NCDRC Holds GNRC Hospital Liable for Gross Medical Negligence Resulting in Permanent Disability
Pranav B Prem
The National Consumer Disputes Redressal Commission (NCDRC) has held GNRC Medical Hospital, Guwahati, liable for gross medical negligence resulting in significant and permanent disability to a young accident victim. The Commission found that the hospital and its doctors failed to provide standard medical care and disregarded ethical and professional responsibilities, ultimately leaving the complainant with irreversible damage to his vocal functions and lifelong dependence on a tracheostomy tube. A compensation of ₹20 lakhs and ₹50,000 in costs has been awarded in favour of the complainant.
The complainant, Takam James, had sustained a serious head injury on July 8, 2013, in a motorcycle accident near Nirjuli in Arunachal Pradesh. Initially treated at the General Hospital in Naharlagun, he was shifted to GNRC Hospital in Guwahati the next day, where he remained admitted until August 27, 2013. During his stay, he underwent two tracheostomy procedures, but his medical records from GNRC lacked basic documentation such as the names, qualifications, and registration numbers of the treating doctors. This omission, the Commission noted, constituted a direct violation of the Medical Council of India regulations and was indicative of negligent conduct.
While under care at GNRC, the patient faced an accidental extubation on July 11, 2013—just two days after admission—even though a CT scan conducted on July 12 had revealed normal airway structure. The Commission considered this extubation a serious event and indicative of ICU mismanagement. Although the hospital claimed the incident was managed promptly, it failed to provide any explanation or report justifying how such a critical lapse occurred in a mechanically ventilated patient.
Further, the complainant contended that during long stretches of his hospitalization—particularly between July 11 to 15 and July 17 to 21—he was not evaluated by any neurosurgical specialists despite his critical head injury. This non-attendance by specialist consultants during crucial periods amounted to a significant deficiency in service, especially considering GNRC’s status as a neurological centre. The hospital, despite claiming that three neurosurgeons were on duty taking daily rounds, was unable to provide documentation to support this.
The first tracheostomy was carried out on July 23, 2013, reportedly due to prolonged intubation. However, the Commission found that there was no record identifying the surgeon who performed the procedure or the method of anaesthesia used. The complainant's medical documentation simply included a standard consent form with no medical personnel’s name or signature, making it impossible to ascertain who explained the risks to the patient’s attendants. Citing the Supreme Court judgment in Samira Kohli v. Dr. Prabha Manchanda [1 (2008) CPJ 56 (SC)], the Commission reiterated that a valid informed consent requires disclosure of the nature of the procedure, potential risks, alternatives, and consequences. The consent form on record failed to meet these requirements and was found to be legally untenable.
After being discharged from GNRC on August 27, 2013, the complainant returned home to Arunachal Pradesh but soon developed alarming symptoms, including extreme coughing and the expulsion of food particles through the tracheostomy tube. These symptoms were indicative of a tracheoesophageal fistula, a life-threatening condition caused by surgical compromise of the windpipe and food pipe. He was eventually taken to CMC Vellore, where advanced diagnostic evaluations confirmed that surgical damage had occurred during the second tracheostomy procedure performed at GNRC.
Medical records from CMC Vellore revealed that the complainant’s trachea and oesophagus were both damaged, and the condition was beyond surgical repair. Despite two subsequent surgeries at CMC Vellore, one in October 2013 and another in January 2014, his condition remained irreversible. He was rendered permanently incapable of speaking and must now live with a tube inserted in his neck.
Expert opinion submitted by Dr. Ranjan Rai Chaudhary, a senior ENT specialist, reinforced the claim of medical negligence. In his affidavit, Dr. Chaudhary stated that the patient had been left with significant disability and that the management of the airway at GNRC Hospital was negligent. He observed that the complications resulting from the tracheostomy were foreseeable and avoidable had proper post-operative care, investigation, and documentation been undertaken. He also emphasized that failing to explain these risks before surgery and not documenting findings during the second tracheostomy reflected either “ignorance or incompetence or both.”
GNRC and its doctors denied any negligence and claimed that all necessary precautions were taken. They argued that the tracheostomy was performed only after the patient failed to wean off the ventilator. They also claimed that the patient was discharged in a stable condition and that any complications arose only after his discharge. Regarding documentation lapses, the hospital argued that it followed standard documentation practices used at other reputed institutions such as AIIMS and that the absence of doctors’ names or signatures was inadvertent. On the issue of informed consent, the hospital contended that the procedure had been explained to the patient’s attendants and their signatures obtained.
Rejecting these arguments, the Commission found multiple inconsistencies in the hospital’s defence. It observed that most critical procedures lacked proper records, including those for the tracheostomy. The Commission underscored that such omissions not only violated legal and ethical medical standards but also caused direct harm to the complainant. It held that the complainant’s condition—permanent voice loss and dependence on a tracheostomy—was a result of negligent surgical intervention and failure to provide appropriate post-operative care.
The bench, consisting of Presiding Member Subhash Chandra and Member AVM J. Rajendra, noted that although the complainant had demanded ₹12.4 crores in compensation, the claim was unsupported by evidence or financial documents. However, given the trauma, lifelong disability, cost of medical care, and impact on the complainant’s quality of life, the Commission found it appropriate to award a compensation of ₹20,00,000. The amount is to be paid jointly and severally by all three opposite parties—Dr. Navanil Barua, Dr. Bivan Bihari Dey, and Dr. Monoj Agarwal—within one month of the order. In case of delay, the compensation would attract simple interest at 12% per annum until full payment is made. Additionally, the Commission directed payment of ₹50,000 towards litigation costs.
Appearance
For the Complainant: Mr. Bodhisattya Haldar, Advocate(VC) Mr. Sushant Rao, Advocate
For the Opposite Parties: Mr. K. P. Pathak, Advocate Mr. Nishant Kumar, Advocate
Cause Title: Takam James vs Dr. Navanil Barua & Ors.
Case No: Consumer Complaint 581/2014
Coram: Hon’ble Mr. Subhash Chandra [Presiding Member], Hon’ble AVM J. Rajendra AVSM VSM (Retd.) [Member]
[Read/Download order]
