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TWELVE WAYS IN WHICH THE DOCTOR CAN BE THE CAUSE OF THE PATIENT DEVELOPING HEMIPLEGIA
OP KAPOOR
Ex. Hon. Physician, Jaslok Hospital and Bombay Hospital, Mumbai, Ex. Hon. Prof. of Medicine, Grant Medical College and JJ Hospital, Mumbai 400 008.
The following twelve ways in which the doctor can be the cause of the patient developing hemiplegia:
1.The diagnosis is TIA - If Aspirin is started with, without excluding a small brain haemorrhage.
2.High dose of anti-diabetic drugs leads to hypoglycaemia, specially at night which can cause paralysis.
3.In a patient of cerebro vascular insufficiency, a large dose of anti-hypertensive drugs will cause a sudden fall of BP and lead to thrombosis.
4.After a wrong pathology report of INR reading a larger dose of anti-coagulant is given to the patient, and he develops haemorrhage in the brain.
5.A cardiologist doing a cardioversion for atrial fibrillation resulting in a cerebral embolus. This is because even after doing a 2-D Echo Cardiography a blood clot can be missed, which could have been picked up only by TEE.
6.A patient of falciparum malaria is being given "inadequate" treatment, now develops cerebral vascular thrombosis.
7.A patient of TB meningitis is not getting steroids.
8.The patient is undergoing surgery for congenital Berry aneurysm for subarachnoid haemorrhage.
9.When the surgeon is doing over-enthusiastic strio-pallidectomy for Parkinson's disease.
10.During the operation of endarterectomy of the carotid vessels.
11.During the interventional procedure of stenting in the neck.
12.Finally, after coronary bypass surgery, hemiplegia is a very well known complication. This is because, the surgeon does not exclude a carotid artery atheroma before the surgery. Then, during the operation, because of hypotension and pump bypass, the patient develops thrombosis of a cerebral vessel.
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