NCDRC Ruling on ENT Surgeon Case

Jaipur: Holding that referring a patient to a higher center is not negligence of the treating doctor, the National Consumer Disputes Redressal Commission (NCDRC) has absolved an ENT surgeon associated with Jain ENT Hospital against the charges of negligence that allegedly led to complications like aspiration pneumonia in a pediatric patient.

The case concerns a patient who was diagnosed with adenoids with bilateral secretary otitis media, sinusitis, and tonsillitis. The ENT surgeon at Jain ENT Hospital performed Adenotonsilliectomy with Bilateral Grommet Insertion in October 2010. The patient was shifted from the Operation Theater at 10:30 a.m. However, she started having a coughing problem at 12:30 p.m., therefore, immediately oxygen was given, an x-ray was done, and the pediatrician was called. The pediatrician examined the child.

It was alleged that the operating surgeon was not careful, therefore, the foreign material entered the bronchus and lungs which developed aspiration pneumonia in the child. The complainant further alleged that the operation package for Rs 16,920/- was fixed by the hospital, but due to the negligence of the doctor, complications arose and the patient was shifted to Babylon and Imperial Hospital. The complainant incurred further expenditure of Rs.28,000/-. Subsequently, the complainant moved the district court.

The District Consumer Disputes Redressal Forum, Jaipur had held the hospital liable for negligence and allowed Rs 28,000/- to the patient.

Aggrieved, the hospital filed a First Appeal before the State Commission, which was allowed and consequently the complaint filed by the patient's mother was dismissed, who in turn moved NCDRC and filed the instant revision petition.

After hearing both parties and perusing the entire material on record including the orders by the District and State Commission, NCDRC opined that it is evident from the medical record that the ENT surgeon examined the patient for the complaints of nasal obstruction. After relevant investigations, he advised adenectomy with bilateral grommet insertion under general anesthesia. He prescribed higher antibiotics. The patient was operated on by the doctor after obtaining proper informed consent. It was the case of the complainant that there was no Pediatrician in the hospital to handle complications like aspiration. The apex consumer court noted:

"From the medical literature on ENT surgery, post-operative minimal aspiration was a known complication. In the instant case, two hours after the operation the child had a cough and immediately the treating doctor attended the patient. A call was sent to the pediatrician also. The child was administered with Oxygen, IV fluids, the higher antibiotics (injection Angmentin, Amikacin & Cefraxone), and nebulization and thereafter the child was referred to a Pediatric hospital."

"It should be borne in mind that referring the patient to a higher center is not negligence of the treating doctor. In the instant case, the doctor took proper decision. Initially, at 4:00 p.m. the child was taken to Babylon Hospital on 11.06.2010 and treated till 13.06.2010 and discharged LAMA. Thereafter, the child was treated in Imperial hospital for five days and discharged on 18.06.2010. She was treated with antibiotics, vitamins, and other medicines and got cured," the Commission added.

It further observed that it is pertinent to note that if the foreign body/material entered into the bronchus during the operation the patient would have severe reflex and suffered respiratory distress immediately. But after the operation, the patient was comfortable for 2 hours till 12:30 p.m. After proper treatment as per the reasonable standard, the patient was referred to a Pediatric Hospital.

"We do not find any deficiency or negligence in the duty of care of the treating Surgeon and the hospital," the court said.

The ENT surgeon and the hospital relied upon the articles namely 'Aspiration Pneumonitis-Mendelson's Syndrome' and 'Common Postoperative Complications'. The court remarked:

"As the revisional jurisdiction of this Commission is limited. Within the meaning and scope of section 21(b), we find no jurisdictional error, or a legal principle ignored by the State Commission as may necessitate interference. It would be apt to rely upon the decision of the Hon'ble Supreme Court in the case of 'Rubi (Chandra) Dutta Vs. M/s United India Insurance Co. Ltd."

Subsequently, NCDRC absolved the charges against the doctor and the surgeon. It noted:

"Based on the aforesaid discussion, we do not find any merit in the instant revision petition, accordingly it stands dismissed."

To view the original order, click on the link below:

View Original Order