State Consumer Disputes Redressal Commission
Santosh Kumar Sharma S/O Vinod Kumar ... vs Dhanvantri Hospital & Researach Centre on 23 April, 2019
1 jkT; miHkksDrk fookn izfrrks"k vk;ksx] cSap la- 2] jkt0] t;iqj ifjokn la[;k %& 04@2012
01. Santosh Kumar Sharma, S/o Vinod Kumar Sharma, aged 17 years minor, by caste Brahmin, r/o Shree Rampura, post devli, Tehsil Lalsot, District Dausa (Raj) through natural guardian and father vinod kumar sharma, s/o Ram Bilas sharma, aged 48 years, by caste Brahmin r/o Shree Rampura, post devli, Tehsil Lalsot, District Dausa (Raj)
02. Vinod Kumar Sharma, S/o Ram Bilas Sharma, aged 48 years, by caste Brahmin, r/o shree Rampura, post devil, Tehsil Lalsot, District Dausa (Raj)
03. Smt. Manbhar Devi, W/o vinod Kumar Sharma, aged 45 years, by caste Brahmin r/o Shree Rampura, post devil, Tehsil Lalsot, District Dausa (Raj) ifjoknhx.k cuke
01. Dhanvantri Hospital & Research Centre (a unit of Dhanvantri Live Care Pvt. Ltd. ), 67/56-A, New Sanganer Road, Mansarovar, Jaipur (Raj) 302020, through its Director Dr. R.P.Saini
02. Dr. R.P. Saini M.S. (Orthopedics), Dhanvantri Hospital & Research Centre, 67/56-A, New Sanganer Road, Mansarovar, Jaipur (Raj) 302020
03. The New India Assurance Company Limited, Branch 330102, Dharma Heights 10 Moti Lal Atal Road, M.I. Road, Jaipur (Raj) through its manager.
foi{khx.k le{k % ekuuh; Jh dey dqekj ckxMh] lnL; ¼U;kf;d½ ekuuh; lnL; Jherh ehuk esgrk 2 mifLFkr %& ifjoknh vf/koDrk Jh foTth vxzoky dh vksj ls Jh vrqy ikjhd vf/koDrk foi{kh la[;k 1 o 2 dh vksj ls Jh euh"k ekFkqj vf/koDrk foi{kh la[;k 3 vf/koDRkk _f"kiky vxzoky dh vksj ls Jh eukst dqekj vf/koDrk fu.kZ; fnukad 23 vizsy] 2019 jkT; vk;ksx jktLFkku t;iqj ¼}kjk Jh dey dqekj ckxM+h] lnL;] ¼U;kf;d½ ;g ifjokn Santosh Kumar Sharma & ors. dh vksj ls Dhanvantri Hospital & Research Centre & ors. ds fo:) bl vk;ksx esa fnukad 25-01- 2012 dks is'k fd;kA izdj.k ds rF; bl izdkj gS fd ifjoknh la[;k 1 larks"k dqekj 'kekZ dh fnukad 03-07-2011 dks mlds xkao esa fctyh dk djUV yx tkus ds dkj.k nksuksa gkFkksa ,oa nksuksa ikaoksa rFkk isV esa bysfDVªd cuZ batjht vkbZ] ftl ij mls rqjUr lkeqnkf;d LokLF; dsUnz ykylksV] ftyk nkSlk ys tk;k x;k] tgkWa ls mls t;iqj fLFkr ljdkjh ,l-,e-,l- vLirky yk;k x;k rFkk IykfLVd ltZjh&;wfuV&A ¼cuZ½ esa fnukad 03-07-2011 dks HkrhZ djok;k x;kA rRi'pkr~ ifjoknh la[;k 1 larks"k dqekj 'kekZ fnukad 05-07-2011 dks foi{kh la[;k 1 /kuoUrjh gkWfLiVy esa foi{kh la[;k 2 MkWa0 vkj0ih0 lSuh] ,e-,l- vkWFkksZ dh ;wfuV esa HkrhZ djok;k x;k rFkk vfxze jkf'k ds crkSj 5000@&:- tek djok;s x;s] ftlds ,ot~ esa foi{kh la[;k 1 o 2 }kjk jlhn fnukafdr 06-07-2011 tkjh dh xbZA foi{kh la[;k 1 vLirky esa HkrhZ gksus ds pkj fnu miajkr foi{kh la[;k 2 MkWa0 vkj-ih- lSuh }kjk fnukad 09-07-2011 dks ifjoknh dks lwfpr fd;k x;k fd ifjoknh la[;k 1 larks"k dqekj 'kekZ dk vkWijs'ku fd;k tk;sxk rFkk mls vkWijs'ku fFk;sVj esa ys tk;k x;k] vkWijs'ku fFk;sVj ls ckgj yk;s tkrs le; ifjoknh la[;k 1 ds cka;s gkFk esa tgkWa mldk vkWijs'ku fd;k x;k Fkk ogkWa ls [kwu fudy jgk Fkk ftlds fy, nks fnu i'pkr~ fnukad 11-07-2011 dks iqu% vkWijs'ku fd;k tkuk cryk;k x;kA ifjoknhx.k dk ;g vk{ksi gS fd izFke rks foi{khx.k }kjk ejht dks muds ;gkWa HkrhZ djok;s tkus ds Hkh 4 fnu ckn vR;Ur foyac ls vkWijs'ku fd;k x;k rFkk 3 f}rh; fnukad 09-07-2011 ij fd;s x;s vkWijs'ku ds rqjUr ckn vkWijs'ku fFk;sVj ls ckgj ykrs le; gh tc foi{kh la[;k 1 o 2 dks ;g Kkr gks x;k Fkk fd ejht ds ckWa;s gkFk esa vkWijs'ku dh txg ls [kwu vk jgk gS rks muds }kjk mls Bhd djus ds fy, nwljk vkWijs'ku djus esa iqu% nks fnu dk foyac fd;k x;k rFkk mijksDr foyacks ds pyrs ejht ds ckWFks gkFk esa xSxjhu gks x;k ftlds dkj.k ejht ds cka;s gkFk dks dksguh ds uhps ls fnukad 15-07-2011 dks QksfVZl ,LdksVZ vLirky esa dVokuk iM+kA ifjoknhx.k dk foi{kh la[;k 1 o 2 }kjk ejht] vFkkZr~ ifjoknh la[;k 1 ds foi{kh vLirky esa HkrhZ gjus ds nkSjku mlds nkWa;s gkFk o nksuksa iSjksa esa vkbZ bysfDVªd cuZ batfjt dk dksbZ bZykt gh ugha fd;k x;k] ftlds dkj.k fMLVy jkbZV Qksj vkeZ esa usdzksfll gks x;k rFkk nka;s vkSj cka;s iSjksa eas xsx a fju gks x;kA ifj.kker% QksfVZl gkWfLiVy esa ejht ds nka;s gkFk esa xzksbu {ks= ls ¶ysi ysdj mls yxk;k x;k ijUrq mlds ckotwn Hkh ejht dk nka;k gkFk dke ugha dj jgk gS rFkk vuqi;ksxh gks pqdk gSA ogh nwljh rjg nksuksa iSjks esa xsx a fju gksus ds dkj.k QksfVZl ,LdksVZ vLirky esa ejht ds nka;s iSj esa VªkUlesVkVklZy ,Ei;qVs'ku fd;k x;k rFkk cka;s iSj esa lkbesl ,Ei;qVs'ku fd;k x;kA bl rjg foi{kh la[;k 1 o 2 dh ykijokgh ds pyrs ifjoknh la[;k 1 nksuksa gkFkksa ,oa iSjksa ls ykpkj gksus ds dkj.k iw.kZr% vikfgr gks pqdk gS] ftldh iqf"V esa ifjoknhx.k }kjk izn'kZ&lh@106 v{kerk izek.k&i= izLrqr fd;k gSa] ftlesa ifjoknh la[;k 1 dks 80 izfr'kr fodykaxrk dkfjr gksuk n'kkZ;k x;k gSA ifjoknh la[;k 1 larks"k dqekj 'kekZ dh oDr ?kVuk vk;q ek= 17 o"kZ gksuk rFkk es/kkoh Nk= vafdr fd;k x;k gSa] ftl ckcr~ ifjoknhx.k }kjk izn'kZ&lh@1 lhfu;j lSds.Mjh ijh{kk 2011 esa 69-08 izfr'kr ekdZ'khV fnuakfdr 27-05-2011 dh gSA ifjoknhx.k dk dguk gS fd ijUrq foi{kh la[;k 1 o 2 dh ykijokgh ds pyrs mldk Hkfo"; iw.kZr% [kjkc gks x;k gS rFkk og thou ;kiu djus d fy, dke djus yk;d ugha jgk gSA ifjoknhx.k }kjk ;g Hkh dgk x;k fd ejht dk vc fookg Hkh ugha gks ldrk rFkk og iaxq cudj 'ks"k thou nwljksa ij vkfJr O;rhr djus ds fy, etcwj gks x;k gSA vr% ifjokn esa pkgs x;s vuqrks"k fnyok;s tk;saA ifjokn ,oa lk{; ds leFkZu esa fouksn dqekj 'kekZ dk 'kiFk&i= ,oa nLrkost izn'kZ&C/1 ls izn'kZ&C/105 izLrqr fd;sA 4 foi{kh la[;k 1 o 2 dh vksj ls tokc esa ifjoknhx.k }kjk yxk;s x;s vkjksiksa ls badkj djrs gq, dgk x;k fd ejht ,l-,e-,l- vLirky ls ,CldksUM gksdj mlds ikl vk;k Fkk rFkk og dkQh xaHkhj fLFkfr esa vk;k Fkk rFkk ejht dk vkWijs'ku djus ls igys mlds pkpk ls gkbZ fjLd dUlsaV ys yh xbZ FkhA ejht ds fnukad 08-07-2011 dks lh-Vh- ,UT;ksxzkQh fjiksVZ dks ns[krs gq, mlds ,y-Mh- ¶ysi ltZjh dh xbZ tks fd fnukad 09-07-2011 dks lEiUu dh xbZ ftlds fy, ejht ds pkpk }kjk lgefr nh xbZ FkhA vkWijs'ku ds i'pkr~ ejht dh mftax gqbZ vFkkZr~ mlds ?kko esa ls [kwu vk jgk FkkA ifjoknh ds ckWa;s gkFk esa tks vkWijs'ku fd;k x;k Fkk og pwfa d lQy ugha gks jgk Fkk vr% ifjoknh ds ckWa;s gkFk dks dkVus ds vykok dksbZ vkSj pkjk ugha FkkA ifjoknh ds ckWa;s ,oa nkWa;s iSj esa Hkh xsx a fju Fkk ftlds pyrs mudks dkVus ds vykok vkSj dksbZ mik; ugha FkkA ifjoknhx.k }kjk ejht dks HkrhZ djok;s tkrs le; ek= 5000@&:- tek djok;s x;s Fks] ijUrq ckn esa dksbZ Hkqxrku ugha fd;k x;kA foi{kh la[;k 1 o 2 dk ;g Hkh dguk gS fd muds }kjk foi{kh la[;k 3 U;w bf.M;k ,';ksjsal daiuh fyfeVsM ls esMhdy bUMsfefuVh ikfylh yh gqbZ gS tks fd foi{kh la[;k 1 vLirky ds fy, 20@&yk[k :- dh gSA foi{kh dh vksj ls tokc ,oa lk{; ds leFkZu esa MkWa0 vkj0ih0 lSuh dk 'kiFk&i= ,oa izn'kZ&D@1 yxk;r izn'kZ&D@13 nLrkost izLrqr fd;sA foi{kh la[;k 3 U;w bf.M;k ,';ksjsal daiuh fyfeVsM }kjk vius ifjokn esa foi{kh la[;k 1 vLirky dks 20 yk[k :- dh ikfylh fn;k tkuk Lohdkj fd;k tkdj ifjokn esa yxk;s x;s 'ks"k vk{ksiksa ls badkj fd;k x;k A U;w bf.M;k ,';ksjsal daiuh fyfeVsM dh vksj ls uohu tsu dk 'kiFk&i= izLrqr fd;kA cgl i{kdkjku vf/koDrkx.k lquh ,oa i=koyh rFkk nLrkostkr dk voyksdu fd;kA ;g izdj.k fpfdRlh; ykijokgh dk gSA fpfdRlh; ykijokgh ds ekeys esa 2010 (I) RLW 722 (SC) Kusum sharma & ors. Vs. Batra Hospital & Medical Research Centre & ors. esa ekuuh; loksZPp U;k;ky; us fuEu fn'kk&funsZ'k fn;s gS%& 5 "On scrutiny of the leading cases of medical negligence both in our country and other countries specially the United Kingdom, some basic principles emerge in dealing with the cases of medical negligence. While deciding whether the medical professional is guilty of medical negligence following well known principles must be kept in view:
I. Negligence is the breach of a duty exercised by ommission to do something which a reasonable man, guided by those considerations which ordinarily regulate the conduct of human affairs, would do, or doing something which a prudent and reasonable man would not do.
II. Negligence is an essential ingredient of the offence. The negligence to be established by the prosecution must be culpable or gross and not the negligence merely based upon an error of judgment.
III. The medical professional is ecpected to bring a reasonable degree of skill and knowledge and must exercise a reasonable degree of care. Neither the very highest nor a very low degree of care and competence judged in the light of the particular circumstances of each case is what the law requires. IV. A medical practitioner would be liable only where his conduct fell below that of the standards of a reasonable competent practitioner in his field.
V. In the realm of diagnosis and treatment there is scope for genuine difference of opinion and one professional doctor is clearly not negligent merely because his conclusion differs from that of other professional doctor.
VI. The medical professional is often called upon to adopt a procedure which involves higher element of risk, but which he honestly believes as providing greater chances of success for the patient rather than a procedure involving lesser risk but highest chances of failure. Just because a professional looking to the gravity of illness has taken higher element of risk to redeem the patient out of his/her suffering which did not yield the disired result may not amount to negligence. VII. Negligence cannot be attributed to a doctor so long as he performs his duties with reasonable skill and competence. Merely because the doctor chooses one course of action in preference to the other one available, he would not be liable if 6 the course of action chosen by him was acceptable to the medical profession.
VIII. It would not be conducive to the effciency of the medical profession if no doctor could administer medicine without a halter round his neck.
IX. It is our bounden duty and obligation of the civil society to ensure that the medical professionals are not unnecessarily harassed or humiliated so that they can perform their professional duties without fear and apprehension. X. The medical practitioners at times also have to be saved from such a class of complainants who use criminal process as a tool for pressurising the medical professionals/hospitals, particularly private hospitals or clinics for extractine uncalled for compensation. Such malicious proceedings deserve to be discarded against the medical practitoners. XI. The medical professionals are entitled to get protection so long as they perform their duties with reasonable skill and competence and in the interest of the patients. The interest and welfare of the patients have to be paramount for the medical professionals.
bl izdj.k esa loZizFke ifjoknh dks ;g lkfcr djuk gS fd D;k fpfdRlh; ykijokgh lsoknks"k vuQs;j VªsM izsfDVl ds dkj.k ifjoknh dh ;g gkyr gqbZ \ ifjoknh ds fo|qr izokg dk djUV yxk ftlls ifjoknh ds gkFk&iSj o isV ty x;k LFkkuh; vLirky esa ys tk;k x;k tgkWa ls mls ,l-,e-,l- vLirky esa Burn ;wfuV esa HkrhZ fd;k x;kA ,l-,e-,l- vLirky esa ifjoknh o mlds ifjtuksa dks dksbZ nyky ;k ogkWa ds fpfdRldksa esa ls gh dksbZ fpfdRld feyk mlus mUgksusa ifjoknh o ifjoknh ds ifjtuksa dks ;g jk; nh fd ,l-,e-,l- vLirky esa dksbZ lqfo/kk ;k lk/ku ugha gS blfy, /kUorjh vLirky esa pys tk;sa ogkWa lkjh lqfo/kk ,oa lk/ku gS] bl ij ifjoknh fcuk ,l-,e-,l- vLirky ls NqV~Vh fy;s foi{kh la[;k 1 ds vLirky esa vk x;k ogkWa mls HkrhZ dj fy;k x;kA vLirky dk ekfyd ;k Mk;jsDVj foi{kh la[;k 2 Fkk] ftlus HkrhZ fd;k rFkk mls Bhd djus dk vk'oklu fn;k] ,MokUl ds :i esa 5000@&:- tek djok;s x;s ckn esa nokbZ;kWa oxSjg nh x;h blls iwoZ blls iwoZ ,l-,e-,l- gkWfLiVy esas ifjoknh dh lh0Vh0 ,aft;ksxzkQh djok;h x;h ftldh fjiksVZ fuEu izdkj gS %& The contents 7 of the Report dated 08.07.2011 of CT Angiography of Upper Limbs are reproduced here-in-below for a ready perusal and reference :-
"Ulcerative changes are seen in bilateral forearm with exposed muscular tissue.
Normal aortic arch, major branch vessels and bilateral subclavian, axillary and brachial arteries.
Bilateral radial and ulnar arteries, palmar arches and digital arteries are also normal with no evidence of any vascular malformation IMPRESSION : Normal Study."
fnukad 09-07-2011 dks ifjoknh dks vkWijs'ku fFk;sVj esa ys tk;k x;k rFkk okfil yk;k x;k rks mlds ys¶V Qksj vkeZ esa Hkkjh CyhfMax gks jgh Fkh vkWijs'ku ds 15000@&:- pktZ fd;s x;sA MkWa0 vkj0ih0lSuh us vk'oklu fn;k fd CyhfMax :d tk;sxh rFkk ml ij iV~Vh cka/k nh x;h 48 ?kaVs rd ifjoknh ds CyhfMax pkyw jgh bl ij ifjoknh ds dqyfeykdj 14 ;wfuV CyM p<+k;k x;kA bl vkWijs'ku esa Hkh ifjoknh ds flQZ ys¶V Qksj vkeZ dk bZykt fd;k x;k FkkA nwljk gkFk nksuksa iSj o isV dk dksbZ bZykt ugha fd;k x;k FkkA tgkWa bZykt fd;k x;k ogkWa Hkkjh CyhfMax gks jgh FkhA foi{kh la[;k 2 Orthopedics ;kfu gM~Mh jksx fo'ks"kK Fkk tc fd ;g dk;Z IykfLVd ltZu dk gSA vLirky esa Burn ;wfuV vyx ls gksuk pkfg, D;ksa fd Burn ds ekeys esa baQDs 'ku rqjUr gksus dk [krjk jgrk gS rFkk ;g baQsD'ku lsIVhflfe;k esa cny tkrk gS] ftlls ejht dh e`R;q gks tkrh gSA baQsD'ku ls cpko ds fy, Hkkjh bafVckW;ksfVd nsuk iM+rk gS ijUrq mlesa Hkh ;g /;ku j[kuk iM+rk gS fd dgha 'kjhj ds vksxZu Mset s ugha gks tk;sa ;g dk;Z fQftf'k;u dk gksrk gSA tc fd bl izdj.k esa losZlokZ MkWa0 vkj0ih0 lSuh gh Fkk] ftlus vkWijs'ku fd;k o bZykt fd;kA vkWijs'ku ds igys tks ltZjh ds fl)kUr gS mlds vuqlkj fuEu /;ku j[kuk pkfg, ftudk /;ku j[kk x;k ;k ughaA vkWijs'ku o fpfdRlh; uksV esa dgha Hkh vafdr ugha fd;k x;k gSA vkWijs'ku ds ckn fuEu /;ku j[kuk pkfg,%& Preoperative details The patient needs to be able to tolerate a surgery that lasts 8 hours or longer.
8 The flap should be planned based on the size and type of tissue needed, and an alternative flap should be considered as a lifeboat.
The recipient vessel should be planned outside the zone of injury.
The patient and the family must understand the extent of the procedure as well as all risks and possible complications, including the possible devastating complication of flap loss.
Intraoperative details The surgical plan should be discussed with the operating team, including the anesthesiologists and the circulating and scrub nurses. This should include the length of the procedure, the positioning of the patient and any need to change position, and the indication and contraindication of use of specific pharmacological agents.
Outline the plan to the circulating nurses and scrub nurses. If 2 surgical teams are to operate simultaneously, ensure that adequate nurses are available.
Prepare the proper equipment.
o Operating microscope o Microsurgical instruments o Microsutures (9-0 and 10-0 nylon) o Vein coupler o Sterile Doppler Position the patient properly.
o Padding of all pressure points o Prevention of nerve traction or compression o Foley catheter o Sequential compression devices on legs to prevent deep venous thrombosis 9 o Sterile preparation of donor and recipient sites as well as sites as needed for harvesting of vein grafts, nerve grafts, or skin grafts.
Surgical details are as follows:
o Surgery always begins with resection of the tumor or the diseased area and proper exploration and preparation of the recipient site.
o Control of infection and adequate debridement are necessary prior to flap transfer.
o The need for free flap reconstruction should be re- evaluated intraoperatively. In some instances, reconstruction may be performed using skin grafts or local flaps based on the reconstructive ladder. o Doppler ultrasonography is useful to localize recipient vessels. The recipient artery and vein must be critically evaluated, and the surgeon must be satisfied with inflow and outflow prior to embarking on flap harvest. A common pitfall is remaining within the zone of injury on a traumatized or irradiated vessel for microanastomosis, thus resulting in higher rates of vessel thrombosis.
o The dimensions and tissue needs of the vascular pedicle. The surgeon must measure the length of pedicle needed to reach the recipient vessels and compare that to the pedicle length available. o Microsurgical anastomoses are performed using meticulous technique and the following principles:
The recipient vessels and the match between the size of the recipient and pedicle vessels must be carefully assessed.
Preparation of vessels to healthy untraumatized tissue (ie, their pretraumatized state), removal 10 of intravascular clots and debris, and irrigation with heparinized saline (100 U/mL) Vessel side branches are examined and legated to prevent hematoma.
Either end-to-end or end-to-side anastomoses may be performed, depending on the recipient vessel, the orientation of the flap, and the match between the size of the vessels.
Avoidance of vessel tension, kinking, and twisting is important.
If tension is excessive, vein grafting is preferred.
Simple, interrupted, full-thickness sutures are preferred and the standard to which all new anastomotic techniques are compared. once flow is established, the anastomotic sites are bathed with warm irrigation and papaverine to relieve vasospasm.
Vascular anastomoses are finally examined and the vascular strip test is performed to check flow. The strip test is performed by gently occluding the vessel distal to the anastomosis with a microforceps and "stripping" the vessel with another microforceps proximally across the anastomosis. Brisk blood flow should then be observed to return across the anastomosis when the proximal microforceps are released. o The vein coupler is becoming more popular and is a useful tool for anastomosing the vein. In the right hands, the coupler is efficient and can help decrease the total operative time.
o Final inset of the flap is performed with care to prevent compression of the vascular anastomoses.11
Occasionally (eg, in head and neck cases), the inset of the flap is done prior to the anastomosis. o While the patient is under anesthesia, final assessment of flap viability is made by clinical observation, and vascular flow is confirmed with Doppler examination The location of Doppler signal in the flap is marked with a stitch for postoperative monitoring. Internal Doppler probes are used when the flap is completely buried under the skin.
o Loose dressings are applied, with a portion of the flap exposed the postoperative monitoring. Splints, if needed, should also be free of compression. Particular attention should be given to the position of the patient to avoid compression or pulling on the pedicle.
Postoperative details The postoperative ward must be staffed with nurses who are familiar with free flap monitoring and general care for patients who have undergone microsurgery.
Pain is well controlled to prevent pain and anxiety leading to vasoconstriction.
Adequate fluid hydration and body temperature are maintained. The location of the free flap is elevated to promote venous drainage and minimize swelling.
Anticoagulation may be used, depending on the operation and surgeon preference. Possible anticoagulant choices include the following.
o Dextran 40 o Heparin o Lovenox o Aspirin Free flap monitoring depends on the operation and surgeon preference. The criterion standard for monitoring remains 12 careful clinical examination that consists of skin color, capillary refill, and flap turgor, Pricking the flap with a needle should result in bright red blood [14] Currently, there is no consensus on which method is most effective for monitoring of free flaps, but hand help Doppler and physical examination remain the standard of care in most institutions. Methods of monitoring the flap include the following: o Surface Doppler ultrasound o Temperature monitoring o Implantable Doppler ultrasound o Pulse Oximetry o Intravenous fluorescein Vascular compromise includes congestion or ischemia of the flap, and it may develop very quickly or more slowly. When a vascular compromise occurs suddenly, the patient needs to be taken immediately to the operating room for exploration of the anastomotic site. When the signs of vascular compromise occur more gradually, the following measurers should be immediately undertaken:
o Reposition the patient to relieve possible vascular pedicle compression.
o Remove compressive dressings.
o Release tight sutures.
o Assess hydration.
o If these simple maneuvers at the bedside are not successful, immediate re-exploration in the operating room is critical.
bldk Hkh /;ku j[kk x;k ;k ugha j[kk x;k] vkWijs'ku uksV esa dgha Hkh vafdr ugha gSA ;fn vkWijs'ku esa dksbZ nks"k vk tkrk gS rFkk CyhfMax 'kq: gks tkrh gS rks mldks rqjUr vkWijs'ku fFk;sVj esa ys tkuk pkfg, rFkk CyhfMax can djus dh O;oLFkk djuh pkfg,A tc fd bldks 48 ?kaVs rd nqckjk vkWijs'ku fFk;sVj esa 13 CyhfMax cUn djus gsrq ugha ys tk;k x;k] rc rd ifjoknh dk bruk [kwu cg pqdk Fkk fd xsaxjhu gksuk laHko gSA ifjoknh ds vkWijs'ku ds ckn fnukad 14-07- 2011 dks lh0Vh0 ,aft;ksxzkQh djok;h x;h ftldh fjiksVZ fuEu izdkj gS %& "Significant stenosis up to 80-85% diameter reduction noted at proximal subclavian artery at over crossing first rib.
Significant ulcerative edematous changes are noted in left forearm involving cutaneous, sub-cutaneous and intramuscular space with surgical emphysema extending up to hand.
Significant reduction of flow due to edematous changes/vasospasm at distal 1/3 of forearm predominantly ulnar artery.
Normal aortic arch, major branch vessels and axillary and branchial arteries.
Left radial arteries, palmar arches and digital arteries are also normal with no evidence of any vascular malformation".
vxj ge izFke lh-Vh- ,aft;ksxzkQh o f}rh; lh-Vh- ,aft;ksxzkQh dks dEis;j djsa rks ;g izrhr gksrk gS fd lkjh dkEiyhds'ku /kUorjh vLirkyh esa HkrhZ gksus vkWijs'ku gksus rFkk [kwu cgus ds ckn gh gqbZ gSA ifjoknh dks ckn esa ,LdksVZ gkWfLiVy ys tk;k x;k] tgkWa ifjoknh dk Left Hand dksguh ds ikl dkVuk iM+k Right Hand iryk gks x;k] ,d vaxqyh [kjkc gks x;h] lkjh vaxqfy;kWa eqM+ x;h nkW;k iSj ds iats ds vkxs dh vaxqfy;k lekIr gks x;h rFkk ckW;sa isj dk iatk pyk x;kA bl izdkj ifjoknh dqy feykdj nksuksa gkFkksa o nksuksa iSjks ls viax gks x;kA Åij of.kZr foospu ds vk/kkj ij ifjoknh] foi{khx.k dh vlko/kkuh ls Due Care o Skill dk mi;ksx ugha djuk lkfcr djus esa lQy jgk gSA vc cMZu vkrk gS foi{khx.k ij bl lac/a k esa II (2009) CPJ 61 SC NIZAM INSTITUTE OF MEDICAL SCIENCES Vs. PRASANTH S. DHANANKA esa ekuuh;
loksZPp U;k;ky; us iSjk la[;k 32 esa fuEu fu/kkZfjr fd;k gS %& We are also cognizant of the fact that in a case involving medical negligence, once the initial burden has been discharged by the complainant by making out a case of negligence on the 14 part of the hospital or the doctor concerned, the onus then shifts on to the hospital or to the attending doctors and it is for the hospital to satisfy the Court that there was no lack of care or diligence. In Savita Garg (Smt.) Director, National Heart Instutute VI (2004) SLT 385 = IV (2004) CPJ 40 (SC) = (2004) 8 SCC 56 it has been observed as under.
"Once an allegation is made that the patient was admitted in a particular hospital and evidence is produced to satisfy that he died because of lack of proper care and negligence, then the burden lies on the hospital to justify that there was no negligence on the part of the treating doctor or hospital. Therefore, in any case, was administered to the patient. It is the duty of the hospital to satisfy that there was no lack of care or diligence. The hospitals are institutions, people expect better and efficient service if the hospital fails to discharge their duties through their doctors, being employed on job basis or employed on contract basis, it is the hospital which has to justify and not impleading a particular doctor will not absolve the hospital of its responsibilities."
ekuuh; loksZPp U;k;ky; }kjk Åij of.kZr fl)kUrksa dks ns[krs gq, vc ;g ns[kuk gS fd D;k foi{khx.k bldk [k.Mu djus esa lQy jgs gS ;k ugha \ izkFkhZ ds djUV yxk rFkk mlls mlds gkFk&iSj o isV ty x;k ;g fooknkLin ugha gSA foi{kh ds vuqlkj mlds 11 ds0oh0 dk djUV yxuk crk;k x;k gS] tks laHko ugha gS ;fn 11 ds0oh0 ds djUV ds dksbZ utnhd pyk tk;sa rks mldk cpuk vlaHko gS] tc fd foi{kh ;g dgrk gS fd mlds og fpid x;k Fkk tks drbZ laHko ugha gSA ifjoknh 'kq: esa izkFkfed fpfdRlk ds fy, x;k gS ogkWa ls ,l-,e-,l- gkWfLiVy esa HkrhZ gqvk gS tks Burn Unit esa HkrhZ gksrk gS rFkk Burn Unit esa bZykt fQftf'k;u djrk gS tc rd vko';drk ugha gks gM~Mh ds MkDVj dk dksbZ egRo ugha jg tkrk gSA izkFkhZ dks ,l-,e-,l- vLirky esa gh lykg nh x;h fd ,l-,e-,l- vLirky esa iwjh O;oLFkk ugha gS tks HkhM+&HkkM+ ds dkj.k lgh Hkh dgk tk ldrk gS ijUrq /kUorjh gkWfLiVy dks jSQj djuk ogkWa fdlh nyky fpfdRld ;k LVkWQ dk dke gks ldrk gS tks /kUorjh gkWfLiVy esa bZykt ds fy, Hkstus dk dke djrk gSA /kUorjh gkWfLiVy esa Hkh MkWa0 vkj0ih0 lSuh losZlokZ Fkk tks gM~Mh jksx fo'ks"kK gSA IykfLVd ltZu ugha gS] mldk ;g 15 dguk fd mlus ,sls lSdM+ks gtkjksa dk vkWijs'ku fd;k gS] ekuus ;ksX; gSA xkao esa nk;h ekbZ lSdM+ks fMyhojh djkrh gS og fMyhojh djkus dh tkudkj gks ldrh gS ijurq DokfyQkbZM ;k fo'ks"kK ugha gks ldrhA ,slh fLFkfr esa ;fn MkWa0 vkj0ih0 lSuh us lsdM+kS gtkjksa vkWijs'ku fd;s Hkh gS] rks mldk dksbZ egRo ugha gSA ifjoknh fnukad 05-07-2011 dks foi{khx.k ds vLirky esa HkrhZ gks x;k Fkk vLirky esa Burn Unit Fkk ;k ugha ;g irk ugha pyrk gS tc fd ;g vfr vko';d gSA ifjoknh dh igyh lh0Vh0 ,aft;ksxzkQh gqbZ gS rFkk fnukad 14-07-2011 dks nwljh lh0Vh0 ,aft;ksxzkQh gqbZ gS ftlesa Hkkjh varj gS rFkk ;g varj foi{khx.k ds vLirky esa HkrhZ ds ckn gh vk;k gSA foi{khx.k ds vLirky esa ,d gkFk dk bZykt gqvk gS ftlesa CyhfMax gqbZ gS nwljs fkGk o iSj dk D;k fd;k ;g dgh Hkh Li"V ugha gSA blls ;g izrhr gksrk gS fd foi{khx.k us Due Care o Skill dk mi;ksx ugha fd;k ek= nokbZ;kWa fy[krs rFkk mlh ds esMhdy LVksj ls nokbZ;kWa vkrh x;h ftldk Hkqxrku ifjoknh o ifjoknh ds ifjokj ds lnL; djrs x;sA ifjoknh vUrr% foi{khx.k ds ;gkWa ls Hkh fcuk NqV~Vh fy;s tc nwljh txg lh0Vh0 ,aft;ksxzkQh djkus x;k rks] ogkWa ls fudy x;k rFkk QksfVZl gkWfLiVy] t;iqj esa tkdj HkrhZ gqvk tgkWa 14-07-2011 ls 21-08-2011 rd ;kfu ,d eghus 7 fnu vLirky esa HkrhZ jgk rFkk fMLpktZ izek.k&i= ds vuqlkj ejht tc HkrhZ gqvk Fkk rc d.Mh'ku D;k fuEu izdkj Fkh %& "At admission patient was conscious and oriented to time, place and person. Vitals-BP- 120/80 mm Hg, PULSE- 88/Min, RR-22/min, Temp 102 O/E; ulcer present over hypogastrium, left forarm electric burn gangrene, gangrene of rt foot and it foot. necrosis prersent over distal right forarm. Rest systemic examinations were unremarkable.
bZykt ds ckn tc NqV~Vh feyh rc mldh fLFkfr fuEu izdkj Fkh %& Parient was admited with above complaints. He underwent Left below elbow amputation, wound debridement rt upper limb with groin flap Rt upper limb under GA on 15.07.2011 Then he again operated for electric burn B/L foot gangrene and underwent Rt transmetatarsa situation with Lt symes amputation under GA on 18/7/11. Pt again operated for groin flap to Rt upper limb under GA on 12.08.2011 pt again operated for debridement, SSG, insetting of groin flap under GA on 12.08.2011. During hospital course pt treatment various antibiotic and symptomatic 16 treatment according to culture senstivity reports. Intra operative and post operative period was uneventful. Patient is stable on discharge.
QksfVZl gkWfLiVy esa gh ifjoknh dk bZykt gqvk mldk ckW;k gkFk vaxqyh vkfn dVok fn;s rFkk nkW;s gkFk dh ,d vaxqyh [kjkc gks x;h lkjh vaxqfy;k eqM+ x;h gkFk iryk gks x;k tks dke djus ;ksX; ugha jgkA ifjoknh ds ckW;s iSj ds iats dh vaxqfy;k dV x;h rFkk iSj lgh ugha jgk rFkk ckW;s iSj dk iatk dV x;kA nksuksa i{kksa dh IyhfMax lk{; o esMhdy nLrkost ls fuEu fLFkfr lkeus vkrh gSA **izFke rks ifjoknhx.k }kjk fyf[kr cgl ds lkFk tks esfMdy fyV~Vjspj izLrqr fd;s x;s gS muds voyksdu ls ;g Li"V gks tkrk gS fd ejht dks ftl rjg dh bysfDVªd cuZ batjht vkbZ Fkh] [kkldj ckW;s gkFk es]a mlds mipkj ds fy;s 72 ?kUVksa ds Hkhrj Q~ysi fjdaLVªD'ku ltZjh dj nh tkuh pkfg, Fkh] ijUrq foi{khx.k dks fnukad 05-07-2011 ij ejht ds Lo;a ds ;gkWa HkrhZ gksrs le; ;g ekywe gksus ds ckotwn Hkh fd bysfDVªd cuZ batjht dks dkfjr gq;s nks fnu gks pqds gS] Q~ysi fjdaLVªD'ku ltZjh esa vkSj pkj fnu dk foyac fd;k x;k] tks fd mudh fpfdRlh; ykijokgh dk |ksrd gSA f}rh; foi{kh la[;k 1 o 2 dk ;g dFku fd ejht dks tc muds ;gkWa fnukad 05-07-2011 dks HkrhZ djok;k x;k rc mlds cka;s gkFk dh gkyr cgqr xaHkhj Fkh rFkk ,Ei;qVs'ku ls cpkus ds fy, vkWijs'ku fd;k x;k Fkk tks fd lgh <ax ls fd;s tkus ds ckotwn Hkh lQy ugha gqvk ftlds pyrs mlds cka;s gkFk dks dksguh ds uhps dkVuk iM+k nLrkosth lk{; ls Li"Vr% xyr lkfcr gksrk gSA mijksDr lUnHkZ esa izFke rks ;g xkSj fd;k tkuk vko';d gS fd foi{kh gkWfLiVy esa HkrhZ jgus ds nkSjku gh ejht dh fnukad 08-07-2011 ij gkFkksa dh lh-Vh- ,UT;ksxzkQh djokbZ xbZ Fkh] tks fd fjdkMZ ij izn'kZ&lh@3 ds :i esa ekStwn gSa] ftlls Li"V gS fd gkykafd ejht ds nksuksa gkFkksa esa ek= vUlsjsfVo psUtst ns[ks x;s Fks vU;Fkk [kwu lIykbZ djus okyh lHkh vkVªhZt ukseZy Fkh rFkk muesa fdlh Hkh izdkj dk dksbZ osldwyj ekyQksjes'ku ugha Fkk rFkk fjiksVZ esa ukseZy dk fu"d"kZ fudkyk x;k FkkA bl ij fnukad 09-07-2011 ij fd;s x;s vkWijs'ku ls Bhd ,d fnu igys nksuksa gkFkksa dh tks lh-Vh- ,UT;ksxzkQh fjiksVZ Fkh og ukseZy Fkh] ijUrq foi{kh la[;k 1 o 2 }kjk fnukad 09-07-2011 dks fd;s x;s vkWijs'ku ds i'pkr~ 17 fnukad 14-07-2011 ij cka;s gkFk dh tks lh-Vh- ,UT;ksxzkQh gqbZ mlls Li"V gS fd ejht ds izksDlhey lcDysfo;u vkVªh esa 80&85 izfr'kr LVsuksfll mRiUu gks pqdk Fkk ,oa cka;s gkFk esa ,fMesVl psUtst vk x;k Fkk rFkk cka;s gkFk ds fMLVy 1@3 esa [kwu dk izokg dkQh gn rd :d x;k FkkA mijksDr otg ls ejht ds cka;s gkFk esa dksguh ds uhps xsx a jhu mRiUu gqvk tks fLFkfr foi{kh la[;k 1 o 2 }kjk fnukad 09-07-2011 dks fd;s x;s vkWijs'ku ds ckn gh mRiUu gqbZ Fkh] ftlds pyrs fnukad 15-07-2011 dks QksfVZl ,LdksVZ gkWfLiVy esa ejht ds cka;s gkFk dh dksguh ds uhps ls dkVuk iM+k FkkA vc gesa ;g ns[kuk gS fd ejht ds vkWijs'ku ls Bhd igys tks mlds ckW;s gkFk dh fLFkfr Fkh og vkWijs'ku ds i'pkr~ D;ksa [kjkc gqbZA mijksDr lUnHkZ esa foi{kh la[;k 1 o 2 ds VªhVesaV fjdkWMZ] tks fd inz'kZ&lh@4 o lh@5 ds :i es]a i=koyh ij ekStwn gS rFkk ftldk dksbZ [k.Mu mDr foi{khx.k }kjk ugha fd;k x;k gS] ds voyksdu ls Li"V gS fd tc fnukad 09-07-2011 dks ejht dk vkijs'ku Qzh ,y Mh Q~ysi ys¶V Qksj vkeZ foFk vukWlVkseksfll fd;k x;k rks vkWijs'ku ds rqjUr i'pkr~ mlds vkWijs'ku dh lkbZV ls gh [kwu fudy jgk FkkA ,sls esa fpfdRlk foKku esa LFkkfir ekin.Mksa ds vuqlkj foi{khx.k dks ejht dks rqjUr gh iqu% vkWijs'ku fFk;sVj esa ys tkdj ;g ns[kk tkuk pkfg, Fkk fd vkWijs'ku lkbZV ls [kwu D;ksa fudy jgk gS rFkk mldk mipkj djus ds fy;s rqjUr gh fjohtu ltZjh djuh pkfg, Fkh] ijUrq foi{kh la[;k 1 o 2 Lo;a ds dFkukuqlkj mDr fjohtu ltZjh fnukad 11-07-2011 vFkkZr~ nks fnu ds foyac ls dh xbZ] ftlds pyrs ejht ds gkFk dh gkyr iw.kZr% [kjkc gks xbZ rFkk ckW;s gkFk ds izHkkfor fgLls esa vkWijs'ku fnukafdr 09-07-2011 ds i'pkr~ nks fnu rd [kwu dk izokg ugha gksus ds dkj.k mlesa xsaxfju gks tkus ds dkj.k ejht dks QksfVZl ,LdksVZ gkWfLiVy ys tk;k tkdj mlds cka;s gkFk dh dksguh ds uhps dkVuk iM+kA ;gkWa ;g mYys[kuh; gS fd foi{kh la[;k 1 o 2 }kjk fnukad 11-07-2011 dks dh xbZ dfFkr fjohtu ltZjh ls lacaf/kr dksbZ vkWijs'ku uksV~l vk;ksx ds le{k ugha j[ks x;s gSa] tks fd vius vki esa gh lkjs izdj.k dks cgqr gh lansgkLin cuk nsrk gS D;kas fd ;g irk gh ugha pyrk gS fd okLro esa fjohtu ltZjh dh Hkh xbZ Fkh ;k ugha rFkk ;fn dh xbZ Fkh rks fdlds }kjk fdl izdkj ls dh xbZ Fkh ,oa mldk ifj.kke D;k jgkA r`rh;] foi{khx.k Lo;a vius mRrj ifjokn esa ekurs gS fd ifjoknh la [;k 1 tc muds ;gkWa HkrhZ gqvk rks uk flQZ mlds cka;s gkFk es]a cfYd mlds nka;
18gkFk esa rFkk nksuksa iSjks esa ,oa isV ij Hkh xaHkhj bysfDVªd cuZ batjht Fkh] ijUrq foi{kh la[;k 1 o 2 ds ;gkWa ejht ds HkrhZ jgus ds ckcr~ izLrqr leLr fjdkMZ ds voyksdu ls mDr foi{khx.k }kjk ejht ds nka;s gkFk o mlds nksuksa iSjksa esa vkbZ bysfDVªd cuZ batjht dk dksbZ bZykt fd;k tkuk izdV ugha gksrk gSA vr% ;g Li"V gS fd foi{kh la[;k 1 o 2 }kjk tgkWa ejht ds cka;s gkFk ds bykZt esa xaHkhj ykijokgh cjrh xbZ] ftldk o.kZu iwoZ esa fd;k tk pqdk gS] ogh nwljh rjQ foi{kh la[;k 1 o 2 }kjk ejht ds 'kjhj ds nwljs nksuksa gkFkksa ,oa iSjks ls iaaxq gks pqdk gSA ;g Hkh le> ls ijs gS fd tc ejht ds ekrk firk ekStwn Fks rks D;ksa dj ejht ds pkpkvksa ls dUlsUV yh xbZA ifjoknhx.k dh vksj ls mijksDr dUlsUV fy;s tkus ds rF; dks fookfnr fd;k x;k gS rFkk mDr lanHkZ esa ;g n'kkZus ds fy;s fd dUlsV izn'kZ&Mh@2 o Mh@3 ij ejht ds pkpk ftrsUnz 'kekZ ds gLrk{kj ugha gS] uk flQZ ejht ds pkpk ftrsUnz 'kekZ dk 'kiFk&i= izLrqr fd;k x;k gS oju~ lkFk gh muds lgh nLr[kr ckcr~ MªkbZfoax ykbZlUs l izn'kZ&lh@107 o ;wdks cSad dk izek.k&i= izn'kZ&lh@108 izLrqr fd;k x;k gSA mDr nkssuksa nLrkost rRdkyhu ,oa ljdkjh nLrkost gksus ds dkj.k lk{; esa xzg.kh; gSA mDr nLrkostksa ij ejht ds pkpk ftrsUnz 'kekZ ds gLrk{kj ds voyksdu ls ;g lkQ Li"V gksrk gS fd mDr nLr[kr dfFkr lgefr i= izn'kZ&Mh@2 o izn'kZ&Mh@3 ls drbZ esy ugha [kkrs gSA ;gh ugha izn'kZ&Mh@2 o izn'kZ&Mh@3 ij tks nLr[kr ejht ds pkpk ds cryk;s x;s gS og ejht dks vLirky esa HkrhZ ds le; yh xbZ lgefr fnukad 05-07-2011 ij ejht ds dfFkr pkpk ds dfFkr nLr[kr ls Hkh esy ugha [kkrs gSA dfFkr lgefr i=ksa esa ftl MkWDVj }kjk vkWijs'ku fd;k tkuk gS mldk uke Hkh vafdr ugha gSA blls Hkh Li"V gS fd dfFkr lgefr i= ek= [kkukiwfrZ ds fy;s jps x;s gSA foi{kh la[;k 1 o 2 }kjk ;g Hkh dgus dk iz;kl fd;k x;k gS fd muds }kjk IykfLVd ltZu MkW0 vfHk"ksd 'kekZ ,ao MkDVj vejh'k xqIrk dks Hkh ejht ds bZykt ds fy;s cqyk;k x;k Fkk bl rjg muds }kjk Lis'kfyLV MkWDVj ls Hkh ejht dk bZykt djok;k x;k] ijUrq ejht ds mipkj ds nLrkostkr ds voyksdu ls mijksDr cpko Hkh lgh lkfcr ugha gksrk gSA ejht ds 09-07-20111 ij ftl MkDVj }kjk vkWijs'ku fd;k x;k og foi{kh la[;k 2 MkWa0 vkj0ih0 lSuh gS tks fd ek= ,e-,l- vkWFkksZifs Md dh ;ksX;rk j[krs gSa uk fd ,elh,p IykfLVd ltZu dhA tgkWa rd MkWDVj vfHk"ksd 'kekZ IykfLVd ltZu }kjk ejht dk mipkj fd;s tkus dk iz'u gS fjdkMZ ij miyC/k fdlh Hkh nLrkost esa mDr IykfLVd ltZu 19 dk uke lkeus ugha vk jgk gSA tgkWa rd MkWDVj vejh'k xqIrk IykfLVd ltZu dk iz'u gSa] mDr MkWDVj }kjk ejht dk foi{kh la[;k 1o 2 ds ;gka HkrhZ jgus ds nkSjku dksbZ bZykt ugha fd;k x;kA cfYd izn'kZ&Mh@6 ds voyksdu ls ;g izrhr gksrk gS fd fnukad 13-07-2011 dks mDr MkWDVj vejh'k xqIrk }kjk ek= ejht dks ns[kk x;k Fkk] ysfdu rc rd ejht ds cka;s gkFk o nksuksa iSjksa esa xsaxfju gksus ds dkj.k mDr fpfdRld }kjk ,Ei;qVs'ku djk;s tkus dh lykg nh xbZ Fkh] ftldks ekurs gq, ejht dks QksfVZl gkWfLiVy ys tk;k x;k FkkA vr% foi{kh la[;k 1 o 2 dk ;g dguk fd ejht dk bZykt o vkWijs'ku djus okyh Vhe esa MkWDVj vfHk"ksd 'kekZ o MkWDVj vejh'k xqIrk tsls IykfLVd ltZu 'kkfey Fks] bl vk;ksx dks xqejkg djus dk xaHkhj ,oa ?kksj fuUnuh; iz;kl gSA foi{kh la[;k 1 o 2 dk ;g dguk fd fnukad 09-07-2011 dks fd;s x;s vkWijs'ku ds i'pkr~ vkWijs'ku dh lkbZM ls CyM mt gksuk xaxfju dh otg ls gqvk gS Hkh ,d vksj >aBw gS D;ksa fd fdlh Hkh nLrkosth lk{; ls ;g dgha iznf'kZr ugha gksrk fd fnukad 09-07-2011 dks vkWijs'ku fd;s tkus ls iwoZ ejht ds cka;s gkFk esa ;k 'kjhj ds fdlh vU; fgLls esa xsx a fju mRiUu gks pqdk FkkA cfYd tSlk fd iwoZ esa vafdr fd;k tk pqdk gS] fnukad 08-07-2011 dks ejht ds nksuksa gkFkksa dh tks lh-Vh- ,aUT;ksxzkQh dh xbZ Fkh mldh fjiksVZ ukseZy vkbZ FkhA foi{kh la[;k 1 o 2 ds fpfdRlk fjdkMZ esa Hkh dgha Hkh fnukad 09-07-2011 dks fd;s x;s vkWijs'ku ls iwoZ ejht ds cka;s gkFk ;k vU; fdlh fgLls essa xax s fju gks tkuk vafdr ugha fd;k x;k gSA mijksDr leLr rF;ksa ,oa ifjfLFkfr;ksa ds voyksdu ls Li"V gS fd foi{kh la[;k 1 o 2 }kjk ejht vFkkZr~ ifjoknh la[;k 1 larks"k dqekj 'kekZ ds bZykt esa xaHkhj fpfdRlh; ykijokgh cjrh xbZ gS ftlds pyrs mDr ifjoknh ds cka;s gkFk esa dksguh ds uhps dkVk tkuk iM+k gS rFkk nka;s gkFk o nksuksa iSjksa dk foi{kh la[;k 1 o 2 }kjk dksbZ mipkj uk fd;s tkus ds ifj.kkeLo:i ifjoknh la[;k 1 dk nka;k gkFk iw.kZr% csdkj gks pqdk gS o nka;s iSj esa VªkUlesVkVklZy ,Ei;qVs'ku djuk iM+k gS rFkk ckWa;s iSj esa lkbuht ,Ei;qVs'ku djuk iM+k gSA bl rjg ifjoknh la[;k 1 nksuksa gkFkksa ,oa nksuksa iSjksa ls O;ogkfjd :i ls iw.kZr% ykpkj gks pqdk gSA tgkWa rd vuqrks"k dk iz'u gS mijksDr lUnHkZ esa ;g xkSjryc gS fd fnukad 03-07-2011 dks tc ifjoknh la[;k 1 bysfDVªd cuZ batjh; vkbZ Fkh rc og ek= 17 o"kZ dk Fkk rFkk izn'kZ&lh@1 tks fd mldh lhfu;j lSds.Mkjh ijh{kk 2011 20 dh ekdZ'khV fnukafdr 27-05-2011 gS ds voyksdu ls Li"V gS fd ifjoknh la[;k 1 dh mDr ijh{kk esa 69-08 izfr'kr ekdZ vk;s Fks tks fd ;g crkrs gS fd ifjoknh la[;k 1 Nk= Fkk rFkk i<+us esa Hkh gksf'k;kj FkkA ;g Li"V gS fd ifjoknh la[;k 1 tks fd rc ,d vYivk;q dk O;fDr gS foi{kh la[;k 1 o 2 dh xaHkhj fpfdRlh; ykijokgh ds pyrs nksuksa gkFkksa ,oa nksuksa iSjksa ls ukdke gks pqdk gS rFkk mlds le{k iwjk thou O;rhr djus ds fy, iM+k gSA ifjoknh la[;k 1 dks vc vius thou;kiu esa Hkh cgqr dfBukbZ vk;sxh rFkk og pkgs rks Hkh 'kY; fpfdRld ugha cu ldrk uk gh iqfyl esa vFkok vkehZ esa tk ldrk gS uk gh vU; dksbZ ,slk dk;Z ftlesa 'kkjhfjd n{krk dh t:jr iM+rh gks dj ldrk gSA ;gh ugha] ifjoknh la[;k 1 dks mfpr thoulkFkh feyus esa Hkh dfBukbZ gksxh D;ksa fd dksbZ Hkh O;fDr ugha pkgsxk fd og viuh csVh dk fookg ,d ,sls O;fDr ls djs tks fd nksuksa gkFk vkSj nksuksa iSjksa ls iaxq gks pqdk gksA blds vfrfjDr lkekftd thou O;rhr djus esa Hkh ifjoknh la[;k 1 dks dbZ fo"kerkvksa dk lkeuk djuk iM+x s kA ifjoknh la[;k 1 uk rks dksbZ okgu pyk ldrk gS uk gh Lo;a ds lk/ku ls vk&tk ldrk gSA ,sls esa mls nwljksa ij vkthou fuHkZj jguk iM+sxkA blls Li"V gS fd foi{kh xQyr] ykijokgh] vlko/kkuh Due Care o Skill dk bLrseky ugha djus ls ;g fLFkfr gqbZA IV (2010) CPJ 50 (SC) MINOR MARGHESH K. PARIKH Vs. DR. MAYUR H. MEHTA esa ekuuh;
loksZPp U;k;ky; us fuEu fu/kkZfjr fd;k gS %& Consumer Protection Act, 1986--Sections 2 (1) (g), 14 (1) (d), 19, 23 - Medical Negligence - Wrong treatment - Appellant admitted for treatment of loose motions - Developed gangrene - Left leg amputated below knee - State Commission held that respondent not exercised reasonable care while treating appellant and awarded compensation - Hence appeal - National Commission set aside order of State Commission only on ground that in his cross- examination, Doctor admitted ten other reasons for gangrene - Hence appeal
- National Commission wad duty - bound to pay serious attention on respondent's failure to produce case papers for 6 long years and called upon him to explain why 21 record pertaining to treatment given to appellant was held back from State Commission till complainant's evidence was virtually over - Order set aside - Matter remanded to National Commission for fresh disposal.
III (2013) CPJ 480 (NC) GOPAL DASS THROUGHT LRS. & ORS. Vs. S.P. MANDAL (DR.) & ANR. esa ekuuh; jk"Vªh; vk;ksx us fuEu fu/kkZfjr fd;k gS %& Consumer Protection Act, 1986--Sections 2 (1) (g), 14 (1) (d), 21 (a) (ii) - Medical Negligence - Wrong diagnosis - Buerger's disease - Surgery performed--Amputation of leg - Deficiency in service
- State Commission Partly allowed complaint - Hence appeal - It was necessary for op1 to have conducted tests required to diagnose Buerger's disease before reaching conclusive diagnosis that this was merely a case of PPRP for which surgery was undertaken -Tests and angiography were undertaken when it was fat too late and complainant's toe had become septic and gangerene had sent in, which necessitated amputation surgeries and complainant's 80% disability - Business and quality of life seriously impacted - OPs are jointly and severally liable to pay compensation enhanced from Rs. 50,000 to Rs. 3,00,000.
IV (2012) CPJ 497 (NC) ANIL JAIN (DR.) &
ANR. Vs. DEVENDRA KUMAR esa ekuuh; jk"Vªh;
vk;ksx us fuEu fu/kkZfjr fd;k gS %& (ii) Consumer
Protection Act, 1986--Sections 2 (1) (g), 14 (1) (d), 21
(b) - Medical Negligence - Pain in abdomen and umbilical hernia - Death of patient after surgery-- Surgery not conducted on time - Mnetal agony and harassment - District Forum dismissed complaint - State Commission awarded compensation and held doctor and Insurance Company jointly and severally liable - Conclusion of inquiry report reveals proof of negligence against doctor - Petitioner has failed to 22 produce any evidence in rebuttal to said report - State Commission rightly awarded compensation.
II (2010) CPJ 212 (NC) S.P. AGGARWAL Vs. SANJAY GANDHI POST GRADUATE INSTITUTE OF MEDICAL SCIENCES esa ekuuh; jk"Vªh; vk;ksx us fuEu fu/kkZfjr fd;k gS %& Consumer Protection Act, 1986--Sections 2 (1) (g), 14 (1) (d) - Medical Negligence - Treatment/diagnosis - Alleged, insertion of Cannula in wrist done in grossly improper, negligent and careless manner, by inexperienced para- medical staff - Permanent disability suffered - Complaint dismissed by State Commission - Hence appeal -
During post discharge consultations/ examinations, further diagnostic tests neither advised, nor conducted by OP institute despite continuous complaint of pain and swelling in hand by complainant - Permanent disability suffered due to collective negligence of OP institute in timely diagnosis of complications suffered due to extravasation proved - Order of State Commission set aside - Compensation granted - OP institute held vicariously liable to compensate complainant.
Åij of.kZr esMhdy fyVªspj i=koyh esa vk;h lk{; ekuuh; loksZPp U;k;ky; o ekuuh; jk"Vªh; vk;ksx }kjk izfrikfnr fl)kUrksa dh jks'kuh esa ;fn ns[kk tk;sa rks ifjoknh dks nyky ds tfj;s vLirky esa yk;k x;k vLirky esa Burn Unit ugha Fkk flQZ gkFk dk bZykt fd;k x;k ftlesa Hkh 48 ?kaVs CyhfMax gksrh jgh 14 ;wfuV [kwu p<+k] lh-Vh- ,aft;ksxzkQh ds vuqlkj ifjoknh ds xsxajhu ;k tks 'kjhj ds ikVZ [kjkc gqbZ oks foi{kh vLirky esa HkrhZ ds ckn gh gq,A foi{kh MkWa0 vkj0ih0 lSuh vkWFkksZifs Md fpfdRld Fkk IykfLVd ltZu ugha FkkA fLFkfr esa foi{khx.k bl ckr dks fl) djus esa vlQy jgs gS fd mldh vlko/kkuh dh otg ls ugha gqvk ;k mlus Due Care o Skill dk bLrseky fd;k blds ckotwn ;g gks x;k] cfYd foi{khx.k dk d`R; flQZ nykyksa ds ekQZr ejht dks vius vLirky esa [khapuk jgk gS fcuk dksbZ O;oLFkk ds bZykt djuk] fcuk dksbZ lftZdy 23 lko/kkuh cjrus ds ifj.kkeLo:i ifjoknh dh ;g gkyr gks x;h foi{kh viuk cpko lkfcr djus esa iw.kZr% vlQy jgs gSA ,slh fLFkfr esa ifjoknh dk ifjokn Lohdkj ;ksX; gS] tks Lohdkj fd;k tkrk gSA vc iz'u mRiUu gksrk gS fd vuqrks"k dk ifjoknh us vius ifjokn esa 25]00]000@& ¼ iPphl yk[k :- ½ Punitive damages ds ekaxs gS] o 25]00]000@& ¼ iPphl yk[k :- ½ vl{ke gks tkus ds dkj.k dekus[kkus yk;d ugha gks ldrk rFkk fookg ugha gks ldrk dh {kfriwfrZ pkgh gS ;kfu dqy 50]00]000@&:- ¼ ipkl yk[k :- ½ dh {kfriwfrZ pkgh gSA bl lac/a k esa II (2017) CPJ 35 (RAJ.) VIKAS ARYA Vs. SANTOKBA DURLABHJI MEMORIAL HOSPITAL & MEDICAL RESEARCH INSTITUTE & ANR esa bl jktLFkku jkT; vk;ksx us LFkk;h fu'kDrrk ds laca/k esa fuEu fl)kUr izfrikfnr fd;k gS%& Consumer Protection Act, 1986--Sections 2 (1) (g), 14 (1) (d) 17 -Medical Negligenc-- Delivery of child -Permanent disability--Mental agony and harassment -Deficiency in service -- Compensation -- Complainant's wife gave birth to male child with normal delivery -- Child is suffering from birth asphyxia - Child has developed cerebral palsy - No document submitted to prove that treatment was carried out properly - Child was not cared properly by doctors - Negligence proved - No money can compensate the suffering and helplessness of child and trauma and mental agony of parents - Quality of life of family members have spoiled forever and child has suffered permanent disablility - Compensation @ Rs. 50 Lakh awarded - Directions issued.
ekuuh; jktLFkku jkT; miHkksDrk vk;ksx }kjk izfrikfnr fl)kUrksa dks /;ku esa j[krs gq, bl [kkrs esa ifjoknh dks 25]00]000@& ¼ iPphl yk[k :- ½ o ifjokn nk;j djus dh fnukad 25-01-2012 ls 9 izfr'kr okf"kZd dh nj ls C;kt fnyok;k tkus dk vkns'k fn;k tkuk mfpr gSA 24 ifjoknh ds ekrk firk gS mldh ;g larku gS ekrk firk ds lkeus iq= dh ;g gkyr gksuk fuf'pr :i ls nq[knk;h gSA ekrk firk dks Hkh tc csVk vLirkyh esa bZykt djok jgk Fkk] rks] viuk dke NksMd + j vLirky esa mldh lsok pkdjh esa jguk iM+k gksxk csVk ?kj esa jgrk gS rks mldh lsok djuh iM+rh gS rFkk csVs ls vius cq<k+ is dk lgkjk ekax jgs Fks mlds LFkku ij csVk muds lgkjs ij jg jgk gSA tks fuf'pr :i ls ekufld vk?kkr gSA bl laca/k eaas III (1998) CPJ 1 (SC) SPRING MEADOWS HOSPITAL & ANR. ETC. V/S HARJOL AHLUWALIA THROUGH K.S. AHLUWALIA & ANR. esa ekuuh; loksZPp U;k;ky; us fuEu fu/kkZfjr fd;k gS %& Consumer Protection Act. 1986 - Ss. 14 (1) (d) (ii) Hirer of the service and beneficiary of the service - Awarding separate amounts of compensation to, for separate types of injury - Legality - Young child taken to a private hospital by parents for treatment - Negligence of the hospital, nurse and doctor in administering injection causing cardiac arrest which in turn resulting in irreparable damage to the child's brain - The child consequently reduced to a vegetative state, requiring life-long care and attention - In such circumstances, held, National Commission was right in awarding an amount of compensation to the parents for their acute mental agony and the life-long care and attention they would have to give to the child, in addition to the compensation awarded to the child for the cost of requisite equipment and the recurring expenses that would be necessary for the child - That, after the child had suffered the said damage, the hospital had taken humanitarian approach and rendered services to him without charging any money, held, could not be a factor for denying compensation to the parents - Award of compensation of Rs. 12.5 lakhs to the minor child and Rs. 5 lakhs to the parents by the National Commission upheld.
ifjoknh ds ekrk firk dks vius iq= ds bZykt ds fy, Hkkjh [kpZ djuk iM+kA vr% izR;sd dks 5]00]000@&: & 5]00]000@&:- dqy 10]00]000@&:-
25¼ v{kjs nl yk[k :- ½ ifjokn nk;j djus dh fnukad 25-01-2012 ls 9 izfr'kr okf"kZd dh nj ls C;kt lfgr fnyok;k tkuk U;k;ksfpr gSA JAIPUR FOOT REHABILITATION CENTER ls ifjoknh ds gkFk o iSjksa ij yxkus ds fy, fuEukuqlkj dksVs'ku vk;h gS %&
1. BELOW ELBOW PROSTHESIS I-LIMB PULSE HAND -INR 1525114/-
2. RIGHT PARTIAL FOOT PROSTHESIS SILICONE P F -INR 60000/-
3. LEFT SYMES PROSTHESIS WITH PACIFICA FOOT -INR 114743/-
ftlesa dqy jde 16]99]857@&:- ¼ v{kjs lkSyg yk[k fuU;kuosa gtkj vkB lkS lRrkou :- ½ gSA vr% ifjoknh dks ;g jkf'k fnyok;h tkuh mfpr gSA ifjoknh ds bZykt esa 7]26]356@&:- [kpZ gq, gS ftlds fcy e; QksfVZl ,LdksVZ gkWfLiVy ds is'k gq, gS ;g jkf'k ifjoknh dks ifjokn nk;j djus dh fnukad 25 tuojh] 2012 ls 9 izfr'kr okf"kZd dh nj ls C;kt lfgr fnyok;h tkuh U;k;ksfpr gSA ifjokn O;; ds 50]000@&:- Hkh ifjokn nk;j djus dh fnukad 25 tuojh] 2012 ls 9 izfr'kr okf"kZd dh nj ls C;kt lfgr fnyok;h tkuh mfpr gSA foi{kh la[;k 3 U;w bf.M;k ,';ksjsl a daiuh ds tokc esa foi{kh la[;k 1 o 2 ds tokc dk leFkZu djrs gq, dgk gS fd mudk 20 yk[k :- dk chek gS blh gn rd oks ftEesnkj gSA foi{kh la[;k 3 U;w bf.M;k ,';ksjsl a daiuh 20]00]000@&:- ¼ v{kjs chl yk[k :- ½ ifjoknh dks vnk djsxh tks ifjokn nk;j djus dh fnukad 25 tuojh] 2012 ls 9 izfr'kr okf"kZd dh nj ls C;kt lfgr vkns'k dh rkjh[k ls nks ekg esa vnk djsxh] 'ks"k 5]00]000@&:- foi{kh la[;k 1 o 2 la;qDr ,oa i`Fkd&i`Fkd :i ls ifjokn nk;j djus dh fnukad 25 tuojh] 2012 ls 9 izfr'kr okf"kZd dh nj ls C;kt lfgr vnk djsxsAa 26 vkns'k 01- vr% ifjoknh dk ifjokn] Lohdkj dj foi{kh la[;k 1 o 2 dks vkns'k fn;k tkrk gS fd os ifjoknh dks vl{ke gks tkus ds dkj.k dekus[kkus yk;d ugha jgus dh {kfriwfrZ Lo:i 25]00]000@&:- ¼ v{kjs iPphl yk[k :- ½ ifjokn nk;j djus dh fnukad 25 tuojh] 2012 ls 9 izfr'kr okf"kZd dh nj ls C;kt lfgr vnk djsa ftlesa ls 20]00]000@&:- ¼ v{kjs chl yk[k :- ½ foi{kh la[;k 3 U;w bf.M;k ,';ksjsal daiuh ,oa 'ks"k 5]00]000@&:- ¼ v{kjs ikWap yk[k :-½ ifjokn nk;j djus dh fnukad 25 tuojh] 2012 ls 9 izfr'kr okf"kZd dh nj ls C;kt lfgr ifjoknh dks vnk djsxAsa 02- foi{kh la[;k 1 o 2 ifjoknh ds ekrk firk dks] vius iq= ds bZykt ij gq, Hkkjh [kpZ dh {kfriwfrZ Lo:i izR;sd dks 5]00]000&5]00]000@&:-
¼ikWap yk[k :- &ikWap yk[k :- ½ dqy 10]00]000@&:- ¼ v{kjs nl yk[k : ½ ifjokn nk;j djus dh fnukad 25 tuojh] 2012 ls 9 izfr'kr okf"kZd dh nj ls C;kt lfgr vnk djsAa 03- foi{kh la[;k 1 o 2 ifjoknh ds gkFk o iSjksa dks yxkus ds fy, gksus okys [kpZ dh jkf'k 16]99]857@&:- ¼ v{kjs lkSyg yk[k fuU;kuosa gtkj vkB lkS lRrkou :-½ ,oa ifjoknh ds bZykt esa [kpZ gqbZ jkf'k 7]26]356@&:-
¼ lkr yk[k NCchl gtkj rhu lkS NIiu :- ½ rFkk ifjokn O;; ds 50]000@&:- ¼ v{kjs ipkl gtkj :- ½ ifjokn nk;j djus dh fnukad 25 tuojh] 2012 ls 9 izfr'kr okf"kZd dh nj ls C;kt lfgr ifjoknh dks vnk djsAa ¼ ehuk esgrk ½ ¼ dey dqekj ckxMh ½ lnL; lnL; ¼U;kf;d½ @ikBd@ 27