CBD injury during laparoscopic Cholecystectomy: Consumer Court slaps Rs 5.1 lakh compensation on hospital, physician, surgeon

Panchkula: The Haryana State Consumer Disputes Redressal Commission (SCDRC), Panchkula, recently upheld the findings of the District Commission, which had earlier held a Sirsa-based hospital and its treating doctors, a physician, and a general surgeon, negligent in conducting gallbladder surgery and providing postoperative care to a patient.

Earlier, the District Commission had ordered the treating hospital and its doctors to pay Rs 5,10,755 towards compensation and medical expenses to the patient, and now, the State Consumer Court has upheld the order, while dismissing the appeals filed by the hospital and its doctors.

While considering the appeal, the State Commission found that the treating surgeon had injured the patient’s common bile duct (CBD) during a laparoscopic cholecystectomy. It further held that post-operative complications were not diagnosed in time. This, the Commission noted, led to multiple corrective surgeries and prolonged hospitalisation.

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According to the case record, the complainant approached the opposite party's hospital in July 2013 with pain on the right side of her abdomen. After tests, she was diagnosed with cholecystitis and cholelithiasis and was advised surgical removal of the gall bladder. She was admitted on July 22, 2013, and laparoscopic cholecystectomy was performed by the surgeon. She was discharged on July 24, 2013, after her husband deposited Rs 25,000 towards treatment expenses.

Within four to five days of the surgery, the complainant developed severe abdominal pain and vomiting. When she returned to the hospital, the surgeon allegedly told her that such complications were “bound to occur” after gall bladder removal and advised her to consult the physician, who prescribed antacids and painkillers. As her condition did not improve, she was taken to Bathinda, where radiological investigations revealed bile leakage into the abdomen. Later, she was advised immediate referral to a higher medical centre due to the risk to her life.

Subsequently, the complainant was admitted to a hospital in Ludhiana, where doctors found massive bile collection in the abdomen caused by injury to the bile duct. Emergency surgery was performed to drain the bile, and she remained hospitalised for several days. Later, she was taken to PGI Chandigarh, where she underwent a major surgery to repair the bile duct injury.

Alleging that the injury occurred due to negligence during the initial surgery and that post-operative complications were ignored, the complainant filed a consumer complaint.

On the other hand, the treating hospital and doctors pointed out that the complainant did not produce any document or any expert opinion that would show a deficiency in the treatment of the patient. They also pointed out that the treating surgeon was well qualified and the hospital was well equipped, having all required equipment.

They also contended that all the precautions were taken before conducting the surgery, which was done as per the accepted procedure through laparoscopy. According to the hospital and the doctors, the complainant's post-operative recovery of the complainant was smooth and uneventful. When the complainant was readmitted with complaints of chest pain, medicines were prescribed, ultrasound was conducted and there was no free fluid and there was no dilation of bile ducts.

The hospital and doctors pointed out that the bile is stored in the gallbladder and it passes through the hepatic duct and thereafter the gallbladder release the same into the common bile duct which further takes it to the duodenum and in this type of surgery the cystic duct is ligated with clips and the gallbladder is removed. However, the hepatic duct was not touched and the treating surgeon did not legate the common bile duct. They also relied on the records of Dayanand Medical College, Ludhiana and argued that it did not depict any negligence on the part of the treating surgeon.

Earlier, the District Consumer Commission allowed the complaint and directed the hospital and doctors to pay Rs 5,10,755 with interest. Challenging this order, the treating hospital and doctors approached the State Commission, contending that the surgery was conducted as per accepted medical practice, and that even the expert evidence did not indicate any negligence by the treating doctors.

After examining the record and hearing both sides, the State Commission rejected the appellants’ arguments and relied on expert evidence from the surgeon who treated the complainant.

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Referring to the expert testimony, the Commission recorded that, “At the time of removal of gall bladder only cystic duct was to be clipped whereas the common bile duct was clipped and injured which led to leakage of bile juice.”

The Commission further noted that the treating doctors failed to identify the complication despite clear symptoms after surgery, observing that, “There had been failure of diagnoses post operational complications.”

Emphasising the duty of care owed by surgeons after an operation, the Commission held,

“It was the duty of the doctor to get the patient diagnosed through some Specialist Radiologist.”

Based on the medical record and expert affidavit, the Commission concluded that negligence was evident both during the surgery and in post-operative care, stating, “A perusal of the history/treatment record of complainant and affidavit of Dr. Chiranjiv Singh Gill reflects that appellant No.3 was negligent while conducting operation of complainant as at the time of removal of gall bladder.”

Upholding the District Commission’s order in entirety, the State Commission ruled, “This Commission has arrived at an inescapable conclusion that learned District Consumer Commission has examined all relevant facets/evidence brought on record. There is no fallacy, legal or factual committed by learned District Consumer Commission while passing impugned order.”

Accordingly, the appeal was dismissed as devoid of merit, and the compensation awarded to the complainant was affirmed.

To view the order, click on the link below:

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