NCDRC Awards Rs 1 Crore Compensation To Parents For Death Of Child During Squint Eye Correction Surgery Due To Gross Medical Negligence

The National Consumer Disputes Redressal Commission, New Delhi, on Friday, awarded an exemplary compensation of Rs. 1 Crore to the parents of a a 6 year old child, who met with his untimely death due to gross medical negligence and deficiency in service Sankara Nethralaya, Chennai, during a squint eye correction surgery.  

The Commission, presided over by the President of the Commission, Justice R.K. Agrawal, and the Members, Dr. S.M. Kantikar, and Binoy Kumar, reiterated the Apex Court decision in National Insurance Co Ltd v. Kusum wherein the Court had held that payment of compensation to parents for death of a child, including stillborn, ought to be just and not pittance, and observed, 

"in our view, no amount can be just and adequate in an absolute sense. By no stretch of imagination, we should award a paltry sum for gross negligence; conversely exemplary compensation need not be awarded in case minimal negligence".

Accordingly, Rs. 1 Crore compensation was regarded 'just and fair' in the instant case. 

The parents of the deceased child were the Complainants in the instant case. The Opposite Parties named were the hospital (Opposite Party 1), Dr. Senior Surgeon T.S. Surendran (Opposite Party 2) and Anesthetist, Dr. Kannan (Opposite Party 3). 

As per the allegations of the Complainants who are the parents of the deceased child, and represented by Advocates Partha Sil, Soumya Dutta, Tavish B. Prasad, and G.S. Modak, their only son, was taken to Sankara Nethralaya, Chennai, and as per the suggestions of the doctor there, a minor squint eye surgery was suggested and referred to Senior Surgeon, Dr. T.S. Surendran for the surgery on June 14th, 2000. On the day before the surgery, when the child was examined by the Physician, Dr. Sujatha, she noticed a faint functional systolic 'murmur' and chest wall abnormality, which was thereupon brought to the notice of the Senior Cardiologist, Dr. S. Bhaskaran, who further examined the child and conducted some exercises and concluded that there was no murmur. He also ruled out the necessity for any further tests such as ECG, ECHO or Chest X-ray, and declared the child as being 'Fit for General Anesthesia'. The child was taken to the hospital on empty stomach at 9.00 AM on the scheduled date, while he was allotted a bed and taken to the Operation Theatre only at 2PM and 3PM respectively. It was alleged that the gap of 9 hours 20 minutes during which time the child had been kept on fasting led to him being hypoglycemic, which could potentially lead to a cardiac arrest. It was further pointed out that Halothane was used as an anesthetic agent which was known to cause bradycardia, and in such cases, Atropine was given as a pre-medication to prevent the same. However, in the instant case, it was alleged that the child had not been administered the right dose at the right time, and that there had been a huge gap of time between atropinization and actual surgery. The Complainants further alleged that the patients case summary was only issued two days later. The discharge summary was also vague without details of Cardio Pulmonary Resuscitation (CPR) and the happenings in the operation theatre. Further, it was contended that since the surgery was not an emergency one, and since the Senior Surgeon had already completed 16 surgeries that very day, there had been no need to complete the surgery of the deceased child that very day. Thus, a compensation of 1,00,20,000/- was claimed, upon filing the complaint under Section 21 of the Consumer Protection Act, 1986. 

On behalf of the Opposite Parties, represented by Advocates C.S. Vaidyanathan, S. Gurukrishna Kumar, S. Hari Haran, and Arvindh Gupta, it was contended that the Senior Cardiologist, Dr. S. Bhaskaran, had reviewed the case sheet and lab investigation reports, took the history and also put the child to various positions and exercise, and auscultated, It was on this basis it was ascertained that the child had no cardiac problem to undergo surgery under General Anesthesia. It was also contended that as per medical guidelines, routine pre-operative ECG, ECHO and X-Ray were not necessary for children and persons below the age of 40 years, except when medically warranted. On behalf of the Hospital, it was contended that for squint surgery the infrastructure and operation theatre (OT) is fully equipped with monitor, centralized Oxygen and all facilities for administering GA or any type of anesthesia. It was submitted that all efforts were taken by the Anesthetist, the Cardiologist and other doctors to resuscitate the patient. It was also contended that all cooperation was extended to the parents, and the entire medical record was also furnished on 30th October 2000 pursuant to the request, thus negating any possibility of deficiency in service. The allegations regarding improper dosage and timing of Atropine were also submitted to be baseless. It was further argued that the patient was also intubated through the standard procedure for children, and such life threatening reactions were rare. 

The Commission in this case categorically laid down that the expected degree of  skill from Cardiologist was more and a higher degree of care ought to be there, which was found lacking in the instant case. The evidence of Senior Cardiologist, Dr. K.P. Mishra, was also not accepted due to the same reasoning. Although the Commission did not find any significance as to the submissions made regarding the fasting of the child, it was found that the use of Scoline further precipitated the bradycardia which was already occurred due to Halothane anesthesia. It was opined by the Commission that the Anesthetist ought to have warned the cautioned the operating surgeon, and the latter was not aware that any special warnings for the use of Scoline were there in pediatric cases. It was also found that Oculocardiac Reflex (OCR) was the reason for the demise, and in the instant case the Intra-Operative diagnosis of OCR was missed and the child suffered Cardiac Arrest. It was further added that the patients who are considered at-risk for the OCR should warrant particular attention. The Commission also found merit with the contention that the surgery could have been abandoned on the said day. 

The Commission thus, found the Cardiologist, the Operating surgeon, and the Anesthetist liable for medical negligence for having failed to exercise their duty of care with required ordinary skills and standards. The hospital was also held vicariously liable for the acts of omission and commission committed by the second and third Opposite Parties, and as being jointly and severally liable to pay compensation to the Complainant. 

In this light, the Hospital was directed to pay Rs. 85 lakh; the Anesthetist, Dr. R. Kannan Rs. 10 lakh and the operating Ophthalmologist, Dr. T. S. Surendran, Rs. 5 lakh to the Complainants within 6 weeks from the date of the Order, failing which, the amount was stated to carry interest at 9% per annum till its realization. The Hospital was further directed to pay Rs. 1 lakh towards cost of litigation.

Case Title: Dr. Reba Modak & Anr. v. Sakara Nethralaya & Ors. 

Click Here To Read/Download The Order