Hyderabad: On 16 September, the Hyderabad District Commissioner Court ordered a hospital and a neurosurgeon to pay Rs 20 lakh as compensation and Rs 50,000 in additional costs to a US-based endocrinologist because the doctor failed to provide proper medical care for a cerebrospinal fluid (CSF) leak following spinal surgery in March 2021.
The hospital, Venkateshwara Ortho Health Care Pvt Ltd, which operates Srikara Hospitals, and consultant neurosurgeon Dr. Mohammed Imran were directed to pay the amounts jointly and severally. The complainant was Dr. Chandrasekhar Kota, a US-based endocrinologist.
According to the reports, the commission found that the doctor didn’t suture the tear; instead, they applied a surgical sealant, a conscious mistake and a failure to provide reasonable care during a complicated procedure.
The September 16 order said, “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.”
Dr. Kota is an Overseas Citizen of India (OCI) cardholder and a US passport holder. He has been practising endocrinology in the US since 1994.
According to the reports, the complainant developed severe pain in his right leg and couldn’t walk in March 2021.
He was admitted to a hospital in Hyderabad and underwent a laminectomy and discectomy surgery performed by a neurosurgeon on March 13, 2021, to control the pressure on his nerves.
During the surgery, the membrane around the spinal cord developed a tear.
According to the reports, the doctor used a fat patch to seal the tear, and the complainant was discharged on March 17, 2021.
Allegedly, the fluid continued to leak from the patient’s wound after his discharge. On March 21, the patient returned to the hospital, and the doctor advised stitching the wound using local anaesthesia.
However, he never sutured the area; rather applied a surgical seal on the wound without informing the patient or his family about the change in the treatment plan.
According to the case details reported by Hyderabad Mail, the medical records showed that the plan was to perform secondary suturing under local anesthesia, but a surgical adhesive was used instead. The commission found no adequate explanation for this change and no evidence that the patient had been informed.
On March 24, 2021, the complainant was discharged again, but he continued to experience the leak.
On April 2, 2021, he had another surgery in the US, where a neurosurgeon stitched his wound and closed it.
The case record reportedly showed that approximately 150 cc of CSF had collected near the tear, along with fragments of disc and bone material.
However, the complainant developed ongoing pain in his left leg from the hips to his toes. He was informed by a doctor in the US that the reason for the pain was chronic arachnoiditis associated with the prolonged CSF leak and that his nerves were soaking in the CSF fluid, resulting in clumping of his nerves.
In May 2023, Dr. Kota reportedly developed further pain and underwent another spinal surgery on May 24, 2023.
After the diagnosis from the US doctor, the patient approached the Hyderabad Consumer Commission and alleged that the hospital and the neurosurgeon did not treat the leak properly and did not provide better post-operative care.
The hospital and doctor rejected the claims made against them, arguing that the case should be dismissed because the patient missed the legal filing deadline set by the Consumer Protection Act.
The hospital said that a CSF leak is a known risk after a laminectomy procedure and it cannot be considered negligence.
The commission rejected the limitation objection. According to a report examining the order, it noted that there was no proof that the requested treatment records had been supplied to the complainant.
The commission also considered the medical literature submitted by the defence, which indicated that using a sealant alone carries a higher failure rate than combining a sealant with sutures. It clarified that the case concerned the management of the post-operative complication, rather than the surgeon’s qualifications or the original operation itself.
“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 said.
The Commission granted Rs 20 lakh in compensation due to deficient service, along with Rs 50,000 for litigation expenses, in order to deliver a fair judgment. It directed the hospital and neurosurgeon to comply within 45 days. If they fail to pay within that period, the compensation will carry interest at 9% per annum from the date the complaint was filed until payment. Dr. Kota filed the complaint on February 7, 2025.
(Rh/ARC/MSM)
