The national consumer disputes redressal commission (NCDRC) has upheld the Rajasthan state consumer commission’s finding of medical negligence against Udaipur-based Geetanjali Medical College and Hospital and its ear, nose and throat (ENT) specialist Dr AK Gupta, in a case involving a botched nasal surgery that left a 16-year-old girl with brain injuries. However, while agreeing that the doctor and hospital failed in their duty of care, the commission reduced the overall compensation awarded by the state commission, holding that it was 'excessive and unsupported by evidence'.
In an order last week, the NCDRC bench of justice AP Sahi (president) and Bharatkumar Pandya (member) says, "...we partly modify the directions in the state commission’s order. The total joint liability of Dr Gupta and Geetanjali Medical College and Hospital is quantified at Rs10 lakh with 9% simple interest from the date of filing of the complaint i.e. 3 May 2010 till the date of payment. Out of this amount of joint liability, Oriental Insurance Company shall pay Rs5 lakh with 9% interest for the period 3 May 2010 till the date of payment, within two months from the date of this order. The balance amount of Rs5 lakh with 9% interest and the cost of Rs50,000, shall be paid jointly by Dr Gupta and the Geetanjali Medical College and Hospital jointly within a period of two months from the date of this order. The failure to make requisite payments on or before the due date shall entail an enhanced rate of interest of 12% in place of 9% starting from the date next following the due date as directed under this order."
The case arose from a complaint filed in 2010 by Swechha Kothari and her father Arun Kothari, who alleged that a nasal polyp surgery performed at Geetanjali Hospital in April 2008 caused severe neurological complications due to gross negligence. The surgery, conducted by Dr Gupta, was performed without a mandatory pre-operative CT scan of the paranasal sinuses, despite the patient’s condition being located close to the brain.
According to the complaint, immediately after the surgery, the teenager suffered severe headaches. A subsequent computed tomography (CT) scan revealed a subarachnoid haemorrhage (SAH), a dangerous form of bleeding in the brain. A magnetic resonance imaging (MRI) taken later showed a bony defect at the base of the skull with brain tissue herniating into the nasal cavity, a condition known as encephalocele. The family eventually shifted the patient to SAL Hospital in Ahmedabad, where she underwent corrective brain surgery.
The complainants alleged that Dr Gupta failed to conduct the CT scan, fabricated hospital records to suggest that the scan was 'advised but refused' and delayed referring the patient for neurological evaluation. They claimed that these omissions caused lifelong physical and mental trauma to the young girl, who was advised to avoid driving, exposure to heights and strenuous activities.
In 2021, the Rajasthan state consumer commission found the Hospital and doctor guilty of negligence and awarded a compensation of Rs17.34 lakh, including medical expenses, mental agony and future treatment costs, with 9% annual interest. It also held the Hospital vicariously liable and directed its insurer, Oriental Insurance, to indemnify up to Rs5 lakh.
Challenging the verdict, Dr Gupta and the Hospital approached NCDRC, arguing that the patient’s father had refused the CT scan, despite being advised that the complication (SAH) was a known and rare post-surgical risk, and that three independent medical committees, including one by the Rajasthan Medical Council had found no gross negligence.
They maintained that the surgery, a routine nasal polypectomy and not a more complex functional endoscopic sinus surgery (FESS), did not mandatorily require a CT scan. They also asserted that all post-operative care, including neurosurgical consultations, was properly undertaken.
However, NCDRC, in its judgement, rejected the appeal on merits, agreeing with the state commission’s finding that the failure to conduct a pre-operative CT scan amounted to negligence. The bench held that the record showing 'CT PNS advised but patient refused' is inserted later in a different handwriting and ink, undermining its authenticity.
“The attempt at manipulation of records itself is a serious infraction of ethical medical conduct,” the order stated, observing that the hospital’s subsequent insertion appeared to be an effort to 'cover up the lapse' of not conducting the scan.
The commission agreed that the surgery was undertaken hastily without any emergency justification and that a CT scan would have enabled the surgeon to anticipate skull base defects and prevent complications.
NCDRC also cited the Rajasthan Medical Council’s 2011 order, which, though stopping short of calling it 'gross negligence', had warned Dr Gupta 'to be more vigilant while performing surgery'. The commission found this warning significant, holding that it corroborated the finding of negligence and lack of due care.
At the same time, NCDRC partially accepted the appeal regarding the quantum of damages. It ruled that while the negligence was proven, the compensation of over Rs17 lakh lacked evidentiary support, as the Kotharis failed to produce documents showing continued treatment, prolonged disability, or post-surgery medical expenses beyond the SAL Hospital bills.
Citing Supreme Court precedents including HUDA vs Shakuntla Devi (2017) and Charan Singh vs Healing Touch Hospital (2000), the commission observed that compensation in consumer cases must be 'fair, reasonable, and commensurate with proven loss or injury'. It says that the state commission had relied on assumptions rather than evidence to quantify damages for mental agony and future treatment.
“There is no evidence of prolonged inability or limitation of the patient in pursuing normal lifestyle… the quantum of compensation to the tune of nearly Rs16.84 lakh appears unfounded, one-sided, and conjectural,” NCDRC noted. It also observed that Geetanjali Hospital, being a charitable institution, had charged only Rs15,500 for 11 days of hospitalisation, showing no commercial motive or exploitation.
Accordingly, the national commission upheld the finding of medical negligence and ethical misconduct but ordered that the compensation be scaled down to a 'reasonable amount proportionate to the proven loss and suffering'. The revised amount will include verified treatment expenses and a reduced sum for pain and suffering, though the exact figure will be determined in the execution stage.
(First Appeal Nos84/2022 and 25/2022 Date: 3 November 2025)
