Conservative management of fracture does not amount to negligence- Consumer court relief to orthopedic doctors

In the order, dated October 6, 2023, pronounced by the bench of Anil Kumar Bamba, Member; Adarsh Nain, Member and Surinder Kumar Sharma, President it was clarified that the complainant didn't provide any evidence to prove that the doctors at the hospital were negligent or didn't do their job properly.

The case was filed by an insured individual under the Employee State Insurance Corporation (ESIC) insurance. According to the complainant, he suffered a right knee fracture due to an accident in Noida on November 25, 2012. He initially sought treatment at Lal Bahadur Shashtri Hospital, Delhi, but he was not satisfied with the care received. Following his discharge from Lal Bahadur Shastri Hospital, he turned to Indira Gandhi ESI Hospital in Jhilmil, Delhi.

At Indira Gandhi ESI Hospital, the two orthopedic specialists and the doctor advised him on a treatment plan, which involved plastering the injured knee and taking complete bed rest for three months. The complainant followed this advice, but he continued to experience severe pain in the injured knee. Subsequently, he sought emergency care at Shanti Mukand Hospital, Karkardooma, Delhi, on May 27, 2013, where an X-ray revealed that the fractured knee had not properly healed. Doctors at Shanti Mukand Hospital recommended bone grafting surgery, which the complainant underwent on May 27, 2013, incurring significant expenses.

The complainant alleged that the treatment received at Indira Gandhi ESI Hospital had been inadequate and that the medical advice given by the doctors was negligent, leading to his need for surgery and additional medical expenses. He sought compensation, including Rs 16,00,000 for mental harassment and Rs 51,000 for litigation expenses.

Responding to the allegations, Indira Gandhi ESI Hospital and the two orthopedic specialists argued that they had provided appropriate care by opting for conservative management for the patient's knee fracture. They claimed that operative management had inherent complications and, therefore, they decided to opt for a conservative approach, which was a well-accepted method of treatment for such cases. They further stated that the patient was discharged with no complaints, deformities, or pain when he was considered fit for work.

To assess the case, the Commission sought a medical expert opinion from GTB Hospital, which was provided by a board of doctors, Dr. V.K Goyal and Professor Dr. Manish Chadha, in a report dated November 25, 2019. The medical experts' report confirmed that conservative management and surgery were both accepted methods of treatment for the type of fracture the patient had suffered. The board of doctors opined;

"Patent had minimally displaced medial condyle fracture (Rt) tibia, which can be treated conservatively in plaster cast or operated, and both the treatment modalities are accepted methods of treatment. If the patient is treated conservatively in plaster cast, and later on if it is found that fracture gets displaced/malunites and patient becomes symptomatic, then a corrective surgery is require."

Examining the case, the District Consumer Disputes Redressal Commission found no merit in the complainant's case. They noted that the complainant had not provided any evidence to prove negligence on the part of Indira Gandhi ESI Hospital and the two orthopedic specialists. Subsequently, the complaint was dismissed. The Commission noted;

"From the perusal of the above referred opinion given by the Board of Doctors of GTB Hospital, Delhi. It is revealed that there is nothing on record to suggest that the doctors of Opposite Party No. 1 hospital were negligent or that there was deficiency of service on their part. On the other hand, the Complainant did not lead any evidence to show that the doctors of Opposite Party No. 1 were negligent or that there was deficiency of service on their part. In view of the above discussion, we do not find any merit in the case. The complaint is dismissed."

To view the original order, click on the link below: