Allegations Not Supported by Evidence
The National Consumer Disputes Redressal Commission (NCDRC) has dismissed a Rs 23.23 crore medical negligence complaint filed against Apollo Hospitals Secunderabad and two of its doctors, including an orthopaedic surgeon and a consultant neurologist. The complaint was related to the amputation of a young man’s right leg above the knee. The Commission emphasized that allegations of medical negligence must be backed by clear, convincing, and reliable evidence.
Court’s Observation on Medical Negligence
Amputation Alone Does Not Prove Negligence
The bench, comprising Dr Inder Jit Singh and Dr Justice Sudhir Kumar Jain, observed that a doctor cannot be held liable merely because a patient’s limb was amputated. It stated that negligence must be proven by demonstrating a failure to exercise reasonable care, skill, and adherence to accepted medical standards.
Background of the Case
Injury and Initial Surgery
The case dates back to 2016 when the patient suffered a fracture in his right knee after falling from a two-wheeler. He was admitted to Apollo Hospital, Secunderabad, where he underwent surgery for a tibial condyle fracture. A locking plate with screws was fixed in his knee during the procedure.
Post-Surgery Complications
Complaint of Numbness and Foot Drop
After the surgery, the patient complained of numbness and inability to move his right foot and toes, though he had normal movement before the operation. He was later diagnosed with right foot drop by a consultant neurologist and was prescribed medication. The hospital maintained that such symptoms can occur in high-velocity knee injuries due to nerve swelling.
Treatment at Second Hospital
Diagnosis of Irreversible Ischemia
As his condition worsened, the patient was admitted to Yashoda Hospital in Hyderabad. He was diagnosed with irreversible ischemia of the right lower limb, popliteal artery occlusion, foot drop, Vitamin D deficiency, and hyperthyroidism. A fasciotomy was performed initially, but due to muscle death, the leg was eventually amputated up to the knee.
Complainants’ Allegations
Claim of Negligence and Vicarious Liability
The patient’s parents alleged gross medical negligence, claiming that timely monitoring and referral to a vascular surgeon could have prevented the amputation. They further argued that the hospital management company was vicariously liable for the actions of the treating doctors and sought compensation for deficiency in service, mental agony, and harassment.
Hospital’s Defense
Treatment as per Medical Standards
The hospital denied all allegations and argued that the patient was treated in accordance with established medical protocols. It contended that there were no signs of vascular injury at the time of discharge, as pulse oximeter readings were normal and distal pulses were clinically present. The doctors maintained that popliteal artery occlusion can be a delayed complication of high-velocity knee injuries.
Commission’s Final Ruling
No Proof of Breach of Duty
After reviewing the records, the Commission found no material evidence to establish negligence or vicarious liability. It held that the orthopaedic surgeon performed the procedure with due care and skill, and the neurologist’s treatment was appropriate given the absence of vascular deficit signs. Concluding that negligence cannot be presumed without proof of breach of duty, the NCDRC dismissed the complaint.
