Esophageal tears during Anterior cervical discectomy: NIMHANS told to Pay Rs 5 lakh compensation
Bengaluru: Opining that medical negligence on the part of the treating doctor of the National Institute of Mental Health and Neuro Sciences (NIMHANS) resulted in esophageal tears, the District Consumer Court of Bengaluru has directed the hospital to pay Rs 5 lakh as compensation. The patient was admitted to the hospital with acute shoulder pain and underwent Anterior cervical discectomy at NIMHANS.
Although the hospital claimed that the esophageal tears (damage in the food pipe), as a problem, is one of the known complications which can occur in Anterior Cervical discectomy, the consumer court bench comprising of Sri K. S. Bilagi, (President), and Smt. V. Anuradha (member) opined that damage in the patient occurred due to the negligence of the treating doctor at NIMHANS.
The case concerns a patient who had developed acute pain in the shoulder in January 2008 and got admitted to the treating hospital. Following tests and diagnosis, doctors diagnosed the patient suffering from C4-5 Mild Disc-Bulge C5-6 Disc Prolapse. As per the advice given by the doctors, the patient underwent the surgery.
The complainant patient claimed before the Commission that during the operation, due to the negligence of the doctors of the treating hospital, the patient had ruptured and damaged his food pipe (Esophageal tears). Thereafter, the patient needed to be fed by way of Jejunostomy.
On 14.01.2008, another operation was performed on the patient and after this, he consulted another gastroenterologist from a second hospital. Ultimately the treating hospital discharged the patient on 11.06.2008.
Six months after operation, the patient underwent another surgery at Wockhardt Hospital. The discharge summary of the hospital clearly indicated that the complainant had history of cervical operation at NIMHANS 6 months back. There was injury to esophagus during operation. The patient developed swelling and discharge from the jejunostomy site. Incision and drainage done for the same since then there is continuous discharge from the site, purulent, foul smelling and continuous." The Gastro-Duodenoscopy Report issued by the Wockhardt that there was an indication of Cervical esophageal injury. It further indicated that small linear mucosal tear seen just at thelevel of cricopharynx, on the right side.
The complainant patient further claimed that due to the damage caused by the doctors of the treating hospital, he started living on a liquid diet and lost strength of both his legs and hands. He also claimed of losing earning capacity. Thus, the patient approached the Consumer Court asking for a direction upon the treating hospital to compensate Rs 20 lakhs for the medical negligence and deficiency of service.
On the other hand, the treating hospital denied all these charges although accepted the basic facts of the case- including the admission of the patient and the damage to the food pipe.
The treating hospital contended that Esophageal tear which had occurred to the patient is one of the known complications which may occur in Anterior Cervical discectomy.
The hospital authorities further denied that the patient had lost strength in legs and hands. They filed an affidavit by a doctor who stated "Esophageal tear which had occurred to the complainant is one of the known complications which can occur in Anterior Cervical discectomy."
It was further stated that for conducting the Anterior Cervical discectomy, food pipe i.e. Esophagus blood vessels trachea have to be moved aside for having easy access to the vertebra to conduct discectomy.
Meanwhile, in 2016, the complainant patient produced two more documents- Disability Certificate issued by the Government of Karnataka which indicated 40% physical impairment, and the discharge summary issued by a second Hospital on 12th August 2008 which indicated that the patient had history of cervical operation at NIMHANS.
In 2018, the patient submitted two more documents, a copy of the disability certificate and discharge summary of another hospital which also indicated the history of cervical operation. However, the Commission noted that the complainant patient failed to produce any medical records to show that he lost control over his both legs and hands and there is a reduction of his earning capacity.
After listening to all the contentions by both the parties and taking note of all the documents, opinions and references made, the Commission opined
"Even though opposite parties have examined doctor ***, who is working as Associate Professor of Neurosurgery in opposite party hospital. But he is not a doctor who conducted procedure either on 10.01.2008 or on 14.01.2008.The non-examination of the doctor who conducted the procedure over the complainant is a clear indication that due to negligence of the doctor of opposite party the food pipe of the complainant was damaged. It is also admitted fact that due to damage caused to the food pipe, the food was being supplied through Jejunostomy. To this extent complainant proves the negligence of the opposite parties."
However, the Commission also noted
"Subsequent to 2008, the complainant has not produced any medical records about his further sufferance with regard to loss of control over both legs, hands and loss of income."
Taking note of all these facts, the Commission opined that the claim of Rs 20 lakh as compensation is an exorbitant amount. Thus, the Consumer court directed the treating hospital, "to pay Rs.5,00,000/- (Rupees Five Lakhs only) towards compensation and Rs.25,000/- (Rupees Twenty Five Thousand only) towards the cost of litigation to the complainant... "If the opposite parties fail to pay this amount, they shall pay interest at the rate of 12% p.a. on Rs.5,00,000/- from the date of complaint till the date of realization.
To view the original order, click on the link below.
https://medicaldialogues.in/pdf_upload/nimhans-consumer-court-151648.pdf
