The Madras High Court has directed G.G. Hospital in Chennai to pay a compensation of ₹40 lakh with interest at the rate of 12% from 2014 to a Sri Lankan Tamil woman settled in France for having punctured her sigmoid colon, leading to leakage of faecal matter, while performing a laproscopic surgery. It was done while removing a fibroid in her uterus and an adhesion in her abdomen, as part of infertility treatment.
Justice G. Chandrasekharan decreed a civil suit filed by the patient Flora Madiazagane in 2014 and held that she was entitled to compensation for the “faulty” first surgery which led to performance of multiple surgeries subsequently.
Stating that the petitioner had suffered permanent disability associated with those surgeries and she could not lead a normal life, he said, she must be compensated for her pain and suffering.
The judge pointed out that the patient was 43 years old when she approached the hospital for infertility treatment and had already undergone two surgeries, three dilation and curettage (D&C) procedures and seven failed In Vitro Fertilization (IVF) procedures. Therefore, in all fairness, the doctors at G.G. Hospital ought to have discouraged her from taking the treatment in view of the possible complications, he said.
“However, they have not advised the plaintiff not to go ahead with the treatment, but rather found the plaintiff fit to undergo the surgery. Having found the plaintiff fit to undergo the surgery, the doctors should have taken extra caution while performing the surgery to find out whether adhesions were properly removed and whether any injury was caused to other body parts, during the course of surgery,” the judge wrote.
“If any injury is caused to other body parts, like in this case, perforation to sigmoid colon, immediate steps should have been taken to plug/to close the perforation. Unfortunately, that was not done,” he added.
The faulty first surgery performed on May 15, 2013 had necessitated the performance of an open surgery on May 18, 2013 when a colostomy bag was fixed outside the patient’s body for collecting the faecal matter.
Even after the second surgery, her health deteriorated and she complained of breathlessness necessitating a shift to another private hospital because the defendant hospital did not have the facility of assisted ventilation support.
“When the first defendant hospital had taken the risk of performing surgery, it is expected that the facility for assisted ventilation treatment should also be in place in the first defendant hospital,” the judge said.
He went on to state: “Without having such a basic facility, the very idea of conducting surgery on plaintiff and going ahead with the surgery is itself a questionable decision taken by the doctors at first defendant hospital... Defendants, especially, fourth defendant (Dr. Deepu Rajkamal Selvaraj) had not performed laproscopic surgery and adhesiolysis surgery with the skill and expertise required from an expert.”
The judge also found fault with the plaintiff for not having informed the defendant hospital and its doctors about the seven failed IVF procedures that were undertaken by her elsewhere and said, she probably wanted to give another try on being carried away by the popularity of G.G. Hospital.
In its defence, the hospital had told the court that the surgery was necessitated because the patient’s uterus, bowel/intestine and certain other organs were stuck/attached together and were affixed to the abdominal wall. Therefore, a laparoscopic adhesiolysis was performed to remove the adhesions followed by laparoscopic myomectomy to remove the fibroid from the uterus and laparoscopic salpingectomy to remove the right fallopian tube.
After surgery, the patient was recuperating well and there was no evidence or symptoms of perforation or rupture in the sigmoid colon due to the laparoscopic adhesiolysis surgical procedure.
If there was any perforation or rupture during surgery, there would have been immediate emptying of the contents of the colon through the opening and that would have been seen by the surgical team. No such incident was reported during the surgery on May 15, 2013, the hospital said.
Stating that a portion of the sigmoid colon attached to the abdominal wall was weak and exposed, the hospital said, the sigmoid colon had ruptured after the surgery due to its inability to withstand the expansion pressure that follows bowel movements as the the patient had begun to take oral liquids from May 16 and soft solids from May 17. The rupture was a natural cause and not due to any medical negligence, the defendant hospital argued.