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Kidney Stone Nightmare: Delhi Commission Rejects Doctor's Appeal, Sticks with ₹1 Lakh Penalty for Botched Surgery
In a ruling that underscores the critical role of verifiable medical records in negligence claims, the has dismissed an appeal by Dr. Rajnish Sharma and K.K. Surgical & Maternity Hospital. The bench, led by Hon’ble Justice Sangita Dhingra Sehgal (President) and Hon’ble Ms. Bimla Kumari (Member) , upheld a district commission's order awarding ₹1 lakh compensation plus costs to patient Mohd. Sameer for alleged failure to remove a ureteric kidney stone.
From Hospital Hope to Lingering Pain
Mohd. Sameer, a Ghaziabad resident, faced right-side ureteric calculus diagnosed via KUB X-ray in . Advised open ureter lithotomy at GTB Hospital but unable to proceed due to unavailability, he turned to Dr. Sharma's facility, paying ₹32,000 for treatment starting .
Instead of open surgery, DJ stenting was performed, touted as a "guaranteed" stone removal method. Readmitted , Sameer underwent a second procedure (URS with lithotripsy). Stents were removed , but pain persisted. Tests at another facility on revealed a 17.2mm stone at the same right UV junction—larger than before, just 3.5 months post-surgery.
Confronting Dr. Sharma, Sameer was told the original stone was fully removed and this was a "reoccurrence," with demands for another ₹40,000 procedure. Filing under the , he claimed and sought ₹4 lakh total relief.
Doctor's Defense: Standard Care or Shoddy Proof?
Appellants (Dr. Sharma and hospital management) argued their endoscopic approach—DJ stenting followed by URS/lithotripsy—was "standard management" for high-grade obstructions. They cited a disputed September 3 X-ray showing "no evidence of stone" and claimed recurrence is common (up to 38% cases). Citing , they stressed courts aren't medical experts and must defer to specialists; failed outcomes don't equal negligence.
Respondent Sameer countered that open surgery was advised, the stone persisted/enlarged per independent tests, and appellants' records were incomplete or fabricated—lacking OT notes, uncorroborated X-rays (name discrepancy noted by experts).
Scrutinizing the Expert Lens and Gaps in Evidence
The commission relied heavily on a
, expert opinion
from Lok Nayak Hospital (originally GTB), which affirmed: endoscopic procedures match open surgery efficacy for lower ureteric stones, and initial stenting is standard for obstructions. However, it flagged missing
OT notes/discharge records
, a contested X-ray (patient name mismatch), and crucially:
"It is unlikely that a 1.5cm stone will form in 3 months."
Echoing the Supreme Court's caution in Martin F. D'Souza , the bench deferred to this expertise but rejected appellants' unproven recurrence claim—no literature or independent proof supported a 17mm stone regrowing so fast. The September X-ray was discarded as unverified (no film, affidavit, or rebuttal to fabrication allegation). Late-filed OT details (after 2.5 years) remained unproven.
As other reports note, this highlights how "standard procedures" falter without documentation—turning potential vindication into vulnerability.
Key Observations
"The committee is of the opinion that an endoscopic procedure (URSL) is the de facto standard in managing lower ureteric stones."
"If the X-ray and Ultrasound both are correct, then it may be a case of recurrent stone. However, it is unlikely that a 1.5cm stone will form in 3 months."
"The courts and Consumer Fora are not experts in medical science, and must not substitute their own views over that of specialists."( Martin F. D'Souza vs. Mohd. Ishfaq )
"The has not been able to prove this fact that stone of such size can reoccur in a period of 3.5 months."
No Reversal: Appeal Dismissed, Liability Stands
"Consequently, the present appeal stands dismissed with
."
The district order— ₹1,00,000 compensation at 6% interest from filing, plus ₹15,000 costs —remains intact. This reinforces that while procedures may be standard, proving success demands ironclad records. For future cases, doctors face heightened scrutiny on documentation and recurrence claims, potentially guiding consumer forums to prioritize expert probabilities over bare assertions.
