A general practitioner who relocated to India has been hit with a substantial £128,000 medical negligence bill after she failed to arrange a same-day face-to-face consultation for a British patient suffering from the severe infection necrotising fasciitis.
Failure to Diagnose Leads to Severe Consequences
Dr Nupur Mittal, who was working at the Waterfield Practice in Bracknell at the time, saw patient Oriana McDonald, 57, on July 6, 2018. Ms McDonald reported discovering a lump on her stomach and informed the doctor she had a temperature of 36.6C. According to court documents, Dr Mittal did not conduct a physical examination or take her temperature, instead prescribing antibiotics and diagnosing cellulitis.
Three days later, on July 9, 2018, Ms McDonald contacted the practice again, reporting that her condition had worsened significantly. She stated she could not move, the redness had spread, and she was sweating. Despite these alarming symptoms, Dr Mittal prescribed another antibiotic, Metronidazole, without arranging an in-person review or advising the patient to attend accident and emergency.
Emergency Surgery and Life-Altering Scarring
By July 11, 2018, Ms McDonald's partner called for an ambulance as she was in pain and less alert, with concerns the situation had become urgent. She was subsequently diagnosed with a large abscess or cyst on the abdominal wall showing signs of sepsis, with suspicion of necrotising fasciitis – often referred to as the 'flesh-eating disease'.
Ms McDonald underwent emergency surgery the same day, requiring debridement of the anterior abdominal wall, which removed a substantial portion of damaged tissue. This left her with significant scarring, necessitating plastic surgery to close the open wound on September 20, 2018. The procedure resulted in what was described as an 'unsightly' abdominal scar, leaving her without an umbilicus and with asymmetrical overhang.
Legal Proceedings and Court Judgment
Ms McDonald sued Dr Mittal for personal injury, loss, damage, pain, suffering, and loss of enjoyment of life. Nicholas Truelove, her barrister, argued that Dr Mittal breached her duty of care on July 9, 2018, by failing to either see the patient face-to-face or direct her to A&E. He contended that earlier intervention would have led to a shorter recovery period, reduced hospitalisation, and significantly less scarring.
Reading County Court heard that Dr Mittal, who was living in India when the original lawsuit was filed, did not submit a defence. Deputy District Judge Simon Lindsey noted that while Dr Mittal attempted to have the judgment set aside in June of the previous year, she failed to pay the required fee or provide necessary information, so the application was never advanced.
Financial Consequences and Property Charge
At a hearing last month, Judge Lindsey ruled that the debt of £128,204.30, including interest, should be secured against Dr Mittal's beneficial interest in her Berkshire home. Although her husband, from whom she is divorcing, objected to the charging order, the judge specified it would only apply to Dr Mittal's share of the property.
Martha Garcia, representing Ms McDonald, requested additional costs due to Dr Mittal's disregard for court directions, which caused a five-month delay and incurred further legal fees. Judge Lindsey declined to award extra costs, deeming them excessive, but affirmed the charging order to protect the substantial debt.
Aftermath and Current Situation
Dr Mittal arrived at court in person after the hearing had concluded but was informed she was too late to attend. She inquired about an appeal, though the court confirmed to the Daily Mail that no appeal had been received as of Wednesday.
Since late 2024, Dr Mittal has been operating the Ambala Wellness Clinic in Ambala, northern India, which promotes her '20 years of international experience in the UK'. When contacted for comment, a spokesperson for the clinic stated the matter 'is in the appeals court', despite the court's confirmation that no appeal has been lodged.
This case highlights critical issues in patient safety and medical accountability, particularly concerning the diagnosis and management of severe infections like necrotising fasciitis within the NHS framework.
