Error of Judgment Isn’t Negligence – NCDRC Dismisses ₹7 Crore Medical Negligence Claim Over Foot Surgery

“Surgery Followed Accepted Medical Standards” – NCDRC Holds No Deficiency in Hallux Valgus Correction Case Against Indian Spinal Injuries Centre. National Consumer Disputes Redressal Commission (NCDRC) delivered a significant ruling in the realm of medical negligence jurisprudence, emphatically holding that “a mere error of judgment or an adverse outcome does not constitute medical negligence.” The Bench comprising Mr. Subhash Chandra (Presiding Member) and AVM J. Rajendra (Member) dismissed a ₹7.07 crore compensation claim filed by Ms. Sabita Rastogi against the Indian Spinal Injuries Centre, stating that the procedure followed was medically sound, standard, and within the bounds of acceptable professional practice.

The complainant, Ms. Sabita Rastogi, had alleged that a corrective foot surgery — Proximal Metatarsal Osteotomy with Distal Soft Tissue Procedure — performed at the hospital resulted in permanent deformity of her second toe, persistent numbness, swelling, and functional disability. Citing pain, deformity, and loss of professional and social life, she sought damages totaling ₹7.07 crore, arguing that the hospital and the surgeon acted negligently both during and after surgery.

“Surgery Was Medically Indicated And Scientifically Justified” – Court Finds No Medical Negligence

The NCDRC, however, rejected the claim in categorical terms, noting, “The procedure undertaken was entirely consistent with established medical standards. The Proximal Metatarsal Osteotomy with Distal Soft Tissue Procedure is a medically accepted intervention for patients with a hallux valgus angle exceeding 30 degrees and an intermetatarsal angle greater than 13 degrees.”

Citing authoritative orthopaedic literature, the Bench observed, “This procedure is technically demanding but appropriate for deformities with a hallux valgus angle of 35 degrees and an intermetatarsal angle of 20 degrees — both of which were present in the complainant’s case.”

“Jacob Mathew Doctrine Applies” – NCDRC Reiterates Supreme Court’s Principles On Medical Negligence

The Commission drew extensively from the landmark judgment of the Supreme Court in Jacob Mathew v. State of Punjab (2005) 6 SCC 1, reiterating the three essential components for establishing medical negligence:

“Duty of care, breach of that duty, and resultant injury. Mere error of judgment or the fact that a better alternative was available does not, in law, constitute negligence if the procedure followed is accepted by the medical community.”

The Commission clarified, “As long as a medical professional acts in accordance with a practice acceptable to the profession, he cannot be held liable merely because a different course of treatment might have produced a different result.”

On the ‘Blood Group Error’: “Clerical Error Does Not Constitute Negligence Without Consequential Harm”

One of the complainant’s central arguments was that her blood group was incorrectly recorded as O+ instead of O-. However, the Commission dismissed this claim, stating that “Though undesirable, this clerical error does not amount to actionable negligence as there was no blood transfusion required during the procedure, and therefore no harm occurred.”

The Bench added that “Negligence requires not just error, but error resulting in damage. Here, no such damage was established.”

“Deformity of Second Toe Was Pre-Existing or A Known Risk, Not Negligence” – Commission Rejects Causation Argument

The NCDRC rejected the contention that the second toe deformity was the result of surgical error. The Bench observed, “Medical records prior to the surgery reflect the presence of an overriding second toe condition. The post-surgical prominence of this deformity is neither unexpected nor uncommon in hallux valgus correction. This possibility was duly explained to the complainant as part of the informed consent process.”

Addressing the complainant’s argument that the surgeon should have adopted a less invasive method, the Commission remarked, “It is not open to a patient or a consumer forum to dictate the choice of surgical technique when the chosen procedure is medically acceptable and widely practiced.”

On Alleged Premature Discharge: “No Evidence of Improper Post-operative Care”

Dismissing allegations of hurried discharge and inadequate wound care, the Commission noted, “The records do not show any abnormality in discharge procedure. The complainant did not make any request for extended hospitalization, and post-operative complications were managed in accordance with medical protocols.”

“Res Ipsa Loquitur Does Not Apply Here” – Burden of Proof Not Met

The complainant had invoked the doctrine of Res Ipsa Loquitur (the thing speaks for itself), arguing that the very occurrence of a deformity post-surgery was evidence of negligence. The NCDRC rejected this contention, holding, “The doctrine cannot be applied mechanically. In complex medical procedures, an adverse outcome does not ipso facto mean negligence.”

Complaint Dismissed – No Negligence, No Deficiency in Service

In its concluding observations, the Commission stated unequivocally,
“The surgery performed was consistent with established orthopaedic principles. There was no deviation from standard care, no act of omission or commission that could amount to negligence, nor any deficiency in service.”

The complaint was accordingly dismissed in entirety, with the Commission declining to grant any costs, observing, “Considering the facts, there shall be no order as to costs.”

Date of Decision: 21 May 2025