New Delhi: The Post Graduate Institute of Medical Education & Research (PGIMER), Chandigarh has been directed by the National Consumer Disputes Redressal Commission (NCDRC) to pay a compensation of Rs 10 lakh to the family of a patient, Jaswinder Kumar (now deceased), for the amputation of his leg due to alleged medical negligence and improper diagnosis by its doctors.
In his order dated Jan 24, 2017, Dr B C Gupta (Presiding Member) said, “The PGI shall carry out an internal probe in the matter to determine the extent of liability on the individual doctors, who were found negligent in the discharge of their duties. The extent of compensation payable by the individual doctors, if any, shall be determined by them from the outcome of that probe/inquiry. In case, it is concluded that no individual doctor was found responsible for the lapse, the entire amount of compensation in terms of this order shall be payable by the PGI itself as a vicarious liability.”
According to the court records, Jaswinder Kumar, aged 35 years, had been suffering from swelling and pain in his right foot. He decided to take treatment at PGI Chandigarh in the first week of June 2011. He was admitted at the PGI on 13.06.2011 on the advice of Dr R K Sharma, Professor and Head, Department of Plastic Surgery. On 14.06.2011, Jaswinder Kumar was subjected to Digital Subtraction Angiography (DSA) at the Department of Radio-diagnosis. As per the report given by Dr Vivek Gupta, he was found suffering from ‘Intermediately High Flow AVM (arteriovenous malformation) of Dorsum of Right Foot c Feeders from ATA Predominantly.’ Then an operation was conducted upon the complainant, Jaswinder Kumar, on the right foot on 27.06.2011 under the guidance of Dr Sharma and other doctors.
Jaswinder Kumar, thereafter, visited the PGI on 06.07.2011, 13.07.2011 and 21.07.2011 with complaints of mild pain and swelling, when he was advised some ointment, normal dressing, crepe bandage and foot elevation etc. The complainant visited the PGI again on 03.08.2011 and 17.08.2011 with complaints of pain, swelling, inflammation and bleeding, when he was advised that the scar was well healed, but certain medicines were prescribed to him. However, after a few days, he developed lesion again on his right foot, along with unbearable pain and he visited the PGI on 14.09.2011, but he was advised to use compression garments only. As per the complainant, his problem of swelling, unbearable pain, inflammation and bleeding went on increasing, following which he consulted Dr R K Sharma on 05.10.2011, when the doctors decided to perform second surgery PDOA after about 6 months and the date for the same was also fixed as 04.04.2012.
Jaswinder Kumar said that he suspected some serious problem in his right foot and went to Fortis Hospital on 05.11.2011. The hospital found huge mass lesion on the foot, which was badly affected, and they immediately advised biopsy upon the patient to rule out cancerous lesion. The biopsy was conducted at Fortis Hospital on 07.11.2011. As per the result of the biopsy, his condition was diagnosed as “Right Foot Synovial Sarcoma”, i.e., highly malignant tumour, which required urgent intervention. The doctors at that hospital decided to carry out knee amputation, as the tumour had already spread above the knee due to delay in proper and required clinical diagnosis of the tumour at the PGI. The amputation was done on 17.11.2011 on urgent basis and the patient was discharged on 22.11.2011. Jaswinder Kumar claimed that he became 100% disabled due to the medical negligence of the doctors at the PGI.
In its response, the PGI said that the patient complained of progressively increasing swelling on the dorsum of right foot for the last four years. He underwent MRI and other tests at the DMC Ludhiana and was referred to the PGI with a diagnosis of low flow AVM. The patient was seen at the plastic surgery OPD of the PGI on 20.05.2009 and was dated for admission on 14.10.2009 for surgery, but he did not turn-up on the appointed date and time. Thereafter, the patient attended the OPD of the PGI on 08.06.2011. The DSA was performed upon him on 13.06.2011. The tests confirmed the lesion to be an intermediate high flow AVM with feeders from the posterior tibial artery. On 27.06.2011, excision of the lesion was done and the wound was closed primarily and the patient was discharged on 29.06.2011.
It has been stated that the patient was being regularly followed up at the PGI in the Plastic Surgery OPD and was seen by four senior residents and one consultant. He was being treated for AVM as recommended by radiological investigation and there was no record available in the OPD card to suggest development of malignancy in the patient.
During the pendency of the consumer complaint, Jaswinder Kumar died on 02.04.2013 and his legal representatives, namely, Mamta Rani wife and Monika Verma daughter and Darshna Devi mother, were substituted on record.
The State Consumer Disputes Redressal Commission after considering the case concluded that medical negligence on the part of the OPs had been proved and hence, they directed the PGI and Dr R K Sharma to pay Rs 10 lakh to the complainants as compensation and litigation cost of Rs 30,000.
The NCDRC also held that “there is no illegality, irregularity or error in the conclusion arrived at by the State Commission in the impugned order that medical negligence on the part of the OPs stands proved, based on the facts and circumstances of the present case.” It further said that “the State Commission have granted a reasonable compensation to the complainants, based on the facts of the case and there is no ground to make any change in the same.”