The Hyderabad District Consumer Commission has directed a hospital and a neurosurgeon to pay Rs 20 lakh as compensation and Rs 50,000 in costs to a US-based endocrinologist for allegedly failing to properly address a cerebrospinal fluid (CSF) leak following spinal surgery in March 2021. The commission found that instead of suturing the tear, the doctor applied a surgical sealant, failing to take reasonable care while managing the complication.President B Uma Venkata Subba Lakshmi and members C Lakshmi Prasanna and B Raji Reddy observed that the doctor failed to properly evaluate the CSF leak issue reported within four days of the surgery and did not give any explanation for changing the plan from suturing to application of sealant. “The opposite parties (hospital and doctor) have failed to prove that reasonable and accepted steps have been taken to address the known complication in a high-risk patient. Further, there is nothing on the record to show that the change of plan while addressing the CSF leak has been informed to the complainant before applying the (sealant),” the September 16 order said.A surgery, a wound that leaksThe complainant is an Overseas Citizen of India with an OCI card issued by the Government of India and a passport issued by the United States of America. The complainant is a US-based endocrinologist and has been practising since 1994 in eight different states in the United States of America. In March 2021, he developed unbearable pain in his right leg and was unable to walk. An MRI scan revealed that he had prolapsed intervertebral discs. He was admitted to a hospital in Hyderabad, where a neurosurgeon performed a laminectomy (surgical procedure that creates more room in the spinal canal) and discectomy (procedure to remove all or part of damaged spinal disc) on March 13, 2021, to relieve pressure on the nerves.During the surgery, the protective membrane surrounding the spinal cord, called the dura, developed a tear. The doctor applied a fat patch to seal the tear and discharged the complainant on March 17.The patient alleged that fluid continued to leak from the surgical wound after his discharge. When he returned to the hospital on March 21, the doctor initially planned to close the wound with stitches under local anaesthesia. However, instead of suturing it, the doctor applied a surgical sealant, without explaining the change in treatment plan to the patient.Story continues below this adHe was discharged again on March 24, after which he continued to experience leakage. He later travelled to the US, where another neurosurgeon found fluid collected near the tear and performed surgery on April 2, 2021, to close it with stitches.Later, the patient developed a recurring pain in his left leg all the way down from the hip to the toes. His treating doctor in the US informed him that the recurring pain was due to chronic arachnoiditis from a long-standing CSF leak and soaking of nerves in CSF fluid, resulting in clumping of the spinal nerves.The man approached the Hyderabad consumer commission, alleging that the hospital and neurosurgeon had failed to properly treat the leak and provide adequate post-operative care.‘CSF leak a known risk’The hospital and the doctor, while denying the allegations made in the complaint, claimed that the complaint was not maintainable as it was time-barred, and that the complaint was not filed within the legal limitation period prescribed under the Consumer Protection Act. Story continues below this adThey argued that complications such as CSF leak is a known risk associated with laminectomy procedures and are not indicative of negligence. The commission said the main issue was whether the doctor had exercised reasonable care in managing the complication. “It is not the adverse outcome that has to be seen in the present case but the failure to take reasonable care while addressing the known complication. The evidence on the record establishes that the opposite party No. 2 (doctor) has failed to take reasonable care owed and accepted by him while taking the case of the complainant,” the order added.The commission awarded a compensation of Rs 20 lakh for the deficiency in service and costs of Rs 50,000 to meet the ends of justice. Takeaway The ruling highlights that patients have the right to be informed about changes to their treatment plan. If a complication persists or they are concerned about the care provided, they can seek a second medical opinion and preserve their records to support any complaint.Story continues below this adAggrieved consumers may contact the consumer helpline in their respective states (Telangana: 0771-2582902) or call the National Consumer Helpline at 1915 for assistance.Don’t miss out on these stories:Rs 10 parking fee dispute ends in Rs 22 lakh penalty for hospital, contractorTwo ‘strangers’ share one blanket during train journey, Indian Railways fined Rs 25,000Kerala woman’s new doors show cracks, wood worker held liable, to pay Rs 65,000