A surgeon excised a mediastinal tumor but, in the process, sacrificed the patient’s phrenic nerve, leading to lasting complications. The case raised critical questions about whether patients — especially doctors — must be explicitly informed of such risks before surgery.
Irrefutable Facts
The patient, a doctor himself, was diagnosed with ‘Anterior Mediastinum Tumor’ based on chest X-Ray (CXR) and CT scan. The surgeon (OP2) recommended surgery for Median ‘Sternotomy’ and ‘Thymectomy’.
During the surgery, the surgeon accidentally cut thehis left Phrenic Nerve, resulting in the raising of left diaphragm, and thereby patient developed left vocal cord palsy.
He was referred to the ENT department and advised speech therapy, which continued when this complaint was filed.
The patient sued the surgeon. It was alleged that he failed to inform about the postoperative complications. It was further alleged that the surgeon delayed sending the specimen of the ‘Thymus Mass’ for HPE.
Doctors’ Plea
The surgeon stated that resecting the left phrenic nerve was necessary to achieve complete tumor excision. This decision was taken on the operation table and in the patient’s best interest.
Court’s Observations
The court observed from the medical literature that if the tumor engulfed the Phrenic nerve, then two treatment options were available and that in this case, “to achieve complete tumor excision sacrificed the ipsilateral phrenic nerve was chosen by the surgeon. It is an accepted mode of treatment.” Hence, the court concluded that “it was due diligence of the surgeon and he exercised the care during entire procedure.”
The court specifically pointed out that the patient was a doctor himself, but he was not informed about the post-operative complications of nerve injury during such surgery”, which amounted to negligence.
The surgeon was held negligent for this aspect of medical care.
Prevention Is Better Than Cure
Surgeons should thoroughly explain a surgical intervention’s potential risks and benefits pre-operatively and then obtain informed consent. This protocol should be followed even if the patient is a doctor.
Source : All India Institute of Medical Sciences, New Delhi v/s Lt. J. S. Bedi & Ors.
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