Medical Negligence During PCNL Surgery: Jaipur's Manipal Hospital, Doctor Slapped Rs 15 Lakh Compensation

Jaipur: Holding a Jaipur-based Manipal Hospital and its doctor guilty of medical negligence during the Percutaneous nephrolithotomy (PCNL) procedure, a District Consumer Disputes Redressal Commission in Jaipur recently directed them to pay Rs 15 lakh compensation to the patient, who faced major blood loss after the surgery.

Further, the consumer court also directed them to pay the complainant the cost of treatment i.e. Rs 3,10,000 and another Rs 50,000 as litigation costs.

The matter goes back to 2022 when the patient approached the treating hospital with complaints of stomach pain. The doctor advised the patient to undergo sonography and the report revealed that there was a stone of around 13 mm in the ureter of the left kidney and some smaller stones in the other kidney.

It was alleged that the doctor further advised the patient to immediately undergo a PCNL operation. The doctor had allegedly informed that the complainant would be discharged in no time and the stones would be removed through laser operation so that he would not face any problems.

However, after the surgery, when the staff of the hospital was removing the catheter/urine bag, a lot of blood and blood clots were coming out with the urine. Later, the patient was discharged after a few days. However, after 4-5 days, he had to be readmitted in an emergency due to excessive bleeding with urine. Again, the complainant was admitted for Post PCNL/Sepsis and bleeding.

After being treated for a few days at the hospital, the patient was once again discharged. However, he did not get any relief from pain after the laser surgery.

The complainant alleged that during the surgery, a pseudoaneurysm occurred in the lower pole of his left kidney- there was a hole in the lower pole of the left kidney after the PCNL surgery. Due to this, blood was coming out of the urinary bladder of the patient and clots were being formed.

Consequently, the patient was treated at two other hospitals and a doctor at the 3rd hospital removed the blood clots. Despite this, his health continued deteriorating and the patient was referred to a senior consultant urologist who is an expert in the matter. Finally, filing the consumer complaint, the patient demanded Rs. 3,10,000/- spent due to the negligence of the opposition parties and compensation amount for mental agony and complaint expenses etc.

On the other hand, the hospital and the doctor denied all the allegations of negligence and submitted that in a PCNL process, the kidney tube or nephrostomy is removed after the urine has cleared, which usually happens within the next 48 hours after surgery. After this, sometimes there is leakage of urine from the site of removal of the tube, which stops on its own within the next 24 hours.

It was submitted that the patient remained comfortable throughout and there was no complaint of pain during this period. They further claimed that standard medical treatment was given to the patient, there were no complaints/pains at the time of discharge and the urine was also clear.

They submitted that the patient was instructed not to strain or move to urinate and to avoid movement as this increases the risk of bleeding. Despite this, the bleeding began after the patient allegedly made vigorous attempts to urinate. Blood in the urine accumulates in the bladder and can obstruct urine flow leading to urinary retention and swelling in the lower abdomen. Thus a catharsis is required to relieve urinary retention. Bladder Irrigation is started to wash out the blood clot inside it to prevent blood clot from forming inside it. Referring to this, the hospital and doctor claimed that there was no error on their part.

The consumer court noted that the patient's stone was operated on by the treating hospital and doctor and after removal of the catheter, the patient started bleeding profusely. It observed that when the doctor operated on the patient, Pseudoaneyrsym occurred in the lower pole of his left kidney, due to this, blood was coming into the urinary bladder of the patient. 

It was further observed that the patient was treated at another Hospital where the doctor gave an injection in the urinary tract, inserted several wires and after operating closed the hole in the kidney. Only after this, the patient got some relief. However, still, the issue of urine not coming out freely was not solved. Later, the patient had to seek further treatment at other hospitals. He also developed a high fever and the doctor at the 3rd hospital allegedly said that the high fever was due to infection. 

Therefore, the consumer court held that the operation was carried out negligently by the treating hospital and doctor and due to the surgery, a hole was made in the kidney. Observing that this act comes under the category of deficiency of service, the consumer court accepted the complaint and ordered the doctor and the hospital to pay Rs 3,10,000 i.e. the amount spent by the complainant for his treatment.

Apart from this, the consumer court also directed the hospital and the doctor to pay Rs 15,00,000 as compensation for mental anguish and Rs 50,000 towards litigation costs.

To view the order, click on the link below:

https://medicaldialogues.in/pdf_upload/jaipur-consumer-court-235921.pdf

Also Read: Kidney Stones Removal: NCDRC holds doctor guilty of negligence