TB diagnosed as Lung Cancer: Diagnostic firm told to pay Rs 2 lakh compensation

Chandigarh Holding a private diagnostic lab guilty of releasing in incorrect report that diagnosed the ailment of a patient as Cancer Stage 4 instead of the actual disease tuberculosis (TB), District consumer disputes redressal forum has directed the lab to pay a compensation of more than Rs 2 lakh.

The case relates to a patient who visited Government Medical College & Hospital (GMCH) Sector 32 with complaints of continuous cough problem for more than 15 days in the year 2014. The patient was suggested a CT scan of his chest and reports suggested abnormal growth called lymph nodes in the lung region. He was then sent to the pulmonology section of the hospital that conducted the sputum and montier tests to ascertain tuberculosis. Nothing abnormal was detected and the complainant was advised to get broncoscopy test regarding the lymph nodes.

The tube was inserted and on receipt of the report of the GMCH lab, same was got examined from the pulmonary section and it was diagnosed adenocarcinoma lung i.e. cancer of the lung and was referred to Oncology Department of GMCH. The oncology department adviced the patient PET scan

The PET Scan was further done by a private lab Spiral CT & MRI Centre. The report furnished by Spiral stated that it was cancer Stage IV that had spread out of the lungs and spread into the bones of the patient due to which the bones were likely to become weak and can crack at any stage.

The panic-struck patient opted for chemotherapy treatment and three chemotherapies were done. However, no improvement was noticed.

Thereafter, the patient was shifted to Tata Memorial Hospital, Mumbai. Doctors there opined that on the basis of a minor test of broncoscopy and PET-CT Scan presence of Stage IV lung cancer could not have been diagnosed. As such, biopsy test was done. The report so obtained revealed it to be a case of tuberculosis (TB). The patent took treatment for the same from a Dehradun doctor and was in good health.

The patient then moved the forum alleging that he sustained and underwent pain, suffering and mental stress, fear of hanging death sentence on being diagnosed with cancer. He further alleged suffering from the side effects of chemotherapy. Had chemotherapy not been administered, then his suffering could have been avoided, he added.

GMCH in its response to the allegations furnished No expert opinion was obtained to falsify its documents and its case is all the tests were done and thereafter diagnosis was settled and even SPIRAL LAB had opined cancer had spread to the left pubic bone, sacrum, left iliac bone, 2 rib and right transverse. It was opined to be cancer nd stage IV. As such, chemotherapy was done on being opted by the complainant. It is also the case, there may be chances after conducting three chemotherapies cancer was cured and then tuberculosis was suffered by complainant. On these lines, the cause is sought to be defended.

The private lab Spiral filed its separate written reply and its case is it nowhere opined cancer had spread out from the lungs and spread into the bones of the complainant due to which the bones were likely to become weak and can crack at any stage. GMCH had also advised to correlate the report with the clinical findings. As such, there was no medical negligence or deficiency in service on its part.

Observing the facts of the case, the forum noted that the GMCH for its safety and confirmation had also sought PET scan from the lab which had shown the spread of cancer. After this report, finally, the hospital had suggested chemotherapy or other treatment on which the complainant had opted for chemotherapy and three chemotherapies were undertaken. The basis and grounds to recommend this treatment is the report of the laboratory.

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In the view of the forum, it found no reason to hold the hospital guilty of any medical negligence or deficiency in service rather it found the lab deficient in rendering service to the complainant and it is on the basis of this report regarding the spread of cancer stage IV was opined and GMCH had recommended chemotherapy. Going through the PET report in detail it said

In the first clause it was opined mild FDG avid fibronodular patches the RUL, RL and LLL of the lung. In the third clause it was opined FDG avid ill-defined osseous lesions in the left pubic bone, sacrum, left iliac bone, 2nd rib and right transverse process of D4 vertebrae, as described. Highly suspicious of skeletal metastasis. The metastasis is a cancer and in this opinion they have referred that the lesion has extended to left pubic bone, sacrum, left iliac bone, 2 rib and right transverse process of D4 vertebrae meaning thereby it had nd spread out on these parts. It had expressed the opinion on the basis of PET scan highly suspicious of skeletal metastasis. Thus, after reading of the report of PET scan they were highly suspicious of skeletal metastasis which had spread out. In clause 3 of the report, OP-2 had no suspicion of infective pathology i.e. to say bacterial infection of TB. They were highly suspicious of metastasis. It is on the basis of spread of the lesion doctors of OP-1 (GMCH) had opined, it was a stage IV cancer meaning thereby they were misled with the report of OP-2 (private lab). In the reply furnished OP-2 has taken that of the mild FDG avid fibronodular patches the RUL, RLL and LLL of the lung, infective pathology while under clause 3 it did not insert the word infective but of skeletal metastasis which could have weakened the bone and it was a stage IV of cancer opined on the basis of this report by OP-1. This shows, OP-2 was deficient in rendering service to the complainant and it is on the basis of this report regarding the spread of cancer stage IV was opined and OP-1 had recommended chemotherapy.

The court held the deficiency on part of the private lab

The conclusion is, had there been doubt of infective pathology then OP-1 could not have put the complainant on this chemotherapy. Rather the report of OP-2 had put the complainant on God's airport waiting for the final call to say goodbye to the world and he was put in fear of hanging death sentence. Thus, we hold, chemotherapy was administered which had various side effects, pain and suffering to the complainant and to us it appears, it is on account of deficiency in service on the part of OP-2 chemotherapy was recommended and was undertaken. We do not say it is a case of medical negligence on the part of OP-2 as it is a lab but certainly lacking off in providing proper service on account of which OP-1 was also misled regarding the conformity of skeletal metastasis and had it inserted the word infective under clause 3 of the report, chemotherapy ought not have been advised and treatment would have been for anti infective therapy in the form of antibiotics meant for tuberculosis.

Subsequently, the forum held;

Thus, we are of the firm view, OP-2 was deficient in rendering service in making the correct report particularly so when the machine test was done and the machine could not have given the incorrect picture, rather a magnified picture i.e. tomography was displayed.

The court, thereby, directed the lab to pay Rs 2 lakh as compensation and 15,000 as litigation cost to the complainant.

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