Abstract

Background: A case of operative CBD injury is presented with its medical concerns, legal issues and key takeaways. A discussion of the legal defence taken and how it affected the decision of the courts is discussed, with case law supports. Clinical case Summary: A middle-aged woman was subjected to Laparoscopic Cholecystectomy by a surgeon in Hospital A. She developed problems soon after surgery. After observing for 2-3 days, she was referred to another hospital (Hospital B) in a different city at night. She was treated conservatively for another 2-3 days and then explored. At surgery she was found to have a CBD injury, a perforation in hepatic flexure of colon and faecal & biliary peritonitis. Closure of colon perforation, diversion ileostomy and peritoneal lavage & drainage was done. After a stormy post operative course, she died after 8 days. Litigation Summary: Complaint was filed in SCDRC against Hospital A and Hospital B for medical negligence and deficiency of service, by the family of the deceased. SCDRC decided against Hospital A but absolved Hospital B. Complainant as well as Hospital A preferred an appeal in NCDRC challenging this decision. NCDRC absolved Hospital A also, setting aside the SCDRC order qua Hospital A. The complainant approached the Supreme Court with a Revision Petition/SLP. It held the Hospital A negligent & enhanced the award of compensation from 16 L to 25 L while holding the Hospital B innocent. Conclusion: A known surgical complication, though unwelcome, cannot always be avoided. The current healthcare ecosystem often invites legal action against the doctors for adverse outcomes. This case brings out important medical & legal issues for discussion. The medicolegal lessons from the case are discussed for the readers to understand how the surgical complications and the possible litigation should be handled.

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