The National Consumer Disputes Redressal Commission (NCDRC) has upheld a ruling of the Punjab State Consumer Disputes Redressal Commission, holding a Ludhiana-based hospital, its treating surgeons, and pathologists from a government medical college liable for medical negligence in a case involving radical facial surgery performed without a confirmed cancer diagnosis.
Case Background
The case pertains to a dentist who, in July 2014, noticed a small lesion on her right cheek. She underwent an excision biopsy at a private hospital in Ludhiana, following which the tissue sample was sent to a medical college in Ludhiana for histopathological examination.
On August 2, 2014, the pathology department issued a report stating that the findings were “suggestive of malignant melanoma.” Importantly, the report explicitly mentioned that confirmatory diagnostic tests, including immunohistochemistry (IHC) markers, were required before arriving at a definitive diagnosis.
Surgery Without Diagnostic Confirmation
Despite the provisional nature of the pathology report, the hospital’s surgeons proceeded with radical cancer surgery on August 7, 2014. The procedure involved wide excision of facial tissue along with removal of cervical lymph nodes. As a result, the patient suffered permanent facial disfigurement, nerve damage, and serious post-operative complications.
Subsequent expert evaluations, including an assessment by a medical board at the All India Institute of Medical Sciences (AIIMS), found no justification for such extensive surgery. It was later conclusively established that the lesion was non-cancerous and diagnosed as a Spitz nevus, a benign melanocytic lesion.
Findings of the Consumer Commissions
The NCDRC concurred with the State Commission’s findings that while limited surgical intervention may have been warranted, the extent and irreversibility of the procedure were unjustified in the absence of confirmatory diagnostic evidence. The Commission observed that had the treating doctors waited for mandatory IHC results or sought a second pathological opinion, the outcome would likely have been significantly less devastating.
In its 2018 order, the Punjab State Consumer Commission held that the medical college pathologists were negligent for issuing a tentative diagnosis without completing essential confirmatory tests. It further held that the hospital and surgeons were guilty of medical negligence for undertaking irreversible radical surgery without diagnostic certainty.
The State Commission awarded ₹55 lakh as compensation, with 9 percent interest, allocating ₹45 lakh to be paid by the hospital and surgeons and ₹10 lakh by the medical college and its pathologists.
Appeal Before the NCDRC
The dentist appealed before the NCDRC seeking enhancement of compensation to ₹95 lakh, citing permanent nerve injury, impaired facial movement, psychological trauma, expenses incurred for corrective treatment in the United States, and adverse impact on her professional dental practice. The hospital and medical college also challenged the findings of negligence.
Final NCDRC Order
In its order dated December 19, the NCDRC upheld the findings of medical negligence but declined to enhance the compensation amount. The Commission noted that the patient had provided consent for the surgery and was aware of its potential consequences.
However, acknowledging the physical and emotional trauma suffered by the patient, the NCDRC enhanced the litigation costs from ₹55,000 to ₹5 lakh. The Commission also clarified that the liability of insurance companies would be restricted to the terms and limits of the respective insurance policies.
Medico-Legal Significance
This judgment reinforces the principle that radical surgical procedures must not be performed without definitive diagnostic confirmation, especially in suspected cancer cases. It highlights the shared responsibility of pathologists, surgeons, and hospitals in ensuring diagnostic accuracy before undertaking irreversible medical interventions.
