National Consumer Disputes Redressal
Anand Prakash vs Dr. Satya Sawant & Anr. on 31 January, 2013
NATIONAL CONSUMER DISPUTES REDRESSAL COMMISSION NEW DELHI FIRST APPEAL NO. 369 OF 2009 (Against the order dated 11.08.2009 in RBT No. 15/2008 in Complaint No. 9 of 1998 of the State Consumer Disputes Redressal Commission, U.T. Chandigarh) Shri Anand Parkash, Husband of Smt. Usha Rani (Deceased), Resident of House No. 138, Block 18, Mohalla Dogran, Hisar Appellant Versus 1. Dr. Satya Sawant, Sawant Clinic, 6-7, Churamani Shopping Complex, Hisar 2. Churamani Vishnu Devi Maternity Hospital, Through Dr. Satya Sawant, Medical Superintendent, Hisar Respondents BEFORE: HON'BLE MR. JUSTICE ASHOK BHAN, PRESIDENT HON'BLE MRS. VINEETA RAI, MEMBER For Appellant : Ms. Sangeeta Sondhi, Advocate For Respondents : Mr. Prasenjit Keswani, Advocate for R1 Mr. Sanchar Anand, Advocate for R-2 Pronounced on 31st January, 2013 ORDER
PER VINEETA RAI, MEMBER
1. This First Appeal has been filed by Anand Parkash, Appellant herein and original complainant before the State Consumer Disputes Redressal Commission, U.T. Chandigarh (hereinafter referred to as the State Commission) being aggrieved by the order of that Commission which had dismissed his complaint of medical negligence against Dr. Satya Sawant and Anr., Respondents No. 1 and 2 herein.
2. In his complaint before the State Commission, Appellant had stated that his late wife Smt. Usha Rani (hereinafter referred to as the Patient) on conceiving her second child in March, 1996 was under the medical supervision and care of Respondent No.1, who apart from working in Respondent No.2-Hospital was also doing private practice. On 22.12.1996, the patient approached Respondent No.1 with mild labour pains and was admitted on advice of Respondent No.1 in Respondent No.2-Hospital, where she was put on a drip to induce labour for a normal delivery. Respondent No.1 was fully aware that patients first child had been delivered through cesarean section and that she was also suffering from anaemia with a very low haemoglobin count but no arrangements for blood transfusion in anticipation of any emergency was made. She was kept in the labour room, where after 40 hours of labour she delivered a male child. The patient developed complications immediately after delivery and blood transfusion became necessary. Appellant and his family donated seven units of blood on the spot, which was infused without any cross checking. Soon after, the patient went into an irreversible shock and was declared dead at 5.40 P.M. Shocked and aggrieved by her untimely and avoidable death, Appellant lodged an FIR at the Police Station and also a complaint with the Commissioner, Hisar Division, after which an enquiry was conducted by doctors from the Medical College & Hospital, Rohtak but nothing came out of it because of Respondent No.1s political clout. Appellant, therefore, filed a complaint before the State Commission alleging medical negligence and deficiency in service against Respondents, which led to the tragic and untimely death of his wife, who was gainfully employed. It was requested that the Respondents be jointly and severally directed to pay compensation amounting to Rs.10,65,512/-, which included loss for future earnings at Rs.6500/- per month, medical and other expenses as also litigation costs.
3. Respondents on being served filed written submissions, in which they denied that there was any medical negligence or deficiency in service on their part. Respondent No.1 while admitting that the basic cause leading to the death of the patient was Post Partum Haemorrhage (PPH) contended that following Patients death independent enquiries were conducted by a Medical Board of PGIMER, Chandigarh, which confirmed that there was no negligence or deficiency in service in the medical treatment and care to the Patient.
Further, an enquiry conducted by another Board of experts from Medical College & Hospital, Rohtak also concluded on the basis of evidence before it, including the medical records, that there was no medical negligence in this case. It was specifically concluded that at the time of her delivery, the Patient was not anaemic as contended by the Appellant and it was only after careful assessment of her condition that she was cleared for a normal delivery. The fact that she had previously undergone a cesarean section by itself was not contraindicated in this case since the first cesarean section was necessitated because of pre-oclasptia and not because of any cephalo pelvic disproportion. The process of her labour was carefully monitored and the labour period in fact was less than 24 hours during which period all care and precautions were taken.
The Appellant was also asked to arrange blood well in advance. After the PPH occurred, standard emergency treatment was given, including seven units of blood, but unfortunately patient went into irreversible shock and she could not be saved. It was also contended that the police had investigated the matter and found no medical negligence on the part of Respondents. Respondent No.1 also stated that she had not taken any monetary consideration from the Patient. She treated her not in her capacity as a private practitioner but in the Respondent-Hospital which is run as a Trust. Under the circumstances, the case is not legally maintainable under the Consumer Protection Act, 1986.
4. The Haryana State Consumer Disputes Redressal Commission, after hearing the parties and on the basis of evidence produced before it, including the reports of the Medical Boards of PGIMER, Chandigarh and Medical College & Hospital, Rohtak, dismissed the complaint, following which the Appellant filed an appeal before the National Commission, who vide its order dated 28.04.2008 remanded the complaint to the U.T. Chandigarh State Consumer Disputes Redressal Commission on the grounds that despite a specific request by the Appellant seeking permission of the State Commission to appoint any of the two doctors, namely, Dr. Vijay Luxmi Lal or Dr. G.I. Dhall, to give their expert opinion, this application was not disposed of by the State Commission either by accepting or rejecting it and it, thus, remained pending. The National Commission opined that in the interest of justice, the matter be reconsidered by the State Commission in detail and the Appellant may be given an opportunity to lead the evidence of any of the two doctors as sought by him in his application dated 28.01.1999 before the State Commission. On remand, the State Commission permitted Appellants request to replace the earlier two experts named by her who were not in a position to give expert evidence by either of two other experts, namely, Dr. Vijay Kumar Kadam and Dr. M.C. Gupta. Consequently, Dr. M.C. Gupta appeared before the State Commission and Respondents were given an opportunity to cross examine him. The second doctor (Dr. Vijay Kumar Kadam), however, sent his views in writing and did not appear in person. The State Commission after hearing the parties and considering the entire evidence, including the evidence filed before the Haryana State Consumer Disputes Redressal Commission, concluded that there was no medical negligence in the treatment of the Patient. The relevant observations of the State Commission are reproduced:
25. In view of the above findings by the two Medical Boards constituted by the specialists in the field who had gone into the record of the patient as well as her treatment and who had given a clean chit to the doctors attending upon the deceased, which the complainant has not been able to rebut with any cogent medical evidence/literature, we are of the opinion that in this case, no negligence could be attributed to the doctor for waiting for normal delivery to take place or in the management of PPH. In this context, it is also relevant to mention that Dr. M.C. Gupta, who himself is not a specialist in Gynaecology, has in his evidence not been able to pinpoint or indicate as to where the Medical Boards had gone wrong or what was wrong with the conclusion they had drawn. Consequent to the order of Honble National Commission, full opportunity had been afforded to the complainant to assail the opinion of the Boards but as stated earlier, in our opinion, the complainant has not been successful in doing the same. It is unfortunate that the wife of the complainant died after her delivery but it is on record that the death was due to uncontrollable Post Partum Haemorrage, which the doctors tried their best to manage but were unable to do so and failed despite their best efforts.
26. In the circumstances narrated above, we are of the clear opinion that no medical negligence can be attributed to the treating doctors or the hospital and consequently, the complaint is dismissed. However, under the peculiar circumstances of the case, the parties are left to bear their own costs of litigation.
Hence, the present first appeal.
5. Learned counsel for both parties made detailed oral submissions.
6. Learned counsel for the Appellant contended that the State Commission erred in concluding that there was no medical negligence in the treatment of the Patient despite clear cut evidence that due care was not taken in her treatment and by disregarding the evidence of two medical experts, Dr. M.C. Gupta as also Dr. Vijay Kumar Kadam. It was specifically contended that the Patient being anaemic with a Haemoglobin count of 7.8 gms. and having undergone an earlier caesarian section was made to undergo prolonged and induced labor, which was responsible for both the PPH and her eventual death. The situation was further aggravated by the fact that there was also a doubt whether the blood that was transfused was cross-checked with the Patients blood group since no arrangement was made for blood by Respondents in anticipation of any emergency. It was specifically contended, as observed by Dr. M.C. Gupta, that the Patient had six high risk factors, apart from anaemia and an earlier caesarian section (which makes the wall of the uterus weak) and these and other factors including obesity, small stature as also hypertension makes prolonged and induced labour very risky and is clearly contraindicated. It is safer to perform a caesarian section in such cases. Counsel for the Appellant stated that the two Medical Boards of PGIMER, Chandigarh and Medical College & Hospital, Rohtak gave biased findings of there being no medical negligence and this had also been reported in the local press, which was filed in evidence before the State Commission. It was contended that the State Commission erred in not relying on the medical evidence of Dr. M.C. Gupta merely because he was not a Gynaecologist whereas he had a Post Graduate Degree in Medicine as also the statement/affidavit of Dr. Vijay Kumar Kadam, a well-known Gynaecologist of Delhi, who had opined that there was medical mismanagement of the case.
7. Counsel for the Respondents on the other hand challenged the above allegations and stated that the contention of the Patient having high risk factors was not factually correct. It was specifically pointed out that the Haemoglobin count which was 7.8 gms. during the Patients earlier visits in July and September, 1996 increased to over 10 gms. at the time of admission (as recorded in her bed-chart) because she had been prescribed iron tablets and other drugs to increase the Haemoglobin count.
Further, her blood pressure during these visits as also at the time of her admission and in labour room was within normal limits. It was also stated that the actual period of her labour was less than 24 hours and not 40 hours. The enquiries conducted by two highly reputed medical institutions into this case also clearly confirmed that there was no medical negligence or deficiency in service in the treatment of the Patient. Appellants contention that all the enquiry reports were biased is based on pure conjecture and is prima facie unreasonable.
8. We have considered the submissions made by both learned Counsel as also the evidence on record, including the medical reports and opinions of the Medical Boards and Medical Experts. Patients admission in Respondents nursing home and her death from PPH following a normal delivery are admitted facts. It is further not in dispute that following her death and to ascertain if it was because of any negligence or deficiency in her treatment, as alleged by her husband, detailed enquiries were conducted, including by two Medical Boards as also by a Chief Medical Officer. All these enquiries concluded that there was no medical negligence or deficiency in service in the case and the PPH was an unfortunate and unforeseen incident, for which also emergency treatment was given. This was sought to be challenged by the Appellant on the ground that Patient being high risk case should not have been permitted to undergo prolonged labour and an immediate cesarean section would have saved her life.
From the evidence on record, we are unable to conclude that the Patient was a high risk case. Admittedly her Haemoglobin count was low, three months prior to her delivery as per the medical records but at the time of her admission (as per the bed chart) because of medication, including iron supplementation it had increased to 10 gms., which is not indicative of anaemia. There has been no evidence to controvert that there was any error in the bed chart prepared at the time of her admission. Further, Appellants contention that the Patient had hypertension is also not borne out by the medical records, which clearly indicated that it was very much within normal limits. It is also a fact that though the first delivery was conducted by cesarean section, this was undertaken not because of any cephalo pelvic disproportion but because of her temporary medical condition (pre-oclasptia) at that time, which necessitated a cesarean section. It is also on record that the progression of the Patients labour and delivery was carefully monitored and even when the PPH occurred standard emergency treatment was given, including blood transfusion. These were clear findings of the Medical Boards consisting of highly eminent doctors from PGIMER, Chandigarh, a premier referral institution of excellence, and also from the Medical College & Hospital, Rohtak.
Appellants contention that these reports were biased appears to be both unreasonable and not acceptable since there can be no plausible reason for the medical boards of PGIMER, Chandigarh and Medical College & Hospital, Rohtak to be biased in this case. Also no concrete evidence has been produced by the Appellant in support of these contentions. The Appellant was given a second opportunity to produce evidence of medical expert in support of his contention alleging medical negligence. We agree with the State Commission that the evidence of the medical expert Dr. M.C. Gupta, who had neither examined the Patient nor was a Gynaecologist, has little evidentiary value in this case. In fact, this witness had admitted during his cross-examination that his evidence was based on advice obtained by him from a Gynaecologist. Further, neither he nor other medical expert Dr. Vijay Kumar Kadam, who had filed his written evidence, have been able to point out any deficiency, shortcoming or bias in the reports of the two Medical Boards. Dr. Gupta has made some vague allegations that the report does not mention the date when it was signed by experts and that it does not indicate what evidence they had actually examined. These are trivial observations since they do not in any way contradict the actual findings of the two Medical Boards.
9. Keeping in view these facts, we are unable to conclude that the Appellant, on whom there was onus to do so, has been able to prove that there was any medical negligence in the treatment of his late wife by the Respondents. On the contrary, keeping in view the findings of the Medical Boards from two major institutions PGIMER, Chandigarh and Medical College & Hospital, Rohtak as also the documentary evidence pertaining to the medical records of the Patient, it is clear that there was no negligence or deficiency in the medical treatment and care of the Patient. We, therefore, uphold the order of the State Commission in toto. The first appeal having no merit is hereby dismissed. No costs.
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(ASHOK BHAN, J.) PRESIDENT Sd/-
(VINEETA RAI) MEMBER SB/Mukesh