Delay in performing surgery amounts to negligence: Kamineni Hospital, surgeon directed to pay Rs 6 Lakh compensation

The Commission, comprising of V.V. Seshubabu (Member) and R.S. Rajeshree (Member) found the hospital liable for medical negligence and deficiency in service in performing surgery for the removal of an implant in the right leg and surgery on both legs of the 15-year old patient.

The case pertains to Sai Nath, a resident of Safilguda, represented by his father and natural guardian. Nath was born with cerebral palsy with hemiplegia. He had undergone surgery on both legs at Sunshine Hospital two years ago and had an implant (LCP) fixed in his right leg. The doctors advised him to remove the implant after two years. However, when he approached Sunshine Hospital for the removal, he was advised to go to Kamineni Hospital instead.

On 30.08.2017, he underwent surgery for the removal of the implant and surgery on both legs at Kamineni Hospital. However, on the night of the surgery, he experienced severe pain and was found to have a fractured bone in his right leg. The complainant alleged negligence on the part of the doctor while attempting to remove the implant.

The patient's family alleged that even though the boy was crying and yelling after the surgery, he was only given painkillers.

An X-ray revealed that the bone in the leg was fractured. The doctor suggested that the fractured bone be fixed with a similar plate and stated that the plate will be a permanent one. In the complaint, the boy’s family alleged that the fracture was a result of medical negligence on the part of the doctor. After the second operation, contrary to his previous statement, the doctor informed the family that the new implant will have to be removed after one year.

On the other hand, Kamineni Hospitals and Paediatric Orthopedician contended that the complainant had prior medical issues, including Hydrocethalus, which can lead to neuromuscular disorders and weaker bones. They claimed that they informed the complainant's parents about the risks and complications involved in the surgery. They asserted that the fracture in the right femur was an undisplaced fracture discovered during surgery, and they managed it conservatively.

The Commission, taking into account the evidence presented during the proceedings, noted that the complainant's surgery was performed on 30.08.2017, during which an undisplaced fracture in the right femur was observed. However, it was highlighted that no X-ray was taken on the day of the surgery. The Commission observed;

"Admittedly, no x-ray was taken on 30.08.2017. RW1 (the evidence affidavit filed by the doctor on his and the hospital's behalf) stated that as complainant was not co-operating no x-ray was taken on 30.08.2017; that though bed side x-ray was available but clarity of the images are not clear. Ex.A12 was the x-ray which was taken on 31.08.2017. The perusal of Ex.A12 x-ray film goes to show that, the bone was complete took a different angle and leaned to the right side at the mid region. When the Ex.A12 shows such badly displaced bone, the surgery was performed on 02.09.2017."

Furthermore, the Commission found that there was a significant delay in performing the operation, given the complainant's physical and mental condition. This delay was deemed negligent and a deficiency of service on the part of the Orthopedic Paediatrician. It observed;

"No acceptable reasons are given for such delay inspite of statement of RW1. The patient continuously crying after operation dated 30.08.2017. Taking into consideration the physical and mental status of the complainant the delay in performing the operation amounts to not only negligence but also the deficiency of service."

Additionally, the Commission observed that the record appeared to have been tampered with, to absolve the doctor from negligence. Such tampering raised serious concerns and cast doubt on the reliability of the information presented. It remarked;

"When RW1 (the evidence affidavit filed by the doctor on his and the hospital's behalf) failed to observe the undisplaced fracture at time of operation dated 30.08.2017 (by his own admission), ventured to make a note in the case sheet on 30.08.2017, that the; attendants have been informed the peri-operative event of fracture thigh L screw site. The x-ray on 31.08.2017 (Ex.A12) was advised at 8:30 AM. So, there is no chance for RW1 even remotely to say that, there was undisplaced fracture while he was trying to remove the screw affixed to the plate. Making an entry regarding such fact on 30.08.2017 at 6:00 PM, is nothing but tampering the record to absolve himself from negligence and deficiency of service. The brittleness bones is not the point for consideration to assess the negligence of RW1, but the tampering of record and setting forth of version in the written statement that he observed the undisplaced fracture at the time of operations and thought of treating conservatively and for that reason applied POP etc., is nothing but tissues of false statement. So, all the points are answered against the opposite parties."

In light of the evidence and the complainant's physical and mental condition, the Commission subsequently ruled that the complainant was entitled to compensation, and directed the hospital and the doctor to pay the complainant a sum of Rs 6 lakh with an interest of nine per cent from 2017 till the date of payment, and made it clear that failure to comply with the order within a month will result in an interest of 12 per cent per annum.

Furthermore, the Commission clarified that the liability of the insurance company, which was also a responding party, would only arise after the hospital's payment. The insurance company was, therefore, instructed to reimburse the hospital as per the terms and conditions of the policy.

The Commission held;

"When PW1 failed to place any documentary evidence to show that the complainant is taking physio therapy and when the treatment was given to the complainant under Arogyha Bhadratha Scheme, not incurred any expenses for the treatment. Taking into consideration physical and mental status of the minor complainant we are of the view that compensation of Rs.6,00,000/- with interest @9% from the date of complaint till the date of payment, will meet the ends of justice. The liability of opposite party No.3 arises only after payment of amount by opposite party No.1 & 2 and thereafter opposite party No.3 shall reimburse them as per terms and conditions of the policy."

It added;

"The complaint is partly allowed with a direction to the opposite parties No.1 (Kamineni Hospitals Ltd) & 2 (Doctor Orthopedic Paediatrician) with joint and several liability to pay Rs.6,00,000/- as compensation to the complainant with interest @9% p.a., from the date of complaint i.e., 07.12.2017 till the date of payment, besides costs of Rs.20,000/- that on making such payment by the opposite party No.1&2, the insurer/opposite party No.3 (The Oriental Insurance Co.) is directed to reimburse them."

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