Drain pipe left after laparoscopic Gall Bladder Removal: Hospital, Surgeons directed Rs 6.5 lakh compensation

Chandigarh: The District Consumer Redressal Forum has directed a city-based multi-speciality government hospital to pay a compensation of Rs 6.5 lakh on account medical negligence by its surgeons in leaving a part of drain pipe in the patient's abdomen during a laparoscopic gall bladder procedure

The patient, as a result, had to undergo a second surgery for removal of the gall bladder

The case concerned a Shimla resident who had complaints of abdomen pain. Her ultrasound revealed fatty liver, gall bladder stones, fibroid uterus, and cervicitis

She was then referred to the Government Multi-Speciality Hospital (GMSH) where she was diagnosed to be suffering from cholelithiasis i.e. presence of galls stone – stone in gall bladder whereas Common Bile Duct (CBD) was normal i.e. there were no stones in it. She was then admitted in the hospital for the laparoscopic removal of the gall bladder. Two surgeons Dr Dabar and Dr Bal performed the laparoscopic procedure for removal of the gall bladder and she was soon discharged

It was alleged that after a few days, the patient went to the hospital for the removal of a drain where the two doctors and their staffs allegedly removed it negligently. She was referred for an ultrasound after which Dr Dabar confirmed everything to be normal.

After experiencing pain a few days later, she went for the CT scan which revealed the presence of a foreign object inside, a hyperdense tubular structure was seen in GB fossa extending anterior to the stomach in the peritoneal cavity. It had a diameter of ~4mm and a length of ~12 cm.

Dr Dabar told her that she would be operated again due to the negligence of the hospital and their employees. The second surgery was performed by Dr Dabar and Dr Singh on 29^th October and removed the foreign body.  Two days later the patient was discharged.

The patient then approached the Consumer Forum and claimed medical negligence from the side of doctors in the first surgery. She further claimed that the drain used was too thick and banned. The complainant reflected the amount charged for various procedures and prayed for compensation of Rs 19 lakh along with interest for deficiency in service inclusive of mental and physical harassment and other charges.

The District Consumer Forum sought the reply of the opponent party in this regard.

The Superintendent of the hospital denied the allegations and submitted a written reply by raising preliminary objections of present consumer complaint being not maintainable complainant not being consumer.

It was claimed by the Superintendent that in the first surgery the drain was removed by para medical staff and it was observed, complete inserted portion of the drain pipe i.e. 21 cm had not come out and the portion which came out was only 9 cm thus 12 cm pipe remained inside. It was not due to negligence of the OPs that the patient’s drain was broken or fractured as it could break or develop fracture due to twist, jerks and heavy movements or due to inherent nature of the material of which the drain pipe was made of and drain could get caught in such adhesions which could lead to break/fracture.

She was told to go for the second surgery after CT scan was carried out which showed a hyper dense tubular structure seen in the gall bladder fossa extending into the peritoneal cavity suggestive of foreign body likely residual of the broken drain and needed clinical history. It had a diameter of 4mm and length of 12 cm.

Accordingly, second surgery was conducted to remove it. Later on, the complainant had also visited the hospital on 20^th November and it was observed having urinary tract infection (UTI) and medicines were prescribed. It is the case, there was no carelessness on the part of treating doctors.

The forum went through the case and took note of evidence produced in the form of affidavits and documents.

The forum gave clean chit to Dr Singh who was not part of the first surgery as he had done a corrective surgery, therefore no case of medical negligence was proved against him.

The forum further observed that the day of alleged removal of the drain was one day after the date of discharge.

It is the pleading of the complainant supported by way of affidavit that even on the day of first surgery, Dr Dabar had claimed of complainant being normal though OPs had made the record otherwise of she being told about the left out foreign object in the body and the second surgery was advised, but, this defence does not appear to be believable for the reason that if a patient is told that some foreign body has been left inside, he/she will definitely respond and go for second surgery. Hence, the allegations levelled by the complainant seems to be truthful that she was told to be fit and fine and her surgery was successful as claimed by Dr Dabar on 21^st October 2015.

The District Consumer forum went through the literature of the case and referred to previous judgments of similar cases and noted that-

“Moreover in a case involving medical negligence once the initial burden has been discharged by the complainant by making out a case of negligence on the part of the hospital or doctor concerned, the onus shifts on to the hospital or attending doctors and it is for the hospital to satisfy the Court that there was no lack of care or diligence.”

For the present case, the forum stated-

The version given that she was asked on 21.10.2015 to get herself prepared for second surgery is not convincing as a patient in this situation when a foreign material is left inside would immediately opt for its removal and not run away. Desire to live is natural. We have already referred, as per pleadings, it is apparently a case of negligence as admittedly a 12 cm  of pipe was left inside and the claim was it was broken which does not seem to have been broken unless there was cut inflicted with some sharp edged instrument. It may be due to negligence of the para medical staff of OP-1 for which OPs 2 & 3 are to be vicariously blamed as the para medical staff is meant for their assistance.

The District Consumer Redressal Forum then directed the hospital to pay Rs 6.5 lakh compensation that includes Rs 4 lakh for causing medical negligence and deficiency in service, Rs 2 lakh as compensation for pain, suffering undergone by her and causing mental agony and harassment and Rs 50 thousand as litigation cost.