The Hospital was held vicariously liable to pay Rs. 21 laks towards compensation for negligence of its Consultant.

“sliding hernias are understood by few surgeons at any level of seniority”

http://cms.nic.in/ncdrcusersWeb/GetJudgement.do…

In a Recent judgment, the 3 judges Bench of National Commission was dealing with this question in the case of Kamla Bhat V/s. Manipal North Side Hospital & anr.

The Facts in brief :

Case of the Complainant :
1) The Complainant lost her husband, a leading dentist, to medical negligence. In May 1996, the patient was admitted for the treatment of bilateral inguinal hernia. However, after The operation, the patient vomited for many times and he also had severe abdominal pain. After discharge, when the patient went home, but was uneasy and had severe pain at the site of surgery.
2) After removal of sutures, the next day the patient had mild fever & severe pain in shoulders. it was alleged that the Doctor failed to diagnose post-op problems. After few days, it was also found that the patient had duodenal ulcer (DU) and a surgery, Laperotomy , was performed.
3)It was contended that no proper treatment was followed, no barium meal study or endoscopy were done neither any gastroenterologist was consulted. The patient succumbed to death due a delayed perforation of sigmoid colon leading to faecal peritonitis and it was also alleged that the Hospital was having no proper facilities.

Hospital’s Stand :

1. the Doctor is a consultant and not an employee of the Hospital and hence the Hospital is not liable for the negligence of the Doctor.
2) The hospital is well-known for high standard, hygienic and quality of services. The patient ignored the advice of Doctor to perform bilateral inguinal hernia operation, in time.

Held :
1) The Court rejected the contention that reason for perforation of sigmoid colon was on account of the infection inside because in the case of sliding hernia, during operation there will be possibility of tying the hernial sac along with sigmoid colon wall partially. It causes vascular compromise and necrosis of colonic wall leading to delayed perforation of colon.
2) As per Condon’s dictum ‘‘The anatomy of the inguinal region is misunderstood by some surgeons at all levels of seniority’’ if it is correct, then it is safe to say that sliding hernias are understood by few surgeons at any level of seniority. Thus sliding hernia is important for the special surgical technique and care during intra-operative period which decreases the morbidity.
3) It is the duty of the hospital to satisfy that there was no lack of care or diligence. The hospitals are institutions, people expect better and efficient service, if the hospital fails to discharge their duties through their doctors being employed on job basis or employed on contract basis, it is the hospital, which has to justify and by not impleading a particular doctor will not absolve the hospital of their responsibilities.
4) The Court took into consideration, the current inflation rate while calculating the amount of compensation.
Author : Adv. Rohit Erande, Pune.

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