Anaemic patient dies after unwarranted hysterectomy: Hyderabad consumer court slaps Rs 30 lakh compensation on hospital, gynaecologist
Medical Negligence
Hyderabad: The District Consumer Disputes Redressal Commission, Hyderabad I has directed a hospital and a consulting gynaecologist to jointly pay Rs 30 lakh compensation to the husband of a woman, who died after undergoing a total laparoscopic hysterectomy with bilateral salpingo-oophorectomy.
It was observed by the Commission that even though the patient had anaemia, the treating doctor performed the surgery, which was not warranted. The Consumer Court opined that the gynaecologist and the Akshara Medical and Research Centre did not adduce any evidence with regard to the immediate surgery, "which was not at all required at that juncture."
Background:
The history of the case goes back to 2021, when the 51-year-old patient visited the treating hospital with complaints of severe Dysmenorrhea, prolonged bleeding with clots, and irregular menstrual cycles.
After going through the history, previous media records, the treating doctor suggested that the patient undergo TLH + BSO (Total Laparoscopic Hystectomy + Bilateral Salpingo-Oophorectomy, i.e., removal of uterus and ovaries with both side tubes). She was declared fit for surgery by the general physician. The patient was subjected to various preoperative investigations on 27 & 28 October 2021. All the reports were normal except blood HB was 8.4 Gms.
The surgery was conducted, and the recovery was reportedly satisfactory. After this, the patient was shifted to SICU for further management. However, later that night, the patient's condition deteriorated as her blood pressure and platelet count dropped significantly. The urine output was also minimal.
Repeat blood reports revealed that the blood levels were falling due to bleeding. There was liver failure and kidney failure, leading to jaundice and reduced urine output. The USG scanning revealed minimal fluid in POD, which indicates leakage, i.e., accumulated bleeding in the pelvis in the first post-operative day.
The patient was shifted to Apollo Hospitals to undergo dialysis. The hospital diagnosed that the patient was suffering From Acute Kidney Injury, Renal Cortical Necrosis, and Severe Metabolic Acidosis. The patient was intubated and put on ventilator. In spite of starting Broad Spectrum Antibiotics and supportive treatment, there was no Improvement in the condition, and ultimately, the patient died.
Filing the consumer complaint, the patient's husband alleged that the treating doctor hastily performed the Hysterectomy while the patient was in periods and in anaemic conditions. It was alleged that the doctor failed to diagnose the bleeding and failed to take appropriate action to control the same, and also failed to maintain the vital organs and other parameters by administering appropriate treatment and delaying shifting of the patient to a higher centre at the fag end/critical and irreparable condition. It was alleged that the conduct amounts to a deficiency in service and unfair trade practice.
Providing the details of treatment, the treating doctor and hospital denied any negligence on their part. They submitted that the doctors suspected that the most probable cause was that the patient would have had SEVERE SYSTEMIC INFLAMMATORY RESPONSE SYNDROME which is a very serious condition, due to cytokine storm which may be triggered by any surgery, leading to multi organ dysfunction like Acute Kidney Injury, Disseminated intravascular coagulation, Hypotension, Respiratory failure (Acute Lung Injury).
Observations by Consumer Court:
While considering the complaint, the consumer court took note of the death summary by Apollo Hospitals, which mentioned the patient's diagnosis as acute kidney injury – renal cortical necrosis – severe metabolic acidosis, concerning the chief complaints: complaints of hypotensive episodes and breathing difficulty, sudden in onset post hysterectomy.
"With regard to present illness: patient under went laproscopic hysterectomy on 28.10.2021 and developed hypertension breathing difficulty, anuria and was shifted to Apollo. These findings which are mentioned in Ex.A12 discharge summary which clearly indicates that due to the surgery conducted by the opposite party No.2 (gynaecologist) without monitoring all parameters of the patient who was an anemic. Though the other parameters are normal," noted the consumer court.
The Commission also observed that the treating doctor failed to submit any evidence to show that the patient was in need of immediate surgery. It noted,
"It is to be observed from the medical history of the patient that she was suffering with the problem of irregular periods and bleeding and also the percentage of haemoglobin in the blood was less and she is also an anemic. In view of the same, the opposite party No.2 ought not have conducted the surgery as the patient was anemic and there is no need to conduct the surgery in hasty manner. The opposite party No.2 failed to adduce any evidence to show that there is a need for immediate surgery."
It was also observed that the patient, after admission to the treating hospital, was given 1 unit of packed cell blood. At this outset, the Commission observed, "Despite one unit of blood transfusion, the patient haemoglobin was not improved due to on going bleeding Then, the thought that the patient may not deteriorate further with the localized on going bleed was not intervened and corrected. The critical care team advised one more blood transfusion intraoperatively Prophylactically preserved one more PRBC. In such a situation the opposite party No.2 should not have conducted the surgery keeping in view of the patient earlier condition with regard to that she was an anemic."
The Commission noted that the patient had continuous bleeding and was in severe dysmenorrhea. This, according to the District Consumer Court, clearly showed negligence of the treating doctor in performing the surgery as there was no emergency as per the medical record of the patient.
"It is to be noted that at the time of admission and before conducting the surgery all the necessary tests were conducted and the reports reveals that all the organs were healthy except severe anemia, which was due to blood loss which is due to the abnormality of the periods. At that juncture, the opposite party No.2 should not have performed the surgery," it noted.
"It is to be noted that the opposite party No.2 ought not have performed Hysterectomy surgery while the patient in periods and the patient was known case of anemic. This clearly shows the negligence and deficiency of service on the part of the opposite parties No.1 & 2. The opposite parties No.1 & 2 failed to adduce any evidence to show that the patient was under critical condition and the surgery is necessitated. In the absence of any evidence that the surgery was the only life saving option available at that time, the action to operate upon the patient cannot be said to be prudent decision," the Commission further opined.
Apart from this, the Commission also held that the treating doctor and hospital were deficieny in their service as despite being a reputed hospital they did not have dialysis facility and for the same, the patient had to be shifted to Apollo Hospital.
The DCDRC relied on the decision of Hon’ble Supreme Court in Arun Kumar Manglik Vs. Charaya Medical Health and Medicare Pvt Ltd. to note that in a specific case where unreasonableness in professional conduct has been proven with regard to the circumstances of that case, a professional cannot escape liability for medical evidence merely by relying on a body of professional opinion.
Addressing the submission of the hospital and doctor that the "Severe Systemic Inflammatory Response Syndrome" was the most probable cause leading to the patient's multi organ disfunction syndrome, the Commission noted, "As such the opposite parties No.1 & 2 have invented SIRS as the most probable cause for development of MODS. The opposite party No.1 hospital is not equipped with dialysis facility and also do not have CT scan abdomen facility. Therefore, there is deficiency of service on the part of opposite parties No.1 & 2...The above version of the opposite parties No.1 & 2 clearly shows that the doctors have only suspected the problem and opined that the patient would have had SEVERE INFLAMMATORY RESPONSE SYNDROME which is very serious condition. Hence, the opposite parties No.1 & 2 failed to know the exact cause for deterioration of the health condition of the patient. As there is no need for emergency operation, since the opposite parties No.1 & 2 have not adduced any evidence with regard to the immediate surgery which was not at all required at that juncture."
Accordingly, holding the doctor and hospital deficient and service and negligence, the Consumer Court directed them to pay the patient's husband Rs 30 lakh as a compensation and Rs 20,000 as legal costs within 45 days.
"In the result, the complaint is allowed in part directing the opposite parties No.1 & 2 jointly and severally to i. Pay an amount of Rs.30,00,000/- (Rupees Thirty Lakhs Only) towards compensation for serious inconvenience, hardship and sever mental agony apart from irreparable financial loss; ii. To pay costs of Rs.20,000/- (Rupees Twenty Thousand Only)," mentioned the order.
To view the order, click on the link below:
https://medicaldialogues.in/pdf_upload/2026/04/06/document-86-339975.pdf
