Improper Consent, Discharge Card: ENT specialist, hospital directed to pay Rs 1 lakh Compensation

Mumbai: The State Consumer Redressal Forum has ordered a city-based hospital and a treating doctor to collectively pay a compensation of Rs 1 lakh for alleged deficiency in obtaining consent which was not proper and informed one and in not writing the post-operative instructions to the patient on discharge card.

The incident took place in the year 2010 when the patient consulted Dr Nerurkar at Bombay Hospital & Medical Research Centre with a complaint of reduced hearing on the right side.

After examining the patient the audiometry was performed and surgery of the right ear was suggested by the treating doctor. The said operation (Stapedectomy Right side) was performed at the hospital, Bombay Hospital and the patient was discharged the next day.

The patient was again admitted to the hospital after 5 days with the complaints of severe giddiness and was treated in the hospital for three days. The patient had consulted various ENT specialists and hospitals before and after getting treatment from the said doctor and hospital.

After finding that, post-surgery there was loss of hearing on the right side, even on comparing audiometry reports before the operation and after the operation, there was loss of hearing on the right side.

The patient then approached the District Disputes Redressal Forum and filed a consumer complaint against the treating doctor and hospital alleging medical negligence and deficiency in service.

The District forum requested an expert Committee report from the department of ENT department of J J Hospital and obtained it.

After going through all the record and hearing submissions made by both the parties, the District Consumer Forum dismissed the complaint and thus ruled out any medical negligence for deficiency in service by the doctor and hospital.

The complainant further moved to the State Consumer Disputes Redressal Commission by filing an appeal against the order.

The forum went through the literature of the cases of medical negligence and the judgments given on those cases.

The consumer court took note of the contentions made by the advocate of the complaint.

Along with negligence, it was alleged that there was improper documentation. He referred to guidelines on Consent from patients receiving treatment from the Code of Medical Ethics by Medical Council of India.

It was alleged that apart from the consent, no record of counselling, giving information about operation like name of operation, name of surgeon, name of anaesthesiologist, details about the operation, expected complications and relevant information was mentioned.

The forum noted that ‘the consent form is not signed by treating surgeon. There is no noting of the details of said consent that have been explained.’

“We have observed that there are no presurgical fitness notes or fitness certificate that is mandatory as per the protocol of surgical management of patient. So even though the treating doctor is competent surgeon, he has to take reasonable precautions and care in preoperative and post operative stages.”

The forum stated

“Obviously as mentioned in post-operative care of Stapedectomy, no instructions were received by complainant from opposite parties nor were they written on discharge card. As far as the consent is concerned, the opposite parties did not inform the complainant about the nature of surgery and likely effect of the said surgery, there was no document produced on record in this regard.”

“Here we find that there was deficiency in obtaining consent which was not proper and informed one and in not writing the post-operative instructions to the patient on discharge card.”

District Consumer Disputes Redressal Forum after going through the pleadings, indoor case records along with various investigations- audiometry reports, evidence in the form of expert medical opinion from JJ hospital Mumbai, medical literature placed on record and various case laws submitted by both the parties, came to the conclusion that the opposite parties have provided reasonable care to the patient of hearing loss on both sides due to the disease Otosclerosis and pleased to dismiss the complaint.

The State consumer forum went through the entire matter and kept its findings-

The complainant partly proved that there was deficiency in service/unfair trade practice by the opponents. The complainant proved that the opponents did not obtain Informed Consent, and there was deficiency in documentation. Therefore, the appellant is entitled for compensation.

The forum stated-

“We find that learned forum has not considered, the lack of informed consent and proper documentation in the form of advice at the time of discharge of the patient. We therefore set aside the order of learned District Forum and hold the opposite parties responsible for the deficiency in service as has been pointed out by learned advocate of complainant, we accept the same.”

The forum further directed the opponents to pay Rs 1 lakh as compensation and 10 thousand as litigation cost.