New Delhi: The State Consumer Disputes Redressal Commission has recently ordered Vidya-Sagar Institute of Mental Health & Neuro Sciences (VIMHANS) to pay compensation of Rs 15 lakh for failing to diagnose cancer on time and allegedly causing death due to negligence.
The case concerned, a minor boy from Faridabad who suffered complaints of headache, nausea, and vomiting and his Noncontrast head CT (NCCT) revealed that ill-defined hyper density seen in the right occipital lobe. MRI stated the possibility of Chronic infective neo plastic lesion right lesion but a finding “an infiltrating lesion right parahippocampal gyrus and inferior temporal lobe epicenter being at the posterior part was noted.
With an incidence of vomiting the child became partially unconscious and was taken to Safdarjung Hospital. In the next CT scan report, next day by the Safdarjung Hospital with finding lesion in (R) temporo occipital lobe C significant midline shift of tumor bleed Medulla blastome”. The patient was managed conservatively. The condition of the patient was getting critical. The Safdarjung Hospital referred the case to AIIMS on 15th May but AIIMS did not admit the patient due to lack of beds.
Therefore the complainant got the child admitted at VIMHANS where the NCCT head was done, confirming the ailment detected by Safdarjung Hospital. Soon surgery was performed by the doctors at the hospital for brain tumor/lesion and surgery declared as successful with an assurance that the patient would be alright in 5-6 days was not clinically suspected/co-related with some other ailment other than brain tumor.
The complainant alleged that the treating doctors kept the information at, whenever he tried discussing, their reply was curt.
During the period of about five to six months the patient was hospitalized he was progressively losing vision, speach and getting paralysis and not regaining consciousness from the stage of Coma. Third stage cancer was diagnosed six months later, only on re-opening the brain and thereafter he was discharged with advise of radiology at a Centre of Choice without even whispering or discussing the stage of illness with the complainant father.
The allegation of the complainant against the Hospital was that they were aware of the risk involved in the matter of conducting the surgery right from the beginning but despite that ,the hospital failed to take due and necessary precautions to clinically diagnose the ailments suffered by the patient. Post operative expectation of cure within couple of days was belied since the surgeon failed to apply his mind to rule out the cause of cancer. It is well known that early detection of cancer is curable through drugs and radiotheraphy. That not having been done, the OPs, according to the complainant were deficient and negligent.
IT was alleged that the deceased was admitted for the passage of five months and in the passage of this duration, the deceased was admitted and operated on 15.05.2004 and again re-operated on 19.10.2016 for tumor. The doctors at the hospital in the passage of five months miserably failed to detect the Stage-III cancer. Further, they wrongly and negligently operated the deceased twice without actually knowing the nature of the disease.
The OPs by not consulting the oncologist failed to exercise the reasonable degree of skill and care which a reasonable and prudent man is supposed to have taken.
The complainant approached the Commission demanding compensation.
The doctors and the hospital resisted the complaint both on technical ground and on merit. Their objection on technical ground is that the issues involved in this case being complicated cannot be adjudicated in summary procedure. However no illustration has been made as to what are the complicated issues involved in the case.
Their objection on merit is that there is no deficiency of service on their part. The Hospital is manned and managed by experienced, talented doctors having specialisation on the field. Secondly, the patient was brought in their Hospital in a very critical condition, leaving hardly anytime for them to have an indepth investigation.
The OPs have further averred that the patient had pre-existing disease which had deteriorated either on account of carelessness in providing timely treatment by the complainant or on account of treatment which the patient may have received either at B.K. Hospital, Faridabad, or Safdarjung Hospital or elsewhere.
It was further stated in the defence that at the time of admission, the critical condition, poor prognosis of the patient and need for urgent surgery was discussed with the family. After the consent given by the complainant, surgery was done to save the life. Patient‟s relatives were also informed about the condition regularly by the treating doctors. They had access to all reports. It was further stated that all possible available treatment was given to manage the medical problem of the patient, which is apparent on the own showing of the complainant as prior to admission in VIMHANS his condition was highly critical and he had already been treated in three hospitals prior to Vimhans.
The commission sought the opinion of Maulana Azad Medical College committee which said
To summarise, the patient was a case of Astrocytoma Grade III which is a serious condition by virtue of its high grade malignancy. Patient presented in unconscious which is evident from the fact that child improved after first and second surgery.The inability to pickup cancer on first pathology was due to technical reasons rather than negligence. Second biopsy reported by the same pathologist diagnosed Astrocytoma grade III which was subsequently treated at Batra Hospital.
Based upon the observations on records and clinical course of such disease, the board is of the opinion that there is no prima facie negligence in this case.
After going through the arguments forum stated
The present case is not a case of complicated surgery or a case of transplant of limbs and organs in human body. It is allegedly a case of improper and unconventional method of treatment and delay done in affording treatment. This means the subject matter have to be examined on, the principles of Res ipsa loquitur to reach to a conclusion. Res ipsa loquitur is a rule of evidence which in reality belongs to the law of torts. Inference as to negligence may be drawn from proved circumstances by applying the rule if the cause of the accident is unknown and no reasonable explanation as to the cause is coming forth from the defendant.
Noting what the expert opinion stated the court said
The report notes that Interalia- that the inability of the OP Hospital to detect the cancer on first pathology was due to technical reasons rather than negligence. This report in any way goes to establish the factum about the inability to detect the cancer, be it a technical reason or negligence. There facts take me to a conclusion that the negligence on the part of the the Hospital is writ large on the face. Moreover, no reasonable explanation has been furnished by the the Hospital about their inability to detect cancer. Had this been detected which the OP Hospital should have the competence, the patient could have undergone timely treatment of cancer. The life could have been saved.
The forum quoting various judgements on the matter stated
The professional man should command the knowledge which forms part of professional equipment of ordinary member of his profession. The standard is that of reasonable degree. Having bestowed my anxious consideration to the facts at hand, I am of the considered opinion that the complaint deserves to be accepted. The objections raised by the opponents, in complete ignorance of the facts and the settled legal position, are stated to be rejected sequentially. Having reached to this conclusion the point that remains for consideration is the compensation to be awarded.
The forum then directed the hospital to pay a compensation of Rs. 15 Lakhs (Rupees fifteen Lakhs) to the complainants for the suffering, mental pain and agony caused.