Informed consent must comprehensively cover surgical risks and alternatives, with failure to do so constituting medical negligence leading to liability.

Neurosurgery and Orthopaedic surgery are two high-risk specialties associated with some of the highest number of medical negligence litigations. Amongst those the spinal surgery, most commonly at the lumbar level, has the highest rates of litigations.Informed consent is a significant allegation in most of the cases after spinal surgery.

1. This Complaint was filed by Sh. Sanjeev Jaswal, father of Complainant No. 1 Rohandeep Singh Constituted Attorney against Kokilaben Dhirubhai Ambani Hospital and Medical Research Centre, Mumbai & its 12 Doctors (hereinafter referred to as ‘Opposite Parties’) for the alleged medical negligence and deficiency in service on the part of Opposite Parties.

FACTS:

2. In the year 2004, the Complainant No. 1, Mr. Rohandeep Singh (hereinafter referred to as ‘the patient’) at the age of 12 years for his kypho-scoliosis’ spinal deformity consulted at Sir Ganga Ram Hospital,Delhi. It was diagnosed as D3-D7 intra-medullary tumour and operated on 11.10.2004 at Sir Ganga Ram Hospital. The tumour was reported as‘Ganglioglioma’ a non-cancerous tumour. The doctors advised the patient’s parents to keep watch for growth of tumour. Accordingly, every year MRI was conducted. In year 2012, MRI revealed shrunken size of tumour. The parents agin sought opinion from Sir Ganga Ram Hospital for correction of scoliosis, but the doctors opined possibility of correction of deformity up to maximum 50 to 60% only. In the mean time, the Complainant was transferred to Ahmadabad and they took further consultation at ‘Shalvy Hospital’ in Ahmedabad. The doctors therein expressed 65% correction of scoliosis was possible. They advised to undergo surgery where the Neuro-monitoring machine and facility available, it was to avoid any neurological complications during surgery.

3. Accordingly, on 17.02.2014 the patient consulted Dr. Mihir Bapat (OP No.2) at Kokilaben Dhirubhai Ambani Hospital (herein referred to as ‘the Hospital’ - OP-1). On 04.03.2014 CT scan and few investigations were performed. It was alleged that OP-2 told the patient and his family members that as spine was very flexible and correction up to 80% to 90% was possible. The surgery was fixed on 16.04.2014, but surgery was deferred to 23.04.2014 as the ‘Neuro-Monitoring’ machine was under maintenance.

4. On 23.04.2004, the patient was operated by OP-2. It was alleged that no informed consent was taken. The surgery took long time from 7 a.m. to 4 p.m. After the surgery the patient was shifted to room. The OP-2 came to room and informed the patent’s parents that the patient regained consciousness, but not moving his legs, therefore re-surgery was necessary for releasing the implants and to reduce the correction as carried out in the spine. The parents were shocked to learn about no leg movements and patient lost senses below his chest (rib and cage) after the surgery. It was further alleged that, the patient heard the doctors’ conversation that they should not have accepted and operated the case. The OP-2 did not inform the condition as it was ‘Paraplagia’. Thereafter, condition of the patient continued to deteriorate. On 02.05.2014, he got 103°F fever and again shifted to ICU on 03.05.2014. It was diagnosed as ‘Pyogenic Meningitis’ and the CSF culture detected bacterial infection “Acinetobacter Baumennii Meningitis”. On 27.07.2014 the patient was discharged from OP-1 Hospital in Paraplegic condition( loss of senses below rib cage), no bowel and urine control, Therefore, for daily routine activities of the patient an attendant was needed. Thereafter, the patient was admitted to Dhirubhai Ambani Occupational Health from 27.07.2014 to 07.02.2015. The family consulted number of doctors, but patient’s condition did not i