Patient Dies post Appendix Operation: Consumer Court Slaps Hospital, Surgeon with Rs 4 lakh Compensation
Ahmedabad: The State Consumer Disputes Redressal Commission, Gujarat has held a surgeon and hospital guilty of medical negligence for the death of a 16-years-old girl who had been admitted to the hospital for the removal of the Appendix and died after the operation.
Both the doctor and the hospital have been directed to pay Rs 4 lakh as compensation to the father of the dead patient after the Commission noted that the inquest report showed that pus was found in the right sight of the stomach whereas in the case of ruptured Appendix the treating doctor is required to remove/drain pus from the abdomen area.
"Looking to the above literature it is crystal clear that in the case of surgery of ruptured appendix it is the duty of the operating doctor to remove/drain pus from the abdomen area but in the instant case as per the inquest panchnama; pus is found at the right side of the stomach and therefore if operation was successfully completed then why pus is found at the right side of the stomach? that is a big question in this case," noted the State consumer court as it set aside the order of the District Commission, which had dismissed the Complaint.
The case concerned the daughter of the Complainant, who had suffered sudden abdominal pain back in 2010 and consulted a doctor at Patan, who informed that an appendix operation was needed to be performed. As the cost was higher for the Complainant, he took his daughter to another treating hospital where BPL card beneficiary facility was available.
It has been submitted by the Complainant that after examining the patient, the treating surgeon at the hospital performed the Appendix Operation on 02.12.2010 and assured that the operation was done well and the patient would regain consciousness in a short time.
However, allegedly, even after a long time after operation, the patient didn't regain consciousness and consequently the doctor declared her to be dead.
The Complainant further submitted that a police complaint was lodged by the Complainant at Patan city, Bdivision Police Station and as per Inquest Report she was found to have three injuries on her right side of her abdomen and the pus was also found there.
It had been alleged by the Complainant that the doctor hadn't conducted any necessary investigation and the operation was done on the basis of the reports provided by the first doctor they had consulted. Further, the Complainant claimed that even though his wife knows how to sign, her consent was forcefully taken as the doctor took her thumb impression in the consent form.
Thus, alleging gross medical negligence on the part of the doctor, the Complainant approached the district consumer court and prayed for Rs 5 lakh as compensation. However, the District Commission had dismissed the complaint, and being aggrieved by the same, the Complainant approached the State Commission.
The counsel appearing for the Complainant submitted before the commission that it was a case of Res Ipsa Loquitur and therefore looking to the principle of Res Ipsa Loquitur the order passed by the learned District Commission is not just and proper, as the onus was on the doctor and the hospital to prove their innocence.
He submitted that the treating doctor didn't produce any medical case papers or any other details regarding the operation, didn't inform what type of anesthesia was given to the patient, and it clearly shows the deficiency in service on the part of the treating doctor.
It was further submitted by the counsel for the Complainant that as per Post Mortem report it was revealed that though it was a normal appendix operation, there were 03 injuries marked on the stomach which shows the serious medical negligence on the part of the opponent treating doctor but learned District Commission has erred in observing all these things.
The counsel appearing for the doctor and the hospital, on the other hand, argued that the doctor had taken all the required care and precaution at the time of performing operation. He further argued that the Complainant hadn't any evidence to prove medical negligence against the treating doctor.
He also submitted that the daughter of the Complainant had died due to septicemia as she has been suffering from the said disease for last few days and also submitted that till the time the patient had approached the treating hospital, the condition of the patient had already worsened.
To understand whether the principle of Res Ipsa Loquitor could be applied to the present case the State Commission referred to Madras HC judgment in M/s. Soni Hospital Vs. Arun Balkrishnan Aiyyar, and Apex Court judgment in V. Krishna Rao Vs. Nikhil Super Speciality Hospital and noted that to establish the principle it needs to be observed whether the accident is the kind that would usually be caused by negligent, and whether or not defendant had exclusively control over the instrumentality that causes an accident.
After perusing the operation note of the operating doctor and the anaesthetist, the Commission noted, that the Anaesthetist note had also mentioned few irrelevant facts like the patient was asymptomatic and had complaints of nausea, vomiting, abdominal pain etc.
At this outset, the Commission noted,
"Normally this type of statement not mentioned in anaesthesia note/operating note but above statement of Anaesthetist note clearly established that the doctor is trying to escape from his liability."
Taking note of the fact that the daughter of the Complainant was only 16 years of age and when she was taken to the operation table she was quite healthy, the Commission noted that the case paper mentioned that the Appendix was ruptured.
Perusing the medical literature related to the Ruptured Appendix, the Commission noted,
"Looking to the above literature it is crystal clear that in the case of surgery of ruptured appendix it is the duty of the operating doctor to remove/drain pus from the abdomen area but in the instant case as per the inquest panchnama; pus is found at the right side of the stomach and therefore if operation was successfully completed then why pus is found at the right side of the stomach? that is a big question in this case."
Observing that the Complainant was unaware of the facts that took place inside the operation theatre, the Commission opined,
"In view of the aforesaid discussion this is a case of Res Ipsa Loquitur and therefore looking to the principle of Res Ipsa Loquitur and as observed by the Hon'ble Apex Court in vaious judgments it is the responsibility of the opponent doctor to prove his innocence that there was no any negligence on his part but in the present case opponent doctor has not submitted any single evidence to defend his side and therefore in the opinion of this Commission it is the gross medical negligence on the part of the opponent doctor."
Noting that at the time of operation the daughter of the Complainant was only 16 years of old and she had a whole future to look forward in life, the Commission observed,
"She died prematurely before she could start to understand the beauty and joys of life with all its ups and downs. The loss of human life ultimately at childhood can never be measured in terms of loss in earning or monetary loss alone. The emotional attachments involved to the loss of the child can have a devastating effect on the family which needs to be visualized and understood and therefore in the opinion of this Commission compensation must be granted with regard to future prospects."
Thus, after referring to several Supreme Court judgments to decide the amount of compensation, the Commission directed the doctor and the hospital to pay Rs 4 lakh as compensation to the Complainant as the Commission set aside the order of the District Forum. Further, the State Consumer court asked them to pay Rs 10,000 as the cost of the appeal within a period of 60 days.
To read the Commission order, click on the link below.
https://medicaldialogues.in/pdf_upload/medico-legal-gujarat-161320.pdf
