Important Judgement for Physicans, Radiologists and Surgeons - Read what saved Doctors from paying Rs. 10 lakhs - Adv. ROHiT ERANDE.©

"USG study been indicative and not confirmatory; it should not be construed as a wrong report" ,"the treating surgeon’s clinical assessment with relevant laboratory investigations   should be given more credence".

Adv. ROHiT ERANDE.© 

Case Details : REVISION PETITION NO. 696 OF 2015, decided on 27/01/2021

S. MANIKANNAN, Tamilnadu  (complainant) V/s. DR. T. PANDIARAJ & ANR.(Opponents)

Bench : HON.MR. JUSTICE R.K. AGRAWAL,PRESIDENT & HON'BLE DR. S.M.                                       KANTIKAR,MEMBER.

Judgment Link :

http://cms.nic.in/ncdrcusersWeb/GetJudgement.do?method=GetJudgement&caseidin=0%2F0%2FRP%2F696%2F2015&dtofhearing=2021-01-27

Facts of the case in Short.

1. This is a case of 2007. The complainant after starting severe stomach pain, consulted the physician and as per the advise of physician  he was refereed to the Opponent no.1, for  USG was performed and who reported it as retro-cecal appendicitis. However, the Physician was not satisfied with the said report, and again advised to repeat the USG with the Oppo. No. 1. who repeated the USG scan   and reported as being suggestive of ‘appendicitis’

2. The Physician, being not satisfied with both the USG findings, referred the patient to Dr. Sakthivel, the Surgeon for further line of action. The Surgeon refereed the patient for another USG to Dr. G. Rajkumar, the Opponent no.2. whose USG report stated the finding as “sub-hepatic appendicitis”. based on this 3rd report, the surgeon operated on the patient and the subsequent   Histopathological examination (HPE) also revealed “no evidence of tuberculosis or malignancy and it was fibrosis with chronic non-specific infection”. The Surgeon Dr. Sakthivel told the Complainant  that it was the infection in the large intestine causing the pain and the same was removed by surgery.

3. However , the Complainant filed a case for claiming damages of Rs.10 lakhs against the Opponents alleging interalia therein that due to wrong USG reports, given by the Opponents, he had to undergo unnecessary operation followed by physical and mental pain and loss of money. All this trauma and operation  could have been avoided with the help of proper medications also.

4. To the much of dismay of the Complainant both District Forum and State forum rejected the complaint on the grounds that USG reports were indicative and not confirmatory and that the Complainant failed to give any expert opinion or Medical Literature to establish the Negligence. 

Hence the Revision petition was filed, which was also dismissed.

Held.

1. The National Commission after perusing the entire record and evidence dismissed the Compliant. It was held that  Dr. Sakthivel on the basis of the patient’s clinical symptoms & signs and both the USG reports; made the provisional diagnosis of Acute appendicitis, Ureteric colic and Acute cholecystitis. and   found intraoperatively the infected bowel loops and Omentum. He removed the infected material and took Omental biopsy, sent for HPE study. According to the Surgeon, it was a case of Omental infection causing the pain to the patient.

2. The Commission further held that  as per the standard text books on Surgery any abdominal pain several reasons to be considered. If the clinical signs and investigations (Lab & Radiology) are not leading to definite diagnosis, in that case, opening of the abdomen (laparotomy – exploration) is necessary to find out the cause of pain. The HPE report and the prescription issued by the Surgeon, Dr. Sakthivel confirms that the continuous abdominal pain to the patient was due to Omental and Intestinal infection. 

3. While giving the relief to the Doctors, it was held that, in our considered view the operation was necessary to save the life of patient. Thus, the allegation of the Complainant that the operation was unnecessarily performed is not sustainable. Abdomen is a ‘Pandora’s box’. Many times the appendicular pain gives symptoms of referred pain. 

4. Though both the Radiologists (Opposite Party No.1 and 2) reported it as Appendicitis; it was to be correlated clinically. Thus the treating surgeon’s clinical assessment with relevant laboratory investigations   should be given more credence. 

5. Lastly it was held that the Radiologists - both the Opposite Parties  have given their opinion of USG study been indicative and not confirmatory; it should not be construed as a wrong report. We have to consider the operation was imminent the instant case, it was diagnosed operatively and patient got cure.  

The present case is  perhaps first case of this year, which has given relief to Doctors and have thrown light upon very important topics. Correctness of USG Report. So it is not only the USG or Lab Reports but treating surgeon’s clinical assessment also decide the line of Treatment. 

Thanks and Regards,

Adv. ROHiT ERANDE.© 

Pune.