Kerala Consumer Commission Holds Mother Hospital Liable for Colonoscopy Without Patient's Informed Consent

The District Consumer Disputes Redressal Commission, Thrissur, has held Mother Hospital's Director, Medical Superintendent, and the treating doctor liable for medical negligence after an elective colonoscopy was performed without obtaining the patient's informed consent.

The Commission found that the patient, Sarojini, was capable of making her own healthcare decisions, yet written consent for the planned procedure was obtained only from her daughter. During the colonoscopy, she suffered a bowel perforation that required emergency surgery and a prolonged hospital stay. The Commission concluded that these lapses amounted to medical negligence and deficiency in service.

The Commission observed that the colonoscopy was a planned, non-emergency procedure. In its order, it stated that "informed consent is not a mere formality," emphasizing that patients must be informed about the purpose of the procedure, its potential risks, available alternatives, and possible complications before agreeing to undergo it.

The bench found no evidence that Sarojini lacked the capacity to decide for herself. Instead, consent was obtained from her daughter. It also identified deficiencies in documenting her medical history, assessing individual risk factors, maintaining procedure records, and providing appropriate monitoring after signs of perforation appeared.

Mother Hospital argued that bowel perforation is a recognized complication of colonoscopy and relied on the opinion of the District Medical Officer's Expert Medical Panel, which did not find medical negligence. However, the Commission held that the cumulative shortcomings fell below the standard expected of a reasonably competent medical practitioner and also held the hospital vicariously liable.

A colonoscopy is a commonly performed diagnostic test that allows doctors to examine the lining of the large intestine. It is often recommended to investigate symptoms such as persistent diarrhea, abdominal pain, rectal bleeding, or to evaluate suspected bowel disease. Although generally safe, the procedure carries uncommon but recognized risks, including bleeding, reactions to sedation, and bowel perforation.

Before a planned colonoscopy, doctors are expected to explain the purpose of the test, its benefits, possible risks, and available alternatives so that patients can make their own healthcare decisions. When an adult is mentally competent, permission from a family member cannot replace the patient's own consent.

Also see:Florida Doctor Forgets to Wear Hearing Aids During Colonoscopy, Fails to Hear Patient's Screams

The Commission held Mother Hospital's Director, Medical Superintendent, and the doctor who advised and performed the colonoscopy jointly and severally liable. It directed them to refund ₹28,790 towards the medical expenses incurred for the colonoscopy and corrective surgery, pay ₹50,000 as compensation for pain, suffering, and mental agony, and ₹25,000 towards litigation costs, along with 9% annual interest from the date the complaint was filed until payment. Two other opposite parties were cleared of liability.

The ruling serves as a reminder that hospitals and doctors must obtain valid consent directly from competent patients before planned medical procedures, rather than relying solely on permission from accompanying relatives.

(Rh/TP/MSM)