The State Consumer Disputes Redressal Commission, Punjab, Chandigarh set aside the District Commission's finding of medical negligence, holding that mere subsequent complications do not establish negligence without expert evidence, reinforcing the burden on the complainant in medical negligence cases under the Consumer Protection Act, 2019.
Background & Facts
The Dispute
The complainant, Mr. Kapil Mahajan, suffered a fall from his bike on 13.12.2015 and was admitted to Biala Orthopaedic & Multi Speciality Hospital (OP No.1). He alleged that the surgery performed on his leg was conducted in haste without proper investigation, leading to impending gangrene and multiple subsequent surgeries at Amandeep Hospital, resulting in substantial financial loss. The appellants (the hospital and treating doctors) denied negligence, asserting that the treatment followed standard medical protocols and that the complainant's failure to follow post-discharge advice contributed to his condition.
Key Facts
- Date of injury and admission: 13.12.2015
- Surgery performed: 13.12.2015 (proximal tibial plateau fracture fixation with fasciotomy and decompression)
- Discharge from OP No.1: 26.12.2015 with advice of strict bed rest, non-weight bearing, nerve conduction studies, betadine dressing, and follow-up after ten days
- First admission to Amandeep Hospital: 28.12.2015 (three days after discharge) for wound care; discharged 21.01.2016
- Second admission to Amandeep Hospital: 12.02.2016 with pain and inability to bear weight; surgery performed same day and discharged
- Amount spent on treatment at Amandeep Hospital: approximately Rs.1,00,225/- (as per District Commission) and alleged Rs.7 lacs by complainant
- Relief sought before District Commission: Rs.7 lacs with interest @12% p.a., Rs.12 lacs as compensation, and litigation costs
- Impugned order of District Commission: dated 28.06.2022, awarding Rs.1,00,225/- with interest @7% p.a. from date of filing complaint, compensation Rs.50,000/-, and litigation expenses Rs.50,000/-
- Appeal instituted: First Appeal No.671 of 2022, date of institution 09.08.2022
- Reserved on: 17.08.2026
- Date of decision: 17.09.2026
Procedural History
- 09.08.2022: First Appeal filed before State Consumer Disputes Redressal Commission, Punjab, Chandigarh
- 17.08.2026: Matter reserved
- 17.09.2026: Judgment pronounced
Relief Sought
The appellants sought to set aside the District Commission's order dated 28.06.2022, dismiss the complaint, and obtain refund of the amounts deposited (Rs.25,000/- at filing and Rs.97,037/- in compliance) with accrued interest.
The Legal Issue
The central question was whether the complainant had established, by cogent and convincing evidence, that the appellants/OPs No.1 to 4 were negligent in the treatment provided and that the subsequent condition of his right lower limb resulted from any negligent act or omission on their part.
Arguments Presented
For the Appellant/OPs No.1 to 4
The appellants contended that the District Commission had erred in holding them negligent without expert evidence. They relied on the judgment of the National Commission in Dr. Joseph George Vs. M.R. Vijayakumar, R.P.2721 of 2008, which reiterated that the onus to prove medical negligence lies on the claimant and requires cogent evidence. They argued that the surgery was performed after proper diagnosis, standard protocols were followed, postoperative monitoring was undertaken, and the complainant was given detailed discharge advice. They asserted that there was no evidence of vascular injury during hospitalization and that the subsequent gangrene diagnosed later at Amandeep Hospital could not be attributed to their treatment without expert proof of breach of standard of care and causation.
For the Respondent/Complainant
The complainant maintained that the surgery was conducted in haste without proper investigation, leading to compartment syndrome and impending gangrene. He cited the discharge summary of Amandeep Hospital showing a diagnosis of "O/C/O Vascular Injury (Post Compartment Syndrome)" on 12.02.2016 and argued that the appellants' failure to consult a vascular surgeon and to provide adequate postoperative care constituted negligence. He contended that the District Commission had rightly appreciated the facts and awarded appropriate compensation.
The Court's Analysis
The Commission began by noting that the burden of proving medical negligence rests upon the complainant. It observed that mere adverse outcomes or subsequent complications cannot, by themselves, be treated as proof of negligence. The Commission emphasized that a treating doctor is required to exercise reasonable care and skill but is not obligated to guarantee a particular result, especially where the patient has suffered a serious traumatic injury with a guarded prognosis.
The Commission examined the medical record placed on record by the appellants (Ex.OP1-4/2) which showed a diagnosis of "limb with fracture Proximal Tibia right compartment syndrome with right foot drop, post tibial nerve injury and neurapraxia". It noted that surgery was performed on the same day by Dr. R.K. Arora, assisted by Dr. Ravi Biala and Anaesthetist Dr. Kuljeet Singh, using standard techniques. The record indicated that distal pulses of the right lower limb were palpable postoperatively, sensation of right foot was impaired, and active dorsiflexion of toes was not achieved. The appellants had advised nerve conduction studies, strict bed rest, betadine dressing, and follow-up after ten days.
The Commission found that the complainant did not attend the scheduled follow-up and instead presented at Amandeep Hospital three days after discharge. While the Amandeep Hospital records later diagnosed a vascular injury on 12.02.2016, there was no evidence of such injury during the initial hospitalization or during the intervening period. The Commission held that "In the absence of convincing expert or medical evidence showing breach of the accepted standard of care and a causal connection between such breach and the injury complained of, the appellants/OPs cannot be held liable merely on the basis of conjectures or subsequent complications."
It further noted that the National Commission's reliance on the Apex Court judgment in C.P. Sreekumar (Dr) Vs. S. Ramanujam reinforced the principle that a mere averment in a complaint denied by the opposite side cannot be proved without leading cogent evidence. The Commission concluded that the complainant had failed to discharge the burden of proving negligence, and therefore the District Commission's finding was unsustainable.
The Verdict
The appeal was allowed. The impugned order of the District Consumer Disputes Redressal Commission, Amritsar dated 28.06.2022 was set aside, and the complaint filed by respondent No.1/complainant was dismissed. The amounts deposited by the appellants (Rs.25,000/- at the time of filing the appeal and Rs.97,037/- in compliance of the Commission's order) together with any accrued interest thereon are to be remitted by the Registry to the appellants/OPs No.1 to 4 by way of demand draft/crossed cheque after the expiry of 45 days from the date of receipt of the certified copy of this order.
What This Means For Similar Cases
Burden of Proof Remains on the Complainant
Practitioners must remember that in medical negligence claims under the Consumer Protection Act, 2019, the complainant bears the onus to prove negligence by cogent and convincing evidence. Mere allegations of adverse outcomes are insufficient.
Expert Evidence Is Indispensable
The judgment underscores that expert medical evidence is essential to establish a breach of the accepted standard of care and a causal connection between such breach and the injury. Without such evidence, subsequent complications cannot be attributed to the treating doctors.
Post-Operative Non-Compliance May Affect Causation
The Commission highlighted that the complainant's failure to follow postoperative advice (strict bed rest, follow-up after ten days) created serious doubt about attributing his later condition solely to the initial treatment. This reinforces the need to examine patient conduct when assessing causation.
Reliance on Established Precedents
The decision aligns with the principles laid down by the National Commission and the Apex Court, reinforcing uniformity in the approach to medical negligence cases across consumer forums.
