State Consumer Disputes Redressal Commission
Dr. Malathi Manipal Hospital vs V.S. Ramachandra Murthy on 18 February, 2022
Cause Title/Judgement-Entry KARNATAKA STATE CONSUMER DISPUTES REDRESSAL COMMISSION BASAVA BHAVAN, BANGALORE. First Appeal No. A/3289/2011 ( Date of Filing : 26 Sep 2011 ) (Arisen out of Order Dated 24/06/2011 in Case No. CC/2691/2010 of District Bangalore 3rd Additional) 1. Dr. Malathi Manipal Hospital (A Unit of Manipal Health Systems), No. 45/1, 45th Cross, 9th Block, Jayanagar, Bangalore 560069 Rep. by its Administrator . ...........Appellant(s) Versus 1. V.S. Ramachandra Murthy S/o. Late V.L. Suryanarayana Rao Aged about 57 years, R/o. No. 305/306, Sy. No. 9, 1st Stage, Maruthi Nagar, Sonnenahalli, Ullal Post, Bangalore 560056 . ...........Respondent(s) BEFORE: HON'BLE MR. Ravishankar PRESIDING MEMBER HON'BLE MRS. Smt.Sunita Channabasappa Bagewadi MEMBER PRESENT: Dated : 18 Feb 2022 Final Order / Judgement THE KARNATAKA STATE CONSUMER DISPUTES REDRESSAL COMMISSION, BANGALORE. (ADDL. BENCH) DATED THIS THE 18th DAY OF FEBRUARY 2022 PRESENT SRI RAVI SHANKAR - JUDICIAL MEMBER
SMT. SUNITA C.BAGEWADI - MEMBER APPEAL NO. 3289/2011 Dr. Malathi Manipal Hospital (A Unit of Manipal Health Systems) No.45/1, 45th Cross, 9th Block, Jayanagar, Bangalore-560 069 Represented by its Administrator.
....Appellant/s.
(By Sri./Smt. S.Radha Pyari, Adv.,)
-Versus-
Mr. V.S.Ramachandra Murthy S/o Late Mr.V.L. Suryanarayana Rao, A/a 57 years, Resident of No.305/306, Sy.No.9 of 1st Stage, Maruthi Nagar, Sonnenahalli, Ullal Post, Bangalore - 560 056.
(By Sri/Smt. Ganesh Kumar R., Adv.,) ........... Respondent/s : ORDERS:
BY SMT. SUNITA C.BAGEWADI - LADY MEMBER The appellant/Opposite Party filed this appeal being aggrieved by the order dated:24/06/2011 passed by Bangalore Urban III Additional District Consumer Commission in C.C.No.2691/2010, which allowed the complaint by directing the Opposite Party to pay a sum of Rs.2,00,000/- along with Rs.10,000/- towards litigation cost.
2. The parties to the appeal shall be referred to as complainant and OP respectively as per their rankings before the District Forum.
3. The brief facts of the complaint are as under:-
The complainant submitted that due to high fever and cough, he went for check-up with the Opposite Party's Hospital on 21.01.2010 and he was admitted as an inpatient at Manipal Specialty Hospital, Rajarajeshwari Nagar, Bangalore on the same day. The complainant is a diabetic and his glucose level was normal for past four years. The complainant was advised to get admitted in M/s Malathi Manipal Hospital and the complainant was admitted in the Opposite Party's hospital on 23.02.2010 and the Doctors and nursing staff inserted an IV tube to the left hand arm for the purpose of providing medicines, fluids and to get blood samples. It is further submitted that within two hours after the insertion of the IV tube, he started complaining regarding severe pain in his left hand where the IV is inserted, but the staff has not attended to his complaints. Thereafter, the complainant's left hand forefinger and thumb started turning dark and was swollen. In spite of repeated complaints, doctors and nursing staff never took any interest and neglected to attend to the complaint of the complainant.
3(a). The complainant further submitted that the family members of the complainant immediately requested the doctors to attend to the problem faced by the complainant. The doctor prescribed a painkiller gel and in-spite of the application of the gel, the pain continued. On 24.02.2010, the complainant informed his family members about uncontrollable sever pain and abnormal swelling of the left hand, forefinger and thumb. Further, on request of the family members, the doctor who was on duty after noticing the black colour on the upper portion of the left hand thumb removed the IV and called the lab technician to conduct some tests. By then, the left hand thumb of the complainant had turned charcoal black colour. After removal of the IV, the complainant was subjected to some tests that the complainant came to know as Doppler Test and the test confirmed that there was no evidence of colour flow in the left radial artery from mid forearm. After the Doppler test, the vascular surgeon was called and he suggested an operation to remove the blood clot.
3(b) The complainant further submitted that even after the report of the vascular surgeon, the Opposite Party neglected to conduct the operation immediately to remove the blood clot. Though the operation was fixed at 9.30 a.m. the actual operation was conducted only by 4.00 p.m. by Dr.Venkatesh Reddy. Even after the operation to remove the clot, the complainant's hand was still black in colour and there was no sensation of the left hand thumb. The vascular surgeon prescribed some gel to be applied and informed the complainant that the last option to amputate the affected left thumb and he was also informed if the finger is not amputated, there were chances of infections spreading further.
3(c) The complainant further submitted that the Opposite Party has not taken any care and has neglected to treat the left hand thumb of the patient until he was discharged from the Opposite Party hospital on 14.03.2010. It is further submitted that Dr. Venkatesh Reddy advised the complainant to get admitted at Yellamma Dasappa Hospital and the complainant's left hand thumb was amputated by Dr.Venkatesh Reddy on 29.03.2010. It is further submitted that the Opposite Party did not treat the complainant properly and therefore he lost his left hand thumb and thereby become permanent disability. Hence, issued a legal notice to the Opposite Party to settle the matter in onetime payment, but the Opposite Party simply issued a reply and did not settle the matter. Hence, filed the complaint.
4. After issuance of notice the Opposite Party appeared before the District Commission and filed the version contended that the complainant was diagnosed to be having bilateral pneumonia with respiratory failure with diabetic nephropathy. Due to his symptoms H1N1 was also suspected. Since intensivist support for advance life support if required was not available at that time at M/s Manipal Speciality Hospital, Rajarajeshwari Nagar, the patient was shifted to M/s Malathi Manipal Hospital on 23.02.2010. The complainant was shifted to Intensive Care Unit and was treated with broad spectrum antibiotics, bronchodilators-nebuliser and insulin. Around 2.00 p.m. an arterial line cannual was inserted on the left wrist. This was done to measure blood pressure as well as to draw samples of blood. Around 9.30 p.m. the patient complained of pain in the left hand. The arterial cannula was removed soon after he started complaining pain. The complainant's radial pulse at the wrist was felt at this time. The pulse of his left hand was monitored on regular basis and he was also observed closely on an hourly basis to look for any early sign of reduce blood flow such as bluish or blackish discoloration or pallor. Though none of these sings were present, the complainant continued to complain of pain. Physical examination of the complainant showed that there was bluish discoloration at 8.40 a.m. on 24.02.2010. The Doppler test also revealed that the complainant had developed a clot inside his radial artery for which the patient had to undergo emergency embolectomy under local anesthesia. The patient was shifted out of ICU for further treatment. On 05.03.2010, the patient developed severe respiratory distress for which the patient had to undergo emergency embolectomy under local anesthesia. He was discharged on 14.03.2010 on request with an advice to continue medication with a regular follow-up in Medical OP-Developers and with Vascular Surgeon. The complainant visited the hospital twice after his discharge.
4(a) The Opposite Party further submits that the allegation of the complainant that the Opposite Party had not taken any care and had neglected to treat the left hand thumb is false and frivolous. The Opposite Party submits that whatever treatment rendered to the complainant is according to the established medical practice and there is no negligence or deficiency in service whatsoever on the part of the Opposite Party. The Opposite Party does not admit any liability or the treating doctors responsible for causing the loss as there is no negligence on their part. Hence, there is no deficiency of service on their part and prays to dismiss the complaint.
5. After trial, the District Commission allowed the complaint by directing the Opposite Party to pay a sum of Rs.2,00,000/- along with Rs.10,000/- towards costs.
6. Being aggrieved by the said order, the Opposite Party filed this appeal on various grounds.
7. On perusal of the order sheet, it is seen that the counsel for Respondent reports the death of respondent on 18.08.2013 and this Commission abated the case against the respondent for not taking steps to bring the L.Rs of the deceased/Respondent by the appellant. Thereafter the appellant filed the Miscellaneous petition to re-call the order dated:03.12.2013. Accordingly, after hearing of the petitioner, this Commission re-called the order dated:03.12.2013 and ordered to issue notice to the respondent/L.Rs of the deceased/Respondent. But the respondent did not appear in spite of service of notice and hence, posted the matter to hear the arguments of appellant.
8. We have heard the arguments from appellant. Respondent did not turned-up to address his arguments.
9. Perused the appeal memo, impugned order passed by the District Commission, Bangalore and materials on record, we noticed that it is an admitted fact that the deceased/complainant was referred to M/s Malathy Manipal Hospital, Jayanagar by M/s Manipal Speciality Hospital, Rajarajeshwari Nagar, Bangalore for fever, high cough, breathlessness for 7 days. He was diagnosed having bilateral pneumonia with respiratory failure with diabetic nephropathy. Due to his symptoms H1N1 was also suspected. Since intensivist support for advance life support if required was not available at that time at M/s Manipal Speciality Hospital, Rajarajeshwari Nagar, the deceased/complainant was immediately shifted to M/s Malathi Manipal Hospital on 23.02.2010 for proper treatment. It is also an admitted fact that the complainant has developed a blood clot in his radial artery for the insertion of cannula in the left hand for the purpose of providing medicines.
10. The allegations of the deceased/complainant that after inserting cannula, within two hours he started severe pain in left hand and in spite of complaining the staff, they have not given any attention even though the left hand forefingers and thumb started turning dark and was swollen. In spite of repeated complaints, Doctor and Nursing staff neglected to attend the deceased/complainant. On 24.02.2010 when the duty Doctor noticed the blood colour on the upper portion of the left hand thumb, immediately removed the I.V.Cannula and called lab technicians to conduct lab tests. Doppler test was also done and after the Doppler test, the Vascular Surgeon was called and he suggested for the operation to remove the blood clot. Even after the report of the Vascualr Surgeon, the Opposite Party neglected to conduct the operation immediately and at 4.00 p.m. the operation was conducted by Dr.Venkatesh Reddy though it was advised at 9.30 a.m and after the surgery, the deceased/complainant hand was still black and there was pain and no sensation of left hand thumb. After discharge from Malathi Hospital, the deceased/complainant was admitted in Yellamma Dasappa Hospital and left hand thumb was amputated on 29/03/2010. Due to this negligence of Doctors, the complainant was lost his left hand thumb in spite of having spent lot of amount.
11. Perused the progress sheet and Nurse's, record we noticed that the Opposite Party has followed the proper treatment to the deceased/complainant and it is evident that at the time of discharge complainant's condition was improved. Moreover, the Doppler test also revealed that the deceased/complainant has developed blood clot inside his radial artery for which the patient had to undergo emergency embolectomy under local anesthesia. On 05/03/2010 the deceased/complainant developed severe respiratory distress for which he was taken back to ICU and after proper treatment, his condition was improved and patient was transferred out from MICU on 26.02.2010 under Dr.Manjunath Reddy and at the time of transfer, patient was conscious, oriented, hemodynamically stable and maintaining 98.99% 02 saturation wit 41 of 02 supplementation. Moreover, he was discharged on 14.03.2010 on request with an advice to continue medication with a regular follow-up and deceased/complainant visited the hospital twice after his discharge.
12. Perused the materials on record, at the time of admission the complainant has bilateral pneumonia with respiratory failure with diabetic nephropathy and also suspected H1N1. Hence, Doctor of Malathi Hospital treated him with antibiotics bronchodilatous and insulin. Hence, it is necessary to the Doctors to insert I.V.Cannula to provide medicines and to take samples of blood immediately and it necessary treatment at the first instant. The I.V.Cannula was inserted on 2.00 p.m. on 22.03.2010 as per progress sheet and the deceased/complainant has complained about the pain at 11.30 p.m. When the deceased/complainant complained about the pain, immediately duty Doctors removed the I.V.Cannual and gave him pain killer and gel to apply and on the same day called the lab technicians for blood test and Doppler test also done. As per the opinion of Dr.Venkatesh Reddy, Vascular Surgeon embolectomy was done and removed the blood clot. Means, the Doctors gave proper treatment to the deceased/complainant. However, the complainant is a diabetic and also H1N1 suspected may be it is one of the reason to damage the blood vessels and effects on blood flow of the deceased/complainant's left hand. Moreover, the complainant has not produced any document to show that he suffered from gangrene and for that he lost his left hand thumb. There is no any X-ray, C.T.Scan and MRI Scan reports which can show the organs, blood vessels and bones the Doctor can use the results of these tests to determine how for the gangrene was spread throughout his hand.
13. Moreover, there is no single sentence that what care the deceased/complainant deserved from the Doctors in which the Doctors are failed. What negligence was done during the treatment of insertion of cannula for supply of drug and due to that, infection caused to the deceased/complainant. Mere allegations that after swelling in left forearm, the Doctors and Nurses have not taken any care of the complainant is not sufficient to prove the negligence of Doctors/staff of the hospital unless it is proved by the evidence of Doctor of the Yellamma Dasappa Hospital who amputated the thumb.
14. Further, there is no any single document produced by the deceased/complainant to show that the complainant was hospitalized at Yallamma Dasappa Hospital after discharged from M/s Malathy Manipal Hospital and the left thumb was amputated on 29.03.2010 in the same hospital and also there is no any expert evidence except KMC prima-facie report. The Doctor was not to be held negligent simply because not removing the I.V. cannula after pain was started to the deceased/complainant immediately. Even after proper treatment, the complainant's thumb amputated because it could have happen due to several factors. Moreover, the report of KMC does not revealed that blood clot has happened in the left forearm of complainant due to compression of artery as a result of swelling due to wrongful administration of I.V.Cannula. The KMC report revealed that "this could have happened". Negligence has to be established and cannot be assumed. At the time admission, the deceased/complainant diagnosed as bilateral pneumonia with respiratory failure and diabetic and also H1N1 suspected. People with such diseases increased risk of developing gangrene because blood sugar levels associated with the condition can damage nerves and affects the blood flow. Hence, in our opinion in the absence of evidence and expert opinion regarding the gangrene, the deceased/complainant is failed to prove the negligence on the part of Opposite Party. Hence, in our opinion, the District Commission is not just and proper in passing the judgment by allowing the complaint and hence it requires to be set-aside. Accordingly, we proceed to pass the following:-
:ORDER:
The appeal is allowed. No costs.
The impugned order 24.06.2011 passed by III Additional Bangalore Urban District Consumer Commission in C.C.No.2691/2010 is set-aside.
The amount in deposit shall be transmitted to the concerned District Commission to pay the same to the Opposite Party.
Send a copy of this order to both parties as well as Concerned District Commission.
Sd/- Sd/- Member. Judicial Member. Tss [HON'BLE MR. Ravishankar] PRESIDING MEMBER [HON'BLE MRS. Smt.Sunita Channabasappa Bagewadi] MEMBER