Uttarakhand State Commission Quashes ₹11.5 Lakh Order, Says 2D Ultrasound Not Enough to Prove Medical Negligence Without Expert Evidence
Pranav B Prem
In a significant ruling, the Uttarakhand State Consumer Disputes Redressal Commission has held that allegations of medical negligence must be supported by expert opinion, and that ultrasound scans alone do not amount to conclusive proof of medical error. The Commission set aside an order of the District Consumer Forum, Haridwar, which had directed a radiologist to pay over ₹11.5 lakh in compensation, holding that there was no credible evidence of negligence, and that the complainant failed to implead necessary parties or produce expert testimony.
Background of the Case
The complaint was originally filed by Smt. Renu before the District Commission, Haridwar, alleging that Dr. Manoj Singh, a radiologist at Haridwar Scan Centre, was guilty of medical negligence. The complainant gave birth on 22.04.2014 at Himalayan Hospital, Jolly Grant, and soon discovered that the child suffered from severe physical deformities, including absence or underdevelopment of the femur, lumbar spine, and sacrum, rendering the child unable to sit, stand, or move the lower body.
According to the complainant, she had undergone four 2D ultrasound scans during her pregnancy at the appellant's clinic, specifically on 14.10.2013, 19.12.2013, 03.03.2014, and 26.03.2014, all of which showed that the fetus was developing normally. However, an MRI conducted after birth on 23.04.2014 at Himalayan Hospital revealed serious defects. She further sought treatment at AIIMS, New Delhi and AIIMS, Rishikesh, where doctors allegedly remarked that such anomalies could have been detected earlier.
The District Commission held Dr. Singh guilty of negligence and awarded compensation of ₹8,00,000, ₹3,50,000 for mental and physical agony, and ₹10,000 as litigation cost—totalling ₹11,60,000 with 6% interest from the date of the complaint. Aggrieved by this, Dr. Singh preferred an appeal before the State Commission.
Doctor’s Defense Before State Commission
Dr. Manoj Singh, through his counsel, contended that he was contractually empanelled by BHEL Hospital, Haridwar, for the limited purpose of conducting 2D fetal well-being ultrasounds, and that all ultrasounds were done on referral and as per prescription by BHEL doctors.
He argued that:
He was not authorised to conduct 3D/4D scans, Level II anomaly scans, or MRIs.
The complainant suffered from diabetes and high blood pressure, and it was the responsibility of the treating doctors at BHEL Hospital to recommend advanced diagnostic tests.
The ultrasound reports were interpreted in accordance with standard practices, and no abnormalities were observed on 2D imaging.
The medical board constituted by the Chief Medical Officer, Haridwar, found no negligence or malice on his part.
The complainant failed to submit expert medical evidence or an affidavit from any medical expert to support allegations of negligence.
He also argued that he had no direct contractual relationship with the complainant, as all services were provided on referral by BHEL Hospital, and the hospital paid for the services.
Commission’s Observations and Legal Reasoning
The Commission, comprising Ms. Kumkum Rani (President) and Mr. C.M. Singh (Member), meticulously reviewed the ultrasound reports, prescription records, empanelment agreements, and findings of the medical board. It was confirmed that:
All referrals for ultrasound were made by BHEL Hospital, specifically for 2D scans.
The appellant was not authorised to conduct any test beyond 2D scans under his empanelment.
The complainant did not produce any referral or order for an advanced fetal imaging scan.
The medical board report by CMO Haridwar stated that the condition was a rare congenital abnormality, occurring in 1 in 75,000 to 1,00,000 births, with a detection rate of only 15–20% through 2D ultrasound.
The report further blamed the treating doctors at BHEL for not referring the complainant for more advanced scans considering her diabetic condition and history of high-risk pregnancy.
Significantly, the Commission found that the respondent had not submitted any expert medical report or opinion contradicting the doctor’s stand. The complainant relied solely on the fact that the deformity was visible in postnatal MRI but failed to connect it to any omission by the radiologist during antenatal ultrasound scans.
The Commission relied on key judgments:
Hemlata v. Dr. Vipin Premi [IV (2004) CPJ 694]- ultrasound results are not conclusive proof and require corroboration.
Senthil Scan Centre v. Shanthi Sridharan [III (2011) CPJ 54 (SC)] – ultrasound is not a perfect depiction of the fetus.
Martin F. D’Souza v. Mohd. Ishfaq [2009(3) SCC 1] – expert medical testimony is essential in cases alleging negligence.
Quoting the Supreme Court’s ruling in Martin F. D’Souza, the Commission noted: “The true test for establishing negligence in diagnosis or treatment on the part of a doctor is whether he has been proved to be guilty of such failure as no doctor of ordinary skill would be guilty of if acting with ordinary care.”
Applying these legal principles to the present case, the Commission found that there was no breach of duty by the doctor. Instead, it observed that the treating doctors should have ordered more advanced scans based on the risk profile of the patient, especially given the absence of any instruction to the appellant to do so.
Verdict
In conclusion, the State Commission held that:
The complainant failed to establish any deficiency in service or negligence.
There was no expert evidence or doctor’s opinion submitted by the complainant.
The condition was rare and difficult to detect via 2D ultrasound.
The doctor had adhered to his contractual and professional obligations.
Accordingly, the Commission allowed the appeal, set aside the order dated 31.10.2018 of the District Commission, and dismissed the consumer complaint. No order was made as to costs. The statutory amount deposited by the appellant was directed to be refunded.
Appearance
For Appellant: Sh. V.P. Tiwari, Sh. R.K. Devliyal, Advocates
For Respondents: Sh. Sandeep Gupta, Advocate
Cause Title: Dr. Manoj Singh V. Smt. Renu
Case No: SC/5/A/180/2018
Coram: Ms. Kumkum Rani [President], Mr. C.M. Singh [Member]
