Doctors Not Liable For Consequences From Pre-Existing Conditions, North Chennai Commission Dismisses Complaint

Brief Facts:

Mr T Saravanan (“Complainant”) suffered a left knee injury while riding a vehicle that skidded and toppled. He was subsequently admitted to the St. Isabel Hospital (“Hospital”) for treatment, and diagnosed with a comminuted interarticular supracondylar fracture of the left distal femur. The head of the Orthopaedics department, Dr. George Thomas (“Doctor”) performed surgery on the Complainant. Despite discharge, the Complainant experienced persistent pain, leading him to seek a second opinion from Dr. P.V.A. Mohandas at MIOT Hospitals. During the 2nd inspection, the Complainant was informed about the poor fracture reduction which was the root of the pain he endured. As a result, the Complainant had to go through another corrective surgery which involved removing the implant, repositioning the medial femur condyle, and fixing it with a contoured locking plate.

Alleging negligence on the part of the Doctor during his initial surgery, the Complainant issued a notice to the Hospital and the Doctor. The Hospital didn't reply to the notice and there was an evasive reply from the Doctor. Feeling aggrieved, the Complainant filed a consumer complaint in the District Consumer Disputes Redressal Commission, North Chennai, Tamil Nadu (“District Commission”).

In response, the Hospital contended that all medical procedures and decisions were made by established standards and protocols. Furthermore, the Hospital emphasized that the Complainant's post-operative care was diligently monitored, and appropriate measures were taken to address any concerns or complications that arose. The Hospital maintained that it acted with due care and diligence in managing the Complainant's medical condition, and any subsequent issues may be unrelated or beyond its control.

The Doctor asserted that the Complainant was afflicted with post-polio residual paralysis affecting both legs, resulting in an approximate 90-degree fixed flexion of the knees. Upon initial examination, the Complainant's normal mode of movement was crawling, as both legs were incapable of walking. Before admission to the Hospital, the Complainant's leg was in a plaster cast, accompanied by severe pain. The Doctor maintained that he recommended surgery to correct the flexion deformity in the left knee to the maximum extent possible. It was argued that due to pre-existing polio, the affected bone in the Complainant's left leg lacked normal shape and strength. The Doctor contended that the consequences of the surgery were communicated to the Complainant before the procedure, including the expected post-operative pain and the time required for the fracture to heal.

Observations by the Commission:

Upon thorough examination of the entire records and contentions presented by both parties, the District Commission held that the Doctor conducted the surgery to achieve the removal of the fracture and strengthen the lower limb in the Complainant's left leg. Therefore, the District Commission noted that the intended outcome was to enable the Complainant to attempt standing, given his previous mode of movement, which involved crawling with his knees. The District Commission also held that since the Complainant was already suffering from pre-existing polio, the Doctor cannot be held liable for negligence.

Reviewing the operation notes and discharge summary, the District Commission held that it was established that the Doctor adhered to recognized medical procedures during the surgery. The Complainant, supported by opinions from two other Doctors, failed to substantiate any faults or deficiencies in the surgical procedure.

Further, the District Commission also held that the reported increase in pain and the subsequent corrective surgery were attributed to the Complainant's pre-existing condition of lacking normal shape or strength in his left leg due to prior polio. The District Commission acknowledged that such circumstances are beyond the control of the Hospital and Doctor, and they cannot be held responsible for the consequences arising from the pre-existing condition.

Referring to a precedent established in Kusum Sharma and others versus Batra Hospital and Medical Research Centre and others (Civil Appeal No. 1385/2001) by the Supreme Court of India, the District Commission emphasized that a medical practitioner is only liable when their conduct falls below the standards of a reasonably competent practitioner in their field. The District Commission noted that in the realm of diagnosis and treatment, differences of opinion among professional Doctors are acknowledged, and the mere variance in conclusions does not amount to negligence. Thus, the complaint was dismissed.

Case Title: T. Saravanan vs St. Isabel Hospital and Anr.

Case No.: C.C. No.270/2018

Advocate for the Complainant: S. Muthuvenkataraman and other

Advocate for the Respondent: A.S. Kailasam & Associates

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