State Consumer Disputes Redressal Commission
Chhotey vs Manglam Medical Centre on 25 November, 2010
IN THE STATE COMMISSION:DELHI IN THE STATE COMMISSION: DELHI (Constituted under Section 9 of The Consumer Protection Act, 1986) Date of Decision: 25.11.2010 Complaint Case No.218/2002 Sh. Chhotey, . Complainant. S/o Sh. Inayat, L-378, Sunder Nagari, Delhi Versus 1. Manglam Medical Centre Opposite Parties E-131, Dilshad Garden, C-Opposite LIC Colony, Delhi 110094. 2. Yashoda Hospital III-M, Nehru Nagar, Ghaziabad (UP) CORAM Justice Barkat Ali Zaidi ... President Ms. Salma Noor Member
1. Whether reporters of local newspapers be allowed to see the judgment?
2. To be referred to the Reporter or not?
Salma Noor, Member
1. The short facts of the case are that on 22.12.2001, the complainant got his wife Smt. Chaman Ara alias Chanchal admitted in OP No.1 Manglam Medical Centre for getting his wife checked up for pain in her abdomen/stomach, whereupon concerned doctor/staff asked the complainant to deposit a sum of Rs.6000/- for the operation of his wife and after its deposit the concerned doctor/staff took his wife to the operation theatre for the operation for the stone in gall bladder. After two hours thereafter two doctor told the complainant that they were going to refer the case of his wife to another hospital and the concerned doctors of OP No.1 Manglam Hospital laid got his wife in a private ambulance and took her to OP No.2, Yashoda Hospital, Ghaziabad UP, without heeding to his request that he accompany his wife and asked him to reach Yashoda Hospital.
2. The complainant with some of his relatives reached OP No.2 Yashoda hospital where the doctors of OP No.1 and as OP No.2 obtained his signatures on many blank papers and the letter heads. The doctors of OP No.2 thereafter clearly told the complainant that his wife was unconscious and in a very critical state and there was hardly any possibility to save her life and yet at the insistence of doctors of OP No.1 the doctors of OP No.2 put his wife on ventilation with malafide intention to divert his attention and to mislead the complainant. Two days thereafter, OP No.2 handed over the dead body of his wife to the complainant with two tubes injected in both sides of her neck. The doctors and their henchmen reached his house and advised him, with malafide intention that he must cremate her dead body quickly else it would decay.
3. On 30.04.2002 the complainant contacted the above doctors to supply him the treatment papers of his deceased wife, but the doctors misbehaved and threatened him of dire consequences in case he came again or disclosed this matter to anyone or the police or requested for supply the record.
4. The complainant has therefore come with a complaint before this Commission pointing out the following lapses alleging deficiency of service against the opposite parties.
(i) One test shows blood sugar 250 mgdl on 22.12.2001. Generally operation is done after controlling the blood sugar, because in high blood sugar level, anesthetists avoid giving anesthesia, while on the other hand anesthetist instilled anesthesia, showing normal value of blood sugar which he mentioned in his notes, shows that value of blood sugar has been fabricated.
(ii) In his note the surgeon mentioned firstly, that patient was in spontaneous respiration condition and opening eyes, and secondly that patient needs ventilation support, which is contradictory to each other.
(iii) Why the patient was not shifted to GTB Hospital at a distance of less than 1 KM from Manglam Hospital Centre, Dilshad Garden, Delhi or nearby Anand Hospital, Preet Vihar, Delhi or Pushpanjali Hospital where the ICU are available in Delhi and was taken to Yashoda Hospital, Ghazaiad, which is far from Manglam Medical Centre at a distance of 24 Km.
(iv) The two tubes in both sides of neck of the patient were pointer of the fact that formaline was injected in the body of the patient to stop the decaying process in the body for two days.
(v) Neither the Manglam Medical Centre nor Yashoda Hospital gave any discharge slip, death slip and proper recodes to the complainant. They conducted unnecessary tests but did not perform ECG, which could establish whether the patient was alive or dead?
5. The complainant thus alleged that gross negligence was committed by the surgeon and anesthetists at Manglam Medical Centre. The wife of the complainant was of 32 years only. The complainant is having 6 minor children (including milk sucking baby) and there is nobody in the family to look after them. He sent legal notices to both the OPs but within no result. The complainants prayer is that OPs be directed to pay a compensation in the sum of Rs.20,00,000/- with costs of litigation
6. OPs opposed the claim and filed the separate written statements. OP No.1 averred that on 19.12.2001 patient Smt. Chaman Ara @ Chanchal alongwith her husband Chotey came to OPD of OP No.1 at about 11.00 AM with a prescription slip dated 18.12.2001 of Dr. Shiv Kumar. She complained of pain in abdomen and indigestion since last six years for which she was in the habit of taking treatment from local quacks in the form of tablets. The patient was initially admitted by Dr. Sehgal and subsequently without delay she was transferred to specialist Dr. Subodh. The patient was excessively obese, having six children in home deliveries. Patient and her husband on query did not disclose any history of chronic ailment, drug allergies, TB, diabetes, hypertension, prolonged fever and convulsive disorders etc. Prior they came to OP No.1 Hospital, the patient had visited GTB Hospital but the complainant did not want to take treatment from any Government hospital. The surgical treatment which the OP No.1 suggested was also advised to the patient by the doctors of GTB Hospital, Delhi on her examination weight of the lady patient was found 90 Kg , pulse 84 min., BP 149/90, tenderness present over the area of epigastrium and right hypochondrium (region of abdomen), although rest of that was NAD. The patient was carrying two ultrasonography reports/film, with her which clearly revealed chronic cholecystitis with chronic cholelethiasis.
7. The patient was examined, investigated and diagnosed by specialist Dr. Subodh, who also found her suffering from Chronic Cholecystitis with Chronic Cholelethiassis and advised open cholicystectomy under GA, pros and cons and final outcome of said surgical treatment, the risk involved in anesthesia procedure were explained and the tentative expenses to be incurred in her treatment were also informed to the complainant and his wife.
8. After getting the consent of the patient and her husband to operate upon on advise of Dr. Subodh, pre-requisite routine investigations (haemogram, urine, RE/urine, ME, blood urea, blood sugar, ECG, x-ray chest, BT CT etc. tests were performed prior to submitt the patient for pre-anesthetic clearance, which were found within the normal limits). Thereafter the patient was admitted on 21.12.2001 in the OP No.1/Nursing Home under care of Dr. Subodh, who again examined her and the necessary surgical procedure under GA was planned for 22.12.2001 and on obtainment of her and complainants consent in the morning of 22.12.2001, producing all the investigations, pre anesthetic clearance from Dr. R. Singhal, Anesthetist was obtained. The patient was then shifted to the Operation Theatre at about 12.00 Noon on 22.12.2001 after the thorough check-up and related instruments (i.e. anesthesia apparatus, pulse oximeter, cardiac monitor, boyels, apparatus and requisite/life saving medications etc. were kept ready Dr. Subodh performed the surgery after getting consent from anesthetist who declared the patient fit for anesthesia (GA). Thus the operation was performed by well qualified and experienced specialist surgeon (Dr. Subodh) and anesthesia was given/maintained by well qualified and experienced anesthetist Dr. R. Singhal according to the prescribed norms with due reasonable skill, care and diligence.
9. Patient was reversed from anesthesia at 1.40-1.45 PM who started giving normally expected response to the verbal command, her vitals were normal which were shown to the complainant and the relatives. Thereafter when the arrangement for shifting the patient to ward room were being made at 1.55 PM the patient expectedly stated generalized convulsions and froth started coming out of her mouth, to control requisite drugs were given, there was oxygen saturation she was given the oxygen, in consequence whereof the patient became stable and her all vital parameters being maintained.
10. At about 4.30 PM, she again started convulsions and the requisite measures were taken energetically, and the medications were given. Other senior anesthetist Dr. Atul Gupta was also called in the interest of patients health and life and opinion of a senior physician Dr. N.K. Gupta was also taken and they on examination of the patient advised same line of treatment. The complainant and his relatives were allowed to see the patient and explained about the conditions and convulsions of the patient. Past history of convulsions/seizures was again probed into from the husband and relatives of the patient, which unraveled that the patient was suffering from convulsive disorder since last 7-10 years and was being treated by some Hakim and also using dora and Gandas etc. But the patient had started having convulsions after every 1 hour and Dr. Subodh, Dr. R. Singhal, Dr. Atul Gupta, Dr. N.K. Gupta discussing the issue decided that at any time patient may require ventilators assistance in ICU, it will therefore be better in the interest of patient to shift the patient into a big hospital, having vacant ventilator machine. On the request and instructions of patients husband, not to shift the patient to any Government hospital where ventilators were available, while in private hospitals they are rare, yet enquiries from nearby hospitals for ventilator were made in the best interest of the patients health and life, and finally a vacant ventilator bed was discovered in nearby Yashoda Hospital. A free ambulance from a local organization was called at 10.20 PM to shift the patient to Yashoda Hospital which is very near to OP No.1, the patient on 22.12.2001 at about 11.30 PM, was safely put on a stature and shifted to Yashoda Hospital under care of operating surgeon and anesthetist, in stable condition with her vital parameters normal and discharge card treatment file were handed over to the treating doctor of OP No.2 available in Yashoda Hospital, through patients husband in original form, after retaining the photocopy of them. The death of the patient had not taken place in the premises of OP No.1 or in the hand of treating consultant/doctors.
11. The OP No.2 in its written reply opposed the claim and averred that on 22.12.2001 at about 11.30 PM the complainants wife was brought from OP No.1 hospital in a comatose state as OP No.1 had no vacant ventilator bed. A perusal of the medical record of OP No.1 Hospital, revealed that an open cholecystectomy under general anesthesia was performed on her by Dr. Subodh of OP No.1 Hospital and during reversal of the anesthesia the lady had generalized Tonic Clonic Seizure, she was given an injection of Epsolin 600 mg I/V after which she had comatose. The doctors at OP No.2 immediately admitted the complainants wife to the ICU and put her on respirator, blood investigations were done. On 23.12.2001 the complainants wife went into Hypotension with pulse rate 120/minute and blood pressure of 70 mmhg systolic. She was immediately put on dopamine drip. Further the planters bilateral were not ellicitible. On 24.12.2001 at about 5.30 PM the complainant argued with the doctor of OP No.2 that he wanted to take his wife home. The doctors of OP No.2 tried their best to persuade the complainant not to take her away, but the complainant paid no heed to their advice and took away her against medical advice. The two tubes that the complainant is trying to misinterpret and misrepresent were nothing but endotrachial and Ryles tubes that were put to maintain proper ventilation and gastric aspiration, which were not injected on the sides of the neck but were inside the mouth and nose of the patient. OP No.2 further denied that it did not give any discharge slip and other proper record to the complainant, and the death slip was not given to the complainant because his wife was alive. The relevant medical records and documents were handed over to the complainant by OP No.2. The OP No.2 denied that complainants wife died due to gross negligence of the doctors of OP hospitals and that they are fully responsible for the same and all allegations made by the complainant are baseless, made in an attempt to blackmail, harass, pressurize and extort money from the OPs.
12. To prove its case the complainant has filed his own affidavit and some treatment papers and the OP hospitals in support of their case have filed an affidavit each and the copy of the relevant hospital record.
13. What we have to decide in the first instance is the question whether the complainant took away his deceased wife from hospital against the direction of OP No.2 Yashoda Hospital, because if that is the case no liability can be fastened on OP No.2 Yashoda Hospital.
14. The version of OP No.2 is that the complainant gave in writing that he was taking home his wife against the advice of the hospital at his own risk. The writing is on record and the signatures of the complainant thereon are not denied. The complainant says that it was OP No.2 Hospital which had asked him to take his wife, and he did not take her back on his own free will. In fact his case is that his wife had already expired in OP No.1 Manglam Hospital and that she was in dead state when she was transferred to OP No.2 Hospital. If the wife of the complainant was dead, he could have raised the matter there and then in OP No.1 Hospital. As regards the writing in which the complainant has said that he was taking back his wife home against the advice of OP No.2 hospital, the mere oral statement of the complainant that he was made to sign plain papers will not suffice to conclude, that the complainant was made to sign blank papers. The complainant should have protested at the time, when he was asked to sign blank papers. There are no particular circumstances, which may provide credence to the version of the complainant to sign blank papers. The contention of the complainant in this regard cannot therefore be accepted. It is also difficult to believe that the doctors of both the hospitals will behave in this unethical manner, and conspire to do such things, as are alleged by the complainant. There can sometimes be fatal reactions even in case of approved surgical procedures and if that were the case there was no reason it could not have said so. There was no reason for him to hide the real state of affairs from the complainant and to cheat him in this manner. It may also be observed that the OP No.2 could not have admitted a dead body and kept her in the treatment for those days. Such deception would not have remained hidden from all the staff of the hospital, and the theory of the complainant in this regard is clearly improbable.
15. As regards the treatment of the deceased at OP No.1 hospital, there is no evidence to assume that any wrong treatment was given to her, or there was any negligence. All required usual tests were done before the operation, and it was only thereafter the lady was operated upon. The doctors of OP No.1 hospital says that they were not told that the lady was subject to convulsions. The hospital staff cannot be called negligent if the lady suffered from convulsions, because it is not usual or prescribed procedure to make the patient undergo a specific test for any such things before operation, unless the patient discloses it. It is also difficult to believe the contention that the doctors went ahead with the operation, even, when there were indications to the contrary for the sake of obtaining the operation fees.
16. The operation charges were only around Rs.8000/- and it is difficult to believe, that the doctors will rush through the operation only for the sake of earning the operation fee. The version of the complainant that the hospital people went to his house and asked him the process of burial also seems improbable because there was no occasion for the doctors to go to his house and to ask him to speed up funeral. If that was so the suspicion of the complainant and others should have been aroused, and they should have filed an FIR so that the body could have been detained by the police for post-mortem examination. No FIR was filed by the complainant.
17. The allegations contained in the complaint cannot therefore be accepted, and the complaint is accordingly dismissed, but without costs.
18. A copy of this order as per the statutory requirements be forwarded to the parties free of charge and thereafter the file be consigned to Record room.
Announced on 25th day of November 2010.
(Justice Barkat Ali Zaidi) President (Salma Noor) Member Tri