Right ovary missing post cystectomy: Forum directs Delhi Gynaecologist to pay Rs 5L compensation for negligence

New Delhi: Holding a gynaecologist associated to Shri Mool Chand Khairati Ram Hospital negligent in her service as a doctor, the District Consumer Disputes Redressal Forum-II in New Delhi has directed her to pay a compensation of Rs 5 lakh along with a litigation cost of Rs 50,000 to a patient whose right ovary was removed instead of operating the left ovarian cyst, causing permanent disability, hormonal imbalances, and psychological distress.

The bench of Monika A Srivastava, President, Kiran Kaushal, Member, U K Tyagi, Member observed that the doctor though possessed of requisite skills has not exercised the skill as per the competency.

Background

This case which began in 2001 concerns a patient, who filed a consumer complaint against Shri Mool Chand Khairati Ram Hospital, the gynaecologist and the United India Insurance Company alleging medical negligence during Endoscopic Ovarian Cystectomy.

The patient sought Rs 5 lakhs in damages for a series of physical and emotional traumas she experienced. She alleged permanent disablement, mental anguish, extensive nursing and hospital expenses, and deprivation of her role as both a wife and a mother due to negligence on the part of the hospital.

She had initially consulted the hospital due to gynecological issues, particularly a cyst in her left ovary.

The Allegations

The patient claimed that Shri Mool Chand Khairati Ram Hospital, specifically the gynaecologist, had recommended surgery to remove the ovarian cyst. However, the hospital mistakenly removed her right ovary instead of addressing the left ovarian cyst.

As a result, she suffered permanent disability, hormonal imbalances, and psychological distress.

She further alleged that the hospital and its staff attempted to conceal their mistake by manipulating documents, including prescriptions and laparoscopic reports. She presented evidence, including ultrasound reports and histopathological examinations, suggesting that both her ovaries were intact before the surgery.

The Hospital and the Doctor’s response

Meanwhile, the hospital denied the allegations, stating that the left ovary was already missing and that the surgery had been conducted correctly.

The doctor argued that the complainant had concealed fact and did not file the medical papers with regard to the laparoscopic surgery undertaken by her about ten years back in 1990, and therefore it is manifested that the right ovary of the patient was already removed before she was operated by her.

She further submitted that the mention of Rt in histopathological was wrong. She explained that this happened as the Resident Doctor had wrongly recorded that cyst was removed from the right ovary (instead of left ovary) and left ovary (instead of right ovary) was missing.

The Medical Evidence

The case hinged on medical evidence, particularly ultrasound reports conducted over several years. These reports contradicted the hospital's assertion that the left ovary was missing, as they consistently showed the presence of both ovaries. Furthermore, histopathological reports indicated the removal of the right ovary during surgery, further complicating the hospital's contention.

The Legal Battle

The case went through multiple stages, with the District Consumer Disputes Redressal Forum initially ruling against the patient in 2005. However, this decision was overturned by the State Commission in 2009, leading to a fresh hearing. The hospital's counsel relied heavily on the notion that the patient had hidden her medical history, specifically her surgery in 1990.

Expert Opinions

To resolve the case, expert opinions were sought. Safdarjung Hospital's experts could not definitively confirm the presence of the right ovary at the time of surgery due to contradictory evidence. This further led to confusing the case.

The Order

After considering the evidence and arguments from both parties, the District Commission found discrepancies in the statements provided by the hospital and the doctor.

The Forum noted that;

“It has also seen the prescription provided by the doctor with over writing, left ovary cyst is made as right ovary cyst and overwriting is also seen in another parts of the prescription where L is cut and R is written but the important part is that it still mentions cystectomy and not removal of right ovary”

“Although the doctor has given an explanation that it is on account of the mistake of resident doctor that the left ovary is mentioned as right ovary yet this fact is inexplicable in view of the fact of sonography reports of the complainant pertaining to the years prior to the surgery of the complainant conducted at Shri Mool Chand Khairati Ram Hospital in the year 2001.”

Referring to case of Jacob Mathew vs. State of Punjab and other relevant cases in the Hon’ble Supreme Court, the Forum reiterated that doctors are expected to exercise a reasonable degree of care, skill, and knowledge while treating patients. Failure to meet this standard amount to medical negligence.

It further said that;

“The prescription given by the doctor apart from overwriting of Lt to Rt but apart from overwriting, it is mentioned cystectomy and not removal of right ovary. This coupled with the fact that past sonography reports after the first surgery of the complainant in 1990 indicate that both the ovaries of the complainant were present whereas the later sonography reports after the surgery was performed by the doctor in 2001 indicate that the right ovary is missing therefore, we opine that the doctor has been negligent in conducting the surgery of the complainant based on the documentary proof filed on record. It is also noted that the doctor in her reply of legal notice had stated that the left ovary was already missing which is in contradiction to her averments made in her reply to the complainant”

The Commission placed its reliance on the expert report of Safdarjung Hospital and concluded that;

“There is definite contradiction in the statements made by the doctor relating to the presence of left/right ovary of the complainant.”

Based on the evidence and case laws, the District Commission, subsequently, held the hospital and the doctor liable for negligence and ordered them to pay Rs 5 lakhs as compensation to the complainant for the physical and mental suffering caused by their medical negligence. Additionally, they were directed to bear the legal expenses incurred by the complainant.

It said;

“In the present case the doctor though possessed of requisite skills has not exercised the skill as per the competency therefore this commission is off the view that the professor is negligent in her service as a doctor. The doctor is directed to pay to the complainant a sum of Rs 5 lakh as compensation along with Rs 50,000 as cost of litigation within three months from the date of this order failing which the doctor shall be liable to pay an additional sum of Rs 2 lakhs to the complainant till payment is made. It is open for the doctor to recover this amount from op 4 () as a valid indemnity policy which was in place at the relevant time.”

To view the original order, click on the link below: