Non-insertion of Ileostomy bag after surgery: Mysuru hospital, gastroenterologists told to pay Rs 8 lakh compensation

Mysuru: Holding a Mysuru based hospital and its Gastroenterologists negligent while treating a patient suffering from Chronic Calcific Pancreatitis, the District Consumer Disputes Redressal Commission, Mysuru has directed them to pay a compensation of Rs 8 lakh to the daughter of the deceased patient.

The District Consumer Court passed such an order after taking note of the fact that the treating doctor admitted that they had not inserted Ileostomy bag to the intestine after conducting surgery on the patient, who died as a result of deteriorating health condition.

"...it appears that due to non-inserting of Ileostomy bag to intestine, the urine and waste are blocked inside the stomach which results in deteriorating the health condition of the patient as such he went to Coma," opined the Commission.

Directing the hospital and its doctors to pay compensation, the consumer court bench ordered, "The opposite party Nos.1 to 3 are jointly and severally liable to pay compensation / damages of Rs.8,00,000/- to complainant No.2 with interest at 6% from the date of this complaint, within 2 months from the date of this order till payment."

The matter goes back to 2015 when the husband of the complainant had been admitted to Vikram Jyoth Hospital for stomach pain. It was alleged that the doctors of the hospital conducted Laparoscopic Surgery on the patient without informing the complainant. The doctors also reportedly informed that the patient might be suffering from Cancer, Ulcer or TB. 

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It was alleged by the complainant that despite the operation, the ilesostamy bag was not put to the patient, and the doctors did not check whether the stitches were put to the intestine properly or not. Allegedly, the health of the patient deteriorated as urine and waste filled in the stomach caused problems to the patient and pus was formed. Thereafter, the patient went to Coma.

Another allegation was that the patient had been administered injections directly without giving the test dose and it resulted in failure of multiple organs. Consequently, the doctors advised the patient for undergoing biopsy (Cancer test) and the report was delayed by 2 months. Meanwhile, the health condition of the patient deteriorated seriously and a second operation was conducted by Dr Raghavendra and Ileostamy bag had been fixed. However, the condition of the patient became unstable and he started having uneasiness in breathing. 

Thereafter Byepap was put on and the patient was shifted to ICU. The condition worsened and the patient went to Coma for a period of 14 days. After discharge, the patient was shifted to Apollo Hospital, Mysuru, but the patient died in December 2015. 

Alleging negligence on the part of the Vikram Jyoth Hospital and its doctors- Dr. Rajkumar P.Wadva and Dr.N.Raghavendra of Vikram Hospital, the complainants demanded a compensation of Rs.19,93,000.

On the other hand, the hospital and its doctors, who are specialist doctors in Gastroenterology, denied negligence on their part and submitted that the patient was suffering from Chronic Alcoholic Illness before 2015. Submitting that the late patient was a regular patient of the hospital, it was further submitted that the patient was diagnosed with Chronic Pancreatitis and he was on conservative treatment in maintaining his health.

When he got admitted to the hospital, the patient was a known and proven case of Chronic Calcific Pancreatitis. They also submitted that the medical records revealed that the reason for the health condition of the patient was his style and history. The doctors had advised him to stop alcohol consumption.

Dr. Raghavendra, the surgeon claimed that all the allegations including the claim regarding operating on the patient without informing, non fixing of Ileostomy bag are all baseless. He submitted that Ileostomy was not usually done for right colonic surgeries unless the patient is high risk. It was further submitted that the patient developed anstomotic leak after the operation with leaking of intestinal contents into peritoneal cavity, causing severe fecal peritonitis and septicemia shock and CT scan confirmed the same.

Providing further details regarding the treatment procedure and the fact that the patient had been shifted to ICU, the doctor further submitted that the patient never recovered from Kidney failure. He also claimed that the patient had died due to Chronic health conditions occurring due to his life style and history of illness.

After considering the submissions of all the parties, the District Consumer Court also referred to the cross-examination of the doctors. Taking note of the allegation that the health of the patient deteriorated due to non insertion of Ileostomy bag, the Commission referred to the cross-examination of the doctor and noted,

"R.W.1/OP No.3 Dr.N.Raghavendra in his cross-examination has admitted that on 01.08.2015 after conducting surgery they have not inserted Ileostomy bag to the patient and further admits that Ileostomy bag will be inserted for healing process of intestine. From the cross-examination of R.W.1, it is also crystal clear that after conducting operation on 01.08.2015 on the patient, the doctors did not insert Ileostomy bag."

Therefore, opining that the allegations were true in this regard, the Commission noted,

"Therefore, the allegation of the complainant that due to non-inserting of Ileostomy bag to the patient after conducting operation on 01.08.2015, the urine and waste filled up inside the stomach of the patient which results in deteriorating the health condition of the patient and pus was formed etc., is appears to be true and believable."

"As admitted by R.W.1/OP No.3 the Ileostomy bag will be inserted for healing process of intestine admittedly operation was conducted to intestine of the patient, but doctor did not inserted the Ileostomy bag, it appears due to negligence act on the part of OP No.3 Dr.Raghavendra, the urine and waste was filled in side the stomach of the patient which results in deteriorating the health condition of the patient," it further observed.

Opining it to be the reason for the worsened condition of the patient, the DCDRC bench further mentioned in the order,

"Therefore, it appears that due to non-inserting of Ileostomy bag to intestine, the urine and waste are blocked inside the stomach which results in deteriorating the health condition of the patient as such he went to Coma."

Taking note of the fact that the complainants had spent around 25 lakh rupees for the treatment of the patient, the Commission noted,

"...it shows that the complainant No.1 and deceased were having fond hope of recovery of deceased in the hands of the OP Nos.2 and 3 the doctors attached to OP No.1 hospital, but due to negligence act of the OPs and due to non-fixing of Ileostomy bag after conducting the operation on 01.08.2015 to pass the urine and waste, the same was blocked inside the stomach which caused serious implication on the health of the deceased and the health condition of the deceased aggravated and deteriorated and went to Coma for which the OPs are solely responsible."

Referring to the relevant orders passed by the National Consumer Court explaining medical negligence, the Commission observed, "The aforesaid decisions are aptly applicable to the present set of facts of the case of the complainants."

Directing the hospital and the doctors to pay a compensation of Rs 8 lakh to the daughter of the patient, the Commission further mentioned in the order, "Therefore, we are of the considered view that the OPs are liable to pay compensation to the complainant No.2 who is the daughter of deceased complainant No.1 and deceased K.Shankar Narayan for alleged medical negligence caused by them. Hence, we are of the opinion that the justice will be met if OPs are ordered to pay compensation of Rs.8,00,000/- with interest."

To read the order, click on the link below:

https://medicaldialogues.in/pdf_upload/mysore-doctors-fined-198913.pdf

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