Surgery not performed during exploratory laparotomy not negligence- Max Hospital in New Delhi gets exonerated
No Medical Negligence
Delhi: The District Consumer Disputes Redressal Commission, East Delhi, recently exonerated Max Hospital Patparganj from the allegations of medical negligence while treating a patient with a complex pelvic mass with solid and cystic components.
Filing the consumer complaint, the patient alleged that she was recommended surgery and a procedure without proper diagnostic tests. Apart from this, she alleged that the mass flesh, which was supposed to be removed during the surgical process, was not removed in the same procedure as the hospital had intended to perform a second operation for financial gain.
While considering the consumer complaint, the District Consumer Court noted that there was no expert evidence to support her claim. Further, the Commission observed that she did not follow up at the hospital.
The history of the case goes back to 2018, when the patient developed a mass of flesh in her body and approached Max Hospital for treatment. It was alleged by the complainant that the hospital, without conducting any tests, recommended a Laparotomy procedure- a surgical procedure generally used for people with severe abdominal pain to find the cause of the problem and to treat it and oophorectomy- surgical procedure to remove one or both of a woman's ovaries.
According to the complainant, there was no mass in the ovaries; instead, it was found to exist in the uterus and could have been removed during the same surgical procedure. However, the hospital allegedly decided to close the operation without doing the needful so that they could charge her for a second surgery.
The complainant claimed that the hospital also failed to ensure informed consent from her. She alleged that due to the negligence by the hospital, she had to suffer immense pain and suffering and had to make several trips to various doctors, which caused mental and physical agony to her, and even she could not fulfill her household responsibilities and other duties towards her family members. Accordingly, filing the consumer complaint before the District Commission, the complainant claimed an amount of Rs 19,81,901 from the hospital as compensation.
On the other hand, the hospital submitted that the treating doctors at the hospital counselled and performed their duties diligently. It was submitted that the complainant visited the Gynae OPD with abdominal lump, along with reports of the USG whole abdomen and doppler study, suggesting large complex pelvic mass with solid and cystic components and evidence of neovascularization in solid areas, high-risk ovarian mass.
Further, the report of the CT whole abdomen, done in Rajiv Gandhi Cancer Institute-Delhi, was suggestive of large complex cystic lesion indenting right lateral wall of the uterus and displacing it to left side.
After going through these USG and CT report, the patient's counselling was done and the patient was posted for Exploratory Laparotomy with frozen section biopsy and and it was proceeded on 10.05.2018 after consulting Gynae Onco Surgeon Dr. Gupta. The patient was taken up for surgery along with Dr. Gupta as a team.
The hospital submitted that the peroperative findings suggested B/L tubes and ovaries were normal. A huge mass was seen arising from the posterior surface of the uterus, about 20 weeks in size, a fibroid uterus. Consequently, the patient's husband was called and informed about the finding and further plan of medical management, followed by myomectomy, which was discussed
It was contended by the hospital that after seeing these reports and the examination of the complainant, the surgery was not done in the same sitting because all investigation reports suggested of ovarian mass likely malignant, but instead it was found to be huge myoma arising from the uterus. According to the hospital, the patient's counselling and consent were required for the same, and since the patient was under general anaesthesia, it was not possible.
The hospital submitted that the patient was planned for medical management first, to shrink the uterine mass so that fewer surgical complications and the best treatment could be given to the patient. As the patient was recently married with no children, medical management prior to removing the uterine mass would help save the uterus and reduce excessive bleeding. However, the hospital claimed that the patient never turned up for follow up and further treatment was offered. Accordingly, the hospital denied the allegations of medical negligence.
While considering the matter, the District Commission opined that
"in absence of an expert opinion on this aspect it cannot be ascertained as to whose suggestion is at better footing but it can be said with certainty that opinion of the complainant is at lower footing than that of the opinion/findings of the expert/doctors who were performing the procedure at that very relevant time. There is no scope for alleged deficiency by alleging that the procedure should have been done in particular manner and it has been done in some other manner. This by itself does not constitute any negligence on the part of treating doctors."
Further, the Commission noted that admittedly, the patient never approached the hospital for follow-up, whereas the hospital submitted that the patient was planned for medical management first to shrink the uterus mass so that there were fewer surgical complications.
"It is also matter of record that the patient never turned up to follow-up & further treatment was not done by the OP and even the complainant who had received treatment from CMC Vellore, had not shared the documents of that hospital with the OP to make any opinion on that treatment. Therefore there is no record before the Commission from where it can be ascertained that OP/Doctor has done something which they were not supposed to do. The complainant otherwise had also claimed a huge amount under various heads but then there is no evidence in support of such contention," observed the Commission.
"All this facts as discussed hereinabove do not show any malafide on the part of doctors rather it suggests that the doctors have handled the situation with quite care and sympathy and even the petitioner’s husband was also taken into confidence," held the consumer court.
"It is admitted fact that further treatment has not been taken by the complainant from the OP. This also suggests that the contention of the complainant that the mass was not removed from the uterus or in the same procedure with the intention of charging more money for second operation is without any basis. As far as pain and suffering is concerned it is admitted fact that even a small surgery undertaken by any patient causes some pain and suffering, as healing does take time for every surgical procedure howsoever minute it may be. Therefore this contention of the complainant is also not having any legal support. Admittedly the complainant has not visited the hospital after 12.05.2018 and therefore the Commission does not have any documents to appreciate as to which procedure the other hospital had done," it opined.
Accordingly, in the absence of expert opinion, the consumer court dismissed the complaint.
To view the order, click on the link below:
https://medicaldialogues.in/pdf_upload/delhi-dcdrc-no-medical-negligence-297166.pdf
