Deviation From Standard Medical Practice During Choledocholithiasis Treatment, Kangra District Commission Holds Fortis Hospital, Its Doctor Liable

Brief Facts:

The complaint arose from a series of medical events surrounding Mrs Beena Devi's (“Complainant”) abdominal pain, vomiting, and subsequent diagnosis of choledocholithiasis. Initially seeking treatment in Pathankot, Punjab, the Complainant underwent MR Cholangiogram, at Gurdaspur, Punjab, where the condition was diagnosed. Due to the unavailability of adequate treatment in Pathankot, attributed to COVID-19 restrictions, the Complainant was transported to Delhi for further medical attention. Upon arrival, the complainant was examined at Apollo Clinic in Indrapuram by Dr. Tarun Kumar, who then referred her to Dr. Ajay Bhalla for ERCB & Stenting treatment. Subsequently, the Complainant was admitted to Fortis Hospital (“Fortis”), under Dr. Bhalla's care, where she underwent ERCP + EPT With Biliary Stenting. Following discharge, the Complainant continued medical visits as per the doctor's instructions but experienced persistent pain. During treatment at Amandeep Hospital at Pathankot (Punjab), it was found that Fortis extracted an amount from the Complainant in the name of ERCP, Stenting and even removal of stenting, though she was not operated/treated. Feeling aggrieved, the Complainant approached the District Consumer Disputes Redressal Commission, Kangra, Himachal Pradesh (“District Commission”) and filed a consumer complaint against Fortis and Dr. Bhalla.

In response to the complaint, Fortis and Dr Bhalla contended that the medical procedures, including the ERCP, stone removal, and biliary stenting, were conducted in accordance with standard medical protocols. It maintained that there was no negligence or deficiency in the complainant's treatment. It argued that all necessary medical procedures were performed competently, and any dissatisfaction or lack of relief from pain did not indicate malpractice or inadequacy in their services.

Observations by the District Commission:

The District Commission noted that according to the documentation, the Complainant underwent a Cholecystectomy and was diagnosed with Choledocholithiasis during her treatment at Fortis Hospital. However, discrepancies occurred between the procedure notes and subsequent ERCP procedures conducted by Dr. Suresh Gurkha. Despite cross-examination, the District Commission noted that there was no specific denial made by Fortis regarding the removal of stones from the Common Bile Duct (CBD) during Dr. Gurkha's procedure. Moreover, the formation of stones within seven months post cholecystectomy remained unexplained. It held that it was evident that proper diligence was not exercised in maintaining accurate procedure notes, and deviations from standard medical practice were observed. Dr Gurkha's subsequent procedures to remove stones further highlighted deficiencies in the initial treatment.

Furthermore, the District Commission noted that Fortis failed to provide a satisfactory explanation for the recurrence of stones in the CBD after its clearance in December 2020. This lack of clarification contradicted established medical knowledge and protocol.

The District Commission reiterated the four D's of medical negligence: Duty, Dereliction/Deviation, Direct Cause, and Damages. It held that the Complainant successfully demonstrated negligence on the part of Fortis and Dr. Bhalla, supported by expert testimony and discrepancies in medical documentation.

Therefore, the District Commission found gross negligence and deficiency in service on the part of the Fortis, particularly Dr. Bhalla. Given the Complainant's suffering and the need for additional medical interventions, the District Commission directed Fortis and Dr Bhalla to compensate the Complainant with Rs. 5,00,000/- and bear litigation costs amounting to Rs. 20,000/-.

Case Title: Beena Devi vs Fortis Hospital vs Anr.

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