Two Heart Attacks after Spinal decompression: NCDRC exonerates Neurosurgeon, Anesthetist of Fortis Hospital from Negligence after 15 years

New Delhi: The National Consumer Disputes Redressal Commission (NCDRC) recently exonerated Fortis Hospital and its doctors from charges of medical negligence while conducting Spinal decompression on a patient back in 2005.

It was opined by the Apex consumer court that there was no deficiency in service after the Commission took note of the fact that even though the treating surgeon was absent after the operation, the patient was constantly under observation of other doctors, who managed the sudden post-operative cardiac complications of the patient and shifted the patient to other hospital. 

Apart from this, the Commission also referred to the opinion given by an eminent cardiologist, Dr. Upender Kaul, who after reviewing the entire medical record, held no negligence in treating the patient.

Therefore, exonerating the doctors and the hospital after more than 15 years, the top consumer court mentioned in its order, "Based on the discussion above, in our view, the Complainant failed to prove negligence of treating doctors OP-1 and OP-2 at Fortis Hospital. The Complaint is devoid of merits, it is dismissed."

The history of the case goes back to 2005 when the patient, who himself is a doctor by profession, approached Dr. Singh, the Director of Neuro Sciences of Fortis Hospital for complaints of back pain. After examining the patient, the doctor advised surgical intervention by Spinal decompression and fusion with screws and rods.

It was alleged that the patient was made to wait for hours and there was postponement of surgery. After the operation, the patient experienced severe pain radiating up to the leg, but allegedly noone attended him. In fact, the patient suffered two heart attacks, but allegedly no cardiologist or other doctors attended him. During this time, the treating doctor was also out of station, alleged the complainant.

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Finally, the patient was shifted to other hospital and only after undergoing Coronary Artery Bye-pass Grafting (CABG) surgery, his situation became stable. In his complaint, the patient has alleged that in order to gain more money, the treating doctor ignored the abnormal ECG.  He alleged that the known complications could have been handled in an effective manner.

He also alleged that instead of attending first the serious cardiac condition of the patient, the treating doctor proceeded to operate for the spinal decompression which resulted into the chain of complications and further permanent impairment to the extent of 50% damage to the patient's heart.

Aggrieved with this, the complainant filed the Consumer Compliant under section 21 of the Consumer Protection Act, 1986 for negligence in pre and postoperative care and demanded Rs 1,22,16,627 as compensation.

On the other hand, the doctors and the hospital denied any negligence and claimed that the doctors had followed an established procedure in treating the complainant. Referring to the ECG report, it was further submitted that the ECG findings are considered normal if the same are without any cardiac ailment, which was the case of the complainant.

Except for history of borderline hypertension which was well controlled with medications (this included a beta blocker) and the fact that he was a smoker as per history given, there were no other risk factors for coronary artery disease, submitted the doctors before the Commission.

In fact, the doctors submitted that the Cardiological assessment of the Complaint was also done and consequently, the Anesthetist had declared the patient fit (ASA grade II) for surgery. They also submitted that the decision for surgery was taken on the basis of the currently accepted international medical guidelines and practices. The patient, being a practicing cardiologist, was in good health and in fairly good functional status. In view of the total clinical picture and his backache due to severe lumbar spondylosis, he was taken for the surgery after informed consent, submitted the doctors and the hospital.

After considering the arguments by both the sides and perusing the entire medical record, the top consumer court opined, "It is pertinent to note that the patient being doctor himself was in good health and during his preanesthetic check-up denied any history of cardiac problem. The ECG did not reveal any signs of infarction."

Referring to the concerned medical literature and the opinion given by an cardiologist Dr. Upender Kaul, the Commission further noted, "the instant patient had no clinical minor cardiac signs /predictors for developing perioperative cardiac morbidity. As per Lee's modified cardiac risk index, the patient's overall good clinical condition still 0.4% risk remains to major peri-operative cardiac evet. Dr. Upender Kaul, an eminent cardiologist, after reviewing the entire medical record, held no negligence in treating the patient. The said opinion has neither been rebutted nor disapproved."

"Most of patients, after spinal surgery, suffer back ache for 1st postoperative day and get relief by pain killer medication. Admittedly, the OP-1 had gone to Rishikesh due to some personal exigency, however the patient was constantly under observation of the doctors in the team of OP-1. Therefore, there was no deficiency in service. The patient post-operatively suffered cardiac complications, which were stabilised and shifted to Kailash Hospital. We do not find any lapses on the part of Fortis hospital," observed the Commission as it dismissed the complaint.

To read the order, click on the link below:

https://medicaldialogues.in/pdf_upload/no-medical-negligence-195116.pdf

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