State Consumer Disputes Redressal Commission
Smt.Ranjeeta Verma & Ors. vs Mittal Cancer Hospital on 19 September, 2017
CHHATTISGARH STATE
CONSUMER DISPUTES REDRESSAL COMMISSION,
PANDRI, RAIPUR (C.G.)
Complaint Case No.CC/2016/79
Instituted on : 06.01.2017
1. Smt. Ranjeeta Verma Aged 31 years,
W/o Late Lankeshwar Verma.
2. Minor Kumari Neha Verma, Aged 12 years,
3. Minor Neeraj Verma, Aged 09 years.
Both Daughter/Son of Late Lankeshwar Verma,
4. Smt. Indrawati Verma, Aged 58 years,
Late Dhansingh Verma.
R/o : Mathpara,
Urkura, Raipur (C.G.). ... Complainants.
Vs.
1. Mittal Cancer Hospital,
Through : Dr. Mou Roy,
Address : Avanti Bai Chowk, Pandri,
Raipur, Tehsil & Dist. Raipur (C.G.).
2. Mittal Cancer Hospital,
Through : Director Ashish Mittal & Suman Mittal,
Address : Avanti Bai Chowk, Pandri,
Raipur (C.G.)
3. Oriental Insurance Company Limited,
Divisional Office D.O.-1, Madina Manzil,
Kutchery Chowk, Jail Road,
Raipur (C.G.) ... Opposite Parties
PRESENT: -
HON'BLE SHRI JUSTICE R.S. SHARMA, PRESIDENT
HON'BLE SHRI D.K. PODDAR, MEMBER
HON'BLE SHRI NARENDRA GUPTA, MEMBER
COUNSEL FOR THE PARTIES:
Shri R.D. Shukla, Advocate for the complainants,
Miss Praveen Arora, Advocate for O.P. No.1.
Shri Manish Sinha, Advocate for O.P. No.2.
Shri Manoj Prasad, Advocate for O.P. No.3.
// 2 //
ORDER
Dated : 19/September/2017 PER :- HON'BLE SHRI JUSTICE R.S. SHARMA, PRESIDENT. The complainant filed this consumer complaint under Section 17 of the Consumer Protection Act, 1986 against the OPs seeking following reliefs :-
(1) To direct the OPs to pay a sum of Rs.1,75,000/- (Rupees One Lakh Seventy Five Thousand) incurred in the operation and a sum of Rs.1,00,000/- (Rupees One Lakh) incurred in medicines.
(2) To direct the OPs to pay compensation of Rs.20,00,000/-
(Rupees Twenty Lakhs) to the complainants.
(3) To direct the OPs to pay a sum of Rs.5,000/- (Rupees Five Thousand) towards cost of litigation to the complainants. To award other reliefs as deems fit by this Commission.
2. Briefly stated the facts of the complaint of the complainants are that the husband of the complainant No.1, father of the complainant No.2 and complainant No.3 and son of complainant No.4, Late Lankeshwar Verma got operated for cancer in O.P. No.1 Hospital. Late Lankeshwar Verma was having cancer in right side of his tongue. He was checked by the O.P. No.1 and O.P. No.1 told that operation of cancer of Late Lankeshwar Verma is required to be done and after operation, he would be cured from Cancer. Late Lankeshwar Verma, was admitted in the O.P. No.1 Hospital on 01.03.2016 and on // 3 // 03.03.2016 the O.P. No.1 conducted operation of Late Lankeshwar Verma. He was discharged by the O.P. No.1 on 17.03.2016. At the time of discharging Late Lankeshwar Verma, the O.P. No.1 examined him and told that his operation, is successful and cancer is not remained left. This assurance was given by the O.P. No.1 to Late Lankeshwar Verma. In the above operation, 50% tongue of Late Lankeshwar Verma, was cut. The O.P. No.1 also assured him that he would be able to completely speak. For the above operation, the O.P. No.1 took Rs.1,75,000/- (Rupees One Lakh Seventy Five Thousand) from Late Lankeshwar Verma. After one month of the operation, Late Lankeshwar Verma told the O.P. No.1 that he is realising that he cancer was not cured and after examining Late Lankeshar Verma, the O.P. No.1 told that his cancer is completely cured and if he has doubt that his cancer was not cured, then the O.P. No.1 advised for Chemotherapy/Radiation Therapy. Chemotherapy /Radiation Therapy was done in Medical College Hospital, Raipur, as per advice given by the O.P. No.2. During conducting Chemotherapy/Radiation Therapy, Late Lankewar Verma went to O.P. No.1 & O.P. No.1 and after checking him, they told that cancer of Late Lankeshwar Verma is completely removed. After completion of Chemotherapy / Radiation Therapy, on 06.09.2016, test regarding cancer of Late Lankeshwar Verma, was done in which it was found that his cancer was not cured and symptoms of cancer are available in the tongue of Late Lankeshwar Verma. Late Lankeshwar Verma informed the O.P. No.1 // 4 // that his cancer was not cured and he got his check-up, then the O.P. No.1 conducted check up and told him that his cancer has not been cured and again his operation is required to be done. The O.P. No.1 while conducting operation of the cancer of Lankeshwar Verma, committed negligence due to which cancer was not completely cured If again operation of Lankeshwar Verma, is conducted, then 50% tongue has already been cut and again operation is conducted 50% tongue will also be cut. If the operation was properly done by the O.P. No.1 then Lankeshar Verma, would have not suffered cancer. Thus the O.P. No.1 committed deficiency in service and unfair trade practice. Hence, the complainants filed instant complaint.
3. The O.P. No.1 & 2 filed their written statement separately but their defence are common. They averred that Late Lankeshwar Verma came to the O.P. No.1 hospital and after examination, it was informed that he was having cancer in his tongue and he was advised for operation. After obtaining consent from Late Lankeshwar Verma, operation was conducted. The O.P. No.1 & O.P. No.2 never assured Late Lankeshwar Verrma that the surgery was successfully done and cancer was completely removed. There was no symptom / sign of the cancer and Lankeshwar Verma, was advised for Radiation Therapy according to NCCN Guidelines Version 1.2015 Cancer of oral Cavity. The symptom of recurrence mentioned in the M.R.I. report prove that the at the place of symptoms of cancer looking earlier, new symptoms of cancer are looking which is a normal incident in Medical Science.
// 5 // The revival & occurrence of new symptom is normal incident and it has no relation with the operation of the tongue of Late Lankeshwar Verma, which was done earlier. The operation of Late Lankeshwar Verma was done through National Comprehensive Cancer Network and according to prescribed guide line and this guideline is being determined by the world's cancer expert doctors. The O.P. No.1 O.P. no.2 are not liable to pay compensation of Rs.20,00,000/- to the complainants. The O.P. No.1 & O.P. No.2 did not act anything while treating Late Lankeshar Verma, due to which he suffered mental and physical agony and financial loss. After alleged notice dated 27.10.2016, Late Lankeshwar Verma, was coming to O.P. No.2 for his treatment. The operation which was done for treatment of the Lankeshwar Verma, was properly done has two proofs (1) in the Histopathology Report, the elaborate details of the operation is mentioned (2) After operation, in the month of April, 2016, CT scan of Lankeshwar Verma, was done in Medical College Hospital, Raipur and in the CT Scan Report symptom of cancer was not found. In other words, the CT Scan Report issued by Medical College Hospital, Raipur is normal. According to the N.C.C.N. Guideline the symptom of stage of cancer of the Late Lankeshwar Verma was T2N2bMo Stage IVA for which operation was done according to prescribed guideline. In the operation, no negligence or misconduct was committed. The O.P. No.1 & O.P. No.2 discharged their duty with their experience and honestly as well as according to medical protocol. O.P. No.2 is // 6 // having M.C.H. Degree and is a Cancer Specialist. The O.P. No.1 & O.P. No.2 did not commit any negligence while performing operation. The O.P. conducted operation of Late Lankeshwar Verma on 03.03.2016. From the Histopathogy Report, it is proved that the operation conducted by the O.P. No.2 was fully correct. Thereafter on 08.04.2016, the CT scan of Late Lankeshar Verma, was done at Medical College Hospital, Raipur and according to SC Scan Report on 08.04.2016 no symptom of cancer was existed in Late Lankeshwar Verma. The O.P. No.1 & O.P. No.2 obtained Professional Indemnity Policy from the Oriental Insurance Company Ltd. which was effective for the period from 14.08.2015 to 13.08.2016 and other policy No. is 1911000/48/2016/834. The complaint is liable to be dismissed against the O.P. No.1 & O.P. No.2.
4. The O.P. No.3 filed its written statement and averred that the complaint filed by the complainants is not maintainable against the O.P. No.3. The O.P. No.3 is not a necessary party. In the instant case the insured Dr. Mou Roy was not made party. The complainants are not consumer of the O.P. No.3 The O.P. No.3 issued Professional Indemnity and Doctor Policy in the name of Dr. Mou A. Roy. Insurance policy was issued under terms and conditions of the policy. The O.P. No.3 is not a necessary party, therefore, the instant complaint is not maintainable against it. The complainants have not made any averment against the O.P. No.3 and the O.P. No.3 has been made party to harass it. The complaint is liable to be dismissed with cost against // 7 // O.P. No.3. The complainants are not entitled to get any compensation from the O.P. No.3.
5. The complainants have filed documents. Annexure A-1 is registered notice and receipt dated 27.10.2016, Annexure A-2 is Admit Card dated 01.03.2016, Annexure A-3 is IPD Discharge Receipt dated 17.03.2016, Annexure A-4 is Test Report dated 29.03.2016 of Dr.B.R. Ambedkar Memorial Hospital, A-5 is Procedure for Chemotherapy/Radiation Therapy, Annexure A-6 is Test Report dated 06.09.2016.
6. The O.P. No.2 has filed documents. Documents are Professional Indemnity Doctors Policy Schedule in respect of Policy No.191100/48/2016/834 issued by The Oriental Insurance Co. Ltd., Certificate regarding Master Degree, Memorandum of Marriage, Letter dated 22.02.2017 sent by Dr. Mou Roy to The Divisional Manager, Oriental Insurance Co. Ltd., Raipur. Annexure D-1 is Surgical Pathology Report dated 10.03.2016, Annexure D-2 is CCECT FACE NECE dated 08.04.2016, Annexure D-3 is NCCN Guideline Version 1.0215, Annexure D-4 is OPD building Advice Voucher dated 13.02.2017, Annexure D-5 Discharge Summary dated 17.03.2016.
7. Shri R.D. Shukla, learned counsel appearing for the complainants has argued that the husband of the complainant No.1, father of the complainant No.2 & 3 and son of complainant No.3, Late Lankeshwar Verma was having Cancer in right side of tongue. He // 8 // went to Mittal Cancer Hospital where after his check-up, it was advised that operation is required to be done and after operation he would become completely cured from cancer. Late Lankeshwar Verma was admitted in Mittal Cancer Hospital on 01.03.2016 and on 03.03.2016, Dr. Mou Roy operated Late Lankeshwar Verma and he was discharged on 17.03.2016. The O.P. No.1 and O.P. No.2 both have told Late Lankeshwar Verma that his cancer was removed and he is alright. In the above operation 50% tongue of Lankeshwar Verma, was cut. It was assured by the O.P. No.1 & O.P. No.2 he would be able to completely speak. Late Lankeshwar Verma deposited Rs.1,75,000 with the O.P. No.1 Hospital. Chemotherapy /Radiation Therapy was done in Medical College Hospital, Raipur, as per advice given by the O.P. No.2. During conducting Chemotherapy/Radiation Therapy, Late Lankewar Verma went to O.P. No.1 & O.P. No.1 and after checking him, they told that cancer of Late Lankeshwar Verma is completely removed. After completion of Chemotheraphy / Radiation Theraphy, on 06.09.2016, test regarding cancer of Lankeshwar Verma, was done in which it was found that his cancer was not cured and symptoms of cancer are available in the tongue of Late Lankeshwar Verma. It shows that Dr. Mou Roy had negligently conducted operation of Late Lankeshwar Verma, therefore, cancer was not completely removed and his 50% tongue had already been cut, hence he suffered mental agony and financial loss. The O.P. No.1 & O.P. No.2 committed medical negligence, deficiency in service and unfair // 9 // trade practice, therefore, the complainants, who are legal heirs of Late Lankeshwar Verma are entitled to get compensation from the OPs, as mentioned in relief clause of the complaint.
8. Miss Praveen Arora, learned counsel appearing for O.P. No.1 and Shri Manish Sinha, learned counsel appearing for O.P. No.2 have argued that Late Lankeshwar Verma came to Mittal Cancer Hospital and after examination he was informed that he was having cancer in his tongue and he was advised for operation. After obtaining consent from Late Lankeshwar Verma, operation was conducted. His operation was successfully done. They further argued that the symptoms of recurrence of cancer mentioned in M.R.I report proves that at the place of symptoms of cancer looking earlier, new symptoms of cancer are looking which is a normal incident in Medical Science. The revival and recurrence of new symptom is a normal incident and it has no relation with the operation of the tongue of Late Lankeshwar Verma, which was done earlier. The operation was successfully done. The operation which was done for treatment of Late Lankeshwar Verma was properly done and has two proofs (1) in the Histopathology Report, the elaborate details of the operation is mentioned (2) After operation in the month of April, 2016, CT Scan of Late Lankeshwar Verma was done in Medical College Hospital, Raipur and in the CT Scan Report, symptom of cancer was not found. According to N.C.C.N. Guideline, the symptom of stage of cancer of Late Lankeshwar Verma was T2N2bMo Stage IVA for which operation // 10 // was done according to prescribed guideline. Therefore, the O.P. No.1 & O.P. No.2 did not commit any medical negligence, deficiency of service or unfair trade practice. The complaint is liable to be dismissed against O.P. No.1 & O.P. No.2.
9. Shri Manoj Prasad, learned counsel appearing for the O.P. No.3 has supported the arguments advanced by the learned counsels appearing for the O.P. No.1 & O.P. No.2.
10. We have heard learned counsels appearing for both the parties and have also perused the documents filed by the parties in the complaint case.
11. It is admitted fact that Late Lankeshwar Verma went to Mittal Hospital on 01.03.2016 and his operation was conducted on 03.03.2016 and he was discharged from the Hospital on 17.03.2016. It is also admitted fact that 50% tongue of Late Lankeshwar Verma was cut after surgery.
12. According to the complainants, Late Lankeshwar Verm. went to hospital for follow checkup, then it was found that cancer was not cured and cancer was found in the tongue of Late Lankeshwar Verma. It shows that operation was not successfully done.
13. The complainants have filed document Annexure A-4(4) and O.P. No.2 has filed Annexure D-2 which is . Report dated 08.04.2016 issued by Regional Cancer Centre, Dr. B.R. Ambedkar Memorial Hospital, Raipur in which it is mentioned thus :-
// 11 // "Report :
In an O/C/O ca tongue, no focal lesion noted at present..." "The cervical soft tissues show normal configuration, and the cervical spine is normally positioned.
The oral floor muscles are bilaterally symmetrical and normally developed.
The spaces of the oral floor and neck are clear and well defined. Images portions of the parotid and submandibular glands show no abnormalities.
The pharynx show normal boundaries and normal wall thickness. The thyroid gland shows reasonable symmetry and normal size. The thyroid lobes have a normal internal structure. Cervical vessels that can be evaluated with CT have a normal appearance.
The muscular structures of the neck appear normal, and there are no cervical lymphadenopathy."
14. Looking to the above report, it appears that the operation of Late Lankeshwar Verma was conducted on 03.03.2016 and after one month of the operation, Late Lankeshwar Verma again went to Regional Cancer Centre Dr. B.R. Ambedkar Memorial Hospital, Raipur (C.G.) where CT Scan was done in which symptoms of cancer were not found. According to the complainants, on 06.09.2016, when Late // 12 // Lankeshwar Verma again went to hospital for follow check up, then it was found that cancer was not cured.
15. The complainants have filed MRI Report of MRI Face + Neck Contrast Report dated 06.09.2016 issued by Pt. J.N.M. Medical College & Dr. B.R. Ambedkar Memorial Hospital, Raipur (C.G.) which is marked as Annexure A-6(1), in which it is mentioned thus :-
"Report :
K/C/O CA tongue. Hemi-glossectomy post operative status.
Antero-superior surgical margin of tongues shows necrotic irregular lesion measuring 1.57 x 1.6 cm s/o recurrence.
T1 hyperintene soft tissue area seen at operative site (likely postoperative myocutaneous flap placement.) Post operative radiotherapy changes in the form of edema noted in larynx and visualized subcutaneous tissue of lower half of face.
The cervical soft tissues show normal configuration. The position of the cervical spine is normal. Images portions of the parotid and submandibular glands show no abnormalities.
The pharynx show normal boundaries and normal wall thickness.
The thyroid gland shows reasonable symmetry and normal size.
The thyroid lobes have a normal internal structure.
// 13 // Cervical vessels that can be evaluatble with CT have a normal appearance.
There are no signs of cervical lymphadenopathy. No abnormalities are seen in the cervical spinal cord or cervical plexus.
16. The O.P. No.1 has filed Literature on "The Recurrence and Survival of oral Squamous Cell Carcinoma : A report of 275 cases, in which it is mentioned thus :-
"Abstract "....The recurrence rate was 32.7%/. The recurrence time ranged from 2 to 96 months, with a median of 14 months. Univariate analysis showed that T stage degree of differentiation, pN stage, flap application, resection margin, and lymphovascular invasion were factors of recurrence (P < 0.05). Multivariate analysis showed that T stage degree of differentiation, and............"
"....... Despite great progress in chemotherapy, radiotherapy , and targeted therapy in the last three decades, the prognosis of OSCC is poor due to aggressive local invasion and metastasis, leading to recurrence..."
Recurrence factors "Ninety (32.7%) patients had recurrence. Recurrence time from 2 to 96 months, with a median time of 14 months. The tumor recurred in the neck in 45 patients, at the primary tumor site in 36 patients, and at both the primary site and neck in 9 patients. We perform univariate analysis between various clinicopathologic factors and OSCC recurrence...."
// 14 // Discussion In this study. 90 (32.7%) patients had recurrence. Chi-square or Fisher's exact lost and multivariate analysis showed that T stage degree of differentiation, and pN stage were important factors of recurrence (P < 0.001). The 2- and 5-year survival rates were lower in patients with recurrence than in thos without, as determined by the Kaplan-Meler method and log- rank test (P < 0.001)."
Table - 1 Analysis of recurrence factors in 275 patients with oral squamous cell carcinoma (OSCC) Valuable Total (Cases) Recurrence Non-Recurrence P [cases %] [cases %] ........
pN1 + pN2 103 50 (48.5) 53 (51.5) ........
that T stage and N stage were important factors affecting regional recurrence in OSCC. Camisasca of al.[2] have analyzed patient clinicopathologic data... They have concluded that the recurrence rate was 44.9% in 118 patients with OSCC. Statistical analysis showed that co-morbidities, degree of tumor, differentiation, and tumor stage were important prognostic factors for recurrence..."
17. Looking to the above literature, it appears that the rate of recurrence was 32.7% and recurrence time ranged from 2 to 96 months, with a median of 14 months. In the instant case, the operation of Late Lankeshwar Verma was conducted on 03.03.2016 and first CT Scan was done on 08.04.2016 in Medical College Hospital, Raipur, at that time symptoms of cancer was not found in tongue of Late Lankeshwar Verma and after six months of the operation, the above // 15 // symptom was again found, therefore, it is possible that recurrence occurred after six months and recurrence is possible, thereafter any symptom was found after six months in tongue of Late Lankeshwar Verma, it cannot be held that O.P. No.1 and O.P. No.2 committed any medical negligence. The operation was done according to prescribed norms and procedure, therefore, if recurrence was occurred, then the O.P. No.1 and O.P. No.2 cannot blame for it and it cannot be held that O.P. No.1 and O.P. No.2 committed any medical negligence.
18. The complainants have not been able to prove that the O.P. No.1 & O.P. No.2 have committed any medical negligence, therefore, the complainants are not entitled to get any compensation from the OPs.
19. Therefore, the complaint filed by the complainants against OPs., is liable to be dismissed, hence the same is dismissed. Parties shall bear their own costs.
(Justice R.S. Sharma) (D.K. Poddar) (Narendra Gupta)
President Member Member
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