses three hours before bedtime for 2 weeks experienced a 58% increase in their melatonin levels at night. Overall, the quality of their sleep reportedly improved significantly in many ways.

Hormone, sex-steroid, and antibiotic treatment of livestock are major concerns. The main reasons why consumers choose organic foods are concerns about hormone supplementation and treatment with sex-steroids and antibiotics used in conventional livestock farming. Are there sufficient evidences?

  1. Hormone injections, especially with bovine recombinant growth hormone (rBGH), are given to cows to increase milk yield by 10 to 15 percent. Conventional milk does not contain significantly higher levels of bovine growth hormone (GH) compared with organic milk. Also, 90% of bovine GH is destroyed by pasteurization. Bovine GH is biologically inactive in humans, so even if it were absorbed from drinking conventional milk, it would not be expected to cause adverse health effects.
  2. Sex steroids: Treating cattle with sex-steroids accelerates the rate of growth and increases meat yield. It is speculated that ingested estrogen in food derived from sex-hormone-treated animals may lead to earlier development of puberty. Limited studies have not supported this hypothesis in humans.
  3. Antibiotics: On conventional livestock farms, antibiotics are administered in nontherapeutic doses to enhance growth and prevent disease. The presence of antibiotic-resistant bacteria in non-organic foods may be related to the routine use of antibiotics. Organic farming that prohibits the use of non-therapeutic antibiotics may contribute to a reduction in disease caused by drug-resistant organisms (Forman J, et al. Organic foods: health and environmental advantages and disadvantages. Pediatrics 2012;130:e1406).

Can a general MBBS doctor admit patients under him/her self? (Dr KK Aggarwal & Advocate Ira Gupta) Yes, a patient can be admitted under the physician who is a qualified MBBS doctor and who has been registered with the Indian Medical Council or any State Medical Council for treatment of the patient as admission of a patient is essential for treatment of the patient which is the paramount duty of the registered medical practitioner.

As per the Schedules of Indian Medical Council Act, 1956 the qualification in MBBS is a recognized qualification and the person who undertakes the MBBS qualification is entitled to be registered as registered medical practitioner practicing modern system of medicine as per the provisions of Indian Medical Council Act, 1956.

Further, the provisions of Indian Medical Council (Professional Conduct, Etiquette & Ethics) Regulations, 2002 enumerates the code of ethics to be observed by physician who is a doctor with qualification of MBBS or MBBS with post graduate degree/ diploma or with equivalent qualification in any medical discipline.

Thus, once a person has obtained a degree in MBBS and is registered under the Indian Medical Council Act, 1956, then he/she is entitled to practice the modern system of medicine.

Also, as per the provisions of Section 15 of the Indian Medical Council Act, 1956 the registered medical practitioner has a right to sign, issue and authenticate medical or fitness certificate or other certificates to his/her patient.

Also, as per the provisions of Regulation 1.3.1 Indian Medical Council (Professional Conduct, Etiquette and Ethics) Regulations, 2002 the physical is required to maintain the medical records of his/her indoor patients. The indoor patients are those patients who have been admitted by the physician for treatment.

Further, in the matter tilted as “Surinder Kumar (Laddi) versus Dr. Santosh Menon & Others, 2000 (III) CPJ 517(Punj. SCDRC), the Hon’ble Punjab State Consumer Disputes Redressal Commission held that MBBS doctor having obtained degree from the University was competent to practice medicines, surgery and obstetrics. Caesarean operation is a part of surgery. It may be that the persons obtaining diploma like D.G.O may be more qualified to conduct Caesarean operation but it cannot be said that such persons who had obtained such training only were eligible to conduct Caesarean operation. Further, doctor was qualified as well as eligible for conducting Caesarean operation, on the basis of her experience also. 

As pot stocks jump around, FDA chief says hes more worried about teens using marijuana than e-cigarettes. Teen use of marijuana is increasing as more states legalize it for recreational and medicinal purposes. FDA Commissioner Scott Gottlieb worries that more regular use of pot poses new risks. Last years Monitoring the Future survey found nearly one-quarter of teens are using pot.

In an extraordinary rare case, four European patients developed breast cancer after receiving organs from the same donor. The patients developed breast cancer years after their transplants. Three of the organ recipients died after the cancer metastasized. The fourth survived after a series of treatments, including removal of the donated right kidney, stopping of immunosuppression medication and chemotherapy. The cases are reported in the American Journal of Transplantation, online April 6, 2018. The 53-year-old donor had no known medical conditions, and the malignancy was unknown when her kidneys, lungs, liver and heart were harvested (CNN).

Health Ministry has partnered with Dell and Tata Trusts to provide a technological platform for nationwide prevention, control, screening and management program of Non Communicable Diseases (NCDs). MoUs were signed with Tata Trusts and Dell on Thursday. The NCD screening program addresses Hypertension, Diabetes, Oral, Breast and Cervical cancers and covers all men and women over the age of30 years.

Some good news for the country. Over 270 million people in India moved out of poverty in the decade since 2005-06 and the poverty rate in the country nearly halved over the 10-year period, a promising sign that poverty is being tackled globally, according to the 2018 global Multidimensional Poverty Index (MPI) released on Thursday by the United Nations Development Programme (UNDP) and the Oxford Poverty and Human Development Initiative (OPHI).. (ET Healthworld, Sept. 21, 2018).

Dr KK Aggarwal

Padma Shri Awardee

President Elect CMAAO

President HCFI

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