Patient Suffers Compartment Syndrome After Fasciotomy: Telangana Hospital, Surgeon slapped Compensation for negligence

Karimnagar: A city-based Private Hospital and one of its doctors were recently directed by the District Consumer Court to pay Rs 2.5 lakh compensation to a patient, who had to seek treatment at another hospital after undergoing fasciotomy at the hospital.

The patient was diagnosed with compartment syndrome at Apollo Hospital, where he had to seek further treatment. Holding the treating hospital negligent, the District Consumer Disputes Redressal Commission (DCDRC), Karimnagar directed the Renee Hospital and its doctor- Consultant Orthopaedic & Spine Surgeon to pay Rs 2.5 Lakh compensation.

"In view of the sufferance and agony of the complainant due to the treatment of the opposite parties which led to treatment at higher centres shows some amount of negligence on the part of the opposite parties as such the opposite parties are liable to compensate the complainant for a sum of Rs.2,50,000/- with interest and for all the reliefs claimed by the complainant along with interest and costs of the proceedings," ordered the consumer court.

The history of the case goes back to 2014 when the complainant was admitted to the treating hospital for an injury to his right leg, due to a road accident. He was diagnosed with a Bi-condylar Tibial Plateau fracture (SchatzkerVI) with gross swelling and he was kept on traction for internal fixation of fractured Tibia.

Consequently, surgery was conducted for the fixation of fractured Tibia (Rt) with LCP. After surgery, he was shifted to the ICU and he was suffering from severe pain but allegedly the treating doctors did not properly attend it.

As per the complainant, after repeated complaints regarding the persistent tingling pain out of proportion, the treating doctor removed three sutures from the surgery site. Suddenly puss gushed out from the surgical wound site where sutures were opened. Several antibiotics and IV Fluids were administered to the patient even then the pain became lancinating. Again sutures were removed from the surgical site where puss was found as such he was taken to the operation theatre and both the surgical sites below the right knee were connected.

The treating doctor informed the patient about the development of compartment syndrome in the right leg due to a fracture of Tibia. Though the patient underwent fasciotomy, the pain did not subside and again he was shifted to the operation theatre and opened all compartments involved in the right leg. However, there was no relief.

The patient got fever and another complication of a foot drop of his right leg to the infected right leg. He expressed his interest in seeking treatment in a higher centre. Meanwhile, the treating hospital returned Rs 50,000 to the complainant, which he had deposited for treatment. 

Consequently, the patient had to undergo treatment at Apollo Hospitals, Secunderabad, where the patient was found suffering from compartment syndrome which was not found by the doctors despite observing the complications of the said symptoms in the patient. The complainant underwent treatment in Apollo Hospitals for about 30 days by spending a sum of Rs 11,24,784. He was advised to undergo another surgery for correct foot drop with an estimated cost of Rs 6,00,000. Thereafter, alleging negligence by the treating doctor and hospital, the complainant filed the consumer complaint and sought Rs 20 lakh compensation.

On the other hand, the treating hospital submitted that they did not take any amount for the treatment. Denying negligence, the hospital submitted that the complainant's attendants were explained about the complication of the syndrome at the time of admission. Necessary surgeries were conducted and the swelling was subsided and wrinkles appeared around the foot and leg. It was further submitted that after the surgery, the general condition of the complainant was stable and after taking of precautions the main surgery was conducted, the immediate post-operative patient condition was stable and on the next day he got sensation over a common peroneal distribution area and the feeling of tightness complained by the patient and with local anaesthesia fasciotomy was done and the patient reported subsidence of pain. They further submitted that the compartment syndrome (CS) was not caused by the treatment given by them.

While considering the matter, the DCDRC noted,

"On going through the evidence affidavit and counter filed by the opposite parties and the way of answering in cross examination of opposite party no.2 (the Consultant Orthopaedic & Spine Surgeon) it is establishing some sense of negligence on the part of opposite parties in treating the complainant. On the other hand the burden lies on the complainant to prove negligent treatment of opposite parties. Except examining himself, the complainant did not choose to examine the doctors who have given treatment in Apollo Hospital, Secunderabad. In such sense there is no expert/technical authority to say about the negligent treatment of the opposite parties but in cumulative reading of complaint, counter, evidence affidavits and the documents filed by the complainant it is established that there would be a chance of amputation of right leg of the complainant if he has not taken treatment in the higher centre i.e., Apollo Hospital, Secunderabad."

Further, the Commission noted that the patient was discharged at the request made by him and his relatives.

"... otherwise the opposite parties would have continued the treatment in their hospital though there is no possibility of giving better treatment and there would be possibility of amputation of right leg of the complainant. As such in that angle it can be viewed that there is some sort of negligent attitude on the part of opposite parties in rendering services to the complainant. As such deficiency in service is appeared on the part of opposite parties in rendering their services as such they are liable to reimburse to some extent to the complainant," the Commission observed.

Addressing the argument of the hospital that no amount was taken for treatment, the Commission noted that the hospital and doctor provided treatment after receiving the amount of Rs 50,000 from the complainant and

"As their treatment is causing hardship to the complainant the opposite party has discharged the complainant and paid a sum of Rs.50,000/- to the complainant on humanitarian grounds. As such it cannot be said that the treatment rendered by the opposite parties is on free of cost. Thus the opposite parties are squarely covered by the definition of Consumer Protection Act. On that pretext the opposite parties shall not escape from their liability."

However, noting that the complainant could not establish negligence in a scientific way by examining the experts on the field or by examining the doctors of Apollo Hospital, who treated him, the Commission clarified that it was not possible to grant the entire claim pleaded by the complainant. "In the result the complaint is allowed in part. Opposite parties are directed jointly and severally to pay a sum of Rs.2,50,000/- with interest @ 9% PA from the date of filing of this complaint i.e., 14.07.2015 to till payment of entire amount for all the reliefs claimed by the complainant. The opposite parties are further directed to pay Rs.5,000/- towards costs of the proceedings. Compliance within one month from the date of receipt of copy of this order," it ordered.

To view the order, click on the link below:

https://medicaldialogues.in/pdf_upload/leg-amputation-compensation-249927.pdf

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