One thousand compensation for the death of a patient who dies in the hospital: doctors did not adequately warn about the danger

The judges of the Lithuanian Court of Appeal, who confirmed the previous decision of the Klaipėda Regional Court, according to which the Klaipėda University Hospital should compensate the daughter of the orphan for non-pecuniary damage, also indicated in the judgment that it came into force from of the ad.

“The patient died of complications after the procedure, so the applicant lost a close person, his father, and will not be able to reestablish the same or similar connections in the future; this means that the illegal actions of the medical institution did not directly affect death of the patient, but they are undoubtedly indirectly linked to the consequences of the procedure and the death of the plaintiff as a result of the death of the father, ” the court determined that the amount of non-pecuniary damage is, although the plaintiff, who lives in the The United States had estimated its experiences at 100 000. EUR.

According to the judges, before the colonoscopy, the patient was not provided with all the information on the possible consequences: “Although the patient signed a form approved by the Minister of Health, but it was not duly filled out, no detailed information was provided to comply with with the order. formal requirements “.

According to the case data, it was established that a male resident in the port city had been monitored for several decades in the Outpatient Department of Klaipėda University Hospital for rheumatoid arthritis. In 2015 at the end of December, the man came to the hospital for treatment, concerned that he might have an oncological disease, and the doctors who examined him complained of abdominal pain and swelling of the wrists and other ailments. After the prescribed treatment, the patient’s condition improved, but less than a week later, he returned to see a doctor due to severe abdominal pain and exhausting abdominal distention. On the same day, the patient was examined by gastroenterologists who diagnosed chronic constipation and functional dispersion.

December 29 the patient underwent an ultrasound, after a day, fibrogastroscopy for derivatives in the abdomen, and on New Year’s Eve decided to perform a bowel examination, a colonoscopy procedure. The entire colon was examined during the study, but no pathology was found. That same night, the patient complained to the medical staff on duty of the deterioration.

An infectologist on duty, suspected of internal digestive bleeding after the colonoscopy, takes the patient to the Intensive Care Unit. In this room, infusion therapy was administered, after which the patient’s state of consciousness improved temporarily, but he remained in critical condition, so the medical council decided to operate on him.

The man’s treatment continued after the operation, but the condition remained very serious in 2016. On January 3 the death of the patient was noticed at night.

The daughter of the deceased, who brought the Klaipėda University Hospital to trial, explained that the doctors had carried out illegal actions in the provision of health services, but the courts of both instances, having examined the civil case, did not agree with such statements and they denied them.

“The written evidence of the case, based on special medical knowledge, does not confirm that the conduct of the physician who performed the colonoscopy procedure, which implies the death of the patient, was unprofessional, dishonest, inconsistent with the principles of reasonableness or diligence”, the judges stressed.

According to them, experts from the Vilnius branch of the State Forensic Medicine Service did not confirm in their conclusions that “the transformation occurred as a result of an incorrectly performed colonoscopy and therefore the patient died after complications.”

In addition, the State Health Care Activities Accreditation Service found that the fibrocolonoscopy examination was appropriate and that the unwanted outcome of the disease was significantly influenced by the accompanying pathology. “The operation was successful,” says the medical record.

However, the judges found that the physicians did not adequately inform the patient of the impending consequences during treatment.

According to the court, prior to performing a surgical, invasive and / or interventional procedure on a patient, the informed consent of the patient must be obtained to undergo a specific surgical procedure or procedure.

“Said consent must be expressed in writing by signing a form that meets the requirements approved by the Minister of Health,” the court stressed. – In obtaining informed consent for a surgical, invasive and / or interventional procedure, the information is considered relevant when the patient has had knowledge of the nature of the surgical or invasive and / or interventional procedure, its alternatives, nature, objectives, complications known and possible (adverse reactions). consequences), other circumstances that may influence the patient’s decision to accept or reject the surgery or the planned invasive and / or interventional procedure, as well as the possible consequences of rejecting the planned surgical or invasive and / or interventional procedure.

Patient consent for the provision of healthcare must be informed and adequate. Consent is considered reasonable and appropriate if it meets the following conditions 🙂 is given by a person who can adequately express his or her will; 2) is given by receiving sufficient and clear information; 3) is administered voluntarily by the patient (his representative); 4) comply with the formal requirements established by legal acts. If the patient signs a consent form on a form approved by the Minister of Health, it means that the patient has received the appropriate information. ‘

From jurisprudence it can be inferred that the requirement of the patient’s consent is explained by the principle of personal autonomy, according to which only the patient has the right to decide on their treatment: of the patient’s treatment. harm to your health, even if the doctor acted diligently in performing the medical procedure. The operation of a person without their consent is only possible in exceptional and legal cases, such as when medical care is provided in case of need (accident, accident, etc.) and is necessary to save the life of the patient, and the patient cannot express your will. “

According to the judges, health care services were provided to the deceased patient at Klaipėda University Hospital with the written consent, but a dispute arose in the case about compliance with the form and content of the consent with the law.

The Klaipėda Regional Court found that the hospital staff had violated the obligation to inform the patient because they had not adequately provided information about the procedure, its complications and alternative treatment methods before the colonoscopy was performed; At that time, the hospital representatives stated that the patient had signed the consent form, that he agreed to undergo the procedure, that he had been provided with all the necessary information and that the duty of information had not been breached.

The appeals court did not agree with the medical statements: the consent form for the operation or the treatment procedure did not indicate “the code and telephone numbers of the personal health care institution, the telephone number of the department that performs the procedure, the name of the health professional who performs the procedure, clear description), nature, purpose, does not discuss the permissibility of changing the scope of the surgical procedure if it would not be possible to discuss it with the patient, that is, the tacit consent of the patient, disagreement with eliminating an unnecessary option, there is no indication of alternative treatments, and Although the patient agreed to have the possible consequences, deadlines, complications and possible additional economic costs of the treatment explained, the degree of risk of the treatment has not been confirmed. health status of the person (specific pathology that increases the risk of surgery / pro surrender). psnis) “.

“The fact that a patient may die during a procedure (colonoscopy) is not mentioned in the consent form, as it only indicates that the patient is aware that it is not always possible to predict the outcome and complications of the operation / procedure , analgesia and medication, and that the operation / procedure analgesia has its own degree of risk or can even result in death, ”said the panel of judges.

According to them, this is precisely why there is no reason to believe that the patient received adequate information about the colonoscopy procedure before the doctor performed the colonoscopy, as he signed a form approved by the Minister of Health but it was not properly completed. information that meets the requirements for the consent form in the order.

Klaipėda University Hospital did not agree with the lawsuit filed against it and stated that the doctors acted in a lawful manner and were not to blame for the death of the patient, and that the medical services were provided with the utmost care, diligence, attention and caution.

Representatives of the medical institution also disagreed with the statement that they did not inform the patient before the colonoscopy procedure: “The records in the medical history confirm that the patient has signed that he agrees with the procedure. The consent lists possible complications, including various types of injuries, bleeding, etc. The patient’s signature also confirms that all questions have been answered. Therefore, there is no reason to believe that the patient was not informed about possible complications. “

At the time, an outside doctor who prescribed the treatment for the patient explained that he had been told that yoga was the only way to dispel his anxiety diagnosis was a bowel exam, a colonoscopy that would only confirm or rule out worrisome symptoms.

“The patient was explained orally about the procedure and possible complications, so the patient confirmed in writing that they had been explained and agreed to have the procedure performed,” said the doctor.