Pranav B Prem

The Delhi State Consumer Disputes Redressal Commission, comprising Justice Sangita Dhingra Sehgal (President) and Mr. Anil Srivastava (Member), has dismissed an appeal filed by Max Balaji Hospital and Dr. L. Tomar, thereby upholding the District Commission’s finding of medical negligence and affirming an award of ₹5,00,000 as compensation to the complainant, Smt. N.R. Mishra.

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Background of the Case

The complainant, Smt. N.R. Mishra, aged 56, sustained injuries to her right ankle following a fall on June 2, 2010. She was admitted to Max Balaji Hospital the next day under the care of Dr. L. Tomar. An X-ray conducted at Sir Ganga Ram Hospital revealed three fractures—one each in the fibula (below the knee), posterior malleolus (ankle), and medial malleolus (below the ankle). Surgery was carried out on June 4, 2010, during which only two fractures were fixed with screws. The complainant was discharged on June 7, 2010, after spending approximately ₹76,167, with an assurance that she would recover within 4–6 weeks. However, after removal of the plaster on July 18, 2010, she continued to experience severe pain and discomfort despite undergoing physiotherapy. On consulting two orthopedic experts — Dr. Shankar Acharya (Sir Ganga Ram Hospital) and Prof. U.N. Misra, it was revealed that the third fracture (medial malleolus) had not been surgically treated. The complainant alleged that the untreated fracture caused persistent pain and impaired mobility, forcing her to depend on an attendant for daily activities.

Complaint Before the District Commission

Alleging medical negligence and deficiency in service, the complainant approached the District Consumer Disputes Redressal Commission (East), Delhi, seeking compensation of ₹7,25,000. The District Commission observed that the handwritten discharge summary mentioned three fractures, whereas the typed discharge summary omitted the third fracture — a discrepancy it termed as an “attempt at concealment.” It further held that the expert report from GTB Hospital, which absolved the doctors, could not be relied upon as the complainant had not been examined by the panel and the independent expert opinions were ignored. Accordingly, the District Commission held the hospital and the doctor guilty of medical negligence and directed payment of ₹5,00,000 as compensation.

Arguments Before the State Commission

On appeal, Max Balaji Hospital and Dr. L. Tomar denied all allegations, asserting that the surgery was performed as per standard medical practice. They maintained that post-operative X-rays showed proper alignment, and the third fracture was not visible during surgery. They further argued that any omission in the typed discharge summary was a clerical error, as the handwritten summary had been prepared by an intern. The hospital relied upon the GTB Hospital’s expert report that found no negligence and contended that the District Commission erred in rejecting its findings.

Conversely, Smt. N.R. Mishra contended that the hospital’s failure to treat all three fractures amounted to gross negligence. She also alleged that the hospital deliberately omitted the medial malleolus fracture from the final discharge summary to cover up the lapse.

Findings and Observations

After reviewing the evidence, the Delhi State Commission held that the omission of the third fracture from the typed discharge summary was not clerical, but a clear instance of negligence and suppression. The bench observed that a hospital could not shift responsibility by blaming interns for errors in official medical records. It further noted that medical literature produced on record mandated surgical fixation for displaced medial malleolus fractures, whereas the complainant was only given a below-knee plaster, which deviated from established medical protocol.

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The Commission also found the GTB Hospital expert report unreliable, as it neither examined the complainant nor considered the findings of independent experts Dr. Acharya and Prof. Misra, both of whom confirmed that one fracture remained ununited. Concluding that Dr. Tomar failed to exercise reasonable care and professional diligence, the Commission dismissed the appeal and affirmed the District Commission’s order in full, directing payment of ₹5,00,000 as compensation to the complainant.

Cause Title: Max Balaji Hospital & Anr. Vs Smt. N.R. Mishra

Case No:  First Appeal No. 110/2015

Coram: Justice Sangita Dhingra Sehgal (President), Mr. Anil Srivastava (Member)