State Consumer Disputes Redressal Commission
Nandu vs Dr. Munish Mishra on 5 October, 2018
Daily Order M. P. STATE CONSUMER DISPUTES REDRESSAL COMMISSION, PLOT NO.76, ARERA HILLS, BHOPAL FIRST APPEAL NO. 1897 OF 2012 (Arising out of order dated 20.09.2012 passed in C.C.No.143/2010 by District Forum, Khandwa) NANDU ALIAS NANDKISHORE, S/O SHRI MAGAN BHURE, R/O RAMNAGAR, KHANDWA DISTRICT-KHANDWA, EAST NIMAR (M.P.) .... APPELLANT. Versus 1. DR. MUNISH MISHRA, SHUBHAM HOSPITAL, ANAND NAGAR, KHANDWA (M.P.) 2. DR. S. S. CHOUHAN, MD R/O SHASTRI NAGAR/ANAND NAGAR, KHANDWA WORKPLACE-SHUBHAM HOSPITAL, ANAND NAGAR, KHANDWA, TEHSIL & DISTRICTT-KHANDWA, EAST NIMAR (M.P.) 3. THE NEW INDIA ASSURANCE COMPANY LIMITED, THROUGH MANAGER, B.T.COLLEGE ROAD, KHANDWA (M.P.) .... RESPONDENTS. BEFORE : HON'BLE SHRI S. D. AGARWAL : PRESIDING MEMBER
HON'BLE DR. (MRS) MONIKA MALIK : MEMBER COUNSEL FOR PARTIES :
Ms. Sambhavna Rajput learned counsel along with complainant/appellant Nand Kishore.
Shri Ravindra Tiwari, learned counsel for respondent no.1.
Shri Ajay Dubey, learned counsel along with Dr. S. S. Chouhan, respondent no.2.
Shri Pradeep Nighojkar, learned counsel for respondent no.3.
O R D E R (Passed On 05.10.2018) The following order of the Commission was delivered by Dr. (Mrs) Monika Malik, Member:
This appeal is by the complainant/appellant, against the order dated 20.09.2012 passed by the District Consumer Disputes Redressal Forum, Khandwa in C.C.No.143/2010, whereby the complaint filed by him, has been dismissed.
2. The complainant had filed a complaint alleging deficiency in service on part of the opposite party no.1 & 2 stating he was treated for leprosy, without prior proper investigations, as a result of which he developed fever and lapra reaction, resulting in disability.
3. The District Forum dismissed the complaint observing that the treatment which was given to the complainant was in accordance to the prescribed norms, -2- followed for treatment of leprosy. In the absence of any evidence from the complainant substantiating his allegations, the District Forum dismissed the complaint filed by the complainant, hence this appeal.
4. Heard learned counsels for the respondents. Heard the complainant/appellant and opposite party no.2/respondent no.2 Dr. S. S. Chouhan, who appeared in person. Perused the record.
5. Complainant/appellant argued that certain patches appeared on his skin and therefore he visited the opposite party no.1/respondent no.1 hospital on 01.02.2010. The complainant was told that he was suffering from Infectious Leprosy and the treatment was started by the opposite party no.2/respondent no.2 and subsequently within two months of the treatment the complainant/appellant had developed fever, on four different occasions. The complainant alleged that the medicines, which were prescribed by opposite party no.2/respondent no.2 were of very high intensity, because of which he developed severe reaction and had to get admitted in the opposite party no.1-hospital on 08.04.2010. The complainant was not relieved and he visited Indore on 19.04.2010, where the treating doctor declared that the previous prescribed treatment as improper and wrong. It is argued that the complainant was prescribed treatment without proper blood tests were carried out. Medicines which were prescribed were not the proper recourse and this caused reaction in the complainant's/appellant's case, accompanied with fever. The complainant/appellant alleged that he did not have an infectious leprosy and the medicines, which were prescribed for infectious leprosy, by the opposite party no.2 caused reaction. It is argued that the District Forum ignored this fact that if proper treatment is given, no lapra reaction is caused.
6. Learned counsel for opposite partyno.1/respondent no.1 argued that the complainant/appellant was admitted by Dr. S. S. Chouhan, because he developed fever due to lapra reaction on 06.04.2010. The complainant's/appellant's condition was improving but he himself requested referral for Indore from Dr.Chouhan, in order -3- to seek second opinion on 09.04.2010. Dr. Chouhan prepared a reference letter in this regard. It is argued that the complainant/appellant was properly attended during his stay in opposite party no.1/respondent no.1 hospital. On the contrary his attendants misbehaved with the duty staff, during his stay in the hospital.
7. Learned counsel for opposite party no.2/respondent no.2 along with opposite party no.2/respondent no.2 (who appeared in person) argued that Dr. S. S. Chouhan is MD in Medicine and is working as Specialist in opposite party no.1/respondent no.1 hospital, since last 15-16 years. Dr. Chouhan argued that the complainant visited him on 01.02.2010 and on the basis of investigations and clinical observation, he was found to be suffering from Leprosy, which is an infectious disease. The treatment began subsequently. Diagnosis of leprosy in 99.9% of the cases is done by clinical examination, by touch and pain. Only in 1% of the cases, histopathology is required. On 06.04.2010 the complainant/appellant was admitted in opposite party no.1/respondent no.1 hospital since he reported lapra reaction. The complainant/appellant was treated from 06.04.2010 to 08.04.2010. On the request of the complainant/appellant, a reference letter for MY Hospital, Indore was prepared by the opposite party no.2/respondent no.2. Dr. K. C. Khare, in his prescription dated 09.04.2010 has specified that the complainant has symptoms of leprosy and the complainant was prescribed same medicines, which were prescribed by the opposite party no.2/respondent no.2 Dr. Chouhan referred to the guidelines issued by the World Health Organization, in order to submit that the complainant/appellant was given 'Multi Drug Therapy' which is the most relied treatment for leprosy.
8. Dr. Chouhan submits that lapra reactions, observed in complainant's case are part of the natural course of the disease and can occur frequently. He further argued that diagnosis of leprosy is most commonly based on clinical signs and symptoms which are easy to observe by a health worker after a short period of training. The independent opinion given by Dr. Ashwin, is not be relied, since he is only an MBBS and is pursuing studies in the Department of Surgery. The 3 panel -4- doctors' opinion (Exhibit C-5) sought by the District Forum from the District Hospital, Khandwa also supports the treatment given by Dr. S. S. Chouhan. There is no medical opinion available on record to suggest that the Dr.Chouhan's line of treatment is different from the one, which is followed. It is argued that no negligence in treatment has been done by opposite no.2/respondent no.2 and the District Forum has rightly dismissed the complaint filed by the complainant.
9. The opposite party no.3/respondent no.3 argued that the insurance policy in question has been obtained by Dr. Munish Mishra. The opposite party no.1/respondent no.1 hospital and the opposite party no.2/respondent no.2 are not insured under this policy cover. No treatment has been done by Dr. Munish Mishra, who is indemnified by the insurance company. Therefore, this complaint against the opposite party no.3/respondent no.3 is not maintainable and is liable to be dismissed.
10. As we compare the prescriptions of Dr. S. S. Chouhan with those of Dr. K. C. Khare, we observe that the treatment given is more or less similar. Capsule Hansepran has been prescribed by both physicians which is the commonly used drug for the treatment of leprosy. Dr. K. C. Khare, in addition to the medicines which were prescribed by Dr. S. S. Chouhan, has prescribed Tab Vertin. Vertin is used to treat vertigo (giddiness) and holds no relevance in regard to Leprosy. The complainant was also prescribed Tablet Deanxit, which is a medicine used to cure symptoms of anxiety and depression. Tablet Deanxit, as per medical literature holds no significance in treatment of leprosy or lapra reaction. Other than the above, the complainant/appellant was given analgesics and multivitamins.
11. The opposite party no.2/respondent no.2 submitted that if the complainant's/appellant's condition was serious, he would have been admitted in Dr. Khare's hospital. Prescription of Dr. Khare does not indicate his condition to be serious. We observe that as per medical literature Leprosy, is an infectious disease which is transmitted from droplets of nose and mouth. Disease is treated by 'Multi -5- Drug Therapy' since if only one medicine is used in place of multi drug therapy, bacterial resistance develops. As per medical literature:
Leprosy reactions are episodes of sudden increase in the activity of the disease. This is thought to be due to an alteration in the immunological status of the patient. Reactions are the major cause of nerve damage and disability in leprosy. Reactions commonly occur during the early part of the disease. Reactions are part of the natural course of the disease and can occur frequently and be severely damaging in untreated leprosy. Possible occurrence of reactions needs to be explained to the patients, since signs and symptoms of reactions could be misunderstood by them as adverse effects due to the drugs, or might persuade them to think that the treatment they are getting is harming them.
Treatment- If there is no nerve involvement, no pain/tenderness or swelling and loss of sensation and weakness of muscles, the reaction can be controlled by rest and analgesics (aspirin or paracetamol). If there is nerve involvement, this is a severe reaction will need in addition to rest and analgesics, corticosteroids such as prednisolone, given as tablets, by mouth.
12. As rightly held by the District Forum, the complainant has not been able to place evidence which could suggest that the complainant/appellant was given medicines other than those prescribed in leprosy. There is no evidence that the treatment prescribed by the opposite party no.1 & 2 is not proper treatment for Leprosy. We guided by the following judgments of the Hon'ble Supreme Court in this matter.
A) Indian Medical Association Vs V. P. Shantha & Ors. 1995 (3) CPR 412: AIR 1996 SC 550- In this case no opinion of medical expert is forthcoming. A Doctor is required to use the reasonable degree of skill expected of him. It is prima facie not a negligence if a better and more effective treatment was subsequently available. There is no sure guarantee of cure in a surgical operation and so the only fact that the doctor could not cure the complainant and that some other doctor cured him on a further treatment does not ipso facto prove the negligence of the doctor.
-6-B) I (2010) CPJ 29 (SC) Kusum Sharma & Ors Vs Batra Hospital & Medical Research Centre & Ors.- Doctor not guilty of medical negligence as long as they perform their duties and exercise ordinary degree of professional skill and competence.
C) Achutrao Haribhan Khodwa & Ors Vs State of Maharashtra & Ors. (1996) 2 SCC 634 (SC), Rajinder Singh Vs Batra Hospital & Medical Research Centre & Anr. 2003 (3) CPJ 558 (Del.SCDRC)- The Supreme Court observed:- Merely because a medical procedure fails, it cannot be stated that the medical practitioner is guilty of negligence unless it is proved that the medical practitioner did not act with sufficient care and skill and the burden of proving the same rests upon the person who asserts.
13. In the wake of the above discussion and after carefully following the medical literature holding relevance in above regard, we are of the considered view that the opposite parties/respondents cannot be held accountable for any negligence or deficiency in service in treating the complainant/appellant. We do not find any infirmity or illegality in the impugned order. The impugned order is affirmed and this appeal being devoid of any merit is dismissed. However, no order as to costs of this appeal.
(S. D. AGARWAL) (DR. MRS MONIKA MALIK) PRESIDING MEMBER MEMBER