In 2009, the patient went to Poulomi Hospital in Secunderabad for hernia surgery, however, he was later informed of "non-visualisation of left kidney".
Poulomi Hospital in Secunderabad. (Supplied)
You experience the wrenching twist of abdominal pain, a cruel herald to the revelation of a hernia diagnosis. Medical professionals choose the path of hernia removal surgery to take away your discomfort.
Yet, the agony returns, two years later, unveiling a dark secret: During the surgery meant to mend your hernia, your kidney was removed without your knowledge.
In a matter in Telangana, the State Consumer Disputes Redressal Commission has directed a Hyderabad hospital to compensate an individual with ₹30 lakh, following allegations that the person’s kidney was removed during a surgical procedure conducted at the hospital.
In 2009, Renukuntla Ravi Raju, a resident of Kothagudem in Telangana, sought medical attention at Poulomi Hospital in Secunderabad, Hyderabad, upon developing a hernia. He underwent thorough hospital investigations, including a complete abdominal ultrasound scan. The report from the scan indicated “both kidneys were of normal contour and echo texture, with the right kidney measuring 96 x 48 mm and the left kidney measuring 117 x 60 mm”.
Following the hernia surgery at the hospital, Ravi Raju remained in contact with the medical facility, receiving regular prescriptions. However, his health deteriorated, requiring an extended period of rest and preventing him from engaging in physical activities.
Consequently, he took up work as a driver for a light motor vehicle, despite medical advice against strenuous activities.
In 2011, while visiting family in Kolkata, he experienced severe abdominal pain, prompting him to seek immediate medical attention. He was admitted to the hospital, where another hernia operation was performed, involving the insertion of a mesh to prevent further hernias.
Throughout his stay, various investigations and scans were conducted, revealing that his “left kidney was not well visualised,” as reported by the attending doctor.
“It is only then he realised that Poulomi Hospital, in 2009, while conducting the hernia operation, had fraudulently removed his left kidney without his knowledge, information, and consent, and the said fact came to light only in 2011 when the doctor in Calcutta (Kolkata) had informed him,” the petition to the State Consumer Disputes Redressal Commission stated.
In 2012, Ravi Raju suffered severe abdominal pain once again, prompting him to seek assistance from the Kothagudem Area Hospital. Subsequently, he was referred to the Medicare Diagnostic Centre for various medical tests, including an ultrasound scan of the abdomen and pelvis. The results from this scan further confirmed that the left kidney was missing.
Following this, he sought further medical consultation at Mamata Medical College Hospital in Khammam. Once again, the scan report confirmed the inability to visualise the left kidney.
In 2014, Ravi Raju took his case to the Andhra Pradesh State Human Rights Commission, which subsequently referred the matter to the Kushaiguda Police Station in Cyberabad. Upon conducting investigations and inquiries, the police determined that the hospital’s actions “constituted a deficiency in service”.
They further advised Ravi Raju to pursue his case through the State Consumer Disputes Redressal Commission.
“Due to the fraudulent act by the hospital, the precious life of his had been ruined, life span has been reduced and has developed several malfunctioning and his urinary system has also totally crippled his life due to which his marital status has also been affected and he has no children till date,” the petition stated.
“The hospital doctors being influential persons and him being a poor man could not get justice, due to such deficient acts of hospital, he has been suffering continuously but the opposite party had removed his left kidney and earned about ₹50 lakh by replacing it into another person,” said the petition.
In their written statement, the hospital contended that the complainant had received prior treatment at Gandhi Hospital before coming to their facility. They asserted that the complainant had undergone multiple surgeries at Gandhi Hospital. Furthermore, the hospital argued that the absence of kidney visualisation in medical scans did not conclusively indicate kidney removal.
They pointed out that kidney non-visualisation could also be due to kidney atrophy, emphasising that this condition doesn’t necessarily imply kidney removal.
Additionally, the hospital claimed that there was no direct connection between the surgery conducted in 2009 at their hospital and the reported pain experienced by the complainant.
“To receive a kidney for transplantation, huge process and regulations are involved under the special Act called ‘Organ Donation Act’ and the donor of such kidney should be in a healthy condition, whereas in the instant case, the complainant himself is suffering from stones in his kidneys and had underwent several surgeries for the same, as such, removing of the kidney does not arise. Further, the opposite party had pleaded that for a kidney to be transplanted the donor and recipient must be closely related and shall be in good health,” said the hospital.
The hospital provided additional details, stating that after conducting percutaneous nephrolithotomy for renal calculus and performing hernia removal, the patient was discharged. Before discharge, an ultrasound was conducted on 28 July 2009, specifically focusing on the left lumbar region to assess the postoperative condition. According to the hospital, this ultrasound clearly indicated the presence of the left kidney, measuring 123 x 62 mm. They claimed that they showed this documented evidence to the complainant before his discharge.
Furthermore, the hospital highlighted that based on this document, the Kushaiguda Police had concluded their inquiry, finding no grounds for negligence on their part. They maintained that they did not commit any negligent acts during the procedures. Additionally, the hospital suggested that the current complaint was made with the sole intention of extracting money from the hospital.
The hospital also cited that the complaint is time-barred by limitation. They pointed out that the complainant had received treatment from them in 2009 and, according to the complainant’s assertion, the knowledge regarding the non-visualisation of the kidney arose in 2011. As per Section 24 of the Consumer Protection Act, 1986, complaints should be filed within two years of the cause of action.
However, the present complaint was filed in 2017, exceeding this limitation period. Therefore, the hospital argued that the complaint should be dismissed on grounds of being time-barred.
Moreover, the hospital highlighted that since the complainant received services under the Aarogyasri Scheme without paying any consideration, they contended that the complainant does not fall under the category of a consumer. Consequently, they claimed that the complaint is not maintainable as per consumer protection laws.
The Commission’s primary observation was that the complainant did not directly bear the cost of the surgery; instead, it was covered by the government. “It is a fact borne by record that the complainant has not paid any consideration to the hospital but the Government has paid the consideration on behalf of the complainant hence it implies that the complainant has paid the valid consideration and had availed the services of hospital as a beneficiary as such he falls into the definition of ‘consumer’,” said the Commission.
The Commission added that many of the reports submitted by the complainant stated the details as “left kidney not visualised”.
“The hospital who had appeared and filed a written version but had failed to file any evidence affidavit nor any documents, and had contended in the written version that in case of atrophy of kidney, the kidneys will not be visible,” said the hospital.
The Commission emphasised that in cases involving allegations of medical negligence supported by documentary evidence, the burden shifts to the hospital to demonstrate that they acted appropriately and provided diligent services. However, in this particular case, the hospital failed to present any evidence or make efforts to prove that the non-visualisation of the kidney was due to atrophy, as claimed.
Furthermore, the Commission highlighted that the hospital explicitly stated that an ultrasound was conducted on 28 July 2009, prior to the complainant’s discharge, focusing on the left lumbar region post-operation. According to the hospital’s report, the left kidney was distinctly visible in this ultrasound, measuring 123 x 62 mm, “but no such report is filed before this Commission,” it stated.
As the hospital did not provide clarification, the Commission took steps to ascertain the truth of the matter. They directed the complainant to undergo an examination at Gandhi Hospital in Secunderabad. The hospital was instructed to conduct a thorough examination of the complainant and submit a report detailing whether the complainant’s left kidney was visible or had been surgically removed.
This action was taken to establish conclusive evidence regarding the presence or absence of the left kidney, seeking an objective evaluation to determine the accuracy of the claims made by both parties.
The examination conducted by Gandhi Hospital and the subsequent report unfortunately lack conclusiveness for several reasons, the Commission said.
Firstly, the report is handwritten and lacks support from any pathology report or MRI films. Moreover, within the report itself, there are inconsistencies such as noting the left kidney as “not visualised”, while also indicating the presence of a calculus in the same kidney. Additionally, while measurements for the right kidney and the left renal fossa (the location where the kidney is situated in layman’s terms) are provided, there are no specific measurements given for the left kidney.
Furthermore, although Gandhi Hospital included a CD along with the report, regrettably, the CD was found to be empty. Due to these significant discrepancies and the lack of conclusive information, it is not reliable to place confidence in the report provided by Gandhi Hospital.
“The documents speak for themselves, in view of these documents the burden shifts on the hospital to prove that the left kidney was not removed but had shrunk due to atrophy and the same is not visualised but no such evidence is forthcoming from them,” observed the Commission.
It added that all these acts and avoiding and escaping behaviour of hospital led them to irresistibly conclude that the opposite parties, under the guise of hernia operation, had illegally removed the left kidney of the complainant, “the hospital had taken undue advantage of the ignorance of the complainant and deceived him, thereby not only causing organ loss to the complainant but the complainant is forced to live with the fear, frustration, and disappointment,” said the Commission.
“Strictly speaking, the act committed by the hospital is criminal in nature. But here we are dealing with the loss and injury suffered by the complainant due to the acts of the hospital, though any amount of compensation will not restore the loss suffered by the complainant,” said the Commission.
It concluded that while computing the loss suffered, the following things are to be kept in mind — life expectancy has reduced and the loss he may suffer in the future; secondly, the expenditure he would incur in further treatment, loss of future earnings, physical sufferance, and the mental agony in the form of frustration, disappointment, though these sufferings cannot be calculated in monetary terms. But since the complainant had not provided any details of earnings, “we feel ₹30 lakh would be reasonable compensation that can be awarded,” said the Commission.
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