Failure to perform diagnostic tests, re-operation: Max Hospital Mohali, neurosurgeon slapped Rs 4.75 lakh compensation
Medical Negligence
Mohali: Holding the Max Super Speciality Hospital and its neurosurgeon liable for medical negligence, unfair trade practice and deficiency in service during the treatment of a patient suffering from Degenerative LCS and Listhesis L5/S1, the District Consumer Disputes Redressal Commission, SAS Nagar Mohali, has directed them to pay Rs 4.75 lakh to his kin.
Allegedly, after undergoing treatment at the hospital, the patient's condition worsened. He became bedridden and eventually passed away on January 31, 2021.
The history of the case goes back to 2020 when the complainant's husband was treated at the hospital. From 19th March 2020 to 6th April 2020, the patient was hospitalized, operated upon and remained under treatment at the hospital in three spells and Rs 5,93,129 was charged by the hospital.
It was alleged by the complainant, a 74-year-old senior citizen that before treatment, her husband was able to carry on his daily chores himself. However, after surgery, instead of even slightest improvement in his condition, her husband was rendered bed-ridden and he was unable to move.
Referring to the sequence of events, the repeat hospitalisations and surgeries of a 76-year-old diabetic patient within 19 days, the complainant argued the attending surgeon went ahead to perform the surgery without even slightly assessing the fitness of the patient for operation and visualising the post surgery complications/adverse impact, as also without considering the fact that the patient was operated upon in 2017. As per the complainant, this was done only to extort huge money. She claimed that the treating doctor and hospital played with the life of a senior citizen and therefore acted with apparent negligence, including unfair trade practice.
According to the complainant, no preoperative assessment by way of X-ray, Dexa Scan, CT Scan MRI was carried out to declare the patient fit for complex surgery.
On the other hand, the treating hospital and its doctor- a neurosurgeon, senior director and HOD at Max Mohali, opposed the complaint and denied any deficiency of service on their part. They argued that the complainant could not submit any expert opinion, and that the complaint was based on assumption and unfounded motion.
It was submitted that the surgery was planned to improve the quality of life because the patient had persistent pain and he was bed ridden. At no stage, was a cure guarantee.
Providing details of the treatment procedure, they further submitted that degenerative changes in the lumbar spine occur commonly in senior citizen. When these changes cause mal-alignment of the spine and compress the nerves, surgery restores the alignment and relieves compression. So, in view of the extent of decompression required, surgery also mandates insertion of spinal implants that would provide stability to the spine and relieve pain.
The hospital and the doctor claimed that age is not a criteria for denying surgical treatment to senior citizens, as majority of them show that distinct improvement in their painful state, ability to walk and overall quality of life. This way, they are able to manage the comorbid conditions better when they are pain fee.
They also contended that before surgery, both the complainant and the patient were consulted thoroughly about the pros and cons of the operation and thereafter, they gave consent for the surgery. Therefore, using the terms ‘extortion’ and ‘usurping’ money from the complainant are totally malafide and obnoxious.
It was submitted that no surgeon anywhere in the world guarantees favourable outcome, since human body is a biological system and cannot be viewed with a medical prism. Therefore, they prayed to dismiss the complaint.
The Senior Director deposed in his cross-examination that loosening of the screw could be due to the patient suffering from diabetes, hyper tension and old age, however, these factors were not taken into consideration before the surgery.
At this outset, the Commission observed, "The implants (rod and screw) planted during surgery on 21.3.2020 become mal-positioned and screws were protruding the margin and there was chipping of bones within couple of days of first surgery makes it evident that the surgery was performed by OP No.2 Senior director and HoD in OP No.1 hospital without assessing the condition of bones of the patient."
The consumer court also noted that a fresh X-ray report/Dexa Scan ought to have been done before surgery on 21.3.2020. It observed, "...but the OP No.2 proceeded to operate the patient on the basis of X ray allegedly conducted more than a year before. Thus, Ops No.1 & 2 proceeded to operate the patient without carrying out required and basic investigations resultantly the condition of the deceased/patient did not improve and rather deteriorated."
"A perusal of Ex.C1 reveals that the condition of deceased/patient was much better before surgery. Moreover, during cross examination OP No.2 admitted that the patient was able to walk before the surgery which falsifies the stand taken by the Ops No.1 & 2 in their written statement/affidavit," it further noted.
The Commission referred to the Discharge Summary and noted that there was chipping of bones and the screws in the S1 vertebral body were protruding beyond anterior margin of S1 vertebral body.
"The OP no.2 during cross examination admitted and stated that the patient had to take admission in the hospital due to loosening of the right L5 screw and dislocation of the rod. It shows that implantation of (screw and rod) was not successful," the Commission noted at this outset.
"The deceased remained under treatment in three spells from 19.3.2020 to 6.4.2020 in the OP No.1 hospital and the condition of the deceased deteriorated, rendering him bed ridden which eventually led to his death on 31.1.20221. During cross examination, the operating doctor (OP2) stated that he was not sure that Dexa Scan is Carried out to measure the strength thickness and density of bones before opting for surgery and then self stated it is not done in routine. No CT Scan report has been placed on record. The X Ray report which was placed on record is not much relevant as it was more than one year old and the genuineness of report is also in dispute. The Ops appearance, did not assess the suitability of the deceased/patient for surgery correctly and did not exercise due diligence which is evident from the fact, duly borne out on record and as admitted by the Ops that the screws got mal-positioned and screws/rd had to be removed, this happened due to apparent negligence during first surgery on 21.3.2020," the Commission observed.
Accordingly the consumer court held the hospital liable for negligence and observed,
"Based on the scenario described, the actions of the Ops failure to perform proper diagnostic tests (x-ray/Dexa Scan) improper diagnosis and a reoperation for the same issue (charging extra payment) constituted proves medical negligence."
It also held the hospital liable for deficiency in service for failing to diagnose the case and perform essential tests.
"...failing to perform essential tests like and X Ray or Dexa Scan, leading to a failed operation is a breach of the “duty of care” owed to the patient...A second surgery for the same issue, necessitated by the failure of the first due to poor planning or lack of diagnosis, proves deficiency in services," it noted.
The hospital was also held liable for unfair trade practice. It noted,"Charging again for the same procedure that failed due to the Ops negligence is an “unfair trade practice” in addition to negligence. It is settled law that in all cases of medical negligence, expert opinion is not required and each case has to be judged on its own fact. In this regard, we relied upon the case law of Hon’ble Supreme Court of India, (2010) 5 SCC 513, titled as Kishan Rao Vs Nikhil Super Specialty Hospital and Anr."
Accordingly, the Commission directed the hospital and the doctor to pay Rs 4,25,000 to the complainant along with Rs 50,000 as litigation expenses.
"Hence, in the interest of natural justice, the complaint of the complainant partly allowed with the directions to the Ops No.1 &2 to pay a sum of Rs.3,25,000/- to the complainant along with interest @ 9% per annum from the date of filing of the complaint till its realization. Ops are also directed to pay a sum of Rs.1,00,000/- as compensation and Rs.50,000/- as litigation expenses to the complainant," read the order.
To view the order, click on the link below:
https://medicaldialogues.in/pdf_upload/2026/04/20/krishna-rani-vs-max-hospital-342744.pdf
