Medical Negligence -: Wrong Diagnosis and failure to conduct necessary tests before starting treatment

Case Study by Mohit Popli Subject: Failure to conduct necessary test for the proper treatment and wrong diagnosis amounts to Medical Negligence Cancer Patient-Compensation awarded 5 Lacs Kurien Joseph (Dr.) & Anr. Vs.  Govindarajan Equivalent Citation: II(2013)CPJ296(NC) Facts The daughter of the Respondent (Govindarajan) (hereinafter referred to as the Patient) was admitted in Appellant nursing home on 16.8.1992 with complaints of stomach pain and menstrual discharge although she was pregnant. Respondent came to know from one Dr. V.C. Balasubramanium, to whom Appellants had referred her case, on 23.11.1992 that the medical treatment of the Patient by the Appellants was not correct since she was given treatment for cancer although she was not suffering from the same, as a result of which the Patient died at a young age. Being aggrieved because of the medical negligence and lack of proper treatment resulting in the Patient's death, Respondent filed a complaint before the State Commission and stated that Appellants be directed to pay the Respondent a sum of Rs. 10 lakh on account of untold agony and loss caused to the Respondent and also taking into account the young age of the Patient who was gainfully employed as a teacher. Finding by Hon’ble State Commission and National Commission The Hon’ble State Commission after hearing the parties and on the basis of evidence produced before it, including the oral evidence and cross-examination of the Appellant doctor and the Respondent, concluded that the Appellants were guilty of medical negligence and deficiency in service. Relevant parts of the order of State Commission are reproduced: Negligence - That 'prior to starting therapy a full blood count is required and renal and hepatic function must be assessed. Thyroid function should be measured. The blood group of the patient and her partner responsible for the most recent or molar pregnancy is required for the prognostic score'. The nursing home attempted to wriggle out by stating that the patient was not suffering from molar pregnancy. They had not taken any steps to measure thyroid function or find the blood group of her partner. The nursing home not having established conclusively that the deceased was suffering from cancer, it has to be found that chemotherapy was ill-advised to be tried on the deceased. We therefore hold that the opposite parties had been negligent in treating the patient and this had been the cause for the death of the patient. The first pathological report dated 24.8.1992 does not conclude categorically that the Patient had carcinoma. In fact, it only states that there were some appearances in the specimens which were indicative of carcinoma but these needed to be correlated with other tests before reaching a clear finding to this effect. In this connection, the Doctor has himself admitted in his cross-examination that he did not conduct these tests because the Patient came a week later than the time fixed by Appellant Doctor for conducting the same and by that time she was very ill. The Hon’ble National Commission also note that while during cross-examination Appellant Doctor admitted that enlargement of the uterus and ectopic pregnancy need not necessarily be due to cancer yet in the instant case it was primarily on the basis of these very symptoms that Patient was administered 5 cycles of chemotherapy by him. The Appellant Doctor's reason for not conducting a biopsy of the abdominal mass or the cysts was on the ground that it could have caused severe bleeding and also cited medical literature in support. However, it is medically well established that the only way to determine if a growth is cancerous is to remove a sample of it and conduct a biopsy on it. The Hon’ble National Commission further observed that the second pathological report dated 23.11.1992 clearly indicated that the Patient had no malignancy and, thus, confirming the complaint of the Respondent that the Appellants started chemotherapy without taking due care to confirm that the Patient had cancer. The Doctor did not conduct the required tests nor did they consult an Oncologist or get biopsy done, which is the common procedure undertaken in cases of suspected cancer of this nature involving mass in the abdomen and growths. Compensation awarded by Hon’ble Commission  The Hon’ble State Commission, therefore, directed the Appellants to pay a sum of Rs. 5 lakh to Respondent as compensation within a period of 8 weeks from the date of the order failing which the amount would carry interest @ 9% per annum. Rs. 3000 were awarded as litigation costs. The Hon’ble National Commission directed the appellants to comply with the order of Hon’ble State Commission.

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