No Medical Negligence in Treating Patient Suffering from pyonephrosis: NCDRC exonerates doctors, Hospital

Such observation came from the top consumer court while it noted that the patient had remained under consultation of various Doctors and Hospitals and thus, "The Appellants/Complainants failed to produce any cogent proof that the PCN Tube was changed/removed in Respondent Hospital on 06.06.2007."

The history goes back to 2007 when the complainant, who was admitted to the treating hospital for treatment of infection in the urinary tract and pus in the renal pelvis. Initially, she was admitted to a different branch of the hospital where she was operated and right PCNL was done. After being shifted to the main treating hospital nephrostomy drain was put in her kidney.

After being slightly stable, she was discharged with the nephrostomy drain still inside her body. Due to her continuous suffering from the low platelet count, she was being taken to the hospital on a weekly basis.

The patient alleged that she developed the problem during her stay in the Hospital because of improper handling of operation and lack of required post-operative care.

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Later when she was taken to the hospital for removal of nephrostomy drain, the treating doctor removed it, planted the stent and discharged the patient. However, the condition of the patient didn't improve and she had severe pain in the right side of the lower back.

When her husband contacted the hospital, the patient was advised to give "Nimesulide" tablet to the Patient. This didn't help the patient for longer and apart from the burning sensation while passing urine, the problem of low platelet count worsened for the patient.

After being totally bedridden and suffering from continuous pain in her lower right back, she was taken to another hospital, where after undergoing X-ray and ultrasound, it was noticed that the patient had a small rubber/synthetic tube in her body.

The patient alleged that the said piece was left in the body due to negligence either at the time when PCNL was done or at the time when the nephrostomy drain was removed and stenting was done on 12.06.2007.

When the patient approached the treating hospital again, she was again subjected to X-ray and when the matter was brought to the notice of the HOD of the Urology Department, he took over the case and got admitted the Patient in the Hospital with the piece of PCN. On 05.07.2007, the said piece and the stent were removed and again PCNL was done.

However, her condition didn't improve and she had to continue regular treatment at PGI, Chandigarh costing her around Rs 50,000 per week.

Thus, the patient approached the State Commission and alleged gross negligence and deficiency in service on the part of the Hospital and its doctors. She pointed out that due to the negligence on their part, the patient, who was highly educated and running a school in Patiala, was put under permanent treatment. For this, the complainant claimed Rs 35,11,000 as compensation on different heads along with an interest @ 18% p.a.

On the other hand, the Hospital and its doctors filed their joint written version and mentioned that the patient was diagnosed with Pyonephrosis (pus in the kidney) right sided with chronic renal failure and Septicaemia and, accordingly, she was put on life-saving treatment.

They further argued that the platelet count in the patient had come down because of the Septicaemia. For this, the two units of blood had been transfused to the patient and she was put on broad spectrum antibiotics. After giving complete details regarding the treatment procedure of the patient, the doctors and the hospital further submitted that after the TLC and Platelet counts improved in the patient, Nephrostomy drainage i.e. PCN was conducted and as the PCN tube was around 3 months old, the patient was advised for PCN change. They claimed that the condition of the patient improved and on 12.06.2007, she was discharged with PCN intact and functioning.On the request of the Patient, the PCN was retained and was not changed.

They further claimed that the procedure of removal of PCN was never conducted by the treating doctor and they also pointed out that sometime fracture of the pipe, inserted in the kidney to drain the pus, takes place owing to texture of the pipe, which has small pores/holes on its end, which could not be presumed as medical negligence.

It had been claimed by the doctors and the hospital that when the patient came to the hospital on 27/06/2007, she informed the doctors that she had got her PCN pipe removed. X-ray report revealed that rear proximal end which was inserted into the kidney for drainage had broken inside and the patient had come to the Hospital for getting the same removed.

After waiting for some time, surgery was conducted, wherein the stent and the piece of PCN were removed and another procedure of Percutoneous Nephroscopy was conducted on the patient to remove the thick pus flakes and the dead necrotic tissue from the kidney. The kidney was washed and nephrostomy tube was placed.

The State Commission, after considering hearing both the parties, noted that the patient had herself mentioned that she had been going to other hospitals as well. That is why, the Commission had observed that the treating hospital couldn't be held negligent merely on presumption.

When the matter came for considering before the NCDRC, appellant submitted that the State Commission had dismissed the Complaint on surmise and conjuncture and has not properly appreciated the facts of the case which clearly points out the negligence of the Hospital and doctors in leaving the pieces of PCN tube while removing the same from the body of the Patient on 12.06.2007 during the operative procedure.

After perusing the medical record related to the case, the NCDRC noted that "It has been pleaded by the Patient herself in the Complaint that after discharge from the Respondent Hospital on 21.04.2007, the Patient had remained under consultation of various Doctors and other Hospitals. The Appellants/Complainants failed to produce any cogent proof that the PCN Tube was changed / removed in Respondent Hospital on 06.06.2007."

Opining that the Complainant failed to provide any evidence for proving medical negligence, the top consumer court noted, "It is a settled law that the onus to prove medical negligence lies largely on the Complainant and that this onus can be discharged by leading cogent evidence. A mere averment in a Complaint by no stretch of imagination, be said to be evidence by which the case of the Complainant can be said to be proved. It is the obligation of the Complainant to provide hard evidence to prove the case of medical negligence against the Doctors / Hospitals. In my view the present the Consumer Complaint completely failed to provide any cogent evidence to prove the medical negligence on the part of the Respondents/Opposite Parties."

At this outset the Commission referred to the Supreme Court judgment in Kusum Sharma Vs. Batra Hospital and Medical Research Centre, where the Apex court had noted that Courts should be extra careful to ensure that medical professionals are not harassed unnecessarily.

"On the basis of foregoing discussion, I do not find any illegality or perversity in the well-reasoned Order passed by the State Commission. The Appeal is, therefore, dismissed," noted the NCDRC President R. K Agrawal.

To read the Commission order, click on the link below.

https://medicaldialogues.in/pdf_upload/ncdrc-medico-legal-166720.pdf

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