Gynaecologist blamed for lame reasons

  • Posted on: February 22, 2019

Can detection of cancer or any other condition after a complicated procedure be a doctor’s fault? Not when there are no clinical indications to suspect such conditions, says the court.

Sreedevi was taken to Pushpagiri Medical College Hospital with complain of irregular and painful vaginal bleeding. The gynaecologist at the hospital diagnosed her with adenomyosis and performed abdominal hysterectomy and bilateral salpingo oophorectomy.

During the procedure, there was heavy bleeding as the left ureter was injured and the right ureter was found entangled in a ligature. After the procedure, a specimen was sent for pathological examination and its result was shocking for the patient and her family. She was diagnosed with stage II adenocarcinoma involving cervix and lower part of uterus.

Just as the patient’s condition was improving, the gynaecologist observed urine leaking from vagina and a urologist at the hospital advised cystoscopy percutaneous nephrostomy. But it seemed the patient and her family were scared – first at the revelation of cancer and secondly because of the deteriorating condition. The patient sought discharge and went to another hospital where she underwent cystoscopy and stenting after which leakage of urine subsided. The patient underwent few cycles of chemotherapy but succumbed to cancer within five to six months.

The patient’s family strongly believed that late diagnosis of cancer by the gynaecologist was reason behind the death of their beloved, hence they approached Kerala State Consumer Disputes Redressal Commission.

It was alleged that because the diagnosis of cancer was done much later, its medication was also delayed. It was further alleged that a surgery should not have been conducted on a patient suffering from cancer and should have been performed only after treating the patient for cancer. Lastly, it was alleged that the surgery should have been performed by a qualified oncologist and not a gynaecologist.

The hospital and the gynaecologist were sure about what really went wrong – and it had nothing to do with the treatment they provided. It was stated that the USG report brought by the patient just before the surgery didn’t point at any adverse condition. It was further stated that the patient had a history of Dilation & Curettage (D&C) and a biopsy test done during D&C also didn’t raise any suspicion regarding any malignancy or indication. The gynaecologist also pointed out that the patient had reported having undergone hysterectomy evaluation to rule out any intra-uterine pathology a year ago and result of that finding too was normal. Only on basis of these clinical findings and investigations the patient was advised the procedure.

The gynaecologist concluded by stating that ureteric injury is a known complication of any pelvic surgery and that cannot be considered as negligence.

After perusal of medical records and statements from both the sides, the Commission agreed to each and every point made by the gynaecologist and the hospital and stated the following: “It can be seen that there is no basis for allegations that hysterectomy was conducted by the gynaecologist without any independent investigations. There were no reasonable grounds to suspect any malignancy to direct the patient to undergo any further tests. More importantly, nobody has a case that the ureteric injury caused has got any connection with the development of cancer”.

Pushpagiri Medical College Hospital and the gynaecologist were held not negligent.

Source: Order pronounced by Kerala State Consumer Disputes Redressal Commission, Thiruvananthapuramon 21st December, 2018