Significant Disability Caused Due To Medical Treatment: NCDRC Holds GNRC Hospital Liable For Medical Negligence

Brief facts:

The complainant met with an accident in Arunachal Pradesh and was rushed to General Hospital in Naharlagun for his initial treatment. Thereafter, he was referred to GNRC Medical Hospital (“Opposite Party”) in Guwahati and was treated there. He was discharged with a tracheostomy tube in place. On returning home, he faced severe discomfort including extreme coughing and expulsion of food through the tracheostomy tube. His condition deteriorated due to significant damage to his vocal organs pursuant to which he was rushed to a nearby hospital. The attending physician referred him to CMC Vellore for advanced care. On commencement of procedures, it was revealed that the surgical intervention performed at GNRC hospital had resulted in severing of both the food pipe and the windpipe which led to permanent damage to the complainant's vocal organs. The complainant underwent two tracheostomy procedures while at GNRC hospital. Therefore, the complainant filed a complaint with the NCDRC praying for appropriate compensation.

Submissions of the complainant:

The complainant highlighted the unfair trade practices and significant lapses on the part of the Opposite Party. It was submitted that despite a lack of significant improvement, he was detained in the hospital which led to escalation of medical expenses. It was contended that the complainant was put in a super-speciality hospital for an excessive period without receiving any ENT consultation to restore his voice. The postoperative pain and complications suffered by the complainant were on account of lack of improper care and monitoring by the opposite party.

It was further argued that no neurosurgical specialist evaluated the complainant for six days despite serious injuries in the head which constitutes 'deficiency of service'. The complainant cited the Medical standards which indicate that prolonged intubation beyond 10 days can pose a risk to the windpipe thus necessitating tracheostomy. Based on this medical standard, it was argued that there was a failure to perform tracheostomy after 10 days to intubation which constitutes another serious 'deficiency in service'.

Poor documentation on the part of the Opposite Party was also highlighted by the complainant which constituted negligence and unfair trade practice. It was argued that consent forms for tracheostomy procedures lacked necessary doctor's identification and no formal surgical records were maintained for either of the two tracheostomy operations. The complainant argued that an informed consent was not taken for the operations and the consent forms were also not signed by the doctors. Thus, the complainant demanded compensation of Rs. 12,40,19,000.

Submissions of the Opposite Party:

The allegations of medical negligence were specifically denied by the Opposite Party. It was contended that there is no specific timeframe prescribed in standard medical literature for when to perform tracheostomy. It was further argued that there were three neurosurgeons who daily took rounds and monitored the complainant. Independent expert opinion was relied upon by the hospital to argue that both vocal cords of the complainant were symmetrical and approximating well.

With respect to the documentation practice, it was submitted that a similar practice is followed at AIIMS. It was argued that the complainant's condition had worsened due to delay in reporting to CMC Vellore and therefore the opposite party cannot be held liable for the same. On the issue of consent, it was asserted that all procedures were explained to the attendants of the patient and an informed consent was taken.

Observations of the Commission:

The bench observed that despite the complainant's airway being found normal in a CT scan dated 12.07.2013, an accidental extubation occurred on 11.07.2013, which is a serious lapse suggesting lack of ICU supervision. It was observed that the doctor who treated the complainant did not have any signatures in the complainant's clinical notes. It was further observed that when the complainant was rushed to CMC, Vellore, it was confirmed that the trachea and oesophagus were surgically compromised during the second tracheostomy performed at the Opposite Party GNRC Hospital.

Most of the medical records from the Opposite Party hospital lacked names, qualifications, and registration numbers of the doctors. The name of the referring or operating surgeon was never recorded which violated the Medical Council of India regulations.

On the issue of informed consent, the bench observed that every operation carries with it a wide range of risks which may lead to fatal consequences. Hence, it is necessary to discuss all complications with the patient and the relatives so that she may make up her mind for surgery. Reliance was placed on the decision of the Hon'ble Supreme Court in Samira Kohli Vs. Dr. Prabha Manchanda & Anr 1(2008) CPJ 56 (SC) wherein the concept of informed consent was discussed and it was held that a patient has an inviolable right in regard to his body and thus he has the right to decide whether or not he should undergo a particular treatment. It was held that consent for tracheostomy obtained by the opposite party hospital does not contain any actual details of the surgery other than 'tracheostomy' or its implications. The form also did not contain any signature of the medical person and details as to who is the doctor who has given the information, explanations and cautions to the complainant. Thus, the consent recorded by the opposite party was held to be untenable in law.

As regards duty of medical care, the Hon'ble Supreme Court observed that when a medical professional, who possesses a certain degree of skill and knowledge decides to treat a patient, he is duty bound to treat him/her with a reasonable degree of care. Failure to act in accordance with medical standards in vogue is generally considered as medical negligence.

Next, the bench considered the medical expert opinion brought on record by the complainant which stated that management of the complainant's airway at the opposite party hospital was negligent and the complainant has been left with a significant disability.

Thus, it was held that medical negligence on the part of the Opposite Party Hospital is manifest and the failures have resulted in adverse impact in the condition of the complainant who has been rendered with significant disability that he cannot speak normally and has a tube in neck for time to come.

However, the compensation of Rs. 12.4 crores demanded by the complainant was held to be disproportionate and unsupported by any documents.

Hence, the complaint was allowed with the following reliefs:

1. An amount of Rs. 20,00,000 as compensation to be paid by the opposite party
2. An amount of Rs. 50,000 as costs to be paid by the opposite party.

Case Title: Takam James vs Dr. Navanil Barua & Ors.

Case Number: Consumer Complaint 581/2014

Advocates for Complainant: Bodhisattya Haldar and Sushant Rao

Advocates for Opposite Party: K. P. Pathak and Nishant Kumar

Date of Judgment: 30.04.2025