Indian Spinal Injuries Centre told to pay Rs 15 lakh for medical negligence in treating patient with head injury

New Delhi: Upholding the order of the State Consumer court, Delhi, the National Consumer Disputes Redressal Commission (NCDRC) recently held Indian Spinal Injuries Centre and its doctor guilty of medical negligence while providing treatment to a patient suffering from head injury.

While considering the case, where the patient ultimately succumbed to death, the top consumer court observed that there was negligence on the part of the hospital and the doctor and directed them to pay Rs 15 lakh compensation.

This decision was taken by the NCDRC bench while relying upon the opinion of the Board of Medical Experts at MAMC. Upholding the State commission's order, the NCDRC bench observed, "In our considered view, we find that the State Commission allowed the Complaint with reasoned Order and granted just and adequate compensation in the instant case."

The history of the case goes back to 2004 when the son of the Complainant, who was around 27 years at that time, suffered an accidental fall from height and sustained head injury. Immediately he was taken to Indian Spinal Injuries Centre.

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It was alleged by the complainant that the patient needed emergency treatment but the casualty nursing staff neither paid any heed nor provided the required care. Resultantly, the doctors lost the Golden hour and after 3-4 hours, Dr Rajora examined the patient and admitted him to the ICU. CT scan was advised and the doctor assured that there was nothing serious with the patient. Consequently, the treating doctor performed Ultrasonography (USG) of abdomen and after that the patient was examined by Dr Bhalla.

Further, the complainant alleged that while the patient was in the ICU, his head was shaved and without informed consent a tube was put in the neck. The patient allegedly was not put on the ventilator nor was given any Oxygen. The next day, the patient was declared dead.

Being aggrieved due to the alleged negligent treatment and lack of care, the Complainants filed the Consumer Complaint before the State Commission, Delhi and sought Rs 83 lakhs as compensation.

On the other hand, the hospital and the doctor denied any negligence during the treatment and submitted that the patient had sustained serious head injury, he was unconscious, Glasgo Coma Score was E1 V1 M5. His right pupil was dilated and left pupil was constricted which indicates a severe degree of head injury.

He was managed by a team of doctors (surgeon & residents) supported by para medical staff as per the standard protocol. The relevant investigations were sent and the patient was kept under close monitoring. Urgent CT Scan and Neurosurgery consultation was called for. The Chief Administrative Officer of the hospital also inquired about the patient’s condition.

After considering the matter, Delhi State Commission awarded a lump-sum compensation of Rs 15 lakh to the complainants. Thereafter, challenging the State Commission's order, the hospital and the doctor approached the Apex consumer court bench. The Complainants also approached the NCDRC bench seeking an enhancement of the amount of compensation.

It was submitted by the counsel for the complainants that the duty doctor had failed putting the patient immediately on ventilator as directed by the Neurosurgeon. Further, the hospital did not supply the case papers (medical record), submitted the counsel and argued that an adverse inference can be drawn against the hospital and the doctor for sheer negligence. There were several discrepancies in the documents like MLC report, Case sheet and nursing notes with respect to time of admission, further alleged the complainants' counsel.

Meanwhile, the counsel for the hospital argued that the State Commission had not considered the experts' evidence filed by Dr (Prof) R. Bhatia (AIIMS), Dr Rana Patir (AIIMS) working with Ganga Ram Hospital, who also were the employees of the treating hospital. He further submitted that the medical board opinion was not conclusive as the documents were not intentionally provided by the complainants.

The top consumer court noted that the State Commission had sought opinion from Maulana Azad Medical College (MAMC) and accordingly, MAMC Dean had set up the Board of Medical Expert consisting of three experts including Dr. Ajay Sharma, HOD (Neurosurgery) GB Pant Hospital - Convenor, Dr. J.S. Dolly, Prof. (Anesthesia), MAMC - Member, and Dr. Anjali Prakash, Prof. (Radio diagnosis), MAMC – Member.

Addressing the alleged delay in the treatment, the Medical Board opined, "There Is no record to document the fact If the patient was managed in the casualty department before formal admission, and what first aid treatment if any, was given to the late Mr. Gautam."

Further referring to the issue of putting the patient on ventilator, the Board observed, "...although the available records documented that the neurosurgeons have instructed that the patent Late Mr. Gautam be put on ventilator, however, as per available records he was not put on ventilator till 10.30 pm. However, in absence of complete hospital records no comments can be made on whether he was put on ventilator and after how much time after admission. In a patient when a conservative management is planned ventilator support to be patient, if decided by the neurosurgeon, is the standard of the care."

"In view of non-availability of all Brain Imaging films no conclusion may be drawn on this point. Whether late Mr. Gautam should have been operated or drawn on this point. Whether late Mr. Gautam should have been operated or treated by conservative therapy cannot be comment from the provided hospital records. In absence of any Intracranial space occupying Lesion (Intracranial Hematoma) conservative therapy is standard treatment," the Board further opined.

After considering the entire matter, the top consumer court noted, "In our considered view, we find that the State Commission allowed the Complaint with reasoned Order and granted just and adequate compensation in the instant case."

On the basis of the opinion given by the Medical Board, the NCDRC bench also held the hospital and the doctor guilty of negligence and noted,

"Based on the discussion above and relying upon the opinion of Board of medical experts at MAMC, the medical negligence is attributed to the hospital and treating doctor. The Order of the State Commission is reasoned and awarded just and fair compensation to the Complainants; same is affirmed. Both the Appeals are dismissed."

To read the order, click on the link below:

https://medicaldialogues.in/pdf_upload/indian-spinal-injuries-centre-compensation-204624.pdf

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