Leg amputated after botched procedure, delay in referral: Doctor absolved of negligence, Hospital asked to pay Rs 10 lakh compensation to patient

Thane: Holding a private hospital guilty of performing a botched medical procedure and causing a delay in referring a patient to KEM hospital, the District Consumer Disputes Redressal Commission (DCDRC), Thane has directed the hospital to pay Rs 10 lakh compensation to the man, who had to undergo amputation of a leg following the treatment.

However, the Commission has dismissed the complaint against the treating doctor at the hospital as it opined that there was no medical negligence on the part of the doctor in treating the patient.

Apart from Rs 10 lakh compensation, the hospital has also been directed to pay Rs 30,000 as cost of the complainant to the complainant.

The complainant informed the Commission that he fell from a motorbike back on October 22, 2010 and suffered injuries to his right knee. He was unable to walk and was taken to Shree hospital in Kalyan town in Maharashtra's Thane district where he was given initial treatment and a plaster was applied to his leg. He was discharged the next day.

Two days later, he felt there was no sensation in his right leg and got admitted to the hospital where doctors opined that due to tight application of the plaster, blood circulation was obstructed and advised him to approach the King Edward Memorial (KEM) in neighbouring Mumbai.

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Doctors at the KEM were of the view that due to wrong and negligent application of plaster at the hospital in Kalyan, the blood circulation to the man's right leg was obstructed and stopped. They advised amputation of the right leg which was done on October 29, 2010.

The complainant was operated again as he had developed gangrene. His entire lower leg from the right thigh was amputated by operation. The complainant told the commission that he lost his right leg due to the wrong, negligent and faulty treatment at the Kalyan-based hospital and incurred permanent disability.

The complainant could not appear for the Class 12 examination and suffered loss of the academic year. He submitted that he is still not in a fit mental condition due to the shock and it has affected his livelihood. Later, the complainant got an artificial leg affixed for which he spent more than Rs 3.5 lakh and sought a compensation from the hospital.

The consumer commission's president Vijay C Premchandani and member Poonam V Maharshi noted that after discharge on October 23, 2010, the complainant felt there was absolutely no sensation in his right leg.

Hence, his father took him to the hospital immediately and admitted him at around 10 am. Thereafter, at about 5 pm, he was referred to the KEM hospital immediately for further treatment. The said fact has been admitted by the hospital.

It is also admitted that the patient was having emergency and it was seen and observed by a doctor, who advised that he be taken to the KEM Hospital for further investigation and treatment, if any, the commission said.

Since the opponents in their written statement admitted they were having resident doctors available round-the-clock, then why the complainant was kept from 10 am till 5 pm on October 25, 2010, it said.

The commission further noted that "...thereafter, they advised without attending the patient or without providing medical services, keeping the patient in the hospital in spite of having the resident doctors, which amounts to deficiency of service from the concerned hospital i.e. opponent no.1 for which the patient/ complainant has unnecessarily suffered."

"For that hours it is quite possible that the resident doctors on the same time looking to the condition of the patient/ complainant, referred to the KEM Hospital, the scenario might be different. Hence, it is proved from the fact and evidence produced on record that the hospital has provided deficiency in service by keeping the patient from 10.00 a.m. till 5.00 p.m. as on 25/10/2010," opined the consumer court.

While considering the role of the treating doctor, the Commission noted that the patient had a fracture of the tibial condyle with fracture of the upper 3rd tibia with haemoarthrosis. His distal pulsation was present and there were no neurological deficits. The treating doctor planned a knee aspiration of the haemarthrosis and plaster of the leg and the patient was given a plaster cast.

The commission noted that during examination by the doctor, there was no swelling and there were no neurological deficits and there was no complaint at the time of discharge of the patient about swelling or any other complaint.

Referring to the medical report given by KEM Hospital, the Commission noted,

"Hence, it is proved that at the time of admission of the complainant to KEM Hospital, the pulse was absent and swelling was there at the right lower limb. After observation and routine test, it was found that there was a gas gangrene. We perused the text finding and case report of gas gangrene. One of the basic principles of Orthopedic surgery is that the gas gangrene does not develop in closed fractures. That there are exceptions to this rule is demonstrated by the following report of an extremely rare case."

The Commission also referred to the relevant medical literature and noted,

"The complainant has failed to prove the fact that the two layer plaster has to be adopted, one is kuccha and another is pucca. The gas gangrene can be happened due to the infection in a fasciotomy. It is a known occurrence and can be treated with antibiotics and daily dressing. The type of infection in organ involved is not under the control of the doctor in this case infection was gas gangrene. Hence amputation has to be carried out in the best interest of the patient as a life saving surgery. The opponent no.2 has succeeded to prove that the gas gangrene is occurred to the patient due to the infection in fasciotomy not because of the negligence of the doctor."

Exonerating the treating doctor from the charges of medical negligence, the Commission noted,

"When the complainant has alleged that due to the close fracture plaster the gas gangrene occurred. No such case has been proved by the complainant. Therefore, there is no negligence on the part of opponent no.2 to treat the complainant."

Partly allowing the complaint, the Commission directed the hospital to pay the compensation and ordered, "The Opponent no.1 is directed to pay an amount of Rs.10,00,000/- (Rupees Ten lakhs Only) as compensation to the complainant for not treating or advising as on 25/10/2010 from 10.00 a.m. till 5.00 p.m. The complaint against the opponent nos.2 & 3 is dismissed."

"The Opponent no.1 is directed to pay Rs.30,000/- (Rupees Thirty Thousand Only) as to cost of the complaint to the Complainant," stated the order.

To view the order, click on the link below:

https://medicaldialogues.in/pdf_upload/thane-consumer-court-209101.pdf

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