A Hyderabad consumer commission has held that a hospital cannot delay life-saving treatment by waiting for the consent of a patient's family when the patient is unconscious and requires urgent intervention and awarded ₹1 crore compensation to the parents of a 30-year-old PhD scholar who died after suffering a massive stroke. The Hyderabad district consumer disputes redressal commission held Citizens Speciality Hospital and its consultant neurologist, Dr Aparna Vijay Kumar, jointly and severally liable for negligence and deficiency in treatment of Surya Pratap Bharathi, who died on 21 August 2020, four days after he suffered a stroke.
The commission also directed these two opposite parties to pay ₹50,000 towards legal expenses. The compensation will bear interest at 9%pa (per annum) from the date of receipt of the order until payment in the event of default.
In an order last week, the bench comprising president B Uma Venkata Subba Lakshmi and members C Lakshmi Prasanna and B Raji Reddy, said, "...the contention of Citizens Speciality Hospital and Dr Kumar that the delay to perform an emergency procedure (such as mechanical thrombectomy) was due to delay in obtaining consent from Surya Pratap Bharathi's (the patient’s) family and its decision to transfer/discharge the patient by claiming 'it was not a COVID-designated hospital', is not only unjustified but considered as deficiency of service and negligence, especially, when it is known to them that acute ischemic stroke caused by a large-vessel occlusion (such as a massive right middle cerebral artery-MCA infarct) is an extreme medical emergency requiring immediate Thrombectomy to prevent irreversible brain damage of the patient."
"In view of the above findings, this commission is of the considered opinion that Citizens Speciality Hospital and Dr Kumar are found negligent and deficient in providing necessary treatment to the patient or the son of the complainants. And under medical negligence jurisprudence, if prompt interventional treatment within the narrow therapeutic window could have saved the patient’s life or prevented fatal brain tissue death, the hospital is liable for the loss of that chance of life or survival or recovery, if they failed to provide the necessary treatment to the patient," the order said.
However, the commission dismissed the complaint against Medcis Pathlabs India Pvt Ltd, Continental Hospital and Dr Kailas Mirche, holding that the allegations against them were not supported by sufficient evidence.
Mr Bharathi, who was pursuing a PhD in English at the University of Hyderabad, was found unconscious in the corridors of the 'O' wing students' hostel at around 2pm on 17 August 2020.
He was taken to the university health centre and, following a referral, was admitted to Citizens Speciality Hospital at around 4pm.
The case arose during the peak of the COVID-19 pandemic. A rapid antigen test was negative and an HRCT chest examination was normal. An MRI, however, showed a massive hyperacute infarct in the right MCA territory, with complete occlusion of the right MCA and its branches. The commission's record shows that the hospital's medical team identified mechanical thrombectomy as a necessary intervention.
The patient's friends and attendants told the Hospital that they wanted the best possible treatment to be started immediately and were willing to arrange the medical expenses through the student's insurance or crowdfunding.
The complainants alleged that despite this, the Hospital did not proceed with the recommended intervention and that the critical treatment window was lost.
Hospital Blamed Delay on Consent
One of the central issues before the commission was whether Citizens Hospital and Dr Kumar were justified in waiting for the patient's family to provide consent before proceeding with mechanical thrombectomy.
The Hospital and doctor contended that the patient's attendants were only friends and that timely consent from the family was not available. They also argued that Mr Bharathi, the patient, had been brought beyond the therapeutic window for thrombolysis and that mechanical thrombectomy could not be performed because of the unclear onset time and lack of timely consent.
The commission rejected this defence. It noted that the Hospital's own discharge summary recorded that the need for mechanical thrombectomy had been explained to the attendants and that the procedure had been suggested on 17 August 2020 after review of the MRI and discussion with an interventional neurologist.
The commission said that in a medical emergency involving an unconscious or incapacitated patient, doctors can proceed with necessary treatment under the principle of implied or presumed consent where waiting for a family member could cause irreversible harm.
"In medical law, as per the emergency exception doctrine," the commission observed, doctors can proceed with standard emergency treatment without prior explicit consent where a patient lacks decision-making capacity and immediate intervention is required to save life or prevent severe, irreversible disability.
It further held that the medical team ought to have documented the urgency of thrombectomy and proceeded under implied or presumed emergency consent rather than waiting for the patient's family.
‘1.9mn Neurons Die Every Minute’
The commission placed particular emphasis on the time-sensitive nature of a hyperacute large-vessel stroke. It noted that in such a stroke, about 1.9mn (million) neurons die every minute and that prudent medical care requires immediate intervention to prevent catastrophic and irreversible brain damage or death.
The commission also rejected the Hospital's contention that the procedure could be delayed because of the COVID testing process.
According to the order, official health advisories required hospitals to provide immediate emergency care without waiting for a COVID-19 test result where crucial medical intervention was required. Hospitals were expected to follow appropriate infection-control and personal protective equipment protocols rather than postpone emergency treatment.
The commission found that the hospital and Dr Kumar had delayed the necessary treatment and subsequently discharged Mr Bharathi in a haemodynamically unstable condition on 19 August 2020.
The patient was shifted to Continental Hospital on a ventilator. The commission noted that he was sedated and paralysed and that no medical staff from Citizens Hospital accompanied him in the ambulance. He died on 21 August 2020.
Covid Report Allegation Not Established
The parents of Mr Bharathi, the complainants, had also alleged that Medcis Pathlabs issued a false positive Covid-19 report on 19 August 2020, which contributed to the delay and eventual transfer of the patient.
The commission, however, did not accept this allegation.
It said there was no cogent evidence establishing that the RT-PCR report was false. Medcis had produced its internal quality-control report and documentation relating to its participation in the WHO external quality assessment system, and the material remained unchallenged and unrebutted.
The complaint was therefore dismissed against Medcis Pathlabs, Continental Hospital and Dr Kailas Mirche.
Commission Applies ‘Loss of Chance’ Principle
While assessing liability, the commission said the case was not about whether the initial medical approach was itself inappropriate. Instead, the critical issue was the failure to carry out the mechanical thrombectomy after it had been identified as the appropriate intervention.
The commission held that where prompt interventional treatment within a narrow therapeutic window could have saved a patient's life or prevented fatal brain-tissue death, failure to provide that treatment can make the hospital liable for the loss of the chance of survival or recovery.
It concluded that Citizens Speciality Hospital and Dr Kumar were negligent and deficient in providing the necessary treatment.
"OP No1 & 2 are found negligent and deficient in providing necessary treatment to the patient/son of the complainants," the commission held, adding that the hospital was liable for the loss of the chance of life or survival/recovery where timely intervention could have made a difference.
Parents Were Dependent on Their Son
The commission also took into account Mr Bharathi’s age, academic record and potential future career.
The evidence showed that he was a young PhD scholar with potential employment prospects and had been receiving a UGC fellowship. The complainants, his parents, were described in the proceedings as aged and financially dependent on the future support of their son.
The commission said his death deprived the parents of their anticipated financial security and care in their later years, besides causing severe emotional trauma.
It therefore, awarded ₹1 crore under the heads of loss of dependency, income and future prospects, filial consortium and mental agony.
The parents had originally sought compensation of more than ₹5.6 crore for loss of dependency and other losses, along with additional amounts towards filial consortium, refund of expenses and litigation costs.
The commission allowed the complaint only in part, ultimately awarding ₹1 crore and ₹50,000 towards legal expenses.
The ruling underscores the importance of immediate intervention in time-sensitive medical emergencies, particularly where a patient is unconscious and unable to provide consent.
The commission's reasoning also makes clear that the absence of a family member cannot automatically become a justification for delaying a life-saving procedure when the treating team has identified the need for immediate intervention and waiting could result in irreversible harm.
In Mr Bharathi’s case, the commission found that the hospital's own records established the need for mechanical thrombectomy, while the defence that consent was unavailable could not justify the delay.
The commission consequently held Citizens Speciality Hospital and Dr Aparna Kumar jointly and severally responsible for the deficiency in treatment and ordered them to pay ₹1 crore to Mr Bharathi’s parents.
(Case: CC No567/2022 Date: 25 August 2026)
