The National Consumer Dispute Redressal Commission (NCDRC) has dismissed a woman’s complaint against a doctor and a hospital for alleged medical negligence during her treatment of Koch’s spine, also known as tuberculosis of the spine.
The bench, presided by the Justice R.K. Agarwal, President and Dr S.M. Kanitkar, Member, of the National Commission held: “In our considered view, the patient was suffering from severe back ache and based on X-ray and MRI investigations there was no evidence of TB of the spine. Therefore, laminectomy (a type of surgery in which part or all of the vertebral bone (lamina) is removed to ease pressure on the spinal cord) was performed by the doctor. There was no negligence while conducting the surgery. Detection of Koch’s spine after six months has no nexus with the laminectomy. The observations of District Forum and the State Commission are erroneous, wherein no negligence could be attributed to the treating doctor.”
However, the Consumer Forum has asked the hospital to pay Rs 50,000 as an ex-gratia amount to the complainant on humanitarian grounds, considering the facts and the suffering of the patient.
The complaint was filed by the woman against the order of the State Consumer Disputes Redressal Commission, Hyderabad, where the State Commission modified the order of the District Consumer Disputes Redressal Forum-II, Krishna District, Vijayawada, reducing the compensation from Rs 3,00,000 to Rs 50,000.
The complainant moved to the District Commission alleging medical negligence on part of the doctor and the hospital/SVR Neuro & Trauma Super Specialty, wherein she was directed to undergo surgery for her back pain. But her back pain continued even after the surgery. Consequently she was admitted to another hospital, Dr Samaram’s Hospital, complaining of swelling on the back and a burning sensation. There she was advised to consult a neurosurgeon. After consultation with the doctor she was diagnosed with ‘Cold Abscesses caused due to TB of Spine’. Dr Shankar Rao drained out the pus and the patient got some relief. Later she was referred to Nizam Institute of Medical Sciences, Hyderabad where TB of the spine was diagnosed and she was undergoing treatment.
In her plea she had contended that the hospital hurriedly performed the surgery without conducting necessary tests to diagnose the TB. She had further alleged that she suffered prolonged and continuous pain for more than nine months and was bed ridden for several months with mental agony. The district commission allowed her plea and directed the doctor and hospital to pay Rs 3,00,000 which was later reduced to Rs 50,000 by the State Commission. Ultimately, when she moved the NCDRC against the order of the State Commission, her plea was dismissed by the National Consumer Fora.
The commission concluded that the “Complainant failed to prove that she was suffering from Koch’s spine at the time of admission (May 2004). Secondly after laminectomy as per standard surgical practice, it is not mandatory to send the disc material for histo-pathological examination (HPE). The operating surgeon shall decide it on the basis of clinical surgical findings whether there is any need for HPE. We do not think it was neither a failure in standard duty of care nor deficiency in treatment. The complainant’s allegation is not sustainable.”
Further in its observation the commission also concluded that, “we have gone through the medical literature on Diagnosis and Treatment of Tuberculosis, the medical text book “Toman’s Tuberculosis” and the “Tuberculosis of the Skeletal System” by S.M.Tuli. The ESR is a non-specific test and has a prognostic value. There are several reasons for increase in ESR like old age, anaemia, chronic diseases, polymyalgia and Rheumatoid arthritis, etc. For the confirmed diagnosis of TB it is necessary to detect Mycobacterium TB in microscopy or cultures or by immunological tests. We note the NIMS have not conducted any immunological tests to diagnose TB.”