Hospitals Cannot Delay Emergency Stroke Treatment Awaiting Consent Or COVID Report: Hyderabad Consumer Commission Awards ₹1 Crore To Deceased PhD Scholar's Parents
The District Consumer Disputes Redressal Commission-I, Hyderabad, comprising President Mrs. B. Uma Venkata Subba Lakshmi and Members Mrs. C. Lakshmi Prasanna and Mr. B. Raji Reddy, has held Citizens Specialty Hospital and its Consultant Neurologist Dr. Aparna Vijay Kumar liable for medical negligence and deficiency in service for delaying a life-saving stroke procedure while awaiting...
The District Consumer Disputes Redressal Commission-I, Hyderabad, comprising President Mrs. B. Uma Venkata Subba Lakshmi and Members Mrs. C. Lakshmi Prasanna and Mr. B. Raji Reddy, has held Citizens Specialty Hospital and its Consultant Neurologist Dr. Aparna Vijay Kumar liable for medical negligence and deficiency in service for delaying a life-saving stroke procedure while awaiting family consent and a COVID-19 RT-PCR report. The Commission held that the delay resulted in the loss of a crucial therapeutic window for treatment.
Facts
The complainants, parents of Surya Pratap Bharathi, approached the Consumer Commission alleging medical negligence following their son's death on August 21, 2020. Surya, a PhD scholar at the University of Hyderabad, was found unconscious in his hostel room on August 17, 2020 and was rushed to Citizens Specialty Hospital. Medical investigations revealed a massive acute infarct in the right middle cerebral artery (MCA) territory caused by complete arterial occlusion, indicating a severe ischemic stroke.
According to the complainants, the treating doctors informed the attendants that mechanical thrombectomy and decompressive surgery were available treatment options. However, despite the emergency nature of the condition, the hospital allegedly delayed intervention and later deferred surgery pending the patient's RT-PCR result. When the RT-PCR test returned positive on August 19, 2020, the patient was shifted to another hospital in a critical condition. He succumbed two days later.
The complainants further alleged that before the transfer, the patient's condition had significantly deteriorated, requiring intubation and ventilator support. He was transported to Continental Hospital, a designated COVID facility, and subsequently tested COVID-negative there. They contended that the delay in treatment and transfer in an unstable condition ultimately contributed to his death.
Contentions of the Parties
Citizens Specialty Hospital and Dr. Aparna Vijay Kumar denied negligence, contending that the patient was brought beyond the therapeutic window for thrombolysis and that the exact onset of symptoms was uncertain. They maintained that mechanical thrombectomy was advised but could not be performed as the attendants sought time to obtain family consent, and that the hospital had acted in accordance with prevailing COVID-19 protocols.
The diagnostic laboratory defended the RT-PCR report as compliant with NABL and ICMR norms, while Continental Hospital and its neurologist denied negligence, asserting that the patient was admitted only after his condition had significantly deteriorated and that appropriate treatment was provided thereafter.
Observations
The Commission noted that Citizens Specialty Hospital's own records showed that mechanical thrombectomy was considered necessary and had been explained to the attendants. Rejecting the hospital's defence that the procedure could not be performed due to the absence of family consent, it observed that in medical emergencies, where a patient lacks decision-making capacity and urgent intervention is required to save life or prevent irreversible disability, doctors are entitled to proceed under implied consent rather than await formal approval from family members.
The Commission further held that COVID-19 guidelines did not permit hospitals to postpone emergency procedures pending RT-PCR results. Instead, hospitals were required to provide urgent treatment with appropriate protective measures. It found fault with the hospital for delaying intervention and subsequently transferring the patient after receiving the positive RT-PCR report.
Emphasising the time-sensitive nature of acute ischemic stroke, the Commission observed that despite recognising the need for mechanical thrombectomy within the therapeutic window, the hospital failed to perform the procedure. It concluded that allowing procedural and administrative obstacles to impede life-saving treatment amounted to medical negligence and deficiency in service.
The Commission, however, found no evidence that the RT-PCR report issued by the diagnostic laboratory was false and found no negligence on the part of Continental Hospital or its neurologist.
Decision
Considering that the deceased was a young PhD scholar with promising future career prospects and that his parents had been deprived of both future financial support and filial companionship, the Commission awarded ₹1 crore as compensation towards loss of dependency, future prospects, consortium and mental agony, along with ₹50,000 towards litigation expenses.
Citizens Specialty Hospital and Dr. Aparna Vijay Kumar were held jointly and severally liable to satisfy the award. The complaint against the diagnostic laboratory, Continental Hospital and its neurologist was dismissed. The Commission directed compliance within 45 days, failing which the compensation amount would carry interest at the rate of 9% per annum.
Case Title: Ramavadh & Anr. v. Citizens Specialty Hospital & Ors.
Case No.: C.C. No. 567/2022
Advocates Appeared:
- For the Complainants: M/s. Rajasri Manche
- For Opposite Parties No. 1 & 2 (Citizens Specialty Hospital & Dr. Aparna Vijay Kumar): Ch. Lakshminarayana & Lalith Jogi
- For Opposite Party No. 3 (Medcis Pathlabs): Party in Person
- For Opposite Party No. 4 (Continental Hospital): Sri P. Vikram
- For Opposite Party No. 5 (Dr. Kailas Mirche): Suchitra