State Consumer Disputes Redressal Commission
Puneesh Sagar vs Mayo Healthcare Super Specialty ... on 26 August, 2022
STATE CONSUMER DISPUTES REDRESSAL COMMISSION,
PUNJAB, CHANDIGARH.
Consumer Complaint No.509 of 2019
Date of Institution:03.07.2019
Reserved on : 28.07.2022
Date of decision :26.08.2022
Puneesh Sagar Son of Late Smt. Laxmi Sagar, Wife of Late Shri S.D.
Sagar, resident of Sagar Niwas, Shakti Nagar, Jaunaji Road, Solan,
Himachal Pradesh.
.....Complainant
Versus
1. Mayo Healthcare Super Specialty Hospital, through its Managing
Director, Sector 69, Mohali, Punjab.
2. The Managing Director, Mayo Healthcare Super Specialty
Hospital, Sector 69, Mohali, Punjab.
....Opposite Parties
3. Smt. Sunita Sharma wife of Shri Ajay Sharma, Daughter of Late
Smt. Laxmi Sagar, resident of Village Kado, Tehsil Kasauli,
Dharampur, District Solan, Himachal Pradesh.
4. Smt. Neelima Verma, Daughter of Late Shri S.D. Sagar,
Daughter of Late Smt. Laxmi Sagar, resident of Sagar Niwas,
Shakti Nagar, Jaunaji Road, Solan, Himachal Pradesh.
....Proforma Opposite Parties
Consumer Complaint under Section 12 of the
Consumer Protection Act, 1986.
Quorum:-
Hon'ble Mrs. Justice Daya Chaudhary, President
Mrs. Urvashi Agnihotri, Member
1) Whether Reporters of the Newspapers may be allowed to see the Judgment? Yes/No
2) To be referred to the Reporters or not? Yes/No
3) Whether judgment should be reported in the Digest? Yes/No C.C. No.509 of 2019 2 Argued by:-
For the complainant : Ms. Shweta, Advocate For opposite parties No.1&2 : Sh. Rakesh Gupta, Advocate with Dr. Manoj Sharma & Dr. Sanjiv Bhatia JUSTICE DAYA CHAUDHARY, PRESIDENT:
Complainant-Puneesh Sagar has approached this Commission by way of filing the present complaint under Section 12 of the Consumer Protection Act, 1986 (in short the "Act") against opposite parties No.1 and 2 (in short "OPs"). However OPs No.3 and 4 are only the proforma respondents. The grievance of the complainant is that his mother late Smt. Lakshmi Sagar remained admitted in Super Specialty Hospital of OPs No.1 and 2 i.e. Mayo Healthcare Super Specialty Hospital on 27.07.2017 with the pain in her abdomen region and breathlessness. She was admitted in Urology Department where Dr. Manoj Sharma was the incharge. It has further been mentioned in the complaint that as per the discharge summary Ex.C-2 she was diagnosed to have Cholethiasis (Gallstones) and other associated ailments resulting Sepsis. She was admitted in ICU and was put on mechanical ventilation after admission on 27.07.2017. Laprotomy and Cholecystectomy was done on the patient on 29.07.2017 by one Dr. Sanjeev Bhatia stating to be a specialist of the field. Thereafter, she was shifted from ICU to the private room. After shifting a heavy abscess discharge was there from Surgical incision site of the patient. On asking from the concerned Doctor, it was assured that such discharge was not an issue of any relevancy and did not require any more clinical analysis or testing. However, still complainant was interested to know the cause C.C. No.509 of 2019 3 of infection. One Doctor namely Jasmeet was looking after the medicines given to the patient and he advised to consult the concerned Surgeon who operated the patient i.e. Dr. Sanjeev Bhatia. Inspite of making repeated requests to know the reason of abscess flow, no response was there from the Doctors as well the staff. It is further mentioned in the complaint that the patient was discharged from the Hospital along with T-Tube and was advised to approach any other Hospital for ENT Clinic. During the period of admission in the Hospital there were bed sores. It is further mentioned in the complaint that the patient was discharged on the advice of the Doctors so that the infection could be curtailed. At the time of discharge from the Hospital, an amount of Rs.16,03,893/- was paid by the complainant to the Hospital as is clear from Ex.C-1. Further it has been mentioned that the patient was taken to ENT Clinic of one Dr. R.K. Verma in Solen (Himachal Pradesh) for further maintenance of T-tube as per recommendation made by the Doctor of the Hospital. There was a number of talks between the Doctors of ENT of the Mayo Hospital. During that period a telephonic guidance was given towards treatment. However after a period of 3-4 days the problem of discharge of urine and discharge of abscess from Surgical Incision site was increased. Further it has been mentioned as per advice of Dr. R.K. Verma, Dr. Manoj Sharma and Dr. Jasmeet, the patient was immediately taken back to Mayo Super Specialty Hospital on 28.08.2017 and again admitted in said hospital but in a private room with problem of Urine output and discharge from operated site. Inspite of admitting the patient C.C. No.509 of 2019 4 in critical condition in said hospital, still no care was taken by the Doctors of the Hospital. Thereafter the attitude of OPs No.1 and 2 was not positive and they remained careless and negligent towards the patient inspite of critical condition. The request of the complainant for clinical analysis of the abscess oozing from the site of Surgical Incision to determine the exact reason was declined by the Doctors of Mayo Hospital and the patient was put under the direct care of Dr. Manoj Sharma.
2. It has further been mentioned in the complaint that inspite of arranging the visit of concerned Surgeon namely Dr. Sanjeev Bhatia for getting clinical analysis of the abscess oozing from the site of Surgical Incision, Dr. Manoj Sharma by taking it lightly deputed one Operation Theatre Assistant namely Charanjeet to look after the dressing of the operated site, who own its own opened the upper layer of the Surgical site upto 2 to 3 inches deep on 1st or 2nd September 2017 exposing the inner layer to invite further infection. The complainant brought this fact to the knowledge of Dr. Manoj but his attitude was also causal and he did not take any further action. On 04.09.2017, the platelets counts were far below 58,000 and again around 11 am OT Assistant Charanjeet further performed a procedure on the exposed Surgical site without consulting the test reports of the patient and without consulting any Senior Doctor, which resulted in unstoppable bleeding, re- occurrence of Sepsis resulted in complications and ultimately the patient expired in the Hospital itself. It is further mentioned in the complaint that due to negligence, carelessness of the Doctors and C.C. No.509 of 2019 5 assisting staff the condition of the patient was deteriorated and the issue was taken very lightly by the Doctors of the Hospital. It has further been mentioned that due to action and inaction on the part of Hospital authorities and Doctors, the TLC count rose to 14,000 which was due to heavy bleeding from the Surgical site. In the first round for about 20 days the TLC count was brought down from 50,000 to normal range by giving strong antibiotics. On 04.09.2017 at around 6.00 p.m., Dr. Sanjeev Bhatia examined the patient and he also did dressing. However, the patient kept on bleeding for a longer period on 04.09.2017 and 05.09.2017. The patient was taken to ICU at around 11 a.m. on 05.09.2017 for CT Scan and she was retained over there till her death i.e. 13.09.2017. No consent was taken/obtained from the complainant for shifting and keeping the patient in ICU. It has further mentioned in the complaint that in the morning of 04.09.2017, the TLC count of the patient was 9000 which rose to 29300 on 06.09.2017 which had resulted into Sepsis. There was no technical expert available in the Hospital and due to negligence on the part of Hospital/Doctors the condition of the patient became critical. The huge blood loss had ultimately resulted fatal to the life of the patient due to which the patient ultimately expired.
3. Learned counsel for the complainant has submitted that the action and inaction on the part of Hospital Authorities amount gross negligence as no sufficient and reasonable post operative care was taken which amounts to 'unfair medical practice/negligence' and 'deficiency in service' on the part of the Hospital/Doctors. It has C.C. No.509 of 2019 6 further been submitted that due to action and inaction on the part of Hospital Authorities and the staff including Doctors not only the precious life of patient was lost but it was a case of loss of hard earned money of the complainant still patient lost her life because of the negligence of the Doctors and Staff..
4. A prayer has been made in the complaint for issuance of directions to OPs No.1 and 2 to pay an amount of Rs.75,00,000/- as compensation for 'deficiency in service' and 'unfair trade practice' and an amount of Rs.5,00,000/- as costs.
5. Averments made in the complaint have been contested/opposed by OPs No.1 and 2 by way of filing joint written reply wherein certain preliminary objections have been raised stating that the complaint is not maintainable as no case is made out of medical negligence. It has also been mentioned that the complaint was time barred.
6. On merits also it has been denied that the patient/deceased was admitted on account of pain in her abdomen region and breathlessness only but she was suffering from a number of complications as is reflected in discharge summary of PGIEMR Chandigarh i.e. LAMA Summary Annexure R-1. It is further mentioned that the PGI was left against the medical advice. The LAMA summary issued by PGIMER, Chandigarh reflects that the patient was suffering from severe Cholangitis, extra hepatic billiary obstruction, cholethiosis with choledocholethiosis. As per LAMA summary that the patient was having serious problem as she was suffering from Multi C.C. No.509 of 2019 7 Organ Dysfunction and due to severe medical condition the chances of survival were very rare. All the paras of the complaint were replied specifically and also denied the allegations leveled against Doctors and staff. It has also been denied in the reply that the patient was under the control of the staff whereas not only the concerned Surgeon was present but other attending Doctor was also there. The allegations of negligence have also been denied in the reply. The condition of the patient was improved during treatment. It has also been mentioned in the reply that the respondents were not aware as to what happened to the patient when she was at Solan and what treatment was given as the complainant had not brought on record any facts in this regard. The proper care of the patient was taken and all possible treatment was provided. During the surgery and when the patient was in ICU the proper hemoglobin was maintained and she was under the active control of entire staff including Surgeons and other Doctors of the Hospital. It has also been mentioned in the reply that the patient was admitted for the second time and thereafter she was given required medical treatment and medicines but due to severe infection/septicemia and multi organ dysfunction, the patient suffered cardiac arrest on 13.09.2017 at 2 a.m. Inspite of giving injection of Atropine and Adrenaline the patient could not be survived and ultimately expired on 13.09.2017. At the end it has been mentioned that proper medical care was taken at the Hospital and it was not a case of medical negligence on the part of the Doctors or the staff members.
7. Rejoinder to the reply has been filed by the complainant by C.C. No.509 of 2019 8 denying the averments made in the reply filed by OPs No.1 and 2.
8. Ms. Shweta, Advocate learned counsel for the complainant submits that it is a case of gross negligence in the treatment and also in post operative care of the patient as not only the Doctors but staff members were also negligent as sufficient and required treatment was not given and even post operative care was also not satisfactory. Doctors and staff members were totally casual due to which the patient suffered life threatening bed sores, excessive bleeding which resulted into death. It was due to Surgical Debridement procedure which was conducted upon the patient and the same was not only unprofessional but done in gross negligent manner and the same was against the medical norms. Learned counsel further submits that due to Surgical Debridement procedure, a heavy blood loss was there which led to Hypovolemic shock to the organs and had resulted in heart failure and ultimately became the cause of death. Everything was left upon the staff and no proper care was taken by the Doctors as it was for the Doctors to see as to why heavy loss of bleeding was there and how it was to be stopped. Learned counsel further submits that in the documents filed by the OPs Ex.R-4 from page No.281 to 283 there are no entries for 04.09.2017 and 05.09.2017 and a negative inference may be drawn under Section 114 of India Evidence Act against the OP Hospital. On 04.09.2017, Hemoglobin level of the patient was tested twice. In the morning Hb level was 11.00gm/DI and it was declined in the evening to 9.6gm/DI. Due to heavy bleeding on 04.09.2017 as a result of debridement procedure conducted by the Hospital, the TLC count rose C.C. No.509 of 2019 9 to 14400 in the evening. On 05.09.2017, due to critical condition of the patient she was taken to ICU around 11 a.m. for CT scan. On 06.09.2017, the TLC count had risen to 29300 resulting in Sepsis and other problems and thereafter the patient stopped responding to anything as irreversible damage had been caused to her and she continued to bleed from the wound and continued to sink further. Finally on 13.09.2017 the patient expired due to gross negligence, highly inefficient post-operative care, unfair medical practices and deficiency in service on the part of the OPs. Learned counsel has relied upon judgments i.e. (1) "Smt. Savita Garg Vs. Director, National Heart Institute" (2004) 8 Supreme Court cases 56, (2) "Nand Kishore Prasad Vs. Mohib Hamidi" SLP(C) No.34834 of 2015, decided on 10.05.2019, (3) "Arun Kumar Manglik Vs. Chirayu Medical Health & Medicare Private Limited" 2019 SCC Online SC 197, and (4) "Kusum Sharma & others Vs. Batra Hospital and Medical Research Centre and others" 2010(3)SCC 480, in support his contentions.
9. Learned counsel for OPs No.1 and 2 has opposed the submissions/contentions raised by learned counsel for the complainant. Learned counsel submits that the patient came from PGI, Chandigarh. Initially at the time of admission of the patient, she was suffering from various complications as mentioned in Discharge Summary of PGI, Chandigarh i.e. LAMA Summary (left against medical advice). She was suffering from severe cholangitis, extra hepatic billiary obstruction, cholethiosis with choledocholethiosis. The patient was admitted in emergency department of OP Hospital with complaints of C.C. No.509 of 2019 10 breathlessness, drowsiness and H/o pain in abdomen since 25.07.2017. Learned counsel further submits that on seeing the condition of the patient, Laprotomy with Cholecystectomy was done. The patient was put on ventilator and remained in ICU. Thereafter, her condition became stable and she was discharged on 24.08.2017 from the Hospital on the request of relatives of the patient. All risks involved were explained to the relatives of the patient along with requirement of care. Learned counsel further submits that OPs at any point of time did not pressurize the patient for discharge. While the patient was taken to Solan (Himachal Pradesh) nothing was informed as to what treatment and care was given and how her condition was managed as nothing has been brought on record by the complainant in the complaint. Learned counsel further submits that due care was taken in the Hospital by the Doctors as well as by the staff and the patient was under the observations of the qualified and experienced Surgeon at the time of admission. During this period while patient remained admitted in the hospital she was maintaining proper hemoglobin. Even while remained admitted in ICU the patient was under active control of the entire staff i.e. Surgeon and other Doctors of the Hospital. Thereafter the patient was again admitted in the second visit and she was examined without any delay and it was found in the test that the patient was having severe infection, chronic renal failure alongwith protein deficiency and de-hydration. It was also found that the patient was having hemoglobin 8.8, TLC-16100, PLT 1.81, bun urea 215 and creatinine 3.55. Learned counsel further submits that patient was under respiratory distress due C.C. No.509 of 2019 11 to decreased urine output. The condition of the patient was managed according to the international guidelines for Sepsis management i.e.
(a) Maintaining of hydration of the patient through IV fluids.
(b) Inotropic support in view of septic shock.
(c) Ventilation to provide sufficient amount of oxygen supply through a mechanical ventilator or manual ventilation.
(d) Anti microbils in view of Sepsis.
(e) Regular monitoring of the patient.
The patient was also provided required medical treatment and medicines but because of severe Sepsis and multi organ dysfunction the patient suffered with cardiac arrest on 13.09.2017 at 2.00 a.m. and injection atropine and injection adrenaline was given to her but she could not be survived and ultimately expired on 13.09.2017 at 2.20 a.m. At the end, it has been submitted by learned counsel representing OPs that the averments made in the complaint are totally wrong and incorrect and allegations mentioned are wrong and not sustainable as every possible efforts were made by providing adequate and proper treatment. There was no negligence or lapse on the part of the Hospital or Doctors or even staff.
10. Heard the arguments raised by learned counsel for both the parties. We have also carefully perused all the relevant documents available on the file. It is admitted fact of the case that mother of the complainant Smt. Lakshmi Sagar was admitted in OP Hospital with complaint of pain in her abdomen region and breathlessness. She was C.C. No.509 of 2019 12 diagnosed with Cholelithiasis (Gallstones) and other associated illness. It is also the admitted fact that Laprotomy with Cholecystectomy was done on 29.07.2017 and on the request of the relatives of the patient, she was discharged on 24.08.2017 and all the risks were explained to them and were also advised to take care of the patient, as mentioned in the discharge summary. The patient was again re-admitted in the OP Hospital on 28.08.2017 as problem of discharge of urine and discharge of abscess from the surgical incision site was started. The grievance of the complainant is that the pre-operative care had not been taken by OP Hospital and doctors as well as assisting staff which resulted into infection and further resulting into death of the patient. The complainant has alleged 'medical negligence' on the part of OP Hospital, Doctors and assisting staff.
11. The cases of medical negligence can broadly be categorized as under:
i) The doctor does not give immediate treatment to the patient or when it is required.
ii) The doctor does not take necessary precautions as per the medical norms required in a particular case and give timely test dose of medicine failing which it can prove fatal in a particular case.
iii) The Post-operative treatment is not given properly.
iv) The surgical wound is caused at different places more than the required.
v) Improper prescription of dugs/medicines is provided and that too C.C. No.509 of 2019 13 without knowing the diagnosis or proper combination of tablets and injections is not granted or some medicines are given on trial basis or due to any error and not by qualified staff of that field.
vi) Mal-practice adopted by the doctors, such as the investigation reports or there are certain infirmity in the reports or investigations prescribed.
12. In some of the cases, the surgery is done but it is not required or there is a delay in performing the surgery. In some of the cases or instances of death on table or there can be cases of infection in case the patients remained admitted in the hospital for longer period or in some of the cases of emergency, the doctors do not promptly look after the patient or transfuse wrong blood.
13. Moreover, much expectations are there from the medical practitioners to take due care and caution while giving treatment as per the established medical jurisprudence. Meaning thereby, if someone has acted in accordance with the practice accepted or proper by a responsible body of medical men skilled in that particular field, no question of deficiency would arise.
14. In case of 'medical negligence', the issue for consideration is to examine as to whether the treating doctor was sufficiently qualified and competent to provide treatment and has also observed all due and necessary care and precaution. It is also necessary to know as to whether timely/necessary steps for treating the patient were taken or not? The Hon'ble Apex Court in the case of Kusum Sharma v. Batra Hospital reported in (2010) 3 SCC 480 has held in Para-94 as under: C.C. No.509 of 2019 14
"94. On scrutiny of the leading cases of medical negligence both in our country and other countries specially 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 omission 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 expected 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 reasonably 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 C.C. No.509 of 2019 15 higher 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 desired 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 the course of action chosen by him was acceptable to the medical profession. VIII. It would not be conducive to the efficiency 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 unnecessary 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 pressurizing the medical professionals/hospitals particularly private hospitals or clinics for extracting uncalled for compensation. Such malicious proceedings deserve to be discarded against the medical practitioners. 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."
15. In some of the cases, the allegations of medical negligence are defended by taking a plea of bonafide mistake which under certain circumstances may be excusable but sometimes the mistake may C.C. No.509 of 2019 16 tantamount to negligence, which cannot be excused/pardoned.
16. For determining the case of 'medical negligence' in a particular case, it is to be seen as to whether the conduct, action or omission on the part of doctor can result into a case of 'medical negligence' or not. It is also to be seen as to whether the medical practitioner, who is having various types of duties towards his/her patient, has acted with reasonable degree of skill and knowledge or he/she has exercised a reasonable degree of care. However, the skill of a medical practitioner differs from doctor to doctor. There may be more than one course of treatment, which may be advisable for treating a patient. The Courts are quite conscious when allegations of negligence are alleged in the case. It is to be seen/judged as to whether the doctor has performed his/her duties to the best of his/her abilities with all due care and caution. Medical opinion differs with regard to course of action to be taken by a doctor while treating a patient but in case the doctor acts in a manner which is acceptable to the medical profession, the Court finds that the doctor has taken proper and due care. In case, still patient does not survive or suffers with serious ailment, it would be difficult to hold that the doctor has been guilty of medical negligence.
17. Hon'ble Supreme Court of India has observed in the case of Jacob Mathew v. State of Punjab Appeal (Crl.) No.144-145 of 2004 decided on 05.08.2005 as under:
"A medical practitioner faced with an emergency ordinarily tries his best to redeem the patient out of his suffering. He does not gain anything by acting with negligence or by omitting to do an act. Obviously, therefore, it will be for the complainant to clearly C.C. No.509 of 2019 17 make out a case of negligence before a medical practitioner is charged with or proceeded against criminally. A surgeon with shaky hands under fear of legal action cannot perform a successful operation and a quivering physician cannot administer the end-dose of medicine to his patient.
Negligence is the breach of a duty caused by omission 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. The definition of negligence as given in Law of Torts, Ratanlal & Dhirajlal (edited by Justice G.P. Singh), referred to hereinabove, holds good. Negligence becomes actionable on account of injury resulting from the act or omission amounting to negligence attributable to the person sued. The essential components of negligence are three: 'duty', 'breach' and 'resulting damage'.
Negligence in the context of medical profession necessarily calls for a treatment with a difference. To infer rashness or negligence on the part of a professional, in particular a doctor, additional considerations apply. A case of occupational negligence is different from one of professional negligence. A simple lack of care, an error of judgment or an accident, is not proof of negligence on the part of a medical professional. So long as a doctor follows a practice acceptable to the medical profession of that day, he cannot be held liable for negligence merely because a better alternative course or method of treatment was also available or simply because a more skilled doctor would not have chosen to follow or resort to that practice or procedure which the accused followed.
The standard to be applied for judging, whether the person charged has been negligent or not, would be that of an ordinary competent person exercising ordinary skill in that profession. It is C.C. No.509 of 2019 18 not necessary for every professional to possess the highest level of expertise in that branch which he practices. ...... A highly skilled professional may be possessed of better qualities, but that cannot be made the basis or the yardstick for judging the performance of the professional proceeded against on indictment of negligence.
18. The Hon'ble Supreme Court was pleased to approve the test as laid down in Bolam v. Friern Hospital Management Committee. The relevant principles culled out from the case of Jacob Mathew (supra) are reproduced as under:
"b. A simple lack of care, an error of judgment or an accident, is not proof of negligence on the part of a medical professional. So long as a doctor follows a practice acceptable to the medical profession of that day, he cannot be held liable for negligence merely because a better alternative course or method of treatment was also available or simply because a more skilled doctor would not have chosen to follow or resort to that practice or procedure which the accused followed. When it comes to the failure of taking precautions what has to be seen is whether those precautions were taken which the ordinary experience of men has found to be sufficient; a failure to use special or extraordinary precautions which might have prevented the particular happening cannot be the standard for judging the alleged negligence.
c. A professional may be held liable for negligence on one of the two findings: either he was not possessed of the requisite skill which he professed to have possessed, or, he did not exercise, with reasonable competence in the given case, the skill which he did possess. The standard to be applied for judging, whether the person charged has been negligent or not, would be that of an ordinary competent person exercising ordinary skill in that profession. It is not possible for every professional to possess C.C. No.509 of 2019 19 the highest level of expertise or skills in that branch which he practices. A highly skilled professional may be possessed of better qualities, but that cannot be made the basis or the yardstick for judging the performance of the professional proceeded against on indictment of negligence."
In view of the facts as mentioned above and the observations made by the Courts in different important case Laws, now it is to be seen by considering the facts and circumstances of the present case as to whether the treatment given by the concerned doctors to the patient was as per medical norms and also that the doctor attending the patient were qualified to impart treatment and prompt in providing the treatment.
19. In the present case, it is the argument of learned counsel for the OPs that at the time of 2nd admission patient was provided required medical treatment and medicines but because of severe septicemia and multi organ dysfunction, the patient suffered a cardiac arrest on 13.09.2017 at 2.00 a.m.. Injection Atropine and Injection Adrenaline were given to the patient but she could not be revived. It is also the argument of learned counsel for the OPs that complainant has not placed on record any postmortem report to ascertain the actual cause of death. At the time of 1st admission, the patient remained admitted in the OP Hospital for a long period from 27.07.2017 till 24.08.2017 and the complainant has made allegations with regard to post operative care during second admission i.e. on 28.08.2017.
20. As per original research article written by Dr. Ketan Kumar Kapoor, Mir Mohammed Noorul Hassan, the abdominal C.C. No.509 of 2019 20 wound dehiscence is reported to be a severe postoperative complication, with death rates reported as high as 45%. Incidence as reported in literature peaks from 0.4% to 3.5%. Many risk factors are accountable for wound dehiscence such as surgeries in emergency set up, intra-abdominal bacterial infection, malnutrition, decreased Hb, elderly age >65 years, systemic co- morbidities (uremia, diabetes mellitus) etc. Good knowledge of these risk factors is compulsory for prophylaxis. Mortality and morbidity in the form of increased hospital stay, long term repeated consultations, with extra burden on health care resources can be reduced by highlighting the risk factors for wound dehiscence, the incidence rate and prophylactic measures to prevent reduce the incidence of wound dehiscence. In conclusion it has been found that patient in age group of 41-50 years having highest incidence of abdominal wound dehiscence with the mean age reported to be 46.25. In the present case, the age of the patient was 67 years.
21. As per medical literature by Parr Richey Frandsen Patterson Kruse LLP "Cardiac dysfunction is a consequence of severe sepsis and is characterized by impaired contractility, diastolic dysfunction, as well as reduced cardiac index and ejection fraction (EF). Cardiac dysfunction is an important component of multiorgan failure that is caused by severe sepsis. Septic patients with either systolic or diastolic dysfunction or a combination of both have higher mortality than those diagnosed C.C. No.509 of 2019 21 with sepsis but without diastolic or systolic dysfunction.
22. In view of detailed discussion and medical literature as mentioned above and also ratio of judgments in a number of cases relating to cases of medical negligence and also by considering evidence available on record as well as the arguments raised by learned counsel for the parties, it is apparent that the patient was discharged on 24.08.2017 from the Hospital with T-tube, Foley's and RT in Situ and it was advised to take care of T-tube and bed sores. Meaning thereby that at the time of discharge the patient was having bed sores and attendants of the patient were advised to take care of the same.
23. The complainant has not been able to prove from any evidence or documents that the treating Doctors were not qualified/competent for the duty which they performed or were not qualified for doing the surgery or were not having requisite experience or did not adopt proper method of treatment. It has not been proved on record that the complainant at any point of time made any efforts to bring to the notice of the Hospital Authorities that there was any lapse/shortcomings in the action of concerned Doctors or the assisting staff of the Doctors/Hospital while taking care of the patient after surgery or assisting staff was not properly taking care of the patient. Even it has not been proved by averments/evidence or the arguments raised by learned counsel for the complainant that the treatment given to the patient was contrary to well established standard medical protocol or proper due care and caution was not taken while giving C.C. No.509 of 2019 22 treatment as per the established medical jurisprudence or the treatment given by the concerned Doctors to the patient was not as per Medical Norms. It has also not been proved on record that during the course of Surgery, there was any act of negligence on the part of concerned Doctors. Accordingly, we find no merit in the contention raised by learned counsel for the complainant and the complaint being devoid of any merit is hereby dismissed.
24. The complaint could not be decided within the stipulated period due to heavy pendency of Court cases and due to pandemic of Covid-
19. (JUSTICE DAYA CHAUDHARY) PRESIDENT (URVASHI AGNIHOTRI) MEMBER August 26, 2022.
MM