Non-urgent injury turns to amputation nightmare

Non-urgent injury turns to amputation nightmare

Special report: Young man struggles with new plight as disabled while hospitals argue his case

Paisal Srisuwan, a 29-year-old Tha Rua native of Ayutthaya, whose left leg was amputated after an accident last month, is struggling to adjust to his life as a disabled person.

Paisal Srisuwan tries to walk on crutches at his home after his left leg was amputated following a motorcycle accident. Somchai Poomlard

"I am concerned about my future and my grandmother. Being disabled, I don't know how to earn a living to take care of her. I am the only one she relies on," Mr Paisal told the Bangkok Post at his home in Ayutthaya's Tha Rua district.

Mr Paisal's story hit the headlines last month when his relatives, led by his aunt Hansa Tree-arom, 34, filed a complaint with the Damrongdhamma Centre in Ayutthaya province, alleging doctors at Tha Rua Hospital in Tha Rua district misdiagnosed Mr Paisal's injuries.

They are now seeking 1 million baht in compensation from Tha Rua Hospital.

Mr Paisal was injured in an accident on Nov 8, when the motorcycle he was driving hit a road repair sign on Tha Rua-Tha Luang Road in tambon Jampa in Tha Rua district.

Shortly after the accident, Mr Paisal was taken to Tha Rua Hospital, a primary-level hospital. A doctor gave Mr Paisal pain medication and put his left leg in a splint. He was allowed to return home despite his relatives' demand that he be transferred to an advanced hospital.

"Once at home, he was in so much pain during the night. My daughter phoned [Tha Rua] hospital and was told all the beds there were occupied," said Ms Hunsa. She said her nephew cried the whole night because of the pain.

He removed his splint because his leg had swollen so much. On the morning of Nov 9 he was taken to Tha Rua Hospital and then transferred to Ayutthaya Hospital where his leg was amputated on Nov 18.

Mr Paisal said he believes the slow hospital transfer process caused his leg's condition to worsen so much he needed amputation. He and his aunt say a doctor told them that Mr Paisal's left leg suffered a broken blood vessel. The doctor told them that if his leg was operated on earlier, he would not have lost it.

Wiwan Pongpattananon, a doctor at Tha Rua Hospital, who handled Mr Paisal's case, said he was sent to the hospital with a "fracture of proximal tibia", or a break in the shinbone just below the knee.

An X-ray showed the fracture is non-displaced, which means the bone remains properly aligned. Mr Paisal did not have open wounds, according to Dr Wiwan, and his case was defined as non-urgent, implying the patient did not need an emergency transfer. 

Dr Wiwan said she gave him an injection to relieve his pain and put his leg in a splint to support the back of his left leg before allowing him to go home.

He returned to the hospital the next day with more swelling, Dr Wiwan said.

However, his relatives told the doctor that Mr Paisal removed the splint himself against the doctor's advice.

Dr Wiwan denied reports Mr Paisal had compartment syndrome, a painful condition involving excessive pressure inside the muscles. She referred him to Ayutthaya Hospital at midday where medical resources are more advanced.

An Ayutthaya Hospital doctor who asked not to be named said Mr Paisarn was transferred to the hospital with bruised tissue that caused compartment syndrome.

A surgeon operated on the bruised area to relieve the pressure, the doctor said. "The patient's left leg did not suffer from a broken blood vessel," according to the doctor.

He was monitored at Ayutthaya Hospital for more than a week before doctors decided to amputate his leg. The severely bruised tissue caused swelling in his leg that blocked the flow of blood to feed oxygen to his tissues.

Despite the hospitals standing by their actions, Tha Rua Hospital has forwarded Mr Paisal's case to the board for National Health Security Office. He could be entitled to preliminary assistance under the universal coverage healthcare scheme. It covers patients who suffer injury caused by any service provided by the health care unit.

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