Doctor ordered to pay Rs 2 lakh after post-kidney stone surgery bleeding leaves patient in Delhi hospital

The bench noted that after conducting the surgery for a kidney stone by the opposite party, the condition of the complainant had deteriorated, but the doctor neither referred the complainant nor treated him properly till his condition had become worse, and the complainant was referred in April, 2023 to Batra Hospital and Medical Research Centre, Delhi.

The commission observed that negligence arises when a person fails to perform a duty that a reasonably prudent person would have performed, or acts in a manner that such a person would have avoided. Such negligence becomes actionable when it causes injury. The three essential elements are “duty”, “breach”, and “resulting damage”.

Patient alleged negligence after surgery

The case arose from a complaint filed by a man before the commission alleging medical negligence by a urologist during treatment for a 20 mm kidney stone. He first underwent a procedure involving stenting on March 11, 2023. He was subsequently operated upon on March 26 for removal of the kidney stone.

Following the surgery, he developed persistent blood in his urine, blood-clot formation, urinary retention, and severe pain. His condition continued to deteriorate despite repeated treatment and hospitalisation.

On April 7, 2023, the doctor referred him to Batra Hospital and Medical Research Centre, Delhi, where angiography detected a large segmental branch pseudoaneurysm in the lower pole of the kidney. Selective embolisation was performed to stop the bleeding, and he was discharged the following day.

The complainant alleged that the pseudoaneurysm resulted from negligent surgery and further accused the doctor of failing to provide timely post-operative care. He also pointed to discrepancies in the hospital records regarding the procedure performed, noting that earlier discharge summaries recorded RIRS, while the later referral summary mentioned PCNL and DJ stenting.

The doctor denied negligence, arguing that bleeding and pseudoaneurysm are known complications of renal stone surgery and that the complainant had consented to both RIRS and PCNL. He maintained that the patient was treated according to accepted medical standards and was referred for angio-embolisation when required.

Duty, breach and damage established: Order

The commission observed that the complainant’s condition deteriorated after the kidney-stone surgery, with persistent haematuria, blood-clot formation, urinary retention and severe pain.

The commission rejected the doctor’s argument that expert medical evidence was mandatory to establish negligence. It held that expert evidence is necessary only where the case is sufficiently complicated that the consumer forum cannot resolve it without expert assistance; there can be no mechanical requirement of expert evidence in every medical-negligence case.

It relied on the records of Batra Hospital, where angiography revealed a large segmental branch pseudoaneurysm in the lower pole of the kidney and selective embolisation successfully stopped the bleeding. These records corroborated the complainant’s account of continued bleeding and clot retention after surgery.

The commission held that the doctor failed to appropriately escalate the treatment in time. Despite the continuing haematuria and clot retention, the complainant was kept under observation until April 6 and was referred to a higher centre only on April 7, when his condition had become precarious. This delay, along with the treatment provided, amounted to medical negligence and deficiency in service.

Applying the principles of negligence, the commission found the essential elements of duty, breach and resulting damage established against the doctor. Since the doctor was covered by a valid professional indemnity policy during the relevant period, the commission held the insurer liable to indemnify the doctor and satisfy the compensation awarded.

Takeaway

The judgment underscores that consumer forums can establish medical negligence from treatment records without mechanically requiring expert evidence. It also highlights the duty of doctors to promptly escalate care when post-operative complications worsen, and holds professional indemnity insurers liable where negligence falls within the policy’s coverage.

Consumers facing similar grievances may contact the consumer helpline in their respective states (Haryana helpline: 1800-180-2087) or dial the National Consumer Helpline at 1915 for assistance.

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