8-day delay in treating cancer patient's acute cholecystitis: Delhi Consumer Court slaps Rs 5 lakh compensation on Hospital, 2 doctors

New Delhi: The District Consumer Disputes Redressal Commission, South-West Delhi, has directed a private hospital and two doctors to jointly pay Rs 5 lakh compensation after holding them liable for over an eight-day delay in properly treating an advanced cancer patient’s acute cholecystitis.

The compensation was awarded towards mental and physical agony and includes litigation costs. The amount has to be paid within three months, failing which it will attract 6 per cent annual interest from December 23, 2019, the date on which the complaint was filed, until realisation.

According to a report by The Indian Express, the Consumer Commission was hearing a complaint filed by the patient's husband alleging medical negligence in her treatment. The patient was suffering from advanced breast cancer with brain metastasis.

The patient reached the hospital's emergency department on January 17, 2019, complaining of abdominal pain and mild fever. An ultrasound showed a partially distended gallbladder containing sludge, with thickening and swelling of its wall, indicating acute cholecystitis. Her total leukocyte count was recorded at 20,000.

As reported by The Indian Express, the Commission noted that these findings pointed towards infection and said that further investigations and intervention should have been undertaken earlier.

The patient subsequently visited the surgery outpatient department on January 19 and was admitted. Magnetic Resonance Cholangiopancreatography (MRCP) was advised on January 22. The report, received on January 23, showed cholecystitis with a pericholecystic collection and suspected gallbladder rupture.

She underwent laparoscopic cholecystectomy on January 25. The surgical findings included dense adhesions, gangrene, perforation and an abscess. A drain was left in place because of the abscess and the condition of the gallbladder. The woman was readmitted on January 28 after suffering seizures and was discharged on February 8 on request. Hospital records stated that her prognosis had been explained and that the family wanted to take her home for best supportive care. She later died in hospital on February 18, 2019, due to cardio-pulmonary arrest.

As reported by The Indian Express, the Commission, while holding that the delay in treating the gallbladder inflammation amounted to medical negligence, observed:

"This inordinate delay in diagnosing the acute cholecystitis and managing it properly led to worsening of the condition".

The Commission specifically held the hospital and the two treating doctors responsible for the delay in managing the gallbladder inflammation. According to the report, the forum said that the hospital and the two doctors failed to provide the standard level of care expected when the woman approached the emergency department with severe stomach pain on January 17, 2019, and were therefore guilty of medical negligence.

Three other doctors named in the complaint were absolved of negligence, with the Commission finding no clear evidence establishing negligence against them.

The Commission, however, did not find negligence in the treatment of the woman's advanced cancer or attribute all her subsequent complications to the hospital. A medical expert opinion obtained during the proceedings described her as suffering from terminal cancer and multiple co-morbidities.

The forum recorded that she had received palliative radiotherapy for brain metastasis and concluded that the treatment provided by the surgical oncologists, radiation oncologists, neurosurgeon, gastrointestinal surgeon and medical oncologist was the standard of care.

The Commission also rejected the allegation that brain radiotherapy had caused the gallbladder rupture, noting that the radiation was localized to the brain. It further found that the anti-seizure treatment provided to the woman was in accordance with medical care.

Holding the hospital and the two doctors liable for the delay in managing the gallbladder inflammation, the Commission directed them to jointly pay Rs 5 lakh to the complainant as compensation for mental and physical agony, inclusive of litigation costs.