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Cardio Diabetes Medicine 2017 629

An Overview of Legal Issues

in Hypertensive and Diabetic Patients

Dr. T.N.Ravisankar

MBBS,FCGP,DFM,PGDMLE.
Medico legal consultant, Chennai

Abstract: in medico legal situation in the present day context.
Diabetic and Hypertensive patients need to be evalu- Though an initial assessment of the diabetic case
ated in total in outpatient and as inpatient. The equip- status with a digital glucometer is ideal,but to labela
ment used need to be calibrated regularly as per the patient to be a diabetic, one will have to definitely
protocols of the manufacturing company do venous blood glucose fasting, post- prandial and
Diabetes and hypertension, the two major non com- HbA1c, which will be the most appropriate.Trying to
municable diseases in this country, has either con- treat a patient without doing all these above investi-
tributed directly or indirectly for medico legal prob- gations and later found thepatient going for an hy-
lemsfor the practising physicians. poglycaemia with oral hypoglycaemic agents scan
result in medico legal litigation against the physician.
The Diagnosis of a diabetes and hypertension in a It will be aclear case of negligence, if you have not
patient has not been of greatapprehension.For the properly assessed before starting any of the oral hy-
practitioner the first job as the patient enters is to- perglycaemic agents or for the fact that insulin has
takePulse and Blood Pressure of the patient. Quit become the first line of treatment by some of the
often the job is also doneby paramedicalandtrained aggressive physicians or diabetalogists.
personal in a busy practitioner office. It is very im-
perative that BP apparatus is well maintained. The Both diabetes and hypertensionhas one major re-
concept of no mercury is getting percolated in the so- sponsibility cast upon the physician is to communi-
ciety byPollution control board. We have been talking cate with the patient on the nature of the disease.
to our students, until 2010 the value of mercury,BP Whatever you read in your text books which may
apparatus. But today, the situation has changed and run in volumes and volumes, it is ideal to condense
we have moved to the digital era andwe are now itin regional language which patient can understand
using more often adigital BP apparatus.When the and communicate to him what the disease process
physicians take the BP, the patients are happy and is, why it happens in an individual running into the
confident about it. Thevast majority of the busy phy- family history and also life style of the individual and
sician and cardiologist do depend on the paramedical the mental status. Both Hypertension and Diabetes
to take the BP.In thatsituations, we use the digital BP almost have similar social economic factors. Today,in
apparatus. The most important aspect of digital BP the fast world, every person is stressed upon and
apparatus, it has to be calibrated in a regular interval. this issue will have to be informedto the patient.Com-
The number of times apparatus is used per day will municating on the life style, stress factors,causative
have to be calculated, take an average, get aninfor- factors of both diseasesare very much needed be-
mation from the company where you have bought cause tomorrow the patient might find fault on the
the BP apparatus and the calibration is to be done treating physician that he has not explained to him
appropriately.The small change in the systolic BPor what is cause for the onset of disease process and
diastolic BP between 140/100 or 101/110 can always when the disease process has started and what has
make a difference if it is not been intervened at the trigger the whole issue.
appropriate time. Who takes the BP and where the BP All medico-legal experts will always say communica-
is taken and what apparatus is a very important issue tion is one major factor that contributes orprevents

Cardio Diabetes Medicine