Hospitals Cannot Delay Emergency Stroke Treatment Awaiting Consent Or COVID Report: Hyderabad Consumer Court

Hospitals Cannot Delay Emergency Stroke Treatment Awaiting Consent Or COVID Report: Hyderabad Consumer Court

The District Consumer Disputes Redressal Commission-I, Hyderabad, has delivered a crucial ruling affirming that hospitals cannot delay life-saving emergency stroke treatment while waiting for family consent or COVID-19 test results. The Commission held Citizens Specialty Hospital and its consultant neurologist, Dr. Aparna Vijay Kumar, guilty of medical negligence for delaying mechanical thrombectomy in a 30-year-old PhD scholar who subsequently died, and awarded ₹1 crore in compensation to his parents.

A Life Cut Short by Delay

Surya Pratap Bharathi, a first-generation graduate from a Dalit family in Mau, Uttar Pradesh, was pursuing a PhD in Hindi at the University of Hyderabad. On August 17, 2020, he collapsed in his hostel corridor with left-sided weakness and slurred speech. Friends rushed him to Citizens Specialty Hospital within two hours of symptom onset — well within the critical window for stroke intervention.

An MRI revealed a massive hyperacute infarct in the right middle cerebral artery territory with complete occlusion. Doctors suggested mechanical thrombectomy, a procedure that can remove the clot and restore blood flow. But then the clock started ticking for the wrong reasons.

The Three Missed Windows

According to the complaint, the hospital delayed treatment on three occasions. First, when doctors insisted on obtaining consent from family members who were physically absent, despite friends pleading for immediate action. Second, when they waited for an RT-PCR report before proceeding with surgery, even though a rapid antigen test had already returned negative. Third, when the patient developed brain swelling and needed decompressive surgery — but by then he had been transferred to a COVID-designated hospital following a positive RT-PCR result.

By the time he reached Continental Hospital, Bharathi was unconscious and had suffered catastrophic brain injury. He died on August 21, 2020, from cardiac arrest while on life support. A subsequent RT-PCR test at the second hospital came back negative.

Commission Rejects Hospital's Defenses

Citizens Hospital argued that thrombolysis was contraindicated because the exact time of stroke onset was unknown, and that mechanical thrombectomy could not be performed without family consent given the high risk of the procedure. The Commission firmly rejected these arguments.

It noted that the hospital's own medical records showed mechanical thrombectomy was considered necessary and explained to the attendants. The Commission invoked the emergency exception doctrine , stating that when a patient lacks decision-making capacity and requires immediate intervention to save life or prevent irreversible disability, doctors are legally permitted to proceed without prior explicit consent. Waiting for consent from unreachable family members in such a time-sensitive emergency amounted to a breach of duty.

The Commission also held that COVID-19 guidelines from the Ministry of Health and Family Welfare and ICMR did not permit postponing emergency procedures while awaiting RT-PCR results. Hospitals were required to provide urgent treatment with appropriate protective measures.

'Professional Obligation to Render Immediate Care'

In a strongly worded observation, the Commission stated:

"The treating doctors of the patient in O.P.No.1 & O.P.No.2, who had the knowledge of the critical condition of the patient and the impending risk in delaying Thrombectomy treatment, had a duty of care and a professional obligation to render immediate emergency care without letting procedural, administrative, or consent-related hurdles delay life-saving treatment."

The Commission further noted that even assuming the exact onset time was unclear, the 6–24 hour window for mechanical thrombectomy was available from the time of admission. Yet the hospital remained indecisive and failed to act.

Compensation and Accountability

The Commission awarded ₹1 crore to the parents for loss of dependency, future prospects, filial consortium, and mental agony, along with ₹50,000 towards litigation costs. The amount must be paid within 45 days, failing which it will attract 9% annual interest.

The complaint against Medcis Pathlabs (which issued the positive RT-PCR report), Continental Hospital, and Dr. Kailas Mirche was dismissed for lack of evidence.

For the grieving parents, the ruling is more than monetary compensation. As the mother, Bindu, told a news publication: "Nothing will bring him back. But ours was a fight for justice. I don't want others to go through the plight my son underwent."

The case underscores that in medical emergencies, procedural delays — whether for consent forms or test reports — cannot take precedence over a patient's right to timely, life-saving care.