Patient alleges wrong appendicitis report resulted in unnecessary laparotomy: Consumer forum absolves radiologists
Delhi: Upholding the judgment of the state commission, the National Consumer Disputer Redressal Commission (NCDRC) has recently dismissed a plea wherein the patient alleged that laparotomy had been performed unnecessarily on him after the radiologists gave faulty reports suggesting the patient suffering from appendicitis.
The apex commission found the allegations unsustainable and stated that the abdomen is a " Pandora's box ", hence many times the appendicular pain gives symptoms of appendicitis pain. The commission observed that the operation was necessary to assure proper treatment for the patient.
The case concerns the patient who consulted a physician for stomach pain for which he was advised to take an abdomen scan. The abdominal ultrasound (USG) was performed by a radiologist who reported it as retro-cecal appendicitis. However, the Physician was not satisfied with the said report, and again advised to repeat the USG.
The USG scan was repeated and reported as being suggestive of 'appendicitis'. The Physician, being not satisfied with the USG findings, referred the patient to another Surgeon for further treatment.
After examination, the doctor advised another USG from a diagnostic center and the report suggested possibility of "sub-hepatic appendicitis". Based on the reports, the patient was operated on by the doctor on 08.06.2007 and suspected tuberculosis in the abdomen, and a biopsy of the Omentum was taken for histopathological examination (HPE).
The HPE revealed "no evidence of tuberculosis or malignancy and it was fibrosis with chronic non-specific infection". The Surgeon told that it was the infection in the large intestine causing the pain and the same was removed by surgery.
However, the petitioner alleged that it was a failure on the part of the radiologists, who negligently gave the wrong report of appendicitis and because of that he had to undergo the unnecessary operation. The operation could have been avoided and the pain could have been cured by medicines only but due to the operation, the complainant suffered physically, financially and he could not carry out his work efficiently, the counsel for the patient submitted.
Being aggrieved, the patient filed a Complaint before the District Forum, Theni and claimed compensation to the tune of Rs. 10 lakh. The District Forum dismissed the Complaint by holding that the scan reports prepared by doctors were only suggestive in nature and not confirmatory.
Aggrieved by the said Order, the Complainant filed an Appeal before the State Commission, Madurai which was dismissed on the ground that the Complainant failed to prove by expert opinion or medical literature any negligence. Hence, the complainant approached the apex commission with the instant Revision Petition.
After considering the submission of the petitioner, the commission observed that the doctor on the basis of the patient's clinical symptoms & signs and both the USG reports; made the provisional diagnosis of Acute appendicitis, Ureteric colic and Acute cholecystitis. "He operated the patient on 8.6.2007 and found intraoperatively the infected bowel loops and Omentum. He removed the infected material and took Omental biopsy, sent for HPE study. According to the Surgeon, it was a case of Omental infection causing pain to the patient." the court noted.
The commission also noted that " On Surgery any abdominal pain several reasons to be considered. If the clinical signs and investigations (Lab & Radiology) are not leading to definite diagnosis, in that case, opening of the abdomen (laparotomy – exploration) is necessary to find out the cause of pain. The HPE report and the prescription issued by the Surgeon confirms that the continuous abdominal pain to the patient was due to Omental and Intestinal infection."
The Commission then considered the prescription of the doctor and stated
The appendix was friable, the loops of intestine were inflamed, Caseous and gangrenous Omental tissue; thus, emergency operation was needed. In our considered view the operation was necessary to save the life of the patient. Thus, the allegation of the Complainant that the operation was unnecessarily performed is not sustainable.
Stating that the abdomen is like a " pandora's box", the court stated that often the appendicular pain gives symptoms of referred pain.
Hence in the case of both the Radiologists who reported it as Appendicitis;" it was to be correlated clinically. Thus the treating surgeon's clinical assessment with relevant laboratory investigations should be given more credence. The Doctor will choose line of treatment and in the instant case the Surgeon performed exploratory laparotomy (operation) and found inflamed organs as a cause for pain and treated thereafter. In our view, the act of Surgeon was as per standard of practice", observed the commission.
The commission clarified that the Radiologists had given their opinion of USG the report been indicative and not confirmatory, hence, it should not be construed as a wrong report.
The commission also took note of the fact that the operation was imminent in the instant case, it was diagnosed operatively and the patient got cured as well. Upholding the judgement of the District Commission and the State Commission, NCDRC ordered that
Within the meaning and scope of section 21(b), we find no grave error in appreciating the evidence by the two fora below. And, on the face of it, we find no jurisdictional error, or a legal principle ignored, or miscarriage of justice. The Revision Petition, being without any merit, is dismissed. There shall be no Order as to costs.
To view the order, click on the following link:
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