And the best method to detect kidney stones is…

Removing kidney stone is a fairly common and uneventful procedure these days. But in this case, it turned out to be quite the opposite.

The surgeon performed percutaneous nephrolithotomy (PCNL) to remove stone from patient’s kidney. Few days after the procedure, patient experienced discomfort and pain. Few smaller stones were detected in the urinary tract.

Yet another surgery was performed. But to no avail. The excruciating pain and discomfort returned soon thereafter. The patient consulted another doctor at a hospital and received treatment. But did not get any relief.

Eventually patient’s kidney had to be removed at the third hospital.

She sued the surgeon and made a pointed allegation – the doctor did not confirm stones’ location by Intravenous Pyelography (IVP) study, but performed the puncture operation.

The doctor denied any wrongdoing and submitted that the patient was explained about PCNL in detail after which she gave an informed consent. Retrograde Pyelography (RGP) was performed during the procedure to ascertain stones’ location.

The doctor further submitted that RGP was repeated when the patient was brought second time. Her urine output was good after the second procedure which was an indication of good kidney function. The doctor finally stated that patient was advised to come for reconstruction surgery after a month, but she never turned up.

The Commission perused medical literature and voluminous medical records before making following observations:

“The surgeon, based on X-ray and USG report, performed PCNL for upper ureteric calculus. In our view, the functional anatomy of kidney is well judged by IVP. In the instant case there was neither renal insufficiency nor any contraindication to perform IVP. Thus, not doing IVP prior to PCNL was deficiency in service. The exact location of renal stone was not confirmed. It resulted in partial removal of stone and development of subsequent complications”.

The surgeon was held negligent and ordered to pay a sizeable compensation to the patient.