No Medical Negligence in Conducting Laminectomy: NCDRC exonerates Orthopedic Surgeon, Hospital

Published On 2022-05-22 09:46 GMT   |   Update On 2022-05-22 09:46 GMT
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New Delhi: Finding no evidence for proving negligence in performing laminectomy, the National Consumer Disputes Redressal Commission (NCDRC) recently exonerated the Orthopedic Surgeon Dr Abraham and other doctors at Kerala based Mariya Hospital Adoor.

Such a decision was taken by the top consumer court after it took note of the fact that the allegation of the complainant was that the operation was performed at wrong site had no basis.

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The bench noted that the cyst at D-5 level was noted after 8 months. The D-5 level is above the level of L-4 and L-5, the area of laminectomy operation and the spinal cord was not touched or operated. "There is no nexus or relation between the two sites (D5 and L4-5) and the lesions were entirely different. The MRI dated 9.1.2001 did show any Cyst at D5 level," noted the top consumer court.

The case of the petitioner is that she alleged that she had problem at D-5 level, however the treating doctors at Mariya Hospital Adoor had wrongly performed operation at L-4 and L-5 level and removed portions of the vertebra causing injury to nerves which resulted paralysis below the hip. It was alleged that the doctors were not qualified to do neurosurgery.

As a result, the prolonged Physiotherapy was not fruitful. Following this, the patient allegedly consulted a Neurosurgeon at the Medical College, Thiruvananthapuram, who diagnosed a cyst at D5 level and removed the cyst by operation. Being aggrieved by the negligent treatment by the treating doctors at Mariya Hospital, the Complainant filed a Complaint before the District Forum, Pathanamthitta.
When the matter reached the District Forum, after perusing the entire medical record, the Forum had noted that the treating doctor were qualified orthopedic surgeon, Further the surgery done by the doctor was conducted on the basis of a scanning report showing degeneration of L34 and L4-5 in the vertibral disks and mild bulging annulus of L3-4 and L4-5 intervertibral disks causing compression over the existing nerve root bilateral and indentation over the thecal sac.

Taking note of the fact that there was no evidence to prove that the diagnosis and the surgery was wrong and improper, the Forum rejected the main allegation that all the complications of the complainant including the paralysis was due to the negligent and improper Surgery by the treating doctors and the second surgery was necessitated due to the 1st surgery.

Besides, the District Forum had also noted that the available evidence showed that the two surgeries were done at different portions of the vertibra of the complainant based on two separate MRl scanning reports obtained at a gap of 7 months.
The two scanning reports disclosed different diseases at different portions of the vertibra. So it cannot be said that the 2nd disease revealed from the scanning report was an after effect or the consequence of the 1st surgery, the Forum had concluded.

After the Forum had dismissed the complaint, the complainant moved to the State Commission, which again dismissed it. When the matter reached NCDRC, the top consumer court perused the medical record including X- Ray report, MRI, and noted that the reports showed degeneration at L3-4 and L4-5 intervertebral discs causing compression over the exiting nerve root bilaterally and indentation over the thecal sac. The X-ray revealed spondylitis L-5 pedicle with probable spinal stenosis at L4-5 and S-1.

Consequently, the Orthopedic surgeon conducted the laminectomy as per standard procedure with his expertise. The patient was discharged thereafter.

After 2 months, the patient came back with complaints of weakness in both lower limbs due to fall in the house two weeks back. X-ray was performed, no new fracture revealed and the doctor prescribed medicines. At this point, even though the treating surgeon had suspected possibility of cord edema and advised to go for Neuro checkup, the patient didn't follow the advice.

At this outset, the bench noted that the cyst at D-5 level was noted after 8 months. The D-5 level is above the level of L-4 and L-5 the area of laminectomy operation and the spinal cord was not touched or operated. "There is no nexus or relation between the two sites (D5 and L4-5) and the lesions were entirely different. The MRI dated 9.1.2001 did show any Cyst at D5 level," noted the top consumer court.

Therefore, finding no error in the earlier orders passed by the District and State Commission, the NCDRC bench dismissed the complaint and noted, "Thus, considering the entirety of the case in our considered view, it was a reasonable standard of practice adopted by the Opposite Party No.1 & there was no role of Opposite Party No.2 in performing laminectomy. There was neither negligence nor any deficiency /any lapses during the laminectomy operation at L-4 and L-5. Thus, for the reasons stated above , we do not find any material irregularity and jurisdictional error in the Order passed by the Fora below warranting our interference u/s 21(b) of the Act."

To read the order, click on the link below.

https://medicaldialogues.in/pdf_upload/ncdrc-no-medical-negligence-176812.pdf

Also Read: No medical negligence in inserting central venous catheter: Consumer court exonerates Fortis hospital, doctors

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