No Medical Negligence in Exploratory Laparotomy: Consumer Court relief to Indraprastha Apollo Hospital

Following an Exploratory Laparotomy surgery, the condition of the patient gradually worsened and ultimately he expired. However, the Commission opined that there was no deficiency of service or medical negligence on the part of the doctor and treating hospital while treating the patient.

Dismissing the complaint, the Commission noted in its order, "In totality and with due regard to the settled law in this regard, we are of the view that the doctors had performed their duties and exercised an ordinary degree of professional skill and competence, for which, they cannot be held guilty of medical negligence."

The history of the case goes back to 2011 when the husband of the complainant was being treated for Jaundice and Stone and was later shifted to Indraprastha Apollo Hospital. After examination, the treating doctor advised the patient to undergo surgery, and the same was done on 12.05.2011. Following this, the patient was discharged after a few days, and the whole procedure cost around Rs. 21,25,858.

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However, the condition of the patient deteriorated and he had to be admitted to the hospital again and due to lack of funds, the patient was allotted a bed in the EWS (Economically Weaker Section) ward. The condition of the patient deteriorated further after discharge and it had been alleged that the hospital discharged the patient even though his condition was not normal. In fact, no operation of the Discharge Bag was done by the Doctors before discharging the patient.

Following this, the condition worsened and even though the complainant tried to admit the patient to the hospital, the doctor refused to do so. Finally, when the patient was admitted to the Surgical ICU after a few days, his condition had become critical, which led to his death, it had been alleged.

It has further been claimed by the complainant that even though she had requested the doctor to conduct the post-mortem of the patient, the request was declined. Alleging that the patient, who was the only earning member in the family, died due to the failure of the doctors and the hospital to provide proper treatment, the Complainant approached the State Commission and sought Rs 50 lakh as compensation for alleged medical negligence.

On the other hand, the treating doctor in its detailed reply contended that due care and caution was taken while treating the patient and it was further submitted before the Commission that he patient was critically ill at the time of admission. He was diagnosed with intra-abdominal collections and doubtful perforation and the patient was advised for Exploratory Laparotomy surgery, for which High Risk consent was taken.

It was further claimed by the Hospital that the condition of the patient improved gradually after admission even though the patient died there was no scope of Deficiency of Service on the part of the Hospital.

During the case proceedings, the treating doctor failed to file the Evidence by way of Affidavit and that is why, "the averments made in the Written Statement cannot be said to be proved and cannot be taken on record," the Commission mentioned in the order.

After perusing the available material on record, the Commission referred to the Supreme Court judgment in the case of Kusum Sharma and Ors. vs. Batra Hospital and Medical Research Centre and Ors., wherein the top court had clarified the law while determining medical negligence.

Referring to this judgment, the State Commission noted,

"In cases wherein the allegations of are levelled against the Medical Professionals, negligence is an essential ingredient for the offence, which is basically the breach of a duty exercised by omission to do something which a reasonable man would do or would abstain from doing. However, negligence cannot be attributed to a doctor so long as he performs his duties with reasonable skill and competence and they are entitled to protection so long as they follow the same."

In the present case, the Commission while referring to the complaint that the patient was treated differently in the EWS ward, noted,

"So far as the first leg of the argument, with respect to disparity in the treatment provided in the Paid General Ward and the EWS Ward is concerned, the perusal of the record reflects that the Patient was shifted to the EWS ward on 05.08.2011 on the request of the Nodal Officer, Ministry of Health and Family Welfare, Delhi. At the time when the Patient was admitted in the EWS Ward, his condition improved and the Patient was finally discharged on 25.08.2011. While discharging the patient, a course of antibiotics was prescribed, and the relatives of the patient were also told to regularly follow-up with the Hospital. The said fact has not been denied by the Complainant in her Rejoinder to the Written Statement."

"Hence, from the aforesaid, it can be concluded, that only after the Operating Doctors were satisfied that the condition of the patient was improving and with routine check-ups and medication, the Patient may recover, that he was discharged from the Hospital. To say that the Patient was not given proper treatment in the EWS Ward does not stand strong ground, otherwise, the Complainant could have easily raised the issue with the Hospital Authorities as well as the Nodal Officer, if the Complainant was actually dissatisfied with the Service," noted the Commission.

Further referring to the contention that the doctors had discharged the patient along with the Discharge bag, the Commission observed,

"With respect to the leaving of the Discharge Bag is concerned, the same has been refuted by the Opposite Party No. 1 stating that the said action was taken, considering the condition of the Patient. Moreover, the patient was advised regular follow-ups with the Consulting Doctors even after he was discharged from the EWS Ward, however, the same direction was not even complied with by the Complainant or the relatives of the Patient. It has been further argued that on 20.10.2011, the relatives of the Patient reported about the condition of the Patient to the Hospital, and the Patient was not even brought to the Hospital for check-up"

Thus, denying attributing medical negligence against the doctor and the hospital, the Commission noted,

"The acts of the Medical Professionals varies from case to case and not one practice or procedure is applicable to all the cases. It is upon the Condition and Response to the Medical Practices, that the Medical Professional proceed with for the Specific Patient. In the present case also, the action of the Doctors of leaving the Discharge Bag, was taken only after considering the condition of the Patient. The record is also clear, that as a measure of precaution, the Antibiotics as well as regular follow-up was also prescribed, which the Complainant failed to comply with. Hence, we are of the considered view that the procedure followed by the Hospital and its doctors, of leaving the Discharge Bag intact, cannot be said to be an act of Medical Negligence."

Dismissing the complaint, the Commission in the order clarified,

"In totality and with due regard to the settled law in this regard, we are of the view that the doctors had performed their duties and exercised an ordinary degree of professional skill and competence, for which, they cannot be held guilty of medical negligence."

To read the Consumer Court order, click on the link below.