NCDRC Exonerates Orthopedic Surgeon, holds no medical negligence in treating hip bone fracture

It had been alleged by the complainant that the doctor adopted skeleton traction method instead of going for immediate surgery and this resulted in physical suffering of the complainant.

However, dismissing the complaint, the top consumer court noted that apart from the allegations, the complainant could not submit anything to prove deficiency on the part of the treating orthopedic surgeon.

The complainant, a retired IPS officer, sustained fracture of the hip bone after falling in his residence back in 2006. Immediately, he was taken to Apollo Hospitals, Hyderabad, and Dr. Somashekhar Reddy, an Orthopedic Surgeon examined him.

After examining the X-ray, which revealed fracture of left Acetabulum, the treating doctor allegedly opined that there was no need for surgery and advised the patient only skeletal traction for eight weeks.

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It was alleged that the skeletal traction resulted in retention of urine, and the patient had to be put on Foley's Catheterization till August 2006. However, the pain in the hip joint persisted and the patient further developed chest pain and swelling in the left leg. Following this, the Cardiologist and the treating doctor examined the condition as Deep Vein Thrombosis (DVT) and consequently, the patient was treated for three weeks.

The condition deteriorated further and in December, the treating doctor examined the patient and X-ray revealed Osteoporosis and Avascular necrosis of the head of left femur and the neck of femur became smaller and irregular with adjacent cystic changes. Finally, the treating doctor advised the patient to undergo immediate surgery for total replacement of Hip failing which he would be completely bedridden.

It has been alleged by the complainant that even though the Cardiologist expressed the THR surgery at the earliest, the orthopedic surgeon delayed it without any reasons. Finally, the patient had undergone the surgery at Krishna Institute of Medical Science (KIMS).

He alleged that due to the delay and negligent treatment of the treating Orthopedic Surgeon at Apollo, he had to suffer a lot- physically and he also incurred heavy expenses on treatment. Being aggrieved by the negligence of the treating doctor, the Complainant approached the consumer court and prayed for a compensation of Rs 26 lakhs.

The doctors and the hospital on the other hand, denied any negligence in treatment and submitted that the patient was suffering from multiple health ailments. They further submitted that the patient had consented for the treatment plan and accordingly skeleton traction was advised. As the patient was progressing in the treatment, THR was not advised at that stage, submitted the doctors and the hospital.

They further argued that because of several co-morbidities, the patient was not advised for the emergency hip surgery and the initial skeleton traction and medication made to heal together all the acetabular bony pieces to form good bony bed for replacing acetabulum cup. Even though the elective THR was scheduled on 24.01.2007, the patient did not turn up or the surgery.

While considering the matter, the State Commission had concluded that there was no negligence on the part of the doctors and the hospital and had dismissed the complaint. Aggrieved, the complainant approached the NCDRC.

Taking note of the contentions made by both the parties, the NCDRC bench noted that apart from the self-serving evidence, "nothing is placed on record to hold that Op1 is guilty of medical negligence. Had the very same replacement been conducted by Op1 in the first instance the complainant would have found fault with Op1 stating that he could have conducted traction and un-necessarily he conducted the hip replacement obviously in order to make money."

"The perception of the complainant that traction ought not to have conducted is without any authority. We may state that he is unable to prove the deficiency in service on the part of the doctor or placed any medical authority to state that Op1 ought not to have conducted traction in the first instance," further noted the top consumer court as it found there was no merit in the complaint.

After perusing the medical literature concerning Hip fractures, and referring to top court judgment in the case of Achutrao Haribhao Khodwa & Others V State of Maharashtra & Others, and in C. P. Sreekumar (Dr), MS (Ortho) v S. Ramanujam, the NCDRC noted, "In the instant case, I note that the OP-1 treated the patient as per the standard of practice. Any hip fracture shall not be operated as on emergency basis. Initially the OP-1 adopted conservative management i.e. skeletal traction, it was correct the approach; it was neither deviation of treatment/procedure nor deficiency in service. Moreover, admittedly the patient had several co-morbid conditions which involve inherent operative risks."

Dismissing the appeal, the top consumer court observed, "In view of the foregoing reasons and the facts of the case, in my opinion, the treating doctors and hospital were not guilty of medical negligence. Resultantly the Appeal is dismissed."