Causal Link Between Buttock Injection and Peroneal Nerve Injury Sufficient to Prove Medical Negligence: MP State Consumer Commission - 2025-01-09

MP Consumer Commission Upholds ₹50,000 Compensation for Botched Injection Causing Child's Disability

Bhopal: The Madhya Pradesh State Consumer Disputes Redressal Commission has upheld a District Commission order directing Dr. Ramesh Gupta to pay ₹50,000 in compensation to a minor boy who suffered a 40% permanent disability after receiving an improperly administered injection. The Commission found a clear causal link between the injection given by the doctor and the subsequent nerve injury, constituting a "deficiency in service" under the Consumer Protection Act, 1986.

The bench, comprising Presiding Member Mr. S.S. Bansal and Members Mr. A.K. Tiwari and Mr. D.K. Srivastava, dismissed the appeal filed by the doctor, affirming the findings of the District Consumer Disputes Redressal Commission, Vidisha.

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Background of the Case

The case dates back to December 5, 2006, when 8-year-old Lekhpal Singh was taken by his father, Virendra Singh, to Dr. Ramesh Gupta's clinic in Ganjbasoda for fever treatment. Dr. Gupta prescribed medicines and personally administered an injection into the boy's buttock.

Immediately after the injection, when the boy was taken off the dressing table, he was unable to stand on his feet. The complainant alleged that upon pointing this out, the doctor dismissed it as a temporary side effect of the needle hitting a nerve and assured them it was not serious. The doctor then took the child to a government hospital where he was admitted for four days without improvement. Subsequently, he was referred to specialists in Bhopal.

Medical examinations in Bhopal, including a neuroelectrophysiological study by neurologist Dr. Sunil Malik, revealed "significant F-wave abnormalities on study of the Right Common Peroneal nerve, suggesting a Lesion involving proximal part of the nerve/nerve roots." The family was informed that the nerve had been damaged due to the wrongly administered injection and would require surgery. Due to financial constraints, the family could not afford the operation and filed a police report and a consumer complaint seeking ₹5 lakh in compensation for the resulting permanent disability. A medical board later certified that Lekhpal Singh had a 40% permanent disability due to paralysis in his lower right limb.

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Arguments of the Parties

Dr. Ramesh Gupta (Appellant): The doctor's primary defense was that there was no direct link between the injection he administered in the buttock (gluteal region) and the injury diagnosed in the common peroneal nerve. He argued that injections in the buttock could potentially affect the sciatic nerve, but the medical reports showed no injury to the sciatic nerve itself. He contended that in the absence of expert testimony explicitly blaming his actions, he could not be held liable for negligence. He further challenged the validity of the disability certificate, claiming it was fraudulent and prepared without a proper examination by the medical board.

Lekhpal Singh (Respondent): The complainant, through his father, maintained that the child's inability to walk occurred immediately after the injection, establishing a direct temporal link to the doctor's action. They relied on the medical reports from specialists in Bhopal, which identified a specific nerve injury, and the disability certificate issued by the District Medical Board, which quantified the extent of the permanent damage.

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Commission's Analysis and Ruling

The State Commission meticulously examined the evidence, including medical reports and anatomical principles, to establish a causal connection. The order, authored by Hon’ble Member Mr. D.K. Srivastava, rejected the doctor's argument that an injection in the buttock could not damage the common peroneal nerve.

The Commission cited an anatomy and physiology textbook, explaining the structure of the nervous system. The judgment highlighted the following key reasoning:

"The Sciatic nerve is the thickest and largest nerve in the body... In the popliteal region (behind the knee), it divides into the Tibial and Common Peroneal nerves... Therefore, the argument that an injection affecting the sciatic nerve region cannot cause an impact on the common peroneal nerve is not acceptable."

The Commission concluded that since the common peroneal nerve is a branch of the sciatic nerve, an injury in the gluteal region, where the sciatic nerve is located, can directly cause abnormalities in its subsequent branches.

"This abnormality can arise from the effect of a wrong injection administered in the buttock, and it is concluded that it was caused by the effect of the said wrong injection."

Regarding the disability certificate, the Commission upheld its validity, invoking Section 114 of the Indian Evidence Act, which presumes that official acts are performed regularly. The bench noted that the doctor had failed to provide any credible evidence to rebut this presumption or to disprove the 40% disability finding by the government medical board.

Finding no error or illegality in the District Commission's order, the State Commission dismissed the doctor's appeal.

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Final Decision

The appeal was dismissed, and the original order of the District Commission was confirmed. Dr. Ramesh Gupta is liable to pay ₹50,000 as compensation and ₹500 towards litigation costs. The amount is to be deposited in a nationalized bank in Lekhpal Singh's name until he attains adulthood, with the quarterly interest payable to his father. If the payment is delayed beyond one month from the date of the order, it will attract interest at a rate of 6% per annum.