State Consumer Disputes Redressal Commission
Thankam Hospital Of N P M R C, vs Mrs. Jayanthi, W/O Sreekumaran, on 12 August, 2011
Daily Order
Kerala State Consumer Disputes Redressal Commission Vazhuthacaud,Thiruvananthapuram First Appeal No. 800/2005 (Arisen out of Order Dated null in Case No. of District ) 1. The MD,Thankam Hospitals of N.P.M.R.C Chadanamkurissi,West Yakkara,Palakkad BEFORE: HONARABLE MR. JUSTICE SHRI.K.R.UDAYABHANU PRESIDENT For the Appellant: For the Respondent: ORDER
KERALA STATE CONSUMER DISPUTES REDRESSAL COMMISSION VAZHUTHACAUD, THIRUVANANTHAPURAM.
APPEAL NO. 800/2005
JUDGMENT DATED: 12-08-2011
PRESENT:
JUSTICE SHRI. K.R. UDAYABHANU : PRESIDENT
1.Thankam Hospital of N P M R C, Chadanamkurissi, West Yakkara, Palakkad, re. by the Managing Director.
2. The Managing Director, Palakkad Medical & Research Central Ltd., 25/331, Shoranur Road, Nurani, : APPELLANTS Palakkad-4.
3. Palakkad Medical & Research Central Ltd., 25/331, Shoranur Road, Nurani, Palakkad-4.
(By Adv:Smt.Preetha John.K) Vs. Mrs. Jayanthi, W/o Sreekumaran, Sree Vaishnavam, Polpully, Polpully Post, Palakkad. : RESPONDENT (By Adv:Sri.C.S.Rajesh) JUDGMENT JUSTICE SHRI.K.R. UDAYABHANU : PRESIDENT
The appellants are the opposite parties, the Administrators of the particular hospital wherein the complainant underwent treatment for snake bite. As per order in OP.48/04 in the file of CDRF, Palakkad the opposite parties are under orders to pay compensation of Rs.50,000/- and cost of Rs.500/- with interest at 12% from the date of the order.
2. It is the case of the complainant, a lady aged 46 that on 24/12/2003 after 7 pm she sustained snake bite and was taken to the opposite party hospital. The bite was around the area of 4th and 5th toe of the right foot. It is alleged that the opposite parties did not administer antivenom and waited unnecessarily and also did not refer the complainant to a higher centre. Only on 26.12.2003 at the insistence of the relatives of the complainant she was referred to the Jubilee Mission Hospital, Thrissur. At the time of admission the platelet count was 2,90,000/-. On the next day morning it was 2,10,000 and on 26.12.03 morning the platelet count had gone down to 80,000/-. The doctors at the Jubilee Mission Hospital immediately detected that the petitioner was bitten by viper and that she had acute renal failure. She was in a critical condition. If antivenom treatment was administered on 24.12.2003 itself she would have had an early recovery. Subsequently the 4th and 5th toe of the right foot had to be amputated. She is permanently disabled. She has claimed a sum of Rs.5.lakhs as compensation that included medical expenses amounting to Rs.1,50,000/-.
3. On the other hand, the opposite parties have filed a joint version contending that the complainant could not identify the nature of the snake that bit her. There were 3 tourniquets over the right leg above the bite marks and mild swelling at the point of bite and mild discolouration of the foot which was caused due to the tightness of the tourniquets. The swelling had gradually decreased that gave rise to the impression that the snake that bit her was not of a poisonous variety and that the swelling and discolouration was due to the tightness of the tourniquet. She was given the required treatments and was admitted in the ICU for proper monitoring. All routine tests of blood, urine, liver function test and electrolytis and coagulation were done and the results were within normal limits. Only on 26.12.2003 it was found that the swelling of the tourniquet extended to the foot with changing colour and her blood test showed deviation from normalcy. Her BT and CT increased slightly ie 2 minutes 10 seconds and 4 minutes and 50 seconds respectively. The platelet count drastically decreased to 80,000. Her urea and creatinine levels rose slightly and albumin was ++ and RBC 10-15. As her condition warranted tertiary care at the earliest with dialysis facility and the services of an expert Nephrologist she was referred to Jubilee Mission Hospital, Thrissur. She was shifted in the ambulance of the opposite party. It is denied that there was any deficiency or negligence on the part of the opposite parties. It is pointed out that anti snake venom (ASV) can be administered only when the patient showed clear indication of poisonous snake bite.
4. Evidence adduced consisted of the testimony of PWs 1 & 2, Exts.A1 to A4 series and X1 and X2.
5. The Forum has held that the opposite parties failed to diagnose that the complainant was bit by viper and that they delayed in administering the appropriate treatment and that the same resulted in the deterioration of the condition and amputation of her toes.
6. The counsel for the appellant has contended that the opposite parties had closely monitored the condition of the complainant and that there was no indication that the complainant was bit by viper and that it is hazardous to administer ASV without confirming that the patient was bitten by a poisonous snake.
7. PW1 is the Nephrologist of Jubilee Mission Hospital who treated the complainant at the above hospital and Ext.X1 is the case sheet of Jubilee Mission Hospital from which it can be seen that she was an inpatient at Jubilee Mission Hospital from 26.12.2003 to 20.1.2004 ie 26 days. It is seen from Ext.X2 treatment records of the opposite party hospital that the complainant was admitted at 8.15.pm on 24.12.2004. She was referred to the Jubilee Mission Hospital on the 26th at 2.45.pm. It is seen from the blood test results produced that at the time of admission, the platelet count was 2,90,000. On the 25th at 9.45.am, the platelet count is noted as 2,10,000. There is a steady decrease of 80,000. On 26th at 9.45.am the platelet count was only 80,000. Albumin on 25th is noted as + and on 26th as ++. It is pointed out by the counsel for the appellant that within 12 hours of admission at the opposite party hospital there was a decline in platelet count of 80,000 which should have alerted the doctors at the opposite party hospital and that on 26th at 9.45. am platelet count was only 80,000 which would have required blood transfusion and dialysis. Even then she was referred only at 2.45.pm as can be seen from Ext.X3 the case sheet of the opposite party hospital. The albumin rate was + on the 25th and it was ++ on the 26th. The above along with the reduction of the platelet count to a mere 80,000 is a clear indication of impending renal failure and she was referred only after 5 hours despite the admitted fact that the opposite party hospital is not having the dialysis facilities and the services of a Nephrologist. It is seen from Ext.X1 case sheet of the jubilee Mission Hospital that the complainant underwent dialysis and antivenom administration more than once. Complainant developed gangrene to the 4th and 5th toe and the same had to be amputated. Ext.A1 discharge summary of Jubilee Mission Hospital also mentions that she had acute renal failure and DIC (disseminated Intra vascular coagulation). PW1 has stated that if the platelets count reduced drastically over days the same is an indication that the person was bit by a poisonous snake and the platelet count test in the instant case showed drastic reduction in the count. Of course PW1 has not faulted to opposite parties as such. He has stated that at the time of admission at 4.20.pm on 26/12/03 at Jubilee Mission Hospital the condition of the complainant was very critical. At the time of admission the platelet count had further reduced to 15,000. He has also stated that the platelet count can be tested 3 to 4 times a day. The opposite parties herein has tested the complainant for platelet count only once in a day. We find that on 25th when the platelet count was found reduced by 80,000 ie from 2,90,000 to 2,10,000 the opposite parties ought to have done the blood test for platelet count on the same day itself again on the 25th the test was done at 9.45 am. Next time, the test was done. On 26th at 9.45.am ie after 24 hours. We find that there is lapse on the part of the opposite parties in not taking the platelet count test (PCT) more than once on the 25th inspite of finding that the count had drastically reduced and albumin was +. There is also lapse on the part of the opposite parties in not referring the complainant to a higher centre immediately after 9.45 am on the 26th after it was noticed that the platelet count is only 80,000 and albumin is ++. There was steady decrease in the platelet count as by the time the complainant was admitted at Jubilee Mission Hospital the platelet count was reduced to 15,000. Evidently the complainant narrowly escaped from death. Admittedly there was no facility in the opposite party hospital for dialysis and also the opposite party was not having the service of a Nephrologist. Hence also the opposite parties ought not to have retained the complainant at that hospital. The opposite parties have also not testified before the Forum also. We find that the finding of the Forum that there was negligence on the part of the opposite parties is liable to be sustained.
8. The complainant has produced medical bills with respect to hospital charges, laboratory investigations and purchase of medicines amounting to Rs.62,266.55. As noted above she was an inpatient at Jubilee Mission Hospital for 26 days. The 4th and 5th toe of the right leg have been amputated. The amount of compensation are directed to be paid is Rs.50,000/- which we find is only reasonable. In the circumstances, the order of the Forum is sustained. The appeal is dismissed.
Office will forward the LCR along with a copy of this order to the Forum.
JUSTICE K.R. UDAYABHANU: PRESIDENT VL.
[HONARABLE MR. JUSTICE SHRI.K.R.UDAYABHANU] PRESIDENT