In a significant ruling, the National Consumer Disputes Redressal Commission (NCDRC) has directed Dr. Anirban Chatterjee, a vascular surgeon, and Nightingale Diagnostic & Medicare Centre Pvt. Ltd., Kolkata, to jointly compensate a 17-year-old girl with ₹75 lakh after a botched embolization surgery resulted in the amputation of her right leg. The Commission found negligence in obtaining informed consent and the failure to explore alternative treatment methods.
The judgment, delivered by Presiding Member Subhash Chandra and Member AVM J. Rajendra AVSM VSM (Retd.), emphasized that “failure to fully inform a patient or their guardian about all possible risks and alternative treatments constitutes medical negligence.”
Case Background
The complaint was filed by Jaita Mitra Basu and her daughter Srimoyee Basu, a minor, both residents of Kolkata, under Section 21 of the Consumer Protection Act, 1986. They sought a compensation of ₹20.41 crore for medical negligence.
According to the complaint, the minor girl had been experiencing swelling in her right gluteal region since 2000. Initially, multiple doctors diagnosed it as neurofibroma. However, by 2011, the lump had grown, and in 2014, an FNAC test suggested it was an angiolipoma. After further consultations, vascular surgeon Dr. Anirban Chatterjee diagnosed her with Arteriovenous Malformation (AVM) and recommended vascular embolization.
The procedure was conducted on September 16, 2015, at Nightingale Hospital, Kolkata, but complications arose when a small amount of glue (N-Butyl Cyanoacrylate) accidentally entered the main artery of her right leg. The next day, Dr. Chatterjee performed a corrective procedure and assured the family that 95% blood circulation had been restored. However, by September 18, 2015, blood flow to her leg stopped, and signs of gangrene appeared.
Upon the doctor’s recommendation, she was transferred to Sir Ganga Ram Hospital, Delhi, where she was diagnosed with severe vascular complications. On September 22, 2015, doctors were forced to amputate her right leg above the knee to prevent further complications.
The complainants alleged that the unnecessary second procedure allowed gangrene to develop and that alternative treatments such as bypass surgery were not explored, leading to permanent disability.
Legal Issues Before the NCDRC
The Commission considered the following key issues:
- Did Dr. Chatterjee and Nightingale Hospital fail to exercise proper medical care during the embolization procedure?
- Did they provide adequate information to the patient’s family before obtaining consent?
- Did the failure to consider alternative treatments amount to negligence?
- Were the complainants entitled to compensation, and if so, how much?
The complainants, represented by Advocates Alok Saxena and Saksham T., argued that Dr. Chatterjee failed to explain the risks associated with the procedure. They also highlighted an AIIMS medical report dated February 29, 2024, which confirmed that the ratio of glue used (2:1) was within the prescribed limit but could vary based on clinical judgment.
The opposite parties, represented by Advocate Vikas Nautiyal for Nightingale Hospital and Dr. Anirban Chatterjee himself, defended the procedure. Dr. Chatterjee maintained that AVM embolization is inherently high-risk and that the minor’s parents had signed a high-risk consent form acknowledging potential complications. He further argued that alternative treatments such as bypass surgery were not viable, as confirmed by cardiothoracic surgeon Dr. Susan Mukherjee.
Nightingale Hospital contended that it merely provided infrastructure and was not responsible for the outcome of the surgery.
NCDRC’s Findings and Key Observations
The Commission rejected the hospital’s claim of non-liability, holding that both Dr. Chatterjee and Nightingale Hospital were jointly responsible for the procedure and its outcome.
Failure to Obtain Proper Informed Consent
The judgment noted that while the complainants signed a High-Risk Consent Form, it did not explicitly mention the risk of glue leakage into unintended blood vessels. The Commission observed:
“The patient’s parents were not sufficiently informed about the risks and potential complications. Obtaining consent without proper disclosure does not absolve the doctor or hospital from liability.”
The judgment reiterated that “a doctor must ensure that the patient is fully informed of risks in a manner they can understand”.
Medical Negligence in Treatment
The NCDRC referred to the AIIMS expert medical report, which confirmed that glue embolization was a standard treatment, but also highlighted that non-target embolization was a known risk. The Commission stated:
“If such risks were well-documented, additional precautions should have been taken, and alternative methods should have been considered.”
The tribunal further noted that OP-1 (Dr. Chatterjee) failed to explore bypass surgery as an alternative, which could have prevented the amputation.
Negligence Established Despite Complex Nature of Surgery
Citing the Bolam Test, the Commission stated that while doctors cannot be held liable for mere errors in judgment, they are responsible if their decisions deviate from reasonable standards of care. The judgment clarified:
“The complexity of the procedure does not exempt a doctor from exercising due diligence. The failure to mitigate risks and explore alternatives amounts to actionable negligence.”
Final Judgment and Compensation Awarded
The NCDRC awarded a lump sum compensation of ₹75 lakh, payable jointly and severally by Dr. Anirban Chatterjee and Nightingale Hospital, with an additional ₹50,000 as litigation costs. The compensation is to be paid within one month, failing which a 12% simple interest per annum will be imposed until full payment is made.
The Commission cited previous Supreme Court rulings on medical negligence, including Samira Kohli v. Dr. Prabha Manchanda (2008) and Jacob Mathew v. State of Punjab (2005), to underline that failure to inform risks constitutes a breach of duty.
