National Consumer Disputes Redressal
Dr. Mangla L. Paradkar & Anr. vs Shailendra Singh on 13 May, 2011
NATIONAL CONSUMER DISPUTES REDRESSAL COMMISSION NATIONAL CONSUMER DISPUTES REDRESSAL COMMISSION NEW DELHI FIRST APPEAL NO. 171 OF 2009 (Against the order dated 02.04.2009 in C.C No. 48 of 2001 of the State Commission, Madhya Pradesh ) 1. Dr. Mangla L. Paradkar W/o Dr. L.N. Paradkar R/o Civil Lines Paradkar Nursing Home, Narsinghpur (M.P.) 2. Dr. L.N. Paradkar S/o Shri Narayan Rao Paradkar R/o Civil Lines Paradkar Nursing Home, Narsinghpur (M.P) .Appellants Versus Shailendra Singh S/o Shri Raghuraj Singh R/o Village Bamhori The. & Distt. Narsinghpur .........Respondent BEFORE: HON'BLE MR. JUSTICE V.R. KINGAONKAR, PRESIDING MEMBER HONBLE MR. VINAY KUMAR, MEMBER For the Appellants : Mr. Pragati Neekhra, Advocate For the Respondent : Mr.Rajendra Mishra, Advocate Mr. Rajesh Singh, Advocate PRONOUNCED ON: 13th May, 2011 ORDER
PER MR.VINAY KUMAR, MEMBER The appellant Dr Mangala Paradkar, was Respondent No. 1 in the consumer complaint number 48 of 2001 before the MP State Consumer Disputes Redressal Commission. The other two respondents were Dr L.N. Paradkar, husband of Respondent No. 1 and the Paradkar Nursing Home, run by this doctor couple. The State Commission has allowed the complaint filed by Mr Shailendra Singh in which medical negligence was alleged in the case of treatment of his wife Mrs. Vineeta Singh who, a few days later, had died. The State Commission had held the respondents jointly and severally liable to pay a compensation of Rs. 5 Lacs to the complainant, along with Rs. 3000/- towards costs.
2. In brief, the case of the complainant before the state commission was that his young wife had become pregnant in September/October 1999 and had been periodically checked up by the appellant/OP from time to time. She was informed that the foetus was developing normally. The delivery was due sometime in August 2000. On 31.7.2000, she developed fever and was seen by the appellant who gave medicines to deal with fever and advised return to the nursing home after the labour pains had started.
3. According to the complainant, the medicines had no effect and her condition deteriorated. She was therefore, admitted to the nursing home by the appellant on 3.8.2000. The same day, Mrs. Vineeta Singh delivered a stillborn child. Thereafter, her condition deteriorated and by the next morning she was almost unconscious. According to the complainant, at 11:30 AM on 4.8.2000, he was told by the appellant that the condition of his wife was serious and therefore she was advised to be shifted to Jabalpur, which is about 100 kilometres away. They left for Jabalpur as advised, travelled for about 25 km but had to return as the patient was discharging blood from her mouth and had no pulse. She was readmitted at about 1.45 PM and was declared dead at 3.30 PM.
4. Per contra, the case of the present appellant before the State Commission was that the deceased had already undergone an abortion before the present pregnancy. Between October 1999 and August 2000 she did not come regularly for checkups. On1.8.2000 she was advised admission but had returned home by choice, in spite of the risk to the baby in the womb been explained to her. When she came on 3.8.2000, her sonographic test revealed that the foetus was dead.
She delivered a dead child in the night but her general condition, the next morning, was good. During the course of the day, she was treated for fever and vomiting but everything else was normal. On 5.8.2000 her condition was stable but the relatives wanted to shift her to Jabalpur and therefore a reference was issued. Around 5.30 p.m. she was brought back in the ambulance and found to be dead. According to the appellant, she was not readmitted but the death certificate was issued "on humanitarian grounds".
5. On the basis of the records, pleadings of the parties and the documents produced, the State Commission has come to the following conclusions
1. On 1.8.2000, when the patient came with the complaint of fever no complaint symptoms were noted, no investigation was advised and without any examination of the foetus, the patient was put on anti malarial treatment. No tests were either prescribed or conducted to confirm whether she was actually suffering from malaria or not.
2. Medically malaria and pregnancy make a dangerous combination. Therefore, even assuming that she had malaria, she should have been admitted and administered the drug under medical supervision.
3. The medical record has no mention of the patient being advised admission on 1.8.2000. Therefore, this claim of the appellant/OP is an afterthought, unsupported by evidence.
4. For prescribing anti-malarial medicine to a pregnant woman, without any confirmatory tests and without medical supervision amounted to medical negligence on the part of the OP/appellants.
5. The contradictions in the reference it given on 5.8.2000, while referring the deceased to Jabalpur and the case sheet filed by the respondents, make it apparent that the case sheet had been manipulated and prepared later.
6. The claim of the present appellant/OP that the death of Mrs. Vinita Singh was caused due to her negligence and that of her relatives in not following the instructions, has been rejected. The State Commission has held that the doctor has not specified what instructions were given to the deceased and which were not followed by the deceased, which caused her death.
7. According to the death certificate issued by Paradkar Nursing Home, her death was caused by "encephalitis due to peripheral circulatory failure". From the record of treatment and the evidence adduced, the State Commission did not find when exactly this diagnosis of encephalitis was made. And, if such a diagnosis was made, what treatment was given for it.
6. The Appellant/OP-1 has challenged the above order primarily on the ground that the State Commission has failed to establish the nexus of treatment for malaria with the death of the patient. This is strange logic. It overlooks the fact that it was not for the State Commission but for the treating doctor, i.e. the appellant, to show what diagnostic tests were done to confirm that the deceased was actually suffering from the disease she was treated for i.e. malaria. Equally, it was for the doctor, who certified encephalitis as the cause of death, to explain its relationship with the death of the patient. But, what we find is an admission in the appeal petition that the treatment was started because the patient came from malaria-affected area, mentioned as Bamhori Village.
7. Similarly, explaining the certification of encephalitis as the cause of death, all that the appellant has to say is that Learned State Commission was unable to understand at the time of reaching the finding about the cause of death that encephalitis is not a new disease but it is a form of malaria, examination in this regard has been done by the appellants and on the basis of symptoms of fever of the deceased and accordingly the medicines were prescribed. This statement fails to mask the fact that the appellant could not produce any evidence before the State Commission to establish that it was a diagnosed case, not assumed case, of malaria. The question of certifying it as the cause of death can arise only thereafter. In the arguments before us, learned counsel for the Respondent/Complainant has repeatedly referred to the record of treatment to show that no tests were done before starting the treatment. Nor were any tests done to reassess the line of treatment when the condition of the patient failed to improve. Therefore, what we have is in fact a case of two assumptions, one (relating to the cause of death) based on the other (relating to the disease).
8. Learned counsel for the appellant also referred to the affidavit of the driver of the ambulance to show that the patient had died not in the appellant nursing home but on the way to Jabalpur. But, he could not explain why the death certificate was given by the appellant nursing home when death had occurred outside. Nor could he explain the absence of any entry relating to discharge of the patient on 5.8.2000 in the medical records.
9. We therefore conclude that the appellant has failed to substantiate the grounds of challenge to the impugned order. In the facts and circumstances of this case we also do not find any justification to interfere with the quantum of compensation awarded in the impugned order. Consequently, the appeal is dismissed and the order of the State Commission confirmed. Parties shall bear their own costs.
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(V.R. KINGAONKAR,J) PRESIDING MEMBER ..
(VINAY KUMAR) MEMBER S./-