No fault in diagnosis, treatment of hand fracture: NCDRC absolves ESI Hospital Orthopedician, Pediatrician, Surgeon of negligence

The top consumer court, in its judgment, dated 18.06.2021, observed that there was no breach in the duty of care. The Commission also noted that the hospital referred the patient for further treatment to AIIMS in due time.

Thus, setting aside the earlier directions of the State Commission, where it had held the treating hospital guilty, R.K. Agarwal (president of NCDRC) and Dr. S.M. Kantikar (member) observed that the doctors adopted the standard method of treatment.

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The case concerns the daughter of the complainant who suffered an injury in her left hand back in 2006. She was first taken to ESI Dispensary at Jwalapuri, from where she was referred to the ESI Hospital, Basaidarapur.

It was alleged by the complainant that although the X-ray report didn't indicate any fracture, the treating doctors at the ESI Hospital had applied plaster to the left hand of the patient. This ultimately led to the situation, where the patient developed pus discharge and complications in her left hand. The patient, thus, had to undergo several surgeries, after which she was finally referred to AIIMS, New Delhi. However, she didn't cure properly and became handicapped, he complained.

Claiming that the ESI Hospital had provided his daughter with negligent treatment, the petitioner filed a complaint against the ESI Hospital and Dispensary before the District Forum, Janakpuri, New Delhi.

The District Forum partly allowed the complaint and directed the hospital to pay Rs 3 lakh as compensation, instead of Rs 4,50,000 which was claimed by the Complainant. When the hospital challenged the order before the State commission, the order of the District Forum was affirmed. Thus, challenging the State Commission order, the ESI Hospital approached the top consumer court.

After perusing the entire medical record related to the case from ESI Hospital, the Court noted that when the patient approached the hospital after falling from stairs, the doctors at the hospital initially made a provisional diagnosis of fracture of surgical neck of left humerus (arm) and clavicle (collar bone) with rib fracture and osteomyelitis. The treatment advised was U slab, limb elevation, active finger movements, watch for swelling and color changes. X-Ray of the left upper arm was also advised and the doctors gave the patient Tablet Brufen 200 mg.

However, after the treating doctor examined the patient after two days, he advised incision and drainage (I & D) and preparation of OT for an emergency I & D. After conducting the emergency blood tests, routine Urine and chest X-ray, a panel of doctors operated on the patient under General Anesthesia and emergency I & D surgery with debridement of dead tissue was performed. Postoperatively, limb elevation and active finger movements were advised.

The Commission also noted that the patient was under treatment of a team of doctors consisting of an Orthopedician, Pediatrician and Surgeon. After remaining under treatment of the doctors, the patient was ultimately discharged on 30.05.2006. However, in September, another Senior Orthopedician of the Hospital examined the patient again and confirmed it as chronic osteomyelitis with pathological fracture.

Therefore the patient was referred to AIIMS, New Delhi for fibular bone grafting and further management. Although the doctors at AIIMS examined the patient in November 2006 and suggested Fibula grafting, there was no date available for surgery till 30.03.2007.

After perusing the entire medical record, the top Consumer Court observed:

"Due to fall the patient suffered injury to her left arm, there was swelling. It was not compound fracture and there were no external injuries. The treating doctors gave U slab to stabilize the bone and soft tissue."

"It appears that the patient developed acute osteomyelitis due to infected hematoma because there was no surgical intervention at the time of admission. Thus it was hematogenous spread of infection which caused osteomyelitis and subsequently chronic osteomyelitis. It further resulted into degeneration of humerus and for treatment bone grafting was essential," the Commission further noted.

Further noting that AIIMS also couldn't be held responsible for non-availability of operation dated, the top Consumer Court mentioned in its judgment,

"We do not find any negligence of treating doctors at ESI Hospital either in diagnosis or the treatment of left-hand fracture of the patient. The doctors adopted the standard method of treatment. There was no breach in the duty of care. We allow the instant revision petition and set aside the Order of State Commission. Consequently, the Consumer Complaint is dismissed."