Stitches open after hysterectomy: After 2 decades, UP Doctor, nursing home finally exonerated of negligence charges

New Delhi: The National Consumer Disputes Redressal Commission (NCDRC) recently exonerated doctor and nursing home based in Uttar Pradesh from allegations of negligence while conducting hysterectomy operation on a patient.

It was alleged by the complainant that due to the negligence by the doctor during hysterectomy operation, she had to face sudden bust of abdomen and her stitches opened up. However, the NCDRC bench dismissed the complaint as it noted that the patient was obese and the gaping of surgical wound is known complication in the Obese patient and due to increased abdominal pressure at the time of passing stool or urine.

"Therefore, opening of stitches or bust abdomen shall not be construed as medical negligence," noted the Commission.

The history of the case goes back to 1993 when the treating doctor has conducted hysterectomy operation on the complainant. After around 10 days of the operation, the stitches were removed and the complainant was allegedly discharged without any advice. On the day of discharge, when the complainant was sleeping in the night, her abdomen busted suddenly, the stitches opened and the intestine came out. 

It was alleged by the complainant that she suffered severe abdominal pain and even water came out when she drank water. On the morning next, she was immediately taken to the nursing home, where the stitches were made again with sedation. After some time, the patient was discharged and dressing was done courteously for one month.

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However, in her complaint, the patient alleged that the pain continued during the next few months. Even though the doctor assured that the pain would subside soon, the situation did not get better. Therefore, she visited the Government Hospital where another surgery for incisional hernia was advised, but due to heavy expenses and lack of funds, she could not get operated. It has been submitted by the complainant that she is facing problems in walking, sitting on the floor till this day. 

Therefore, alleging negligence against the doctor during the hysterectomy operation, the complainant approached the District Forum Muzaffarnagar and lodged a complaint. After considering the matter, the District Forum passed two orders. While the president of the Commission allowed the complaint and directed the doctor to pay Rs 20,000 as compensation, in a separate order, two members of the commission dismissed the complaint. Therefore, the complaint was dismissed by the Order of the majority. When the order was challenged before the State Commission, it was dismissed once again as the commission pointed out that there was no evidence to prove deficiency on the part of the doctor and the Nursing Home.

Challenging the State Commission's order, the complainant approached the NCDRC bench. It was argued by the counsel for the complainant that the patient had been kept in the hospital unnecessarily for 10 days. Further it was claimed that the Consent was defective and the doctor allegedly did not inform about the possible complications after surgery. Further, the complainant's counsel argued that even though the patient was under continuous follow up till 22.01.1994, the doctor could not diagnose Incisional hernia.

On the other hand, the counsel for the doctor submitted that the doctor had conducted only abdominal hysterectomy operation and therefore, there was no question to interfere with the abdominal organs. Further, the doctor's counsel claimed that the complainant was overweight, obese, and she herself informed that her stitches opened up when she was relieving herself in the morning. So, it was due to the abdominal pressure coupled with her weight the stiches were loosened or broken, claimed the doctor's counsel.

After perusing the record, the NCDRC bench  opined that the mode of treatment and approach of the OP was as per the accepted standard of practice. The bench observed, "I do not find any fault in performing the hysterectomy operation. The post-operative (after 10 days) the gaping of surgical wound is known complication in the Obese patient and due to increased abdominal pressure at the time of passing stool or urine. Therefore, opening of stitches or bust abdomen shall not be construed as medical negligence. It is evident that the patient approached Government hospital wherein she was advised for operation for correction of incisional hernia but she did not opt for it, which in my view it was her carelessness. Therefore, the incisional hernia remained throughout her life, for which the OP was not liable."

At this outset, the bench placed reliance upon the Supreme Court order in the case of C.P. Sreekumar (Dr.), MS (Ortho) v. S. Ramanujam, where the top court had held that the Commission should not presume that the allegations in the complaint are inviolable truth even though they remained unsupported by any evidence.

"Recently, Hon'ble Supreme Court observed the same in the case Bombay Hospital & Medical Research Centre v. Asha Jaiswal and Others," further noted the bench.

Therefore, upholding the order of the State Commission, the bench observed, "I do not find any error apparent or material irregularity in the Orders passed by the District Forum (majority) and the State Commission. Same are affirmed."

To read the order, click on the link below:

https://medicaldialogues.in/pdf_upload/up-hospital-no-medical-negligence-194056.pdf

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