Spinal surgery complication: Hyderabad hospital, neurosurgeon ordered to pay Rs 20.5 lakh

According to The Indian Express report, the District Consumer Disputes Redressal Commission, Hyderabad, passed the order on September 16. The bench, comprising president B Uma Venkata Subba Lakshmi and members C Lakshmi Prasanna and B Raji Reddy, held that the hospital and doctor had failed to establish that reasonable and accepted measures were taken to address the complication. CSF leak persists after spinal operation The Indian Express reported that the complainant, a US-based endocrinologist who has practised since 1994, approached a Hyderabad hospital in March 2021 after developing severe pain in his right leg that left him unable to walk.

An MRI scan revealed prolapsed intervertebral discs. He reportedly underwent a laminectomy, a procedure to create more space in the spinal canal, and a discectomy to remove damaged disc material on March 13, 2021. During the operation, the dura - the protective membrane surrounding the spinal cord - reportedly developed a tear. The doctor applied a fat patch to seal it, and the patient was discharged on March 17.

However, the patient alleged that fluid continued to leak from the surgical wound after his discharge. When he visitied the hospital on March 21, the doctor initially planned to close the wound with stitches under local anaesthesia. According to the complaint, the doctor instead applied a surgical sealant without explaining the change in the treatment plan. The patient was discharged again on March 24, but the leakage reportedly continued.

6L Patient undergoes another surgery in the US The patient subsequently travelled to the United States, where another neurosurgeon found fluid collected near the tear and performed surgery on April 2, 2021, to close it with stitches. He later developed recurring pain in his left leg, extending from the hip to the toes. According to the complaint, his treating doctor in the US attributed the pain to chronic arachnoiditis associated with a prolonged CSF leak and the resulting clumping of spinal nerves.

The patient alleged that the Hyderabad hospital and neurosurgeon had failed to manage the complication adequately and provide appropriate post-operative care. He approached the consumer commission seeking compensation. Hospital says CSF leak is a known surgical risk The hospital and the neurosurgeon denied the allegations and challenged the complaint on the ground that it had been filed beyond the prescribed limitation period.

They also argued that a CSF leak is a recognised complication of laminectomy and does not, by itself, establish medical negligence. The commission, however, focused on whether the doctor had exercised reasonable care in managing the complication after it was detected. It noted that the leak had been reported within four days of surgery, but the doctor had not adequately evaluated the problem. The commission also found no evidence showing that the patient had been informed before the doctor changed the plan from suturing the wound to applying a sealant.

It stressed that the central issue was not simply the adverse outcome, but whether the doctor had exercised the required degree of care while managing a known complication. The commission concluded that the evidence established a failure to exercise reasonable care in treating the patient and held the hospital and neurosurgeon liable for deficiency in service. Rs 20.5 lakh compensation ordered The commission directed the hospital and neurosurgeon to pay Rs 20 lakh as compensation and Rs 50,000 towards costs.

The total amount ordered is Rs 20.5 lakh. Takeaway Patients should seek clear explanations about changes to a treatment plan and retain copies of operative notes, discharge summaries, medical reports and follow-up records.