Madras HC grants Rs 2 lakh compensation for youth over medical negligence

The Madras High Court, on Friday, April 26, ordered the Tamil Nadu government to pay Rs 2 lakh as compensation to a youngster, who suffered medical negligence in 2017, when he was a minor. Vishnu, who is now 22 years old, underwent a surgery for inflammation in the appendix at the Mettur Government Hospital, during which alleged medical negligence caused worsening of his medical condition resulting in mental agony and trauma. A single-judge bench of Justice Anita Sumanth passed the order when hearing a petition filed by Vishnu’s mother Sasikala seeking compensation and action against the doctor who treated Vishnu at the Mettur hospital

The judge said that the “tertiary care system in the state is undoubtedly responsible for the medical trauma that the child was put through,” and that the medical department and the state government did “not entirely convince the court that the threshold for care, overall, have been met satisfactorily.” The court ordered the state government to pay Rs 2 lakh to Vishnu and also directed the district collector to consider the application of Vishnu, who had registered at the district employment exchange, and recruit him to a suitable post, if he is qualified.

Vishnu, son of Sasikala Suresh, was rushed to the Government Head Quarters Hospital, in Salem on October 27, 2016, with complaints of abdominal pain and nausea. The doctors who treated Vishnu had concluded that he had perforated appendix, which refers to an infection in the appendix, based on his blood report. However, the diagnosis was only made on clinical grounds since radiological facilities like ultrasound were not available at the hospital and the patient was rushed for an emergency surgery, which was performed by one Dr Ramesh at the Mettur GH.

During the surgery, the doctors discovered that his condition was far from the initial diagnosis since his appendix was swollen, and it was removed during the surgery. Post surgery, Vishnu experienced excessive rectal bleeding, for which he was treated for the next four days and eventually he was discharged on October 31, 2016. 

On November 5, 2016, he went to the Government Mohan Kumaramangalam Medical College in Salem, where he again underwent a laparoscopic surgical procedure. After certain post-operative complications, his parents sought a discharge against medical advice. On November 16, 2016, he was taken to City hospital, a private one, and later sought discharge from there also. Finally, on November 17, 2016, they approached the Gem hospital where he underwent treatment for enterocutaneous fistula and subsequently got discharged on December 1, 2016. Enterocutaneous fistula is a condition in which an abnormal connection develops between the intestinal tract or stomach and the skin.

The petitioner Sasikala, on January 7, 2017, filed a petition at the court alleging medical negligence. The court heard the petitioners and on June 6, 2023, formed a committee comprising Director and Professor of Institute of Child Health and Hospital for Children Dr Rema Chandramohan, Professor & Head of Pediatric Surgery department of Institute of Child Health and Hospital for Children Dr R Velmurugan, and Professor & Head of Pediatric Gastroenterology department of Institute of Child Health and Hospital for Children Dr D Nirmala.

This three-member committee submitted a report saying that there was no medical negligence and that Vishnu suffered complications because he did not turn up for a medical follow up. However, the court expressed dissatisfaction with the report and ordered a supplementary report. The inquiry committee was reconstituted and Dr Rema was replaced with Dr Dr PS Shanthi, Head of Department of General Surgery, Madras Medical College. 

This committee submitted a report explaining the timeline in detail and that there was no medical negligence on the part of the doctors. The report also said that enterocutaneous fistula is a common complication after a surgery. The report of the Expert Committee appointed by the Court has stated that the traumatic events suffered by the child are not uncommon complications post an appendectomy. However, the court said it was not convinced that the child has received optimum care from the General Hospitals. 

It was based on this report that Justice Anita Sumanth ordered compensation. The court noted that the condition was a result of improper surgical intervention and that the court is not convinced that the child has received optimum care from the General Hospitals. “Had there been sufficient attention devoted and timely intervention, there is a possibility that the complications may have been arrested/controlled or avoided altogether,” the court observed.