State Consumer Disputes Redressal Commission
S. Anil Kumar, vs Care Hospital And Others on 11 September, 2014
BEFORE THE A.P STATE
CONSUMER DISPUTES REDRESSAL COMMISSION AT
HYDERABAD.
CC
110 of 2010
Between:
S. Anil Kumar,
S/o. Late S.
Narayana Rao
Age: 51 years, Private Employee,
Plot No. 31, Rail Vihar Colony
Charlapally, Ranga Reddy Dist.
Complainant
AND
1. The Managing Director
Care Hospital
Road No. 1,
Banjara Hills
Hyderabad-500
084.
2. Karan
Hospital
Rep. by its Managing
Director
Dr. T. S. Kumar
D.No. 10-3-313/3
Vijay Nagar
Colony
Hyderabad
3. Dr. S.
Aruna, Gynaecologist
W/o. Dr. Suman
Chandra, Aged 42 yrs
R/o. 18/A1, P.S.
Nagar Colony
Vijay Nagar
Colony
Hyderabad.
4. Dr.
Jyothsna, W/o. Dr. Ramesh
Gynaecologist
C/o. Suddala
Gautham Krishna
5. Dr.
Ramesh, S/o. Gowrayya
C/o. Suddala
Gautham Krishna
6. Gautham
Krishna
S/o. S. Devayya, Private Employee
Flat No. G5, Chanakya
Shelters
(Proforma Party)
Opposite parties No.4 to 6
Flat No.G5, Chanakya Shelters
R/o Alwal, Secunderabad.
Opposite
Parties
Counsel for the Complainant M/s. Vedula Srinivas
Counsel for the Opposite Parties M/s. A.Srinath (OP1)
M/s
K.Ravinder Reddy (OP2)
M/s
T.Sri Ranga Rao(OP3)
M/s
P.Rajasripathi Rao(Ops 4 to 6)
QUORUM: SRI
S. BHUJANGA RAO, HONBLE MEMBER
& SRI R.LAKSHMINARSIMHA RAO, HONBLE MEMBER THURSDAY THE ELEVANTH DAY OF SEPTEMBER TWO THOUSAND FOURTEEN Oral Order (As per Sri R.Lakshminarasimha Rao, Honble Member) ***
1. This is a complained filed u/s 17(1)(A)(i) of the Consumer Protection Act for a direction to opposite parties no.1 to 5 to pay compensation of Rs.1 crore on account of death of the daughter of the complainant.
2. The brief facts of the complaint are that the complainant was blessed with three children. His elder daughter was Ms. Sneha followed by two sons Sharath and Sagar. His daughter after completing her graduation in Bio-chemistry has been working for a Call Centre 24/7 at Somajiguda for an amount of `12,000/- p.m. While so, on 9.4.2009 at about 10.30 p.m. the complainant received a phone call from Dr. Bhaskar of Care Hospital stating that his daughter is in a critical condition. Immediately, the complainant along with family members rushed to the hospital where they learnt that an abortion was conducted on her at Karan Hospital and later shifted to Care Hospital as her condition became serious. Dr. Bhaskar introduced opposite parties no.4 and 5 as sister and brother-in-law of one Mr. Gautham (opposite party no.6). The complainant submits that Op5 informed him that whiles they were conducting abortion on Ms. Sneha on 8.4.2009 at 11.00 p.m. the patient went into coma on account of excess dosage of anaesthesia.
Mr. Gautham informed the complainant that he and Ms. Sneha were known to each other and on account of their intimacy she became pregnant. As they intend to get the pregnancy terminated admitted her to Karan Hospital (Op2) on 8. 4. 2009. Dr. S. Aruna, Consultant Gynaecologist at Karan Hospital performed abortion on 8.4.2009 at 11.00 p.m. with active participation of Ops 4 & 5. The complainant alleges that his daughter was administered with wrong medicines and excess dosage of anaesthesia. She was deliberately sent into coma and was given treatment whereby she will have a slow death without any external symptoms.
In a calculated manner the management of Karan Hospital and Care Hospital with active participation of their team of doctors have eliminated Ms. Sneha to clear the hurdles faced by Mr. Gautham and his family.
3. The complainant submits that as per the version of hospitals Ms. Sneha was six weeks pregnant and thus there was no need to conduct abortion in a hurried manner at about 11.00 p.m. without informing her family members. The complainant alleges that there was no anaesthetist at Karan Hospital and powerful drugs were administered on the patient in a negligent manner. The consent of Ms. Sneha was not obtained for conducting abortion. The complainant stated in categorical terms that the life of his daughter at the age of 22 years abruptly came to an end at the hands of above hospitals. The complainant alleges that all this had happened due to negligence of Opposite Party hospitals.
4. The complainant got issued a legal notice dt. 11.5.2010 claiming compensation for which Op1 did not give any reply. While Op2 Karan Hospital gave reply dt. 29.5.2010 stating that they did not give any treatment to Ms. Sneha. Ops 4 & 5 gave joint reply dt. 28.5.2010 denying about the admission of Ms. Sneha at Karan Hospital. Op3 got issued a separate reply dt. 20.5.2010 admitting that Ms. Sneha was brought to Karan Hospital (Op2) on 8.4.2009 by Ops 4 & 5 when she was on duty. Op3 stated that the condition of the patient was serious by then and was suffering from severe bleeding and pain. On enquiries it was revealed that she was pregnant and took i-pills to avoid abortion. Op3 in her reply stated that after conducting necessary tests, consent letters were taken for conducting abortion in order to save her life. Op3 administered local anaesthesia, pain killer and sedation whereby Ms. Sneha collapsed immediately. The patient was intubated;
Oxygen was given and shifted to Op1 Care Hospital for specialized treatment by taking necessary consent.
5. The complainant pleads that they were never informed about the admission of his daughter at Karan Hospital or about her critical condition even when she was shifted to Op1 Care Hospital. The reply notices got issued by the Opposite Parties is contrary to each other. There was gross negligence on the part of Opposite Parties in extending medical service to his daughter. The Opposite Parties are liable for the untimely and sad demise of his daughter which is irreparable. The complainant claimed an amount of Rs. 1 crore taking into consideration the loss of earnings, loss of life of his beloved daughter at a young age of 22 years and also for mental agony suffered by the entire family.
6. Op1 Care Hospital filed counter stating that complainants daughter was brought to the hospital at 12.20 a.m. on 9.4.2009 with respiratory arrest. The patient was intubated in an outside hospital and brought by the attendants. At the time of admission of patient in Op1 hospital , medical termination of pregnancy performed allegedly at Karan Hospital was incomplete. The patient was accompanied by an anaesthetist who claimed to be her cousin and also Op6 who claimed to be her husband.
As it is a medico-legal case, police were informed accordingly. After prolonged counselling and discussion, phone number of the complainant was revealed. The staff of Op1 hospital informed the complainant at 10.15 p.m. on the same day about the serious condition of the patient.
7. Op1 reiterated that the patient was brought at 12.20 a.m. on 9.4.2009 consequent on respiratory arrest which allegedly occurred during an elective termination of pregnancy at 11.00 p.m on 8.4.2009 at Karan Nursing Home, Vijayanagar Colony, Hyderabad. At the time of admission in Op1 hospital the patient was found to be comatosed with minimal response to painful stimuli. She had recurrent seizures and was in shock. She was seen by the gynaecologist and advised termination of intubation once the patients general condition improves. The patient continued to be deeply comatosed and there was no improvement in the sensorium over the next few days. The critical condition of the patient, over all poor prognosis with risk to life and low chances of sensorium improving was explained to her attendants. On 20.4.2009 the patient developed severe bradycardia and was declared dead at 2.00 a.m. on 20.4.2009. Op1 Care Hospital submits that they are not aware of what had transpired allegedly at Op2 Karan Hospital. It has no knowledge of what could have happened at Op2 Karan Hospital or as to the role of Dr. S. Aruna, Dr. Josthna and Dr. Ramesh (Ops 3 to 5 respectively). Op1 further submits that they did their level best to save the life of the patient. There is no negligence on the part of Op1 hospital in treating the patient. The complaint is liable to be dismissed as against Op1.
8. Op2 Karan Hospital filed counter denying the allegations made in the complaint. Op2 hospital was established in the year 1990 and till date there are no complaints whatsoever against Op2. Op3 a reputed gynaecologist visits Op2 hospital as a consultant. Op2 submits that on 8.4.2009 Ms. Sneha was brought in a critical condition which required immediate medical attention and the said patient has already taken some medicines for abortion. The situation warranted surgical procedure and the attending doctors have done their level best to save the patient. In every surgical procedure there is an inherent risk and unforeseen complications and in the instant case unfortunately the patient developed complications which are unforeseen and the patient was referred to Op1 Care Hospital for better treatment. There is no negligence either on the part of OP2 or any of the doctors. Op2 is a registered hospital for conducting MTP services. The complainant has no locus standi to file the complaint and prayed that the complaint be dismissed.
9. The opposite party no.3, Dr. S. Aruna a consultant Gynaecologist at opposite party no.2 Karan Hospital filed written version denying the allegations made in the complaint. The opposite party no.3 submitted that on 8.4.2009 Op4 Dr. Jyosthna a post-graduate student of Gynaecology and Obstetrics working at Government Maternity Hospital, Nayapul, Hyderabad brought the patient aged about 22 years suffering from severe bleeding and pain with 7 to 8 weeks pregnancy. According to the patient she took Mioprestol tablets for abortion on the advice of some other doctor. As the abortion did not take place, and she developed pain in the lower abdomen and started bleeding, she approached the opposite party no.3 for Medical Termination of Pregnancy (MTP). The opposite party no.2 Karan Hospital is a recognized hospital and well equipped to conduct MTP. The opposite party no.3 agreed to conduct MTP after obtaining consent from the patient as well as Op4 who is a doctor by profession for the following reasons:
o Sneha (Patient) and Gautam (Op6) are husband and wife confirmed by Op4 Dr. Jyothsna attendant.
o Sneha and Op4 Dr. Jyothsna gave consent.
o She is pregnant by 7 to 8 weeks which is not illegal for doing MTP as per o MTP Rules.
o Because of Contraceptive failure viz., i-pill, Misoprostol etc. was taken for abortion.
o Patient had two episodes of bleeding per vagina o They feared that there was abnormalities because of the above drugs.
10. The patient was admitted in the opposite party no.2 hospital and as per the protocol 800 mg of misoprostol inserted in the vagina and waited for 2 hours to open cerix. Thereafter the patient was shifted to operation theatreto do MTP after giving Xylocaine injection. The patient was given oxygen and was intubated after giving atropine. As there was no improvement in heart rate adrenaline was given. The condition of the patient was got little better with resuscitative measures. The patient needed ventilators support she was admitted in Care Hospital for intensive care management and the opposite parties no.4 and 6 gave their consent thereto, the patient with intubation and cylinder oxygen was shifted to Care Hospital. At the time the vitals of the patient were stable and oxygen saturation was 97%.
11. The opposite party no.3 is not responsible for the death of the patient.
She being a reputed gynaecologist exercised due care in administering treatment to the patient. The opposite party no.3 being a consultant at the opposite party no.2 hospital attended the patient who was in serious and critical condition. The opposite party no.3 has not received any fees as the patient is the close relative of the opposite party no.4.
12. The opposite party no.4 has resisted the claim on the premise the complainant has father of the deceased patient cannot sue and maintain the complaint and he is not consumer under the provisions of C.P.Act. The complainant has no role in admitting the patient with opposite party no.1 hospital and he has not paid the necessary expenditure for her treatment. The complainant has disowned the patient long ago. The patient walked out of the house of the complainant 9 months prior to her death due to the displeasure expressed by the complainant as to her intention to marry the opposite party no.6. Subsequently the opposite party no.6 informed the opposite partyno.4 that he married the patient and residing with her in a separate house from his parents. Out of the marital relationship the patient got pregnant and she felt that it was early for her to have a child and expressed her intention to go for abortion. The opposite partyno.6 and the patient went to the opposite partyno.2 hospital on 8.4.2009 and unfortunately her condition became critical during the course of surgical procedure and she was shifted to the opposite party no.1 hospital.
13. The treatment administered by the doctors at opposite party no.1 hospital is in accordance with the proper norms and principles. There is no negligence on the part of the doctors. The medical council conducted enquiry and gave finding that there was no negligence or latches on the part of the doctors during the treatment of the patient from 8.4.2009 to 20.04.2009. The complainant with a malafide intention filed the complaint to extract money from the opposite parties. Hence, prayed for dismissal of the complaint.
14. The opposite party no.5 has contended that the complainant is not consumer within the meaning of Section 2(1)(d) of C.P.Act and that the complainant disowned his daughter long ago and he did not care for her welfare as also he has not paid the medical expenses for treatment of the patient at the opposite partyno.1 hospital. The complainant has also not admitted the patient at the opposite party no.2 hospital. The opposite party no.6 and the patient got married and they were resident in a separate house at Alwal, Hyderabad. The patient did not want to have a child and accordingly she and the opposite party no.6 went to the opposite partyno.2 hospital for medical termination of pregnancy and during the course the patients condition became serious as a result of which she was shifted to the opposite party no.1 hospital. The medical council conducted enquiry and concluded that there was no negligence on the part of the doctors of the opposite parties no.1 and 2 hospital. The complainant filed the complaint to enrich himself at the expense of his daughters death. Hence prayed for dismissal of the complaint.
15. On behalf of the complainants, PWs1 and 2 had been examined and Exs.A1 to A20 are marked. On behalf fo the opposite parties, affidavits are filed and Exs.B1 to B23 are marked.
16. The learned counsel for the opposite party no.1 has filed written submissions.
17. The points for consideration are:
i) Whether there is medical negligence shown on the part of the opposite parties?
ii) To what relief?
18. POINT NO.1: The learned counsel for the opposite parties no.4 to 6 has contended that the complaint is not maintainable as the complainant has no locus standi to file the complaint on account of the marriage of Sneha(hereinafter referred to as the patient) with the opposite party no.6. The learned counsel for the complainant has submitted that the opposite party no.6 is not related to the patient. The name of the patient is described in the medical record of the opposite party no.1 and 2 as SnehaGoutham. The mere description of the name of the patient as SnehaGoutham does not give the opposite party no.6 the status of husband of the patient. In the report of post mortem examination the patient is described as the daughter of the complainant. The complainant in his notice dated 11.05.2010 issued to all the opposite parties has specifically denied relationship between the patient and the opposite party no.6 and he claimed that the opposite party no.6 is not competent to give consent for the treatment that the patient had undergone at the opposite party no.1 and 2 hospitals.
19. The opposite party no.6 has not shown any cause or reason as to how he could claim the status of husband of the patient. The complainant has stated that for the first time he came to know about the opposite party no.6 at the opposite party no.1-hospital at the time of admission of the patient and prior to that he did not know the opposite party no.6 or the opposite party no.4 and 5. The reply of the opposite party no.1 to the notice of the complainant that the opposite party no.6 could not furnish particulars of the patients parents would further strengthen the fact that the opposite party no.6 failed to prove that he tied knot to the patient.
20. The introduction of the patient by the opposite party no.6 as her husband to the doctors at the opposite party no.1 and 2 hospitals by itself cannot be considered as a factor to hold him with the status of the husband of the patient. The opposite party no.6 though made a party to the complainant, complainant has not chosen to file written version or deny the statement of the complainant that he has no any relation with the patient. Even assuming that the deceased and the opposite party no.6 lived together for a short period, it cannot be inferred that they are husband and wife as the factum of marriage between them has not been established with required evidence. Hence, no importance need to be given to the mentioning of such a relationship in medical record if any. As such we hold the contention of the learned counsel for the opposite parties that the complainant has no locus standi to file the complaint has no any substance.
21. The patient for the first time approached the second opposite party-hospital on 8.04.2009 and according to version of the opposite parties no. 2 and 3, her condition was serious and she required immediate medical attention as to abortion by conducting medical termination of pregnancy. The third opposite party has stated that she obtained consent of the patient, and the opposite party no.4 and 6 to conduct MTP on the patient and she administered local anaesthesia, pain killer and sedation to the patient on which the patient collapsed and immediately the patient was intubated and shifted to Care Hospital. The operation notes speak of the patient complaining pain immediately the opposite party no.3 administered her with local anaesthesia. Thereafter, the opposite party no.3 stopped the procedure and administered Midazolam and Ketamine following the treatment, the patient had respiratory arrest.
22. There was no anaesthetist present in the second opposite party hospital. The patient was bleeding by the time she approached the second opposite party and the opposite party no.3 came to the conclusion that the patient was required to undergo surgery for medical termination of pregnancy. The service of the anaesthetist ought to have been availed when the patient complained of pain immediately after being administered with local anaesthesia.
22. The opposite parties no.4 and 5 denied participating in surgery conducted at the second opposite party hospital. Except in the death summary of the patient, there is no any mention of the fifth opposite party as to his role in the conducting the surgery at the second opposite party-hospital.
23. In the death summary issued by the opposite party no.1-hosptial, the history of events taken place outside the second opposite party hospital is noted. Thus, even if the fifth opposite party is considered to be an anaesthetist he had not administered anaesthesia to the patient at the second opposite party-hospital and it is the third opposite party who administered either local anaesthesia or Midazolam and Ketamine to the patient and not the fifth opposite party. In that event, the opposite party no.2 and 3 ought to have availed the service of the fifth opposite party.
24. The third opposite party has stated that she obtained consent of the fourth opposite party, the sixth opposite party and the patient for the purpose of surgery. The fourth opposite party has stated that she had not administered any treatment to the patient at the second opposite party hospital. The fourth opposite party has denied in her reply dated 28.05.2010 her involvement in the treatment rendered to the patient as under:
My clients denies the allegations that they have participated in the procedures conducted at Karan Hospital and that they have deliberately sent your clients daughter into coma by administering wrong medicines and excess dosage of aesthesia. My clients have nothing to do with Karan hospitals and have never participated in any surgeries conducted there and the allegations that they along with Karan hospitals and have never participated in any surgeries conducted there and the allegations that they along with Karan hospitals and others have cooperative with Gautham under the influence of Sri Suddala Devaiah to eliminate Sneha is not only false, baseless and a fairy tale created by your client but is also highly defamatory.
25. In case the fourth opposite party referred the patient to the third opposite party, there be no need for the third opposite party to obtain her consent to perform MTP upon the patient. Contrary to what is stated in the reply notice of the opposite party no.3, in the operation notes it is mentioned that the fourth opposite party has assisted the third opposite party in performing the operation. In any case, as it is not the case of the third opposite party nor is it mentioned in her reply notice that she had taken assistance of the fourth opposite party for the purpose of performing the operation, it cannot be said that the fourth opposite party has any role in administration of treatment rendered to the patient at the second opposite party-hospital.
26. Coming to the aspect of the consent stated to have been obtained from the opposite parties no.4 and 6 and the patient, it is the plea of the complainant that the opposite parties no.4 and 6 are not competent to give consent and the consent said to have been obtained is not valid. The version of the third opposite party is that she conducted tests and concluded that the patients condition was serious and she had to undergo surgery as also she stated that she had obtained the consent of the patient. It is essential to refer to the decision in Samira Kohli vs Dr.Prabha Manchanda reported (2008) 2 SCC 1 for the reasons for obtaining consent, full disclosure to be made by the treating doctor In that case, the reasons for obtaining consent, full disclosure and informed consent are elaborately dealt with which in brief are :
27. The Supreme Court summarized the principles relating to consent as follows :
(i) A doctor has to seek and secure the consent of the patient before commencing a 'treatment' (the term 'treatment' includes surgery also). The consent so obtained should be real and valid, which means that : the patient should have the capacity and competence to consent; his consent should be voluntary; and his consent should be on the basis of adequate information concerning the nature of the treatment procedure, so that he knows what is consenting to.
(ii) The 'adequate information' to be furnished by the doctor (or a member of his team) who treats the patient, should enable the patient to make a balanced judgment as to whether he should submit himself to the particular treatment as to whether he should submit himself to the particular treatment or not. This means that the Doctor should disclose (a) nature and procedure of the treatment and its purpose, benefits and effect; (b) alternatives if any available; (c) an outline of the substantial risks; and (d) adverse consequences of refusing treatment. But there is no need to explain remote or theoretical risks involved, which may frighten or confuse a patient and result in refusal of consent for the necessary treatment. Similarly, there is no need to explain the remote or theoretical risks of refusal to take treatment which may persuade a patient to undergo a fanciful or unnecessary treatment. A balance should be achieved between the need for disclosing necessary and adequate information and at the same time avoid the possibility of the patient being deterred from agreeing to a necessary treatment or offering to undergo an unnecessary treatment.
(iii) Consent given only for a diagnostic procedure, cannot be considered as consent for therapeutic treatment. Consent given for a specific treatment procedure will not be valid for conducting some other treatment procedure. The fact that the unauthorized additional surgery is beneficial to the patient, or that it would save considerable time and expense to the patient, or would relieve the patient from pain and suffering in future, are not grounds of defence in an action in tort for negligence or assault and battery. The only exception to this rule is where the additional procedure though unauthorized, is necessary in order to save the life or preserve the health of the patient and it would be unreasonable to delay such unauthorized procedure until patient regains consciousness and takes a decision.
(iv) There can be a common consent for diagnostic and operative procedures where they are contemplated. There can also be a common consent for a particular surgical procedure and an additional or further procedure that may become necessary during the course of surgery.
(v) The nature and extent of information to be furnished by the doctor to the patient to secure the consent need not be of the stringent and high degree mentioned in Canterbury but should be of the extent which is accepted as normal and proper by a body of medical men skilled and experienced in the particular field. It will depend upon the physical and mental condition of the patient, the nature of treatment, and the risk and consequences attached to the treatment.
Their Lordships observed The basic principle in regard to patient's consent may be traced to the following classic statement by Justice Cardozo in Schoendorff vs. Society of New York Hospital - (1914) 211 NY 125 : 'Every human being of adult years and sound mind has a right to determine what should be done with his body; and a surgeon who performs the operation without his patient's consent, commits an assault for which he is liable in damages."
28. The second opposite party has failed to see that informed consent is obtained for the purpose of MTP, an anaesthetist is available at the time of performing MTP on the patient and the third opposite party negligently proceeded to administer anaesthesia even when the patient complained of pain due to local anaesthesia that she administered and both the opposite parties no.3 and 4 had been negligent in not seeking for advice of specialist at the time the patient suffered apnoea, i.e., respiratory arrest following the administration of Midazolam and Ketamine.
29. The opposite party no.2 in reply to the interrogatories of the complainant has stated that consent is a part of case sheet and it contains the signatures of the patient and her attendant and to the question as to the capacity of the opposite parties no.4 and 5 to give consent and their registration number etc., it was replied consent is self-explanatory. She was present as an attendant of the patient and has signed as witness to consent form. This answer if viewed in the backdrop of the contents of operation notes showing the fourth opposite party as the assistant of the third opposite party belies the case of the opposite parties no.2 and 3 that they obtained informed consent from the patient.
30. The contention of the learned counsel for the second opposite party that the second opposite party is a hospital where various doctors bring their patients for surgical procedure there and except providing the infrastructure required for the surgical operation, it has no role to play in the treatment of the patient holds no water in the light of its admission that the third opposite party is a consultant and the opposite party no.2 hospital is registered with the competent authority for performing MTP. The contention of the opposite party that it is registered for conducting MTP service with the competent authority would cast much responsibility on it to see that competent doctors including anaesthetists are available for treating the patients undergoing MTP and supervise the surgical procedure commencing from pre-aesthetic check-up, obtaining consent etc., till the patient is discharged and any shortfall in the standard can be construed as deficiency in service on its part. The circumstances narrated in Medical Termination of Pregnancy do not exist in this case. Therefore, the opposite parties no.2 and 3 initiating steps to terminate pregnancy of the deceased also amounts to professional negligence. For conducting MTP, the hospital which has obtained the permission should provide appropriate infrastructure and competent doctors as also the equipment to take care of the patient undergoing MTP and developing complications during the surgical procedure if any.
31. The opposite party no.2 except stating in reply to the interrogatories of the complainant that it is endowed with the standard operation theatre to perform any operation, it has not adduced any evidence. The opposite party no.2 has no explanation as to why the patient was shifted to the opposite party no.1 hospital where the opposite party no.2 had all the required facilities in the operation theatre to meet any kind of exigency during the stage of operation or during post-operative stage.
The opposite party no.2 or the opposite party no.3 failed to show as to how they could come to the conclusion without conducting relevant tests that the patient was pregnant and the pregnancy was to be terminated. Merely stating that the police had seized the record does not help the case of the opposite parties no.2 and 3 that they had exercised due care and diligence in treating the patient.
32. Non-production of the documents as to come to the conclusion that the patient was pregnant at the time she approached the opposite party no.2 hospital by itself is a sufficient factor to come to the conclusion that the opposite parties no.2 and 3 were negligent and proceeded to perform MTP without even ascertaining as to the pregnancy and the age of the foetus by the time the patient was taken to the operation theatre in the opposite party no.2 hospital. It is significant to consider the reply of the opposite party no.5 to the interrogatories of the complainant that though he being a doctor along with the patient was present at the opposite party no.2 hospital, he had no knowledge as to the tests stated to have been conducted by the opposite party no.3. In the backdrop of this situation, the report of the medical board does not stand to any scrutiny particularly where the medical board has not assigned any reasons for coming to such conclusion.
33. The Managing Partner of the opposite party no.2 in his reply to the interrogatories of the complainant has admitted that the patient was not suffering from diabetes mellitus, BP, TB, CAD, Respiratory disease. To the question whether the opposite party no.3 participated in the termination of pregnancy of the patient, he replied that the operation was performed by the opposite party no.3 alone and the opposite party no.4 was an attendant and he evaded to answer the question as to who was the anaesthetist for the MTP of the patient on the night of 8/9.4.2009. He has expressed his inability to name the medicine consumed by the patient prior to her admission to the opposite partyno.2 hospital.
34. Dr.Narayan Reddy, Professor of forensic medicine has stated that the opposite partyno.3 did not wait for the medicine to take effect and started the surgical procedure. He has stated that he has no knowledge whether the opposite parties no.4 and 5 had participated in any of the treatment administered to the patient.
The entire documents placed on record either on the side of the complainant or the opposite parties does not show the participation of the opposite parties no.4 and 5 in the treatment administered to the patient. As mentioned above, the opposite party no.4 attended on the patient as an attendant and not as a doctor. Such being the situation, the opposite parties no.4 and 5 cannot be held to have administered treatment to the patient.
35. The opposite party no.6 though had not chosen to file written version, he is not a doctor and the complaint is primarily filed on the foot of medical negligence of the doctors. Therefore, we are inclined to hold that the complaint is liable to be dismissed against the opposite parties no.4 to
6. As mentioned above, we have considered the negligence of the opposite parties no.2 and 3 in the administration of treatment to the patient from the time of her admission with the opposite party no.2 hospital till she was shifted to the opposite party no.1 hospital.
36. The patient was shifted to the opposite party no.1 hospital on 9.4.2009 in comatose state with recurrent seizures and shock. As seen from the death summary of the patient, she was managed with invasive ventilation, IV fluids, inotropes antiepileptics, antibiotics and supportive care. MTP was performed and no complications were seen during the procedure. There were no reoccurrence of seizures, hypotension and fever improved. However, there was no improvement in the sensorium. She was continued on antidema measures, antibiotics, antipileptics, invasive ventilation and supportive care. However, the poor prognosis is indicated by the patient developing hypotension and tachycardia. All the possible standard measures were taken by the doctors at the opposite party no.1 hospital. However, unfortunately the patient could not survive. We do not find any negligence on the part of the doctors at the opposite party no.1 hospital.
37. The complainant claimed an amount of Rs.one crore towards compensation from the opposite parties no.1 to 5. The patient was bleeding and her condition was critical by the time she was taken to the opposite party no.2 hospital. While quantifying the amount to be awarded as compensation, several factors have to be taken into consideration and the significant factor herein is the critical condition fo the patient by the time she was admitted to the opposite party no.2 hospital.
38. The Honble Supreme Court State of Gujarath vs Shantilal Mangaldas AIR 1969 SC 634. Held the compensation to mean..in ordinary parlance the expression compensation means anything given to make things equivalent; a thing given to or to make amends for loss recompense, remuneration or pay, it need not therefore necessarily in terms of money. The phraseology of the Constitutional provision also indicates that compensation need not necessarily be in terms of money because it expressly provides that the law may specify the principles on which, and the manner in which , compensation is to be determined and given . If it were to be in terms of money along, the expression paid would have been more appropriate.
39. The Supreme Court held that the compensation to be awarded is to be fair and reasonable. In Charan Singh vs Healing Touch Hospital and others 2000SAR(Civil) 935 the Apex Court stressed the need of balancing between the compensation awarded recompensing the consumer l and the change it brings in the attitude of the service provider. The Court held While quantifying damages , consumer forums are required to make an attempt to serve ends of justice so that compensation is awarded, in an established case, which not only serves the purpose of recompensing the individual, but which also at the same time aims to bring about a qualitative change in the attitude of the service provider. Indeed calculation of damages depends on the facts and circumstances of each case. No hard and fast rule can be laid down for universal application. While awarding compensation, a Consumer Forum has to take into account all relevant factors and assess compensation on the basis of accepted legal principles, on moderation. It is for the Consumer Forum to grant compensation to the extent it finds it reasonable, fair and proper in the facts and circumstances of a given case according to established judicial standards where the claimant is able to establish his charge.
40. The negligence or deficiency of service on the part of the opposite parties no.2 and 3 is not by itself a factor contributed to the death of the patient. It is only one of the factors that contributed to the death of the patient. The complainant has not shown any concern for his daughter when she was fighting with the death at the opposite party no.1 hospital. The complainant has not incurred any medical expenditure for the treatment of the patient either at the opposite party no.1 or the opposite party no.2 hospitals.
41. The complainant was so averse to the interest of his daughter that she had to live separately nine months prior to her death. Hale and healthy father cannot be considered as a dependent of the deceased daughter. However, he lost her love and affection and he lost her services during his old age.
Therefore granting compensation on multiplier method cannot be considered.
Taking into consideration of all these facts and applying the principle laid in the aforementioned decisions; this Commission is of considered view that an amount of Rs.5 lakhs towards compensation on all counts would meet the ends of justice.
42. In the result the complaint is allowed directing the opposite parties no.2 and 3 to pay `5 lakhs towards compensation and costs of `5,000/- within four weeks from the date of receipt of the order. The complaint against the opposite parties no.1, 4 to 6 is dismissed without costs.
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MEMBER Dt.11.09.2014 కె.ఎం.కె.* APPENDIX OF EVIDENCE WITNESSES EXAMINED NIL EXHIBITS MARKED For the complainants Ex.A1 Karan Hospital, KMT Medical and Laparoscopic Centre, Operation Notes, dated 08.04.2009- Xerox copy.
Ex.A2 Care Hospital, Department of Critical care, Death Summary, MLC No. 176A/09, dated 09.04.09-Xerox copy Ex.A3 Government of A. P Requisition for Post-mortem Examination- dated 20.04.09-Xerox copy.
Ex.A4 Legal Notice issued by the Complainant to the Opposite parties- dated 11.05.2010- Xerox copy.
Ex.A5 Postal Receipts affixed on separate sheet, dated 12.05.2010- Xerox copy.
Ex.A6 Legal Notice Copies sent to opposite parties through certificate of posting, dated 13.05.2010- Xerox copy.
Ex.A7 Postal acknowledgement Card of R-6, dated 13.05.2010- Xerox copy.
Ex.A8 Postal acknowledgement Card of R-6, dated 14.05.2010- Xerox copy Ex.A9 Postal acknowledgement Card of R-2, dated 15.05.2010- Xerox copy Ex.A10 Postal acknowledgement Card of R-1, dated 15.05.2010- Xerox copy Ex.A11 Postal acknowledgement Card of R-4, dated 28.05.2010- Xerox copy Ex.A12 Postal acknowledgement Card of R-5, dated 28.05.2010- Xerox copy Ex.A13 Reply Notice from R-3 to Complainant Legal notice, dated 20.05.2010 Original Ex.A14 Reply Notice from R-4 & R-5 to complainant Legal notice, dated 28.05.2010-Original Ex.A15 Reply Notice from R-2 to complainant Legal notice, dated 29.05.2010-Original Ex.A16 Reply Notice from R-1 to complainant Legal notice, dated 21.08.2010-Original Ex.A17 Provisional Certificate, dated 07.06.08- Original Ex.A18 Offer of Employment - Original Ex.A19 Annexure-I, dated 23.07.08-Original Ex.A20 Annexure-II, dated 17.07.08-Original For the Opposite parties Ex.B1 Power of Attorney Ex.B2 Registration Data and Inpatient check list slip Ex.B3 Check list for inpatient admission Ex.B4 Death Summary Ex.B5 Investigation Chart Ex.B6 Accident & Emergency Department Record Ex.B7 Progress Notes and Nurses progress notes Ex.B8 Informed consent and High risk surgical procedures Ex.B9 Nurses Progress Notes Ex.B10 Critical care and emergency services/Diabetic Chart Ex.B11 All Test Reports Ex.B12 Authorization for treatment along with authorization for release of information Ex.B13 Letter dated 13.04.09 of alleged husband Ex.B14 Letter dated 16.04.09 of the complainant Ex.B15 MLC Notes Ex.B16 Handing / taking over items Ex.B17 TRR Chart Ex.B18 Undertaking to settle the Hospital fees Ex.B19 Critical Care Ex.B20 Bio Chemistry Report Ex.B21 medico Legal patient record Ex.B22 letter from the superintendent, Osmania General Hospital, Hyd.
Ex.B23 Report of Medical Board.
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