The District Consumer Disputes Redressal Commission, Coimbatore, comprising President R. Thangavel and Member P. Marimuthu, has held a gynaecologist and Genesis Royal Infirmary Pvt. Ltd. jointly liable for medical negligence after finding that a gauze-like foreign material had remained at the site of a hysterectomy, resulting in serious post-operative complications, including pelvic abscess, colovaginal fistula and multiple corrective surgeries.

Facts

The complainant, G. Bhuvaneswari, consulted Dr. Chandrakala Makutapathy (Opposite Party No. 1) at Genesis Royal Infirmary Pvt. Ltd. (Opposite Party No. 2) in October 2018 after experiencing severe abdominal problems. Following diagnosis of uterus and hernia-related issues, she was advised to undergo a hysterectomy. Acting on the doctor's advice, she was admitted to Hindustan Hospital (Opposite Party No. 3), where the surgery was performed on November 16, 2018. She was discharged the next day but continued to suffer persistent abdominal pain. Despite repeatedly approaching the doctor for follow-up treatment, she was allegedly advised to continue taking painkillers.

According to the complainant, her condition deteriorated in March 2019 when she developed heavy bleeding mixed with stools, prompting her to seek treatment at ESIC Medical College and Hospital, Coimbatore. The hospital records noted the presence of a gauze-like foreign material near the vaginal vault, which was removed during treatment.

She was thereafter referred to Government Stanley Hospital, Chennai, where she underwent multiple corrective surgeries for deep organ surgical site infection and colovaginal fistula. She later underwent another surgery at Sri Ramakrishna Hospital, Coimbatore. Alleging prolonged physical suffering, mental agony, emotional trauma and financial hardship arising from medical negligence, she approached the Consumer Commission seeking compensation of ₹50 lakh.

Contentions of the Parties

Dr. Chandrakala Makutapathy and Genesis Royal Infirmary Pvt. Ltd. denied any negligence, contending that the complainant's complications resulted from erosion of a Prolift mesh implanted during a 2007 surgery rather than the hysterectomy. They submitted that the complainant had been informed of the surgical risks and had given consent, and further relied on the surgical records and MRI scan, which, according to them, did not reveal any retained foreign body.

Hindustan Hospital submitted that it had merely provided hospital facilities, including the operation theatre, nursing staff and other infrastructure, while the surgery and treatment were entirely under the care of the treating doctor. It therefore denied any negligence or deficiency in service on its part.

Observations of the Commission

The Commission attached significant weight to the records of ESIC Medical College and Hospital, which documented the discovery and removal of a gauze-like foreign material near the vaginal vault following the hysterectomy. It observed that the subsequent records from Government Stanley Hospital established that the complainant developed deep organ surgical site infection, pelvic abscess and colovaginal fistula requiring repeated surgeries and prolonged treatment. It held that the discovery of the foreign material, followed by infection, abscess and fistula formation, was more consistent with a post-surgical foreign body reaction than with the complainant's pre-existing mesh erosion.

Rejecting the contention that expert medical evidence was necessary, the Commission relied on V. Kishan Rao v. Nikhil Super Speciality Hospital to hold that where negligence is evident from the facts, expert opinion is not mandatory. It observed that retention of surgical material inside a patient's body attracts the doctrine of res ipsa loquitur, and that entries regarding correct swab and instrument counts could not outweigh independent medical records showing the presence of a gauze-like foreign material.

Accordingly, the Commission held Dr. Chandrakala Makutapathy and Genesis Royal Infirmary Pvt. Ltd. jointly and severally liable for medical negligence and deficiency in service. It directed them to pay the complainant ₹12 lakh as compensation and ₹5,000 towards litigation costs within one month, failing which the amount would carry interest at 9% per annum until realization. The complaint against Hindustan Hospital was dismissed as no independent negligence was established against it.

Case Title: G. Bhuvaneswari v. Dr. Chandrakala Makutapathy & Ors.

Case No.: Consumer Complaint No. 01/2022

Advocates: Thiru R. Vinoth for the Complainant; Thiru M. Arumugam for the Opposite Parties.

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