Mumbai: The National Consumer Disputes Redressal Commission (NCDRC) in New Delhi has directed Kokilaben Dhirubhai Ambani Hospital and Medical Research Institute in Juhu, and a doctor from the hospital, to pay Rs40 lakh compensation in equal proportion to a Gujarat-based patient.
The order, if not implemented within six weeks, will carry an interest of 9% per annum till its realisation. The patient had suffered paraplegia after surgery at the hospital and informed consent about the same was not undertaken.
The order dated December 19 was passed by NCDRC presiding member Dr SM Kantikar on a complaint by Rohandeep Jaswal (through constituted attorney and father Sanjeev Jaswal) against the hospital and its 12 doctors, including Dr Mihir Bapat.
Mr Sanjeev Jaswal had consulted Sir Ganga Ram Hospital in Delhi for his son’s kypho-scoliosis spinal deformity when he was 12 years old. It was diagnosed as an intramedullary tumour and operated in October 2004. The tumour was reported as non-cancerous ganglioglioma but the doctors advised to take care and accordingly an MRI was done every year. In 2012, the MRI revealed a tumour of shrunken size. Since the complainant had moved to Ahmedabad, he sought consultation at Shalby Hospital there. The doctors expressed 65% correction through surgery with a neuro-monitoring machine and related facilities to avoid any neurological complications.
In February 2014, the patient consulted Dr Mihir Bapat at Kokilaben. It was alleged that the patient was told that as the spine is flexible, 80-90% correction is possible. The operation was conducted at a postponed date as the neuro-monitoring machine was under maintenance. However, after surgery, the patient's parents were shocked to hear that there was no leg movement and there was no sensation below the chest (rib cage). The patient also suffered meningitis.
It was alleged that no informed consent was taken and the surgery took a long time. After surgery, Dr Bapat informed that another surgery would be needed. The patient later had fever, uncontrolled bowel and urination. When the family consulted another doctor, he informed them that the D-8 vertebra was slightly wedged before surgery but got totally crushed during it.
The Commission, in its order, said that the consent forms for anaesthesia and surgery were devoid of details about the risks of paraplegia. It also said that the doctor did not seek the opinion of a neurosurgeon.
Describing informed consent as one with four components – decision capacity, documentation of consent, disclosure, and competency – the Commission said that the two well-recognised exceptions are medical emergencies and another is a ‘rare’ case.
Calling neurosurgery and orthopaedic surgery as two high-risk specialties associated with some of the highest number of medical negligence litigations, the Commission said that spinal surgery, most commonly at the lumbar level, has the highest rates of litigations.
