Expert opinion ignored, Court invokes doctrine of res ipsa loquitor
New Delhi: The Delhi State Consumer Dispute Redressal Commission held Sir Ganga Ram Hospital and its five doctors negligent and deficient in providing treatment to a patient who underwent splenectomy procedure and awarded the complainant Rs.5,10,000/- as damages, Rs.1,20,000/- for mental agony and Rs.90,000/- as litigation charges. The hospital and doctors were held negligent on account of failure to diagnose the patient and for operative care of the patient.
The facts of the case are that the complainant’s wife was admitted to Sir Ganga Ram Hospital and was diagnosed for Non-Hodkin Lymphoma was consulting physician. Later she was advised splenectomy and the procedure was performed by the surgeon and the patient was informed that the surgery was successful and the spleen has been removed. The complainant requested the surgeon to show the specimen of the spleen but was not shown. A few months later the patient was again admitted with complaints of dehydration and associated symptoms. The patient was treated in the hospital but passed away. The complainant alleged that though he demanded the medical records of his deceased wife the hospital did not provide him. After complaining to the MCI and DGHS he received medical records from the hospital but the complainant alleges that the documents and medical records were forged. Also the complainant submitted before the commission that the documents pertaining to the status of the spleen, films of the ultrasound, bone marrow reports etc were not provided to him by the hospital. Also, the reports received from the hospital were contradictory. The complainant pointed out that though his wife’s spleen was removed through splenectomy the abdominal ultrasound report when his wife was admitted after splenectomy reveals that the spleen was normal in size and echo texture. The complainant brought to the court notice that he has been continuously requesting the hospital to know the status of the spleen which was allegedly removed but has not received any communication from the hospital and hence the hospital should be held negligent for committing gross errors in diagnosis and post-operative treatment.
The doctors defended their line of treatment and submitted that they have handed the entire medical records to the patient. On the issue of spleen the doctors said that the spleen was disposed-off as biomedical waste as per Biomedical waste rules. The doctors further submitted that in this case no CCTV recording was done as not all surgical procedures are recorded. The hospital and doctors highlighted that even the Delhi Medical council has given them clean chit.
The consumer court observed that only after the DGHS directed the hospital to provide the complainant with the medical records he received the medical records but even in the medical records the documents related to the status of the spleen was not provided. The court pointed out to the inordinate delay in providing medical records to the complainant and also to the fact that the records were provided only after DGHS directed the hospital to do so. The court also questioned the ultra sound report post splenectomy procedure which said that the spleen was normal in size and echo texture. The court questioned the doctors as to how could the spleen be spotted in ultra sound when the same was removed through Laparoscopic Splenectomy procedure. The court further said that considering the ultra sound was sub-standard the spotting of spleen after Splenectomy procedure should have prompted the doctors for second ultra sound in different machine to verify the first report. Unfortunately no second ultra sound was done by the doctors. The court said that either the hospital did not perform Laparoscopic Splenectomy procedure at all and charged the complainant for it or even if it was performed the procedure has failed as the spleen was intact. The court further said that it was a standard medical practice to show the patient or his/her relative the specimen of the organ removed but the specimen of spleen was not showed to the patient or their relatives. Also the court pointed out that the procedure was not recorded and the hospital has said that no CCTV recording was done in ICU. The court added that it was a fit case to fall in the domain of the doctrine of res ipsa loquitor. The court also overruled the Delhi Medical council ruling that the hospital and doctors had provided the patient with the standard level of treatment and were not negligent. To court concluded that the hospital and doctors were negligent and awarded the complainant Rs.5,10,000/- as damages, Rs.1,20,000/- for mental agony and Rs.90,000/- as litigation charges.
Legal Prescription
- The hospital/doctor has to provide medical records to the patients / authorised attendant or legal authorities within a period of 72 hours as and when the demand is made by them. While offering the medical records acknowledgement of the receipt of records must be taken from the recipient of medical records.
- The medical records should be complete and missing medical records amount to medical negligence as it contributes to the suspicion of concealing information.
- Any inordinate delay in providing medical records contributes to the suspicion that the hospital/doctors have manipulated the medical records.
- In case of dubious investigation report the hospital / doctors should repeat the investigation again till they are confident about the veracity of the investigation report.
- In case of mishap the hospital / doctors are bound to convey it to the patient and offer patient treatment caused by the mishap.
- Charging the patient for treatment not offered to the patient by the hospital / doctor may invite legal action against hospital / doctors as it amounts to unfair trade practice and may even invite criminal proceedings against hospital / doctor.
- Deviating from standard medical practice amounts to medical negligence. The standard medical practice of showing the specimen of removed organ of the patient to the patient / authorised attendant should not be deviated.
- The non-recording of a procedure by the hospital / doctor without any satisfactory reason contributes to the suspicion of concealing information before the court.