What initially appeared to be a routine orthopaedic repair following a serious accident eventually unfolded into a prolonged medical struggle — and a finding of negligence rooted not in complication alone, but in deviation from established treatment standards.
The patient had suffered a compound fracture of the right humerus along with finger injury and underwent surgery at a nursing home, where an interlocking nail implant was inserted. He was discharged within days but continued to experience persistent pain and functional difficulty in his arm.
Over time, the discomfort worsened. Follow-up consultations revealed that the implant had fractured and the bone had failed to unite — a condition known as non-union. Seeking further care at a specialised hospital in Chennai, the patient underwent corrective surgery involving implant removal, plate fixation and bone grafting.
Alleging that the original procedure had been improperly performed, the patient approached the State Commission seeking compensation for both medical expenses and long-term suffering.
The treating doctors denied negligence, arguing that implant failure was a recognised complication in fracture treatment and that their approach reflected reasonable medical judgment.
Given the technical nature of the dispute, the Commission referred the matter to an independent expert medical board.
The expert panel acknowledged that implant breakage can occur as a known complication. However, it also highlighted critical lapses in how the compound fracture had been managed. Standard orthopaedic protocol for such injuries requires thorough wound irrigation, proper debridement, and stabilisation — often through external fixation — before definitive internal implants are placed.
In this case, medical records did not clearly establish that these essential steps were followed. The experts specifically noted that the operative approach appeared inconsistent with accepted protocol for compound fractures, increasing the risk of non-union and implant failure.
Relying on this expert evidence, the Commission concluded that while complications can occur even with proper care, the initial deviation from standard treatment principles constituted medical negligence.
Compensation of ₹15 lakh was awarded to the patient for medical costs and the physical hardship caused by the prolonged corrective process.
The ruling reinforced a critical principle in orthopaedic negligence cases: known complications do not shield liability when the foundational protocol of treatment itself is compromised.
IML Insight
Courts increasingly lean on independent expert review to distinguish unavoidable complications from protocol failure. Where treatment deviates from established clinical standards — particularly in high-risk injuries like compound fractures — medical outcome defences lose strength. Clear documentation of protocol compliance is becoming as vital as surgical skill itself.
Source : Order pronounced by West Bengal State Consumer Disputes Redressal Commission on 5th December, 2025.