T.A. SUBRAMANIAN Vs. SOMASEKHAR REDDY

JUDGEMENT

(1.) Patients undergoing surgery for a hip fracture have a higher risk of mortality and major complications compared with patients undergoing an elective total hip replacement (THR) operation. The effect of older age and comorbidities associated with hip fracture on this increased perioperative risk is unknown [JAMA. 2015;314(11):1159-1166. doi:10.1001/jama.2015.10842] .

(2.) Brief facts relevant to dispose of this appeal are that:

(3.) The OPs 1 to 3 resisted the complaint, denied any negligence in during treatment of the patient. It was submitted that the patient was suffering from multiple health aliments. The treatment plan was discussed with the wife of patient and as per standard practice initially suggested skeletal traction for 6-8 weeks and then to mobilize the patient. If no significant pain then it could be managed with occasional pain killers. In case if patient develops pain, then THR was suggested. The patient consented for the treatment plan and accordingly skeletal traction was done under general anaesthesia on 17/5/2006 and 8 weeks of skeletal traction was advised, but the patient preferred it at his home with proper hospital type bed. Accordingly, the Physiotherapist was sent to patient's house to assess the suitability for required traction treatment. The patient was discharged at his request on 23/5/2006, and called for review after six weeks. In the meantime, on 27/5/2006 patient suffered retention of urine and treated by Dr. R. Ramesh Chandra Reddy as an out-patient; Foley's Catheterization was done and prescribed few medicines. The patient was called for review after six weeks. Thereafter, on 18/7/2006 he suffered chest pain, breathlessness on exertion, and he was unable to walk because of swelling of left leg. Dr. Shiv Kumar, Cardiologist and Dr. Aftab, General Physician at OP-1 hospital diagnosed it as DVT. The X-ray of hip joint showed signs of healing and the skeletal pin was removed on 19/7/2006. The patient was mobilized with a walker. As he was showing good progress with mobilization, partial weight bearing was commenced from 8/8/2006 and patient was discharged on 9/8/2006. As the progress was satisfactory and patient was managing with a walking stick, therefore, THR was not needed at that stage, which could be done as an elective procedure.