Rs 76 lakh compensation slapped on 6 Doctors, hospital for medical negligence
Medical Negligence
Thanjavur: The District Consumer Disputes Redressal Commission, Thanjavur, recently directed a Tambaram-based private hospital and its six doctors (including an orthopaedic surgeon, a surgeon, 3 Anaesthetists, and a plastic surgeon) to pay Rs 76 lakh compensation to a patient, who became disabled after undergoing treatment at the hospital.
After undergoing six surgeries at the hospital, the complainant/patient was diagnosed with a compartment syndrome and foot drop. The complainant became 50% disabled, requiring the assistance of a round-the-clock attendant.
The history of the case goes back to 2022, when, after meeting with a two-wheeler accident, the complainant was diagnosed with a fracture in his right knee. On the same day i.e. 15.09.2022, the complainant was admitted to Kasthuri Hospital, Thambaram. The doctors diagnosed a normal ECG, a normal Doppler study of the right lower limb arteries, no evidence of stenosis in the arteries, and right lower limb no deep vein thrombosis. After assessing the complainant, the treating doctor- an orthopaedic surgeon, found no signs of compartment syndrome.
A team of doctors, including an orthopaedic surgeon, a Surgeon, and an Anaesthetist (1) operated on the complainant the next day. It was alleged that due to slackness and negligence by the surgeon team, there was post-operative severe pain and swellings and therefore, another surgery was conducted by the same Ortho Surgeon and Surgeon, along with another Anesthetist (2). The post-operative findings mentioned compartmental syndrome (because of surgical complications).
A few days later, the treating orthopaedic surgeon and surgeon operated on the patient again. They were accompanied in the procedure by Anesthetist (3). It was claimed that due to negligent act of the doctors, the complainant's anterior compartmental muscle was found necrotised and the Tibialis anterior was completely removed without the consent of the complainant's family members.
On 27.09.2022, a team of doctors removed the whole anterior muscles of the complainant due to necrosis. Thereafter, on 08.10.2022, a plastic surgeon, along with the Ortho surgeon and Anesthetist (3) harvested the opposite thigh of the complainant for wound cover, and the complainant was allegedly discharged without any improvements.
The complainant claimed that on 15.02.2023, the Thanjavur Medical College Hospital explained him about the foot drop, sensory loss and mentioned that the cause of these issues was the failure due to the earlier surgical procedure done by the doctors of Kasthuri Hospital six times, due to which, he suffered physical injury and pain. Another doctor at Binodhagan Memorial Hospital also examined the patient and narrated the alleged mistakes made by the surgeons of Kashthuri Hospital. Consequently, the patient was advised to go to JIPMER Puduchery for further treatment.
Filing the consumer complaint before the District Consumer Court, the complainant claimed that due to negligence and fault of the surgeons' team, he had to suffer tissue death, and his muscles were removed without his consent. He alleged that he was taken to surgical procedures without his consent six times. As a result, the complainant became a permanently disabled persion and the Government of Tamil Nadu has issued him a disability card with 50% disability. Submitting that he was not able to lead normal life and do his job, the patient claimed compensation of Rs 50 lakh.
On the other hand, the hospital and the doctors denied the allegations of negligence and submitted that proper procedure was followed in the treatment protocol of the patient. They argued that before the surgery and before every procedure, consent was duly obtained from the complainant as per protocol, and either the complainant or his uncle or his brother had given their consent by signing the consent form.
Further, the hospital submitted that the complainant was well informed and was made aware of the procedure and even the post-operation progress was explained to him. It was also claimed that the patient did not clear the entire cost of medical treatment, and free treatment worth Rs 1 lakh was provided to him on humanitarian grounds.
While considering the matter, the consumer court noted that at the time of admission, the patient did not have any signs of compartment syndrome and he was diagnosed with proximal tibia fracture.
Regarding compartment syndrome, the Commission noted that legs in humans are separated into four rooms called compartments. There is no connection between these compartments. It has muscle, nerve, and blood vessels inside. Each compartment is covered by fascia (tight plastic cover like layer which will not expand) in its roof. Bone will be the common base for all compartments. When there is a fracture of bones, blood collects into all these compartments. It collects a lot of blood inside each compartment; the outside covering will not help to expand, hence, it presses the muscle, nerve, blood vessels. This will cause necrosis (dead tissue) formation. These dead tissues will lead to infection. The compartment syndrome in some cases usually occurs within 24 hours, in some cases, it may occur within 48 hours.
"In the case of the complainant there was no compartmental syndrome when he was admitted at 7.30 pm and initially diagnosed but had later occurred within 30 hours from the accident," noted the Commission.
The Commission observed that on Calcaneal Pintraction till the open reduction and internal fixation of fracture tibia was performed on 16.09.2022. After surgery, the patient was shifted to the ICU and late at night, he developed deep and persistent pain in his right leg. When the doctors removed three sutures from the site of surgery, suddenly pus gushed out from the surgical wound site. Thereafter, treatment continued with antibiotics and IV fluids and the hospital and the doctors warned the complainant of the complications of compartment syndrome. However, they assured that with the treatment of fasciotomy, the pain would subside and the discharge of pus would stop. On this pretext, the patient was again shifted to the operating theatre.
It was observed by the Commission that the hospital and the doctors prolonged the patient's stay, assuring him that they would discharge him after the complete eradication of infection. However, later, the complainant was admitted to Thanjavur Medical College Hospital, Thanjavur, Vinodagan Memorial Hospital, Thanjavur and JIPMER Hospital, Pondicherry.
"Thereafter, for skin grafting the complainant incurred expenditure of for correction of drop foot. All these amounts are forcibly spent by complainant for correct treatment and to save from the negligent treatment given by the opposite parties...It is observed that if the opposite parties have given right treatment keeping in view of complications of compartment syndrome, there would be no necessity to the complainant to take treatment at higher centre. The complainant could escape from severe complication of amputation of his right leg due to treatment taken at Kasthuri Hospitals. So the Discharge Summary of Hospital is disclosing the nature of treatment given to the complainant," observed the District Consumer Court.
"It is due to negligence of the opposite parties as they did not respond to the complaints of the severe pain and tightness in the leg and thereby delayed diagnosis of compartment syndrome which resulted in gross infection and foot drop to the complainant. Though the opposite parties denying the symptoms of compartment syndrome of the complainant but the opposite parties falsely stating that complainant was presented in the opposite party hospital with impending compartment syndrome. So the contention of impending compartment syndrome and feeble Distal ATA is not shown in discharge summary. So many important treatment aspects were not shown in the discharge summary and other aspect during his proof affidavit of the opposite party no.7 (hospital) stated that all the aspect of treatment shown in the case sheet but the case sheet was not filed by the opposite parties. On going through the evidence affidavit and counter filed by the opposite parties and the way of answering of the opposite party no.7, it is establishing some sense of negligence on the part of opposite parties in treating the complainant," it further noted.
The Commission also noted that the hospital discharged the complainant only on the request of the complainant and his relatives; otherwise, they would have continued the treatment even though there was no possibility of giving better treatment and there would be a possibility of amputation of the right leg.
"On account of incorrect and negligent treatment by the opposite parties, the complainant had been continuously suffering since 16.09.2022 , the day he was operated and still suffering," noted the Commission, while observing the plights of the complainant, who has now become disabled and requires a round-the-clock attendant to assist him.
"He has and is still suffering mental trauma of physical handicapped, financial loss on medication desks, travelling to Pondicherry on four occasions with round-the-clock attendant cetera only on account of gross medical negligence and deficiency in service of opposite parties... In this clause of relief we are of the opinion that as he is disabled by 50% so he should be given ₹ 1 lakh for each percent of disablement that is ₹ 50 lakhs for this disablement because it is a lifelong pain for the complainant and his family members. The complaint case is decided accordingly," opined the Commission.
Accordingly, the Consumer Court directed the hospital and the doctors to pay the complainant jointly and severally a compensation of Rs 15 lakh, another Rs 10 lakh for doctor's fees, hospital charges, medicines, for different type of tests and travelling, Rs 1 lakh for extra nourishment of the complainant, Rs 50 lakh towards permanent burning sensation, suffering, disfigurement of the right knee, services of an attendant, cost of plea, mental torture and agony.
"The opposite parties are jointly and severally directed to pay all the above reliefs with interest at a rate of 10% from 15.09.2022 within 45 days from the date of judgement of this complaint case otherwise the rate of interest shall be 15% from 15.09.2022 till the date of actual payment," ordered the Commission.
To view the order, click on the link below:
https://medicaldialogues.in/pdf_upload/tn-dcdrc-rs-76-l-compensation--296605.pdf
