Recurrence Of Spinal Disc Prolapse Not Proof Of Negligence If Initial Surgery Followed Accepted Medical Practice: Punjab State Consumer Commission - 2025-09-12

State Commission Overturns Medical Negligence Ruling, Cites Recurrence Not Proof of Faulty Surgery

Chandigarh, Punjab – The State Consumer Disputes Redressal Commission, Punjab, has set aside a District Commission order, ruling that the recurrence of a medical condition after surgery does not automatically constitute medical negligence. In a significant decision, the bench, comprising Hon’ble Mrs. Justice Daya Chaudhary (President) and Mrs. Urvashi Agnihotri (Member), allowed the appeal filed by Joshi Hospital and Dr. Sudhir Sood, dismissing the complaint brought by patient Jaspreet Parhar.

The Commission held that a doctor cannot be found negligent for choosing an accepted course of treatment over another, especially when the decision is based on sound medical reasoning, such as the patient's age and the nature of their condition.

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Case Background: A Tale of Two Surgeries

The case originated from a complaint filed by Jaspreet Parhar, who underwent a Microlumbar Discectomy for a massive L5-S1 disc prolapse at Joshi Hospital on December 10, 2014, performed by Dr. Sudhir Sood. Despite the surgery and follow-up care, Mr. Parhar experienced a return of severe pain in his leg and back within a few months.

A subsequent MRI in June 2015 revealed the same disc problem, leading to a second surgery at a different facility, Satyam Hospital. Alleging that the first surgery was faulty and negligent, Mr. Parhar filed a complaint with the District Consumer Disputes Redressal Forum, Jalandhar, which ruled in his favor. The District Forum ordered Joshi Hospital and Dr. Sood to pay Rs. 1,30,000 for the second surgery, Rs. 2,00,000 in compensation for pain and suffering, and Rs. 10,000 for litigation costs.

Arguments Before the State Commission

Appellants' Arguments (Joshi Hospital & Dr. Sood):

- The appellants argued that there was no negligence. They contended that the recurrence of the disc prolapse was not due to a faulty first surgery but was a known complication.

- Their counsel highlighted that the two MRI reports (from Dec 2014 and June 2015) showed different types of disc extrusion, indicating a case of "recurrence" rather than a "residual" fragment left from the first operation.

- They explained that for a young patient, removing only the extruded fragment (as done in the first surgery) is a medically accepted practice to preserve the disc, even though it carries a risk of recurrence. This decision was a conscious one, aimed at minimizing risk.

- Critically, they presented endorsements from two other neurosurgeons, including the doctor who performed the second surgery, who validated the line of treatment adopted by Dr. Sood.

Respondent's Arguments (Jaspreet Parhar):

- The respondent maintained that the first surgery was conducted negligently, as it failed to resolve the problem, necessitating a second operation.

- It was argued that the failure to remove the entire disc problem in the first instance amounted to a clear "deficiency in service" and patent medical negligence, which caused immense physical, mental, and financial suffering.

Commission's Legal Analysis and Precedents

The State Commission conducted a thorough review of the principles of medical negligence, referencing several landmark Supreme Court judgments, including Jacob Mathew v. State of Punjab and Kusum Sharma v. Batra Hospital .

The Commission emphasized that negligence cannot be presumed merely because a treatment did not yield the desired result. The established legal test, derived from the Bolam test, is whether the doctor acted in accordance with a practice accepted as proper by a responsible body of medical men skilled in that particular art.

Citing these principles, the Commission noted:

"Negligence cannot be attributed to a doctor so long as he performs his duties with reasonable skill and competence. Merely because the doctor chooses one course of action in preference to the other one available, he would not be liable if the course of action chosen by him was acceptable to the medical profession."

The Commission found that Dr. Sood's decision to perform a less aggressive surgery on a young patient was a valid medical judgment. The key distinction was between a residual disc fragment (implying an incomplete first surgery) and a recurrent prolapse (a new event), which the evidence supported.

Pivotal Excerpts from the Judgment

The Commission's reasoning was clearly articulated in its order:

• On Recurrence vs. Negligence: "On perusal of conclusions of both said two MRI reports, it is clearly reflected that it was a case of recurrence and not residual nucleus pulposus. As per medical requirement, the removal of entire nucleus pulposus is normally discouraged in case of young patient..."

• On Doctor's Judgment: "The decision was taken by the Surgeon to extract the entire nucleus pulposus L5-S1 to overcome the probability of recurrence by considering the nature of job and bad posture of the respondent/complainant... The line of treatment was the conscious decision taken by the treating doctor/surgeon..."

• On Absence of Proof: "To establish a liability on such ground it is required to be proved that a usual and normal practice has not been adopted while treating the patient. In the present case nothing has been mentioned or pointed out that the treating Doctor was not competent or he was not having requisite qualifications/experience or he did not adopt usual method of treatment."

Final Decision and Implications

Concluding that the findings of the District Commission were not based on a proper appreciation of evidence, the State Commission allowed the appeal. The order dated December 18, 2018, was set aside, and the complaint filed by Jaspreet Parhar was dismissed.

This judgment reinforces the high burden of proof required to establish medical negligence. It protects medical professionals from being held liable for known complications or for making reasonable clinical judgments, provided their actions align with accepted standards of care within the medical community.