State Consumer Disputes Redressal Commission
1. M/S. Durgabai Deshmukh Hospital & ... vs 1.G.Srimath Bai on 27 May, 2022
CONSUMER DISPUTES
TELANGANA STATE
BEFORE THE
R E D R E S S A L C O M M I S S I O N : H Y D E R A B A D
(ADDITIONAL BENCH)
F.A.No.181/2019 against C.C.No.589/2013,
HYDERABAD.
District Commission -I11,
Between:
&
1.M/s.Durgabai Deshmukh Hospital Research Centre, (A Unit of KPR Medical Associates) Andhra Mahila Sabha, Vidya Nagar, O.U.Road, Hyderabad
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500 044.
2. Dr.M.Sudha Laxmi, Cardiologist, & M/s.Durgabai Deshmukh Hospital Research Centre, (A Unit of KPR Medical Associates) Andhra Mahila Sabha, Vidya Nagar, O.U.Road, Hyderabad 500 044.
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3. Dr.Sanjay Sahu, M/s.Durgabai Deshmukh Hospital & Research Centre, (A Unit of KPE Medical Associates) Andhra Mahila Sabha, Vidya Nagar, 500 044. .Appellants/ O.U.Road, Hyderabad
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Opposite parties 1,4 &5.
And
1.G.Srimath Bai, W/o.Late Narsing Rao, Aged about 41 years, Occ:House Wife, H.No.3-5-1119/21/2, Kachiguda X Roads, Rajmoulla, Hyderabad. Respondent/ Complainant.
2. Dr.Kola Prabhakar Reddy, M/S.Durgabai Deshmukh Hospital & Research Centre, (A Unit of KPR Medical Associates) Andhra Mahila Sabha, Vidya Nagar,
0.U.Road, Hyderabad 500 044.
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3. Dr.M.Sri Krishna Reddy, Cardiologist, M/s.Durgabai Deshmukh Hospital &s Research Centre, (A Unit of KPR Medical Associates) Andhra Mahila Sabha, Vidya Nagar, O.U.Road, Hyderabad 500 044.
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4. Dr.Satish Kumar M Surya,Vamshi, M/S.Durgabai Deshmukh Hospital & Research Centre, (A Unit of KPR Medical Associates) Andhra Mahila Sabha, Vidya Nagar, . . Respondents/ O.U.Road, Hyderabad 500 044.
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Opposite parties 2, 3 8&6 (Respondents 2 to 4 are not necessary parties) Rao Counsel for the Appellants M/s D.Ravishnakar Counsel for the Respondents: M/s.T.V. Rajeevam-R1 cORAM Hon'ble Sri K.Ranga Rao, Hon'ble Member (J, And Hon'ble Smt.R.S.Rajeshree, Member (NJ) OF MAY FRIDAY, THE TWENTY SEVENTH DAY TWO THOUSAND TWENTY Trwo.
Oral Order :(Per Sri K.Ranga Rao, Hon'ble Member (J))
1. This appeal is preferred by the appellants/opposite parties 1,4 8 5 u/s. 15 of the Consumer Protection Act,1986 against the order dt.7.2.2019 of the District Consumer Disputes Redressal Forum-Il, Hyderabad in C.C.No.589/2013.
2. To avoid confusion, it is to be made clear at the very outset that the complainant filed the above complaint against the opposite parties 1 to 6, but the present appeal is preferred by opposite parties 1,4 8 5.
3. For the sake of convenience, the parties are referred to as they were arrayed in the complaint.
4. As seen from the averments of the complaint, it is the case of the complainant that husband of the complainant by name late Narsing Rao having suffered heart problem, approached opposite party no.l1 hospital on 18.3.2013. He was admitted in opposite party no.l hospital on the same day and underwent various tests/clinical examinations as per the advise of the opposite parties 2 to 6 of the opposite party no.1 hospital. The complainant was iníormed by the opposite parties that her husband was required to undergo heart surgery and that there would not be any complications. The complainant and her husband consented for the operation. Even though all the tests were conducted on 18.3.2013 and 19.3.2013, for the reasons best known to them, the opposite party nos. 2 to 6 postoponed the operation. When the complainant and her relatives questioned the opposite parties with regard to the delay of conducting the surgery, they were informed by the opposite parties that even if the surgery is delayed for a couple of days, no harm would be causcd to her husband. They further informed that since the approval of Aarogyasri' is necessary for the surgery, there was delay. It is the further case of the complainant that Aarogyasri Department approved the surgery by issuing CMCO Referral Card in favour of the husband of the complainant on 23.3.2013. All the bills raised by the opposite party no. l1 hospital were also cleared by the complainant as required by opposite party no.1 hospital. After dragging the matter of surgery, the opposite parties fixed the surgery on 28.3.2022, even though there was urgency in the matter.
It is the further case of the complainant that her husband was taken into the operation theatre and was kept there for 15 hours without giving any information to her. In early hours of 29.03.2013, the complainant was informed about the death of her husband and handed over the dead body to her soon thereafter.
The complainant further submits that only on account of delay in conducting the surgery by opposite parties and due to their negligence, her husband died. The opposite parties infact threatened to get out of the hospital by taking dead body of her husband when she questioned about the negligence of the opposite parties in conducting the surgery. The Discharge Summary of the complainant's husband was also not furnished to the complainant at the time of handing over the dead body. It was furnished subsequently when the complainant approached the opposite party no.1 hospital after the funeral.
The complainant further submits that in the Discharge Summary, the date of admission was shown as 26.03.2013 though her husband infact was admitted in opposite party no.1 hospital on 18.3.2013. In the Death Certificate of the husband of the complainant issued by opposite parties it was shown that the complainant's husband was admitted in opposite party no.1 hospital on 23.03.2013. The above wrong entries were made in the Discharge Summary by the opposite parties only to cover up their negligence in conducting the surgery. The complainant submits that due to the negligence of the opposite parties and due to the delay in conducting the required surgery, her husband died due to which she and her lost their and son suffered much hardship and they minor daughter minor children.
unable to feed her livelihood and the complainant is on notice to the opposite parties The complainant got issued legal within a them to pay a sum of Rs.25 lakhs 17.4.2013 calling upon said notice towards from the date of receipt of the period of 15 days death of her compensation for the loss suffered by her due to the of the opposite parties husband which is purely due to the negligence to her husband belatedly, failing in conducting the required surgery would approach the appropriate which she made it clear that she notice was received by Forum for compensation. The said claiming from them.
the opposite parties 18.4.2013, but there was no reply on tune Hence she filed the present complaint restricting her claim to a Forum to pass a decree for the said of Rs.20 lakhs and prayed the amount towards damages and for the costs.
the written version opposing
5. The opposite parties filed c o m m o n the allegations made in the complaint by the complaint by denying that there was no negligence on complainant and they contended filed and the complaint was their part in conducting the surgery to gain harass the opposite parties and without any basis and only to unlawfully.
admitted that the complainant's However, the opposite parties G.Narsing Rao was admitted in opposite party no.1 husband late found to and after necessary tests, he was hospital on 18.03.2013 have suffered heart attack and was advised Coronary Artery Bypass He was also advised to see the surgeon Graft (CABG) Surgery.
merits and demerits of surgery
concerned and get counselling of
the risks involved. Since the patient/husband of the
including
under Aarogyasri Health Care
complainant was not beneficiary
he was admitted under Payment Category'. As the
Scheme
their inability to meet the
complainant and her relatives expressed to expenses of surgery etc. they were advised to shift the patient Osmania General Hospital, Gandhi Government Hospital like etc. for further treatment. But they insisted Hospital, NIMS Hospital no.1 hospital. At the request of the the treatment at opposite party complainant and her relatives, the opposite parties gave 'CMCO' Referral Card for surgery recommendation letter for getting humanitarian grounds with an of CABG under Aarogyasri Scheme on intention to help the patient.
23.03.2013
further submit that on
The opposite parties
Health
CMCO' Referral Card for Bypass Surgery under Aarogyasri
the opposite
Care Scheme was received. Immediately, thereafter,
the husband of the complainant,
party no.l hospital started giving the free medical treatment. Even while the process of obtaining continued to the patient government's permission, the treatment was and he was given all the medications. The opposite parties further counselled the submit that doctors of opposite party no.1 hospital complainant and her relatives about the heart Bypass Surgery including the risks and possible complications and they were also advised to arrange for blood immediately, but they delayed in taking the decision and arranging blood.
became The oppositeparties further submit that heart surgery the patient had 'Acute imminent specially in view of the fact that recurrent chest pain. The Myocardial Infarction' ( Heart Attack) with doctors explained the complainant and her relatives about the high and after risk factor in the surgery and after necessary counselling their consent on 28.03.2013, the surgery was performed, but taking Ventricular the complainant's husband developed Refractory Fibrillation. Inspite of giving the treatment as per protocol, the died with Cardiac Arrest in complainant's husband unfortunately the early hours of 29.03.2013.
The opposite parties further submit that when the complainant and her relatives were asked to take the dead body of the deceased and staff members and they became aggressive on the management hence the police intervened. The opposite parties have taken every per the possible care to treat the husband of the complainant, as standard protocol. There is no negligence on the part of the opposite to the notice got issued parties at all. The opposite parties also replied 23.05.2013. The complainant also not adduced by the complainant on to prove that there was negligence on the part of any expert evidence to her husband and that the opposite parties in providing treatment 2 to 6 infact are there was wrong diagnosis. The opposite parties dedication to the profession. The known for their selfless service and allegations made against them are baseless and unfounded and only to tarnishtheir image and that of opposite party no.1's image, the with false, mischievous and complaint is filed by the complainant the same is liable to be dismissed such, misleading allegations, as with exemplary costs.
filed her evidence
6. During the enquiry/trial, the complainant affidavit as PW.1 and got marked Exs.A1 to A25. On the behalf of evidence affidavit as the opposite parties, opposite party no.2 filed his DW.1 and got marked Exs.B1 to B4.
sides and
7. The District Forum after hearing the arguments of both after examining the material borne the record, partly allowed the by and directed the opposite parties 1 to 6 to pay complaint compensation of Rs. 12 lakhs and costs of Rs.15000/- jointly and Forum fixed the time for severally to the complainant. The District failed to compliance as 30 days only and if the opposite parties for interest @ 8% p.a. comply the order the complainant is entitled , from the date of order till realisation.
1,4 &
8. Aggrieved by the said order, the appellants/opposite parties 5 preferred this appeal with the following grounds .The order of the District Forum directing the appellants/opposite parties to pay compensation of lakhs and costs of Rs.15,000/- jointly and Rs.12 of evidence and severally is contrary to law, weight liable to be probabilities of the case, as such the same is set aside and the complaint of the respondent/complainant is liable to be dismissed;
There is no material on record to say that the hospital the doctors acted in negligent manner in and a performing the surgery on the patient;
The family members of the patient have not taken a decision for giving High Risk Consent upto 28.03.2013 and they gave the High Risk Consent on the said date and therefore, the surgery was conducted on the patient and in view of the same there was no delay on the part of the opposite parties in conducting th surgery. The findings of the District Forum that for no valid reason CABG surgery of the respondent/complainant's husband was belatedly posted on 28.03.2013 , inspite of an endorsement "early CABG" as far back as on 24.03.2013 and therefore no reasonable care was taken by the opposite parties is totally contrary to the material 1 available on record and the same is liable to be corrected and the impugned order of the District Forum is liable to be set aside;
and her relatives also
The respondent/complainant
such there
arranged the blood only on 28.03.2013, as was no negligence on the part of the appellant hospital to and its doctors. The appellants ultimately prayed allow the appeal and set aside the order of the District Forum and to dismiss the complaint of the complainant.
9. Heard the arguments and perused the entire material on record.
10. The points that arises for consideration are:
. Whether there is medical negligence on the part of the opposite parties 1 to 6 as held by the District Forum? i. Whether the impugned order passed by the District Forum is liable to be confirmed, set aside, modified or interfered with in any manner?
ii. To what relief?
11. Before going to decide the above points for consideration, we are of the considered opinion that as to what is medical negligence and what are the duties of Doctor towards a patient, as per standard medical books and settled position of law.
In a book titled "NEGLIGENCE Medical and Non-Medical with S.Sodhi-
Legal Remedies" authored by B.K.Das Gugrath and published by SODI PUBLICATIONS 1997 Edition, Allahabad, at page follows:
270, the definition of medical negligence is given as "Medical negligence is a Breach of Duty owed by a Doctor to his in patient to exercise reasonable care and skill, which results some physical, mental or financial disability". The Hon'ble Supreme Court of India in the case of Dr.Lakshman Balakrishna Joshi vs. Triambak Bapu Godbole reported in AIR 1969 SC page 128, laid down the criteria for determination of the professional duty of medical man in the following way . " a person who holds himself out ready to give medical advice and treatment impliedly undertakes that he is possessed of skill and knowledge for the purpose. Such a person when consulted by a patient Care in deciding owes him certain duties viz: duty of whether to undertake the case; duty of care in deciding what treatment to give, or duty of care in A breach of the administration of that treatment.
right of action for
any of those duties gives a
practitioner must
negligence to the patient. The
and
bring to his task a reasonable degree of skill
reasonable degree of
knowledge and must exercise a
care.
examine the
Keeping in mind the above, now let us proceed to
material evidence borne by the record to decide
the points for
consideration.
examined the whole
12. We have scrupulously and meticulously material borne by record vide the testimony of PW.1 and DWN.1 to B4 and the same manifest the and Exs.Al to A25 and Exs.B1 from them i.e. husband of the following admitted facts emanate respondent/complainant was admitted in opposite party no.1 hospital breathlessness on the complaint of chest pain and 18.3.2013, with 2 to 6, husband of the and at the advise of opposite parties respondent/complainant underwent all the necessary tests/clinical examinations on 18.03.2013 and 19.03.2013 and he was advised for Graft (CABG) Surgery and since the Coronary Artery Bypass husband (patient) were unable to respondent/complainant and her bear the expenditure of surgery initially they were advised by the shift the to Government Hospitals like patient opposite parties to NIMS hospital etc. for Osmania General Hospital, Gandhi Hospital, and her further treatment. However, as the respondent/complainant to continue the treatment at the hospital of relatives insisted of the respondent/complainant, opposite party no. 1, at the request recommendation letter for CMCO' Referral the opposite parties gave on humanitarian grounds. The Card for CABG surgery respondent/complainant's husband was discharged on 23.03.2013 23.03.2013 by opposite parties 1 to 6 but and was readmitted on Ventricular the complainant's husband developed Refractory due to Fibrillation and he died in the early hours of 29.03.2013 "Cardiac Arrest". It is seen from Ex.B2 which is the Photostat copy of the Standard Case Sheet (Aarogyasri) that CMCO referral card was issued by the government on 23.03.2013.
The evidence of DW.1 shows that as per the procedure, the patient was discharged from the hospital on 22.03.2013 and was re-
admitted on 23.03.2013 after he was granted the benefit of Aarogyasri Health Care Scheme from the Chief Minister's office and that the hospital started giving him free medical treatment thereafter.
The evidence of Dw.1
further shows that after
to the
necessary counselling
respondent/complainant and her relatives and after
obtaining
consent from the
respondent/complainant, duly following necessary medical formalities and protocol, surgery was fixed on 28.03.2013. Accordingly, they, the team of doctors who were arrayed as opposite parties in the complaint performed the surgery on the patient.
However, around 23.30 hrs. on the night of the same day, the patient developed Refractory Ventricular Fibrillation and immediately, the team started giving medical attention as per protocol, but unfortunately in the early hours of 29.3.2013 the patient sustained cardiac arrest and could not be revived inspite of resuscitative efforts. Therefore, he was declared dead at 01.15 a.m. on 29.03.2013.
13. The learned counsel for the respondent/complainant in his oral submissions vehemently argued that the patient/husband of the complainant Narsing Rao was admitted in the hospital of opposite party no.1 on 18.03.2013 and as per advise of opposite parties 2 to 6 he underwent various clinical tests incuding Coronary Angiogram Report vide Ex.A5 in which early CABG was advised and even the CMCO Referral Card was issued by the Government in favour of the patient on 23.03.2013 granting the benefit of Aarogyasri Health Care Scheme for undergoing CABG surgery. But as per the material evidence borne by record and as per the evidence of DW. 1, the said surgery was conducted by the opposite parties to the patient on 28.03.2013 belatedly inspite of the fact that the same is needed to be conducted immediately. The learned counsel submits that what made the opposite parties to wait for 5 days from 23.03.2013 to 28.03.2013 for conducting CABG surgery to the patient remained inexplicable. He submits that if the said surgery could have been conducted immediately after the CMCO Referral Card was issued by the Government, the patient could have survived and could be alive in which case no damage could have been caused to the respondent/complainant and her minor children and therefore the District Forum rightly held that there was delay in conducting CABG 10 despite the endorsement 'early CABG' in view of post MI, unstable Angina and it appears that the opposite parties overlooked the seriousness of the case of the complainant's husband and taken the same in a casual and routine manner which resulted in death of the husband of the respondent/complainant and rightly awarded compensation and costs and the said order of the District Forum is sustainable under law.
The learned counsel also submitted that the Tespondent/complainant and her children have lost their livelihood because of death of the deceased Narsing Rao at the age of 42 years and the same caused irreparable damage and hardship to the complainant and his children, as such, they are entitled to the compensation from the opposite parties and the District Forum rightly awarded the compensation and by submitting so he prayed for the dismissal of the appeal and for confirmation of order of the District Forum.
14 Per contra, the learned counsel for the appellants/opposite parties retaliated the arguments of the counsel for respondent/complainant by submitting that inspite of the fact that the opposite parties counselled and explained the high risk factor and need for conducting CABG to the patient, the respondent/complainant, her husband and her relatives have not given the high risk consent and they gave the same on 28.03.2013 and therefore the opposite parties conducted the surgery on the said day, but unfortunately the deceased died due to cardiac arrest and thus there is no negligence on the part of the appellants/opposite parties in conducting the said surgery on 28.03.2013 and by submitting so he prayed the Commission to set aside the order of the District Forum and to allow the appeal and to dismiss the complaint of the respondent/complainant.
15. To decide the bone of contention, meticulous scrutiny of a documentary evidence in particular along with oral testimony of PW.1 and DW.1 is required to be made. It is not in dispute that the husband of the respondent/complainant late Naring Rao was admitted in the opposite party no.1 hospital on 18.03.2013 having suffered heart attack and he underwent various clinical tests on 18.3.2013 and 19.3.2013. Coronary Angiogram Report of the patient
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Narsing Rao dt.19.03.2013 marked as Ex.A5 shows that the samne 11 is signed by opposite party no.4 -Dr. Sudhalakshmi, Consultant Cardiologist of opposite party no.1 hospital. A perusal of Ex.A5 clearly depicts "Early CABG" is adviscd. At this juncture it is rclevant to observe that any patient when he/she approaches a doctor for treatment of any ailment/ disease and if the doctor Cxamines the patient and prescribes the patient to undergo clinical tests with the intent of acting as a healer to diagnose and to provide proper trecatmcnt for the ailment/discase of the said patient, from the same it is clear that doctor patient relationship is established in
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which case the doctor owes certain duties towards the said paticnt as laid down by the Hon'ble Supreme Court of India in the casc mentioned at the threshold of our discussion. It is a Doctor or team of doctors that have to decide as to what sort of treatment that is required to be provided to the patient. In the case on hand as seen from the material borne by the record, it is evident that after the patient Narsing Rao underwent tests on 18.03.2013 and 19.03.2013, with the advise of the opposite parties 2 to 6 doctors, basing on the said clinical examinations/reports, the opposite party doctors made it clear to the respondent/complainant and her husband and further advised that the patient is required to undergo CABG Surgery. The very purpose of the opposite parties giving recommendation letter for obtaining CMCO Referral Card for the benefit of Aarogyasri Health Care Scheme is, for the deceased to under go CABG surgery.
Admittedly as seen from Ex.B2, CMC0 Card was issued by the Government on 23.03.2013 and as per the evidence of DW.1, the husband of the respondent/complainant was re-admitted in opposite party no. 1 hospital on 23.03.2013 after he was granted benefits of Aarogyasri Health Care Scheme and that the hospital started giving him free medical treatment thereafter.
On Ex.B2 at page no.93 the following endorsement is made:
"Early CABG in view of post MI, unstable Angina"
Though date is mentioned on the
no
page on which the above
endorsement is made, the said page is part of the Case Sheet dt.23.03.2013. Even at page no.98 of the said Case Sheet dt.23.03.2013, it is noted that "Plan Early CABG". Even in the Case Sheet dt.24.03.2013 it is endorsed "Early CABG".
Having endorsed "Early CABG" why CABG was posted to 28.03.2013, remained inexplicable. The Case sheet of 25.03.2013 and that of 26.03.2013 (page no.105) of Ex.B2 contains the endorsement of Risk High Consent had not yet taken'. Even the endorsement on Case Sheet 12 dt.27.03.2013 contains the advise for taking High Risk Consent. The consent of the husband of the respondent/complainant was obtained on 19.03.2013. Even on 26.03.2013 consent was obtained from the respondent/complainant's husband for "CABG" Surgery. Even as 23.03.2013 consent was obtained. It cannot therefore early as on be said that for obtaining the consent from the husband of the respondent/complainant and respondent/complainant, there was a delay and CABG was posted on 28.03.2013, on account of the said delay. The opposite parties having obtained the consent of the respondent/complainant's husband on 23.03.2013 and on 26.3.2013, they could have also obtained High Risk Consent from him and the respondent/complainant on 23.03.2013, if it was required. It was already pointed out, that the approval of the Government for treatment under Aarogyasri Scheme was given on 23.03.2013. But inspite of that, Case Sheet of the respondent/complainant's husband dt. 25.3.2013, 26.03.2013 and 27.03.2013 shows that High Risk Consent not yet signed. The inevitable conclusion that follows from the same is that for no valid reason CABG Surgery of the respondent/complainant's husband was belatedly posted on 28.03.2013, inspite of an endorsement "Early CABG" as far as back as on 24.03.2013. Therefore, it can be concluded from the same that no reasonable care was taken by the opposite parties so far as CABG surgery is concerned. It appears that seriousness of the case of the complainant's husband was overlooked and the case was taken up in a casual and routine manner.
It is settled position of law that reasonable degree of care is to be exercised by the medical practitioner, in providing the treatment to his patient as laid down in the case of Jacob Mathews VS. State of Punjab 2005 (6) SCC I.
16. In view of our aforesaid discussion, we are of the considered view that the inexplicable delay on the part of the opposite parties in conducting CABG surgery on the respondent/complainant's husband amounts to negligence/medical negligence on their part in providing treatment to the respondent/complainant's husband. As such , we hold that the opposite parties are liable to pay compensation to the respondent/complainant, as she suffered mental agony and hardship and lost her livelihood due to the death of her husband and the District Forum rightly awarded the compensation and we do not find any circumstances to interfere with the order of the District Forum. As 13 Such, the appeal is dismissed and the order of the District Forum is confirmed.
17. In the result, appeal is dismissed. Order of the District Forum is confirmed. There shall be no order as to costs.