Hyderabad: A consumer court in Hyderabad has held Yashoda Group of Hospital, Malakpet, and its consultant spine surgeon liable for medical negligence, directing them to pay Rs 50 lakh in compensation to a woman from Tripura who underwent spinal surgery in 2019 and has since remained permanently disabled.
The District Consumer Disputes Redressal Commission-2, Hyderabad, passed the order on April 21, five years after the complainant, Jhumanath, filed her case.
The surgery that changed everything
Before she walked into Yashoda Hospital, Jhumanath worked as a casual announcer at All India Radio in Belonia, Tripura, travelling 50 kilometres each way to reach her office. She taught tuition classes in the evenings, covering batches from pre-primary to Class XII. She walked three to four kilometres daily and handled all her household work.
She had suffered lower back pain for six months. An MRI in February 2019 showed Grade I spondylolisthesis at L5-S1, a slippage of one vertebra over another.
Surgeon assured ‘100%’ cure
In March 2019, she consulted Dr Venkata Ramakrishna T, a spine surgeon at Yashoda Hospital, who conducted monthly outreach visits to Agartala. According to her complaint, he told her surgery was ‘the only option for her cure’ and assured her she would be ‘100% alright after the surgery.’
She flew to Hyderabad with her family in May 2019. The surgery took place on May 17. She was discharged on May 22 with a note that she was fit to travel by air, with wheelchair assistance.’
She could not stand.
Her return tickets had to be cancelled. She stayed in the hospital’s guest house before flying back to Agartala on May 26, in a wheelchair.
A life reduced to dependence
What followed dismantled her life piece by piece.
She spent seven months under the surgeon’s follow-up care. The pain did not reduce. She visited multiple hospitals across Tripura, Kolkata and Bangalore, seeking answers.
A bone scan at the Regional Cancer Centre, Agartala, in November 2019 recorded ‘abnormal foci of increased tracer concentration in the L4 and L5 vertebrae.’
‘Failed Back Syndrome’ detected
A CT scan at NIMHANS, Bangalore, in April 2021, found a ‘post-operative defect seen in the posterior element of L5 vertebra.’
Most significantly, a doctor at St John’s Medical College Hospital, Bangalore, diagnosed her condition as ‘Failed Back Syndrome’ and stated, as the commission recorded, that ‘as her case was at Grade-I stage, therefore, surgery was not at all required.’
By the time her complaint reached its conclusion, she could not sit for more than ten minutes at a stretch. She could not feed herself, write, cook, walk unaided or turn in bed. Her income, which stood at Rs 70,000 per month before the surgery, had stopped entirely. Her monthly expenditure had risen to Rs 50,000, covering medicines, transport and household help. Her husband, a schoolteacher, now carried the financial weight of a family of seven.
What the commission found
The commission identified several specific failures on the part of the hospital and the surgeon.
On the change in diagnosis, the commission noted that the surgeon’s own prescription from March 2019 recorded the condition as ‘Grade-I Listhesis,’ while the discharge summary after surgery listed it as ‘Grade-II Listhesis.’
No fresh MRI was taken after her admission.
“The Opposite Party No.1, i.e., hospital, had not conducted any MRI test on the Complainant after she was admitted to their hospital. They themselves changed the problem of the Complainant Grade-I to Grade-II,” the commission recorded.
On the decision to operate without attempting conservative treatment first, the commission held: “The Opposite Parties No. 1 and 2(the doctor) have not adopted and suggested a conservative non-surgical method of treatment for the Complainant.”
The commission applied the Meyerding classification of spondylolisthesis, under which Grade I and Grade II cases are categorised as ‘low-grade,’ and noted, based on expert opinion and medical literature, that ‘for grades 1 and 2 no need for surgery. It will be managed by other conservative non-surgical methods of treatment instead of heading straight for spine surgery.’
Commission finds negligence and deficiency of service
On the central question of liability, the commission recorded: “We are of the considered opinion that service is deficient on the part of the Opposite Parties No. 1 and 2 for conducting the wrong surgery to the patient who was suffering from Grade-I spondylolisthesis L5-S1. As per other treating doctors and medical literature, surgery was not required for Grade-I and Grade-II patients.”
On the consequence of that negligence, the commission found: “Due to negligence and deficiency of service by the Opposite Parties No. 1 and 2 the Complainant had became bedridden her entire life and also dependent on others her entire life physically and financially."
The hospital’s defence
The hospital and the surgeon pushed back on every central allegation.
On the grade of the condition, they maintained the complainant had ‘L5-S1 Grade II Listhesis,’ not Grade I, and that ‘with the history of 6 months of the above-mentioned complaints, and on conservative management by other doctors, who they have already seen, the complainant/patient had persisting symptoms. As there was failure of relief from conservative management for a period of 6 months,’ surgery was the appropriate course.
On informed consent, the hospital stated: “The complainant/patient and their attenders were explained in their own understandable language about the surgical procedure and the possible risks and complications associated with the same, such as neurological deficits, cerebrospinal fluid leak, infection, intra-operative bleeding, anaesthetic complications and need for prolonged ICU stay. Informed written consent was taken about the same and video counselling was done.”
On the outcome of the surgery itself, the hospital argued: “The CT scan clearly shows a bone graft was placed in the L5-S1 disc space, which was taken from the L5 lamina. CT scan also shows proper placement of the screws and no abnormality for the patient.”
On the complainant’s follow-up visits, the surgeon stated in his written version: “He has been reviewing the complainant/patient, during his regular visits to Agartala and the complainant/patient always came walking to the OPD and on some occasions she complained of back pain. However, on examination, the motor power in her limbs was found to be normal.”
‘Calling the operation a failure is baseless’
On the allegation of a failed surgery, the hospital said, “The allegation by the other doctors that the surgery conducted by the Opposite Party No. 2 is a failure is baseless and without any documentary evidence or any expert opinion.”
The commission did not accept these arguments as sufficient to discharge the burden of negligence.
Order and compliance
The commission directed Yashoda Group of Hospital and Dr Venkata Ramakrishna T to pay Rs 50 lakh jointly and severally as compensation for ‘physical trauma, mental agony and financial loss caused to the Complainant for her entire life and also to her family members,’ along with Rs 20,000 as costs.
The order gives the hospital and surgeon 45 days to comply. If they fail, the compensation amount will attract interest at 9 per cent per annum from the date of default until realisation.
The complaints against the two insurance companies named in the case were dismissed.