Doctor may blame busy environment

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By Rizwana Sheik Umar

Durban - The Durban doctor facing four counts of managing a patient in a manner that was incompetent or negligent is set to argue that her environment was not conducive to providing detailed clinical notes.

Dr Sujatha Hariparsad is due to testify at an inquiry commissioned by the Health Professions Council of SA that she did not document her clinical notes in as much detail as one would in private practice, where there is more time.

She will say the environment she worked in was busy.

Hariparsad has pleaded not guilty to: failure to keep adequate clinical notes; failure to correctly diagnose 40-year-old Ravine Parmanand’s condition; failure to take his full and complete history; and failure to admit him for further observation.

In November 2008, Parmanand suffered a fatal heart attack after being examined and thereafter discharged from Netcare uMhlanga Hospital by Hariparsad.

Altus Janse van Rensburg, acting on behalf of Hariparsad, said his client would testify that her notes were not “scanty”, as expert medical witness Dr Ravinkumar Ramdass had described them, but ought to be read in conjunction with the rest of the notes in the file.

At the resumption of the inquiry earlier this week, Ramdass had testified that Hariparsad’s clinical notes regarding Parmanand’s history were inadequate.

“As a reasonable doctor I am supposed to ask a patient about their social history, like if they smoke, consume alcohol, etc. These things were not noted by Dr Hariparsad. It cannot simply be said that the patient did not volunteer the information,” Ramdass said during cross-examination on Wednesday.

Van Rensburg said the clinical notes, comprising 20 pages, were the most comprehensive he had ever seen.

Ramdass stood his ground.

“All med students are told, ‘If you don’t write it, you didn’t do it.’ She should have documented everything,” he said.

Van Rensburg said the defence did not accept Ramdass’s opinion that the patient suffered from angina.

He said that to say Parmanand had angina would be “stretching it”.

Defence witness Andrew Geard would testify that Parmanand died of a possible ventricular fibrillation – a severely abnormal heart rhythm – Van Rensburg put it to Ramdass.

“Ventricular fibrillation is the process by which Parmanand died and not the cause of death,” Ramdass countered.

Van Rensburg argued that his client had made a “differential” diagnosis because angina was not obvious. Ramdass disputed this.

“It was obvious,” he said.

The inquiry was adjourned until May 13. - Daily News

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