8-day delay in treatment: Delhi court orders hospital, doctors to pay Rs 5 lakh

The commission said the delay worsened the patient’s condition, with her gallbladder later found to be gangrenous and perforated, and included litigation costs in the compensation amount.

The order was passed by the District Consumer Disputes Redressal Commission, South-West Delhi, on September 21. The panel directed the hospital and the two doctors to pay the amount within three months. If they fail to do so, 6% annual interest will apply from December 23, 2019, the date the complaint was filed, until the money is paid.

What the commission found?

The commission was hearing a complaint filed by a man over the treatment of his wife, who was suffering from advanced breast cancer with brain metastasis and other medical conditions. The panel held that there was an “inordinate delay in diagnosing the acute cholecystitis and managing it properly”, which led to a worsening of the condition. It said this delay in treating the gallbladder inflammation amounted to medical negligence.

“This inordinate delay in diagnosing the acute cholecystitis and managing it properly led to worsening of the condition,” the commission said in its order. The commission directed the hospital and two doctors to jointly pay the complainant Rs 5 lakh as compensation for mental and physical agony, inclusive of litigation costs.

Emergency visit and early warning signs

The woman reached the hospital emergency on January 17, 2019, complaining of abdominal pain and mild fever. An ultrasound showed a partially distended gallbladder containing sludge, with its wall thickened and swollen, indicating acute cholecystitis. Her total leukocyte count was recorded at 20,000.

The commission noted that these findings pointed towards infection and said further investigations and intervention should have been undertaken earlier. She visited the surgery outpatient department on January 19 and was admitted, The Indian Express reported.

A Magnetic Resonance Cholangiopancreatography (MRCP) was advised on January 22. Its report, received on January 23, showed cholecystitis with a pericholecystic collection and suspected gallbladder rupture. She underwent laparoscopic cholecystectomy on January 25.

During surgery, doctors found dense adhesions, gangrene, perforation and an abscess. A drain was left in place because of the abscess and the condition of the gallbladder.

Later complications and death

The woman was readmitted on January 28 after suffering seizures and was discharged on February 8 at the family’s request. Hospital records stated that her prognosis had been explained and that the family wanted to take her home for best supportive care. She later died in hospital on February 18, 2019, due to cardio-pulmonary arrest.

Negligence found only in gallbladder care

The commission specifically held the hospital and two treating doctors responsible for the delay in managing the gallbladder inflammation. It said they failed to provide the standard level of care expected when the woman came to the emergency department with severe stomach pain on January 17, 2019, and were therefore guilty of medical negligence.

Three other doctors named in the complaint were absolved of negligence because the commission found no clear evidence establishing negligence against them. The commission did not find negligence in the treatment of the woman’s advanced cancer or attribute all her subsequent complications to the hospital. A medical expert opinion obtained during the proceedings described her as suffering from terminal cancer and multiple co-morbidities.

It recorded that she had received palliative radiotherapy for brain metastasis and concluded that treatment provided by the surgical oncologists, radiation oncologists, neurosurgeon, gastrointestinal surgeon and medical oncologist was the standard of care.

The commission also rejected the allegation that brain radiotherapy caused the gallbladder rupture, noting that the radiation was localised to the brain. It found that the anti-seizure treatment given to the patient was in accordance with medical care.

The case highlights the importance of timely action when serious infection signs are identified in a hospital setting. Patients and their families should not ignore persistent or worsening symptoms. If a hospital identifies signs of a serious infection, they can ask what further tests or treatment are needed, seek a second medical opinion when concerned, and keep copies of prescriptions, test reports and treatment records.

For consumer-related grievances, individuals may contact the consumer helpline in their respective states (Delhi: 1800-11-4000) or call the National Consumer Helpline at 1915 for assistance.