The patient, a young girl of about twelve or thirteen years, experienced sharp pain in the abdomen. She was taken to the hospital where bicomuate uterus was diagnosed, a rare congenital disorder.
The surgeon performed exploratory laparotomy, and the patient was discharged after few days. However, the young girl experienced excruciating abdominal pain after a month. She was again taken to the surgeon.
USG was performed; the surgeon diagnosed necrosis in left ovary and blood clot in left horn. Exploratory laparotomy was performed again, patient’s left ovary was removed. But even this measure did not relieve her.
The patient again experienced abdominal pain after a month or so. She was taken to another hospital where yet another surgery was performed.
The girl’s father sued the surgeon and hospital owner, who was a MBBS doctor. It was alleged that the patient should have been referred to a gynaecologist before removing the left ovary, which was removed without consent.
Both doctors denied allegations of negligence, pointing out the following:
- The necrotic left ovary was removed in patient’s interest after explaining possible consequences to patient and her parents
- Every fact and anomalies were recorded in the case sheet. Patient’s family was advised to consult a gynaecologist for further care and treatment
The Consumer Commission perused medical records and ruled that the doctors were at fault, as it observed the following:
“The surgeon should have paid due attention to USG reports before conducting second laparotomy. Early diagnosis is essential and despite the reports, he failed to diagnose patient’s condition and proceeded to perform the second laparotomy. Hematometra can occur in premenarcheal, reproductive age females and the reason should be properly assessed. It may be due to various reasons – congenital anomalies, previous surgery, blockage of genitourinary outflow. Without assessing the cause, the surgeon conducted second laparotomy”.
“Parents of the young girl ought to have been informed and their consent taken. In his written version, the surgeon has submitted that laparotomy was done through same old incision. Uterus enlarged bicornuate, left horn tense thick, remains of left ovary were necrotic and gangrenous. But this is not supported by the USG trans abdomen report nor does the discharge summary support the findings. If he thought that the left ovarian tissue was necrotic or gangrenous, then it should be supported by a biopsy report and it needs to be diagnosed by blood tests. This reveals deficiency and negligence on his part”.
“Further, the patient was in their facility only for a few days after having undergone this major procedure. There is no record of the post-operative care or reports on the evidence of a necrotic ovary”.
The doctors were held negligent and ordered to pay six lakh rupees compensation.
Source : Order pronounced by Telangana State Consumer Disputes Redressal Commission on 24th January, 2024.