State Consumer Disputes Redressal Commission
Sarla Arora And Others vs Fortis Health Care And Another on 1 March, 2011
STATE CONSUMER DISPUTES REDRESSAL COMMISSION, PUNJAB,
SCO NOS.3009-12, SECTOR 22-D, CHANDIGARH.
Consumer Complaint No.30 of 2002
Date of institution: 29.05.2002
Date of decision : 01.03.2011
1. Smt.Sarla Arora w/o late Sh.Gobind Ram Arora r/o H.No.768, Sector 9,
Panchkula.
2. Bharat Bhushan Arora s/o late Shri Gobind Ram Arora r/o H.No.699,
Sector 16, Panchkula.
(Names deleted vide interim order dated 21.2.2011)
3. Shri Ravinder Arora s/o Late Shri Gobind Ram Arora resident of H.No.768,
Sector 9, Panchkula, Haryana.
4. Shri Sanjay Arora s/o Late Shri Gobind Ram Arora resident of H.No.768,
Sector 9, Panchkula, Haryana.
.....Complainants
Versus
1. Fortis Health Care Limited, Sector 62 (Phase VIII), S.A.S. Nagar, Mohali
through its Managing Director.
2. Dr.H.S.Bedi, Department of Cardiology, Fortis Heart Institute, Sector 62
(Phase VIII), S.A.S. Nagar, Mohali.
.....Respondents
Consumer Complaint under the Consumer
Protection Act, 1986.
Before:-
Hon'ble Mr.Justice S.N.Aggarwal, President
Mrs.Amarpreet Sharma, Member
Mr.Baldev Singh Sekhon, Member Present:-
For the complainants : Shri Ashwani Talwar, Advocate For the respondents : Sh.P.S.Mattewal, Advocate JUSTICE S.N.AGGARWAL, PRESIDENT It is a sad case where Shri Gobind Ram Arora has died in the Fortis Health Care Limited Hospital respondent No.1 (in short "the respondent hospital") where he was admitted for medical treatment but the question to be determined in this complaint is whether the respondent hospital and/or Dr.H.S.Bedi respondent No.2 (in short "the respondent doctor") or any other doctor of the respondent Consumer Complaint No.30 of 2002 2 hospital have committed any medical negligence which led to the death of Gobind Ram Arora (now deceased) (in short "the patient").
2. Originally, this complaint was filed by 4 complainants being the LRs of Gobind Ram Arora (now deceased). During the pendency of the complaint, Smt.Sarla Arora (widow) complainant No.1 and Shri Bharat Bhushan Arora (son) complainant No.2 died. On the application of the complainants (M.A.No.77 of 2011), the names of complainants No.1 and 2were ordered to be deleted vide order dated 21.2.2011. This complaint is now prosecuted by complainants No.3 and 4.
3. The complaint was originally filed in this Commission on 29.5.2002. It was decided by this Commission vide order dated 28.2.2003 and the complaint was dismissed on merits. The complainants had filed an appeal in the Hon'ble National Commission (First Appeal No.200 of 2004). This was accepted by the Hon'ble National Commission vide order dated 4.1.2010. The impugned order dated 28.2.2003 was set aside and the case was remanded back to this Commission for fresh decision of the case with a direction to refer the matter for expert opinion from an independent Government Hospital/Medical College and then to decide the case afresh.
4. This is how this case is before us.
5. It was pleaded in the complaint that the patient was in perfect health but had some pain in the chest. He went to the respondent hospital and contacted the respondent doctor. The patient was admitted in the respondent hospital on 2.10.2001 for undergoing CAG followed by CABG-double. The respondent hospital was to charge a package amount of Rs.1.9 lacs on account of the said surgical operation as cost of surgery. It was paid by the complainants. The respondents had assured the complainants that the health of the patient would be alright after the bye-pass surgery was performed. The patient was to stay in the respondent hospital for about 10 to 12 days.
6. It was further pleaded that the reports were made available to the complainants and to the patient on 3.10.2001. The patient was recommended for Consumer Complaint No.30 of 2002 3 the surgical revascularisation. The patient was finally operated on 17.10.2001 and he was discharged from the respondent hospital on 25.10.2001. As per the discharge summary given by the respondent hospital, the condition of the patient at the time of discharge was stable and the organs were functioning properly and "the sternal wound (was) healthy. The leg and neck wounds (were also) healthy." But infact, the wound cut on the chest of the patient had not healed. There was always some kind of fluid flowing out from the open wound. The respondent doctor ought not to have discharged the patient as the wound had not properly healed nor did the fluid stop flowing. Therefore, the discharge summary dated 25.10.2001 was not correct.
7. It was further pleaded that although the respondents had entered a package deal with the patient and the complainants for an amount of Rs.1.9 lacs but the respondents forced the complainants to pay a sum of Rs.3,87,129.45 at the time of discharge of the patient on 25.10.2001. The patient was going to the respondent hospital everyday from 25.10.2001 till 30.10.2001 for dressing as he was in terrible agony and pain and was very uncomfortable.
8. It was further pleaded that the patient had gone to the respondent hospital on 30.10.2001 as he had serious pain in the chest. He was attended by the respondent doctor. He opened the stitches and advised re-admission of the patient. Accordingly, the patient was re-admitted in the respondent hospital on 30.10.2001 and the cause of his problem was diagnosed as sternal dehiscence. The patient remained admitted in the respondent hospital for a sufficient long time and was discharged on 4.12.2001. The doctors of the respondent hospital were not able to control the pain and agony of the patient. The wound on the chest was not healing. The doctors of the respondent hospital in order to cover up their own negligence recommended the plastic surgery for repairing the sternal wound of the patient. This recommendation clearly pointed out that some negligence was done at the time of surgery by the doctors of the respondent hospital including the respondent doctor. Moreover, the health of the patient was not returning to normalcy. Consumer Complaint No.30 of 2002 4
9. It was further pleaded that since the respondent hospital was demanding another amount of Rs.2 lacs for plastic surgery although it was not required and it was hoped that the heart operation should start healing on its own but it appeared that the patient suffered some infection from the respondent hospital itself and for that reason, the wound was not healing. The puss was flowing and to cover up the shortcoming, the doctors of the respondent hospital had advised the plastic surgery. Therefore, the patient and the complainants refused this recommendation and the patient was discharged. At the time of discharge, the complainants had to pay another sum of Rs.65,000/- towards the treatment of the patient for the period the patient remained admitted in the respondent hospital.
10. It was further pleaded that at the time of discharge of the patient on 4.12.2001, the respondent doctor had advised that the patient should get dressing done daily. Accordingly, the complainants took the patient to the respondent hospital almost every day and the dressing was got done in the respondent hospital on payment of Rs.75/- for each dressing. The condition of the patient continued deteriorating.
11. It was further pleaded that the patient was got re-admitted in the respondent hospital on 14.1.2002. The wound was not healing and the patient even stopped passing the urine. He was unable to get up from the bed and his health condition was getting from bad to worse. At the time of re-admission, the complainants had deposited another amount of Rs.15000/-. Ultimately, the patient expired in the respondent hospital on 30.3.2002.
12. It was further pleaded that the patient suffered a lot of pain, agony and mental tension during all this period. The vital organs of the patient started failing and the patient after the date of his first admission in the respondent hospital led the life of a hell which ultimately proved fatal. The patient was working in the Punjab State Human Rights Commission till Ist October, 2001 and by his surgery in the respondent hospital, the patient got the death instead of Consumer Complaint No.30 of 2002 5 recovery from the chest pain. The complainants and other family members of the patient were shocked as they lost the gem of their family by the medical negligence of the respondents.
13. It was further pleaded that the respondent hospital was very greedy. Against the package deal amount of Rs.1.9 lacs, the patient and the complainants had to spend a huge amount at the time of his first admission, second admission and the last. They had also to purchase medicines from outside. The medical negligence on the part of the doctors of the respondent hospital was the only cause of the death of the patient. Hence, the complaint for recovery of Rs.10 lacs as compensation with interest @ 18% p.a.. Costs were also prayed.
14. The respondents filed the written reply. It was pleaded that the patient had come to the respondent hospital for the first time on 15.9.2001 in the OPD. He was diagnosed as a case of unstable angina. He had a history of old anterior wall myocardial infarction (heart attack) in the year 1996 for which the patient was given earlier the blood thinner (thrombolysis). The patient had felt the chest pain on slightest exertion. He was diabetic for the last 12 years. In fact, the patient had come to Endocrinologist on 15.9.2001 and he was attended by Dr.K.P.Singh. The patient had earlier got a coronary angiography done in the hospital in New Delhi in the year 1998. This revealed that the patient had 80-90% blockage in all the three arteries and he was advised surgery (CABG).
15. It was further pleaded that the patient was admitted in the respondent hospital for the first time on 2.10.2001 for angiography. The angiography was done by Dr.G.S.Kalra, Senior Interventional Cardiologist. The angiography showed severe blockage in all the heart arteries. He was advised surgical revascularization. As a normal routine, to know the blockage in the arteries, a Carotid Doppler test was done. This showed that apart from the blockage in the heart arteries, there was a blockage in the left carotid artery which supplies blood to the brain. It was, therefore, necessary to do a carotid angiography. This was also got done and it confirmed a blockage of the left carotid arteries. Consumer Complaint No.30 of 2002 6
16. It was further pleaded that after a thorough perusal of the case and after holding a discussion with Cardiac Surgeons, Cardiologists, Anaesthetists, Intensivist and Neurologist, it was decided that best option for the patient was a combined carotid endarterectomy and coronary artery bypass surgery. The patient and his attendants were told that the carotid arteries were blocked to the extent of 90% and 100%. The patient and his attendants were advised at that time that the patient would need not only a coronary bypass surgery but also surgery of the carotid arteries. It was duly explained to the patient and to his attendants that this type of surgery was a high risk procedure keeping in view the severeness of the blockage, age of the patient and that the patient was a diabetic. The sons of the patient had signed the consent in writing to this high risk surgery.
17. It was denied if the complainants had the package deal for Rs.1.9 lacs. Rather the package deal was for Rs.3.25 lacs as carotid surgery was also to be performed. The complainants had consented to this kind of surgery and with this amount of package.
18. It was further pleaded that the surgery of the patient was taken up on 17.10.2001. The patient underwent a major complex surgical procedure - a combined procedure CABG (Coronary Artery Bypass and Grafting) and Carotid Endarterectomy (The Blockage in Carotid Artery - the Artery supplying the blood to the brain is removed and venous patch placed) were performed. The patient stood this surgery very well and he was discharged on 25.10.2001 in healthy and stable condition with healthy wounds, afebrile (no fever), walking around and diabetes controlled. All this was mentioned in the discharge summary.
19. It was further pleaded that the patient was examined on 30.10.2001. The discharge from the sternal wound i.e. wounds of the chest was noticed. It was diagnosed as a case of Sternal dehiscence (mediastintis). His re-admission was advised. The patient was accordingly admitted in the respondent hospital on 30.10.2001. During this admission, the patient was properly treated with debridement (cleaning of dead tissues from the wounds) and dressings thrice a day Consumer Complaint No.30 of 2002 7 with antiseptics and healing of the wound with suitable antibiotics and controlling the diabetes and other treatment were done. The patient improved. In fact, his wound was not healing for the reason that the patient was a chronic diabetic and he was more than 60 years of age. Even as per the test books, the open heart surgery of the patients who were diabetic and who were over 60 years of age, sternal dehiscence was a common and known complication. The only way for closing the gap was by way of plastic surgery which was the well known procedure advised to the patient and his family members. The circumstances were also explained in detail to them. The plastic surgery procedure to close the sternal dehiscence wound was the only course in the surgery advised in the test books. However, inspite of repeated advice, the patient and his attendants did not agree and the patient left the hospital against medical advice on 4.12.2001.
20. It was further pleaded that the patient had again come to the OPD of the respondent hospital in emergency in the evening of 13.1.2002 with copious of foul smelling pus discharge with sternal dehiscence. His blood investigations were sent which showed increased TLC (13,200), DLC-P90, L5, M2, E3. His wound swab showed Staph. Aureus sensitive to Ciplrofloxacin, Linzolid, Vancomycin etc.. Accordingly, he was advised admission. However, the patient refused and went back home. On 14.1.2002, the patient came for admission. He was admitted with the complaint of shortness of breath since one day and decreased urine output since 3 days. On examination, it was found that the patient had heart rate of 98 per minute regular, BP - 130/80 mm/Hg, pedal edema, distended abdomen, ascites, liver enlarged (4 ccm+), bilateral basal crepts with decreased air entry bilaterally and uncontrolled diabetes. A diagnosis of acute renal failure with septicaemia with LVF, with sternal dehiscence was made and the treatment was started on the same lines.
21. It was further pleaded that on 25.1.2002, the patient was taken for secondary closure and Omentopexy was performed on him. Post operatively, his sternal wounds healed well. Unfortunately, the patient went in the renal failure and Consumer Complaint No.30 of 2002 8 he was put on dialysis on 11.2.2002. Subsequently, the patient continued to be on Ryles tube feeding and on 27.2.2002, to improve his nutrition intake feeding jejunostomy was done. The patient developed multi organ failure which required ventilatory support with dialysis which was given to him. His condition went on deteriorating and unfortunately, he succumbed on 30.3.2002.
22. It was denied if the respondent doctor and any doctor in the respondent hospital had committed any medical negligence. It was also denied if the patient or the complainants were forced to pay more amount than was payable by the patient or his attendants. Dismissal of the complaint was prayed.
23. The complainants had filed Annexures C-1 to C-8. The complainants also filed the affidavit of Sarla Arora complainant (now deceased) as Ex.C1. Bharat Bhushan Arora complainant (now deceased) filed his affidavit dated 3.6.2002. Ravinder Arora complainant filed his affidavit dated 3.6.2002 while Sanjay Arora complainant filed his affidavit dated 3.6.2002. On the other hand, the respondents filed the affidavit of Dr.H.S.Bedi respondent No.2 as Ex.R1. They also proved documents Ex.R2/1 to Ex.R2/7.
24. After the matter was received by remand from the Hon'ble National Commission, the complainants filed an application (MA No.1032 of 2010) for referring the matter for medical opinion in terms of the direction of the Hon'ble National Commission. Reply to this application was filed by the respondents. The matter was referred to the Director, Post Graduate Institute of Medical, Education and Research, Chandigarh (in short "the PGI") for obtaining the opinion of the Board of doctors. The report of Board of Doctors of the P.G.I. was received vide letter dated 28.6.2010 (collectively exhibited as CX). Thereafter, the complainants had filed an application (MA No.1987 of 2010) for a copy of the report of the Medical Board of the PGI and for permission to file the written submissions. It was supported by the affidavit of Ravinder Arora complainant.
25. The complainants had filed another application (MA No.2178 of 2010) for giving direction to the respondents to produce the entire medical record Consumer Complaint No.30 of 2002 9 of the treatment of the patient. This application was again supported by the affidavit of Ravinder Arora complainant. This Commission vide interim order dated 20.8.2010 had directed the respondents to produce the entire record/CDs. The respondents had filed the affidavit of Dr.Deepak Puri, Cardiothesis Surgeon of the respondent hospital to the effect that the entire medical record was produced in this Commission but the CD was never produced before the Hon'ble National Commission. Efforts were made to trace out the CD but it could not be traced as the matter was more than 5 years old.
26. The respondents had filed another affidavit of Col. Harinder Chahal, Director of the respondent hospital that the entire record was produced in this Commission which was at one time produced before the Hon'ble National Commission.
27. The arguments were heard. The complainants also filed written arguments. The respondents have also filed the written arguments.
28. The submission of the learned counsel for the complainants was that the patient was hale and hearty on 1.10.2001 but he had slight problem of the chest pain for which he was admitted in the respondent hospital on 2.10.2001. He was operated by the respondent doctor and other doctors in the respondent hospital on 17.10.2001 and was discharged on 25.10.2001. He was re-admitted on 30.10.2001 and was discharged on 4.12.2001. He was again admitted in the respondent hospital on 14.1.2002 but he died in the respondent hospital on 30.3.2002. The respondent doctor and the other doctors of the respondent hospital had treated the patient with medical negligence which clearly proved fatal for the patient. It was submitted that the complainants be awarded compensation against the respondents for their medical negligence. It was also submitted that although, there was a package deal of specific amount between the complainants and the patient on the one hand and the respondent hospital on the other hand but the respondents have charged highly excessive amount from them. So much so they also obtained a decree for certain amount against the complainants exparte inspite of the fact that Consumer Complaint No.30 of 2002 10 the complainants were always available either in this Commission or in the Hon'ble National Commission and the respondents got the decree without effecting service on them. Hence, it was prayed that the suitable amount of compensation be awarded to the complainants.
29. On the other hand, the submission of the learned counsel for the respondents was that the respondents had not committed any medical negligence while medically treating Gobind Ram Arora. Rather they had medically treated him with all full care and caution on all the three stages i.e. pre-operation, during operation and post operation. It was also submitted that the complainants had not even paid the amount which was payable by them to the respondent hospital for which the respondent hospital had to resort to the remedy through a court of law. Hence, it was prayed that the complaint be dismissed with heavy costs.
30. Record has been perused. Submissions have been considered.
31. The version of the complainants is that the patient was in perfect health on 1.10.2001 except that he had some pain in the chest for which he had gone to the respondent hospital on 2.10.2001 and he was admitted in that hospital.
32. This version of the complainants is falsified by the pleadings of the respondents, according to which, the patient had originally come to the respondent hospital on 15.9.2001 in the OPD and he was diagnosed as a case of unstable angina. He had a history of old anterior wall myocardial infarction (heart attack) in the year 1996 for which he had been given blood thinner (Thrombolysis) earlier. He had complained of chest pain on slightest exertion. He was also a diabetic patient for the last 12 years. He had come on that date in the OPD to the Endocrinologist where he was attended by Dr.K.P.Singh as the patient was also a diabetic. Apart from this, in the year 1998, the patient had also got a coronary angiography done from a hospital in New Delhi. This also had shown blockage of 80-90% in all the 3 arteries and was advised surgery (CABG). Consumer Complaint No.30 of 2002 11
33. Although the respondents have not placed on the file any document to show about the visit of the patient on 15.9.2001 in the respondent hospital but at the same time, the complainants have not denied these facts.
34. It is not disputed between the parties that the patient was admitted in the respondent hospital on 2.10.2001. As per the version of the complainants, the patient was having good health except some pain in the chest. Cardiac case notes were recorded, a copy of which has been proved by the respondents as Ex.R2/A, according to which, the diagnosis of the patient was CAD, IDDM, Neuropathy, allergic, bronchitis, post anti wall M1, USA. The respondents have pleaded that on 2.10.2001, the patient was examined by Dr.G.S.Kalra, Senior Interventional Cardiologist and the angiography was performed on the patient. The angiography revealed severe blockage in all the heart arteries and the patient was advised Surgical Revascularization of the same by the Cardiologist. The carotid Doppler test was also done. This revealed that apart from the blockage in the heart arteries, there was also a blockage in the left carotid artery which supplies blood to the brain. The reports of the Doppler test and carotid angiography were produced by the respondents as Ex.R2/2. The document Ex.R2/2 is dated 4.10.2001 and it was duly signed by Dr.G.S.Kalra, MD, DM (Cardiology). It reads as under : -
"Diagnosis : CAD, TVD, Normal Left ventricular systolic function, Planned for CABG Carotid Doppler : Significant left internal carotid artery block Procedure : Selective Carotid Angiogram Route : Right Femoral Artery Anaesthesia : 2% Xylocaine (Local Anaesthesia) Hardware : 5 F JR4 Contrast : 76% Urograffin HAEMODYNAMIC DATA Aorta : 120/80 mm HG Consumer Complaint No.30 of 2002 12 SELECTIVE LEFT CAROTID ANGIOGRAM * Normal left common carotid artery * 90% stenosis at origin of left internal carotid artery * Normal left external carotid artery SELECTIVE RIGHT CAROTID ANGIOGRAM * Normal right common carotid artery * Normal right internal carotid artery * 100% block at origin of right external carotid artery FINAL IMPRESSION * Left internal carotid artery 90% ostial stenosis * Right external carotid artery 100% block RECOMMENDATIONS Left Carotid Endarterectomy Sd/- sd/-
Dr G S Kalra Dr Sandeep Singh
MD, DM (Cardiology) MD, DNB, DM (Cardiology)
Sr.Consultant and Associative-Invasive
Invasive Cardiologist Cardiologist"
35. The above narrated facts clearly falsified the version of the complainants that the patient had good health as on 1.10.2001 but for the chest pain. Rather he had numerous medical problems when he had come to the respondent hospital on 2.10.2001.
36. Ultimately, the medical problem of the patient was discussed by the doctors of the respondent hospital namely Cardiac Surgeons, Cardiologists, Anaesthetists, Intensivist and Neurologist and it was decided that the best option for the patient in this case was a combined carotid Endarterectomy and coronary artery bypass surgery. The patient and his attendants were also told that the carotid arteries of the patient were blocked to the extent of 90% and 100%. The patient and his attendants were also told that not only a coronary bypass surgery was Consumer Complaint No.30 of 2002 13 required but the surgery of the carotid arteries was also required. The patient and his attendants were duly informed by the Doctors of the respondent hospital that it was a high risk procedure as the patient was not only above 60 years of age but he was also a diabetic and because of the severeness of the blockage involved. It was duly explained to the patient and his attendants namely the complainants for which the complainants had signed the consent Ex.R2/3. The consent part of the document Ex.R2/3 reads as under : -
"I also fully understand the high risk of the procedure in view of the severity of disease and of the risk of death and stroke in the operative and peri-operative period. I give consent for his surgery.
Sd/- sd/-
Ravinder Arora B.B.Arora
Relationship to patient Relationship to patient
Son Son
''
37. This document, therefore, clearly proves that the proposed surgery of the patient was a high risk case because of the history of the diseases which he had and because of complicated surgery which was required because of the severeness of the blockage of heart arteries and carotid artery. The complainants themselves have produced on record the Echocardiography Laboratory report dated 3.10.2001 as Annexure C-2 in which after giving measurements of vital factors relating to heart and imaging the final diagnosis was given as under :-
"FINAL DIAGNOSIS
* MILD APICAL HYPOKINESIA
* LEFT VENTRICULAR DIASTOLIC
DYSFUNCTION
* NORMAL LEFT VENTRICULAR SYSTOLIC
FUNCTION (LVEF 56%)"
38. The other report of the Department of Cardiology dated 3.10.2001 showing the diagnosis which is a part of Annexure C-2 also reveals that after Consumer Complaint No.30 of 2002 14 discussing the diagnosis, procedure etc. gives the Final Impression at the bottom of this report as CAD, Triple Vessel disease, Normal left ventricular systolic function and recommended Surgical Revascularisation. The Carotid Colour Doppler Report dated 4.10.2001 which is also a part of Annexure C-2 reads as under : -
"REPORT High resolution duplex 2D Doppler scanning of right carotid arterial system revealed normal origin of innominate artery from the aortic arch. It goes up and bifurcates into the right common carotid and right subclavian arteries. The right common carotid artery has a normal luminal diameter of 6.3 mm and Peak flow velocity of 50/11 cm/sec with normal color flow pattern. The carotid bulb and bifurcation of right common carotid was well visualized, there is a small non-obstructive plaque in right carotid bulb.
The right internal carotid artery (Luminal diameter) 3.8 mm; Peak flow velocity (89/32 cm/sec) and right external carotid artery (Luminal diameter) 4.3 mm; Peak flow velocity (54/23 cm/sec) was found to be free of disease.
The left common carotid artery was scanned cephalad from its origin (Luminal diameter) 6.4 mm; Peak flow velocity (88/18 cm/sec.). The left carotid bulb and bifurcation was well visualized. No obstructive plaque or stenosis was seen. Left internal carotid artery shows about 70% proximal stenosis and there is gradient across the stenosis, Peak flow velocity (356/135 cm/sec). Left external carotid artery Consumer Complaint No.30 of 2002 15 (Luminal diameter) 3.7 mm; Peak flow velocity (155/21 cm/sec) found to be normal with no evidence of obstructive plaque or stenosis.
IMPRESSION RIGHT CAROTID
1. Duplex Scanning of RCCA revealed a small non-obstructive plaque in bulb and RICA revealed normal diameter of the lumen.
2. Doppler study revealed normal velocities with no spectral broadening and normal laminar color flow pattern.
3. Ratio of peak flow velocities of RICA:RCCA with in normal range.
LEFT CAROTID
1. Duplex scanning of LCCA revealed normal diameter of the lumen and LICA shows about 70% proximal stenosis"
39. All these reports, therefore, clearly reveal that the patient had a number of medical problems and his proposed surgery was a high risk care. The version of the complainants that the patient enjoyed good health as on 1.10.2001 except pain in the chest was not correct.
40. Secondly, the complainants have also pleaded that the package deal between the patient and the complainants on the one side and the respondent hospital on the other side was for Rs.1.9 lacs on account of the surgical operation and the complainants were assured by the Doctors of the respondent hospital that the patient was to remain in the hospital only for 10 to 12 days. It appears that when the patient was admitted in the respondent hospital on 2.10.2001, it was considered to be a case of bye-pass heart surgery and for that reason, the complainants had deposited a sum of Rs.1.9 lacs on 2.10.2001 vide receipt Consumer Complaint No.30 of 2002 16 Annexure C1. After the medical investigation was conducted and the medcial tests including carotid colour Doppler report were performed on 3.10.2001 and 4.10.2001, it had come to light that the left carotid artery was blocked and it also needed surgery, then the amount of package deal was enhanced to RS.3.25 lacs. It was pleaded by the respondents that it was not only a heart bypass surgery but it also involved the arteries supplying the blood to the brain i.e. left carotid artery. It was also proved by the respondents by document Ex.R2/3 that the package was for Rs.3.25 lacs. The extra charges outside the package were blood donation and certain more amounts which have been stated in the upper part of the consent letter Ex.R2/3. This document is undated but it appears to be after 4.10.2001 but certainly before the surgery. It reads as under : -
"Patient name : Mr. G R ARORA Procedure planned : CABG + Left Carotid Endarterectomy Package : Rs.3.25 lacs Extra charges outside package :
- Blood donation : @ Rs.1500 per donor (donors to be brought by attendants) - minimum 8 donors required.
- IABP : Rs.35,000/- has been already instituted
in view of severity of disease
- Cell saver - at cost
- Imported medicines - at cost
- Albumen - at cost
- Cost of conduit : at cost
- Cost of valve : at cost
- Extra stay :
* More than 3 days in SICU : @ 4,500/- per day
* More than 7 days in ward : @ 2,000/- per day
Consumer Complaint No.30 of 2002 17
I have been fully explained the above package. I undertake to clear all dues - if any - at the time of discharge."
41. This document Ex.R2/3 was duly signed by Ravinder Arora complainant and Bharat Bhushan Arora complainant (now deceased). The lower portion of it has already been reproduced above.
42. The complainants have produced receipt No.1214 dated 2.10.2001 as Annexure C-1, according to which, the complainants had made the payment of Rs.1.9 lacs to the respondents on account of CAG followed by CABG - Double. Document Annexure C-1 only explains that this was the amount deposited by the complainants with the respondents for that operation. It does not falsify the consent letter which was duly signed by Bharat Bhushan Arora complainant and Ravinder Arora complainant as the sons of the patient in which the package amount was specifically mentioned as Rs.3.25 lacs besides other expenditure. Therefore, the version of the complainants that the respondents had charged extra amount over and above the package deal amount is unbelieveable.
43. The next submission of the learned counsel for the complainants was that at the time of discharge of the patient on 25.10.2001, the respondents had mentioned in the discharge summary that the sternal wound was healthy which was wrong. The patient was being taken by the complainants to the respondent hospital from 26.10.2001 to 30.10.2001 everyday for dressing. He was re-admitted in the respondent hospital on 30.10.2001 with the complaint that there was a discharge in the sternal wound. Therefore, the respondents had not only committed medical negligence while performing the operation on 17.10.2001 but they also should not have discharged the patient on 25.10.2001 when sternal wound was not yet healed.
44. The entire medical record (excluding the CDs) relating to the medical treatment of the patient in the respondent hospital from 2.10.2001 to 25.10.2001 has been placed on the file.
Consumer Complaint No.30 of 2002 18
45. In order to appreciate the merits in the submission of the learned counsel for the complainants, it is better to peruse the entire contents of the discharge summary dated 25.10.2001 Annexure C-3. It reads as under : -
"Diagnosis 1. CORONARY ARTERY DISEASE
2. UNSTABLE ANGINA
3. TRIPLE VESSEL DISEASE
4. IDDM
5. LEFT VENTRICULAR DYSFUNCTION
6. PERIPHERAL NEUROPATHY
7. ALLERGIC BRONCHITIS
8. OLD MYOCARDIAL INFARCTION
9. LEFT INTERNAL & RIGHT EXTERNAL CAROTID ARTERY STENOSIS
10. OLD CEREBELLAR INFARCT Operation :
EMERGENCY COMBINED CORONARY ARTERY BYPASS GRAFTING (CABGX3) + LEFT CAROTID ENDARTERECTOMY WITH SVG PATCH ON 17/10/2001 Reverse Saphenous Vein Graft to LAD, PDA, OM1 Brief History A pleasant 65 yrs old Male was admitted with the complaint of Discomfort in the chest on Exertion, which increased in intensity after the meals & it, was constricting in nature. The patient also complained of breathlessness on exertion. He is a known case of CAD, had an non Q M1 in 1996 AND thrombolysed, no h/o of TIA, PVD, or BLEEDING DISORDERS. On admission he was conscious, oriented, and Consumer Complaint No.30 of 2002 19 hemodynamically stable with pulse rate of 72/min, regular and BP of 130/80 mmHg. There was no cyanosis, clubbing, jaundice, pedal edema or raised JVP. Systemic examination was unremarkable. His echocardiography revealed Left Ventricular Dysfunction with the EF of 35%. His angiography revealed TVD. However, he developed fever and delirium and so his surgery had to be postponed. His carotid angiography revealed severe stenosis in his left internal carotid artery.
Past History
Known case of DM ON REGULAR
TREATMENT
No h/o COPD, No h/o any allergy. No h/o peripheral vascular disease, no h/o bleeding disorders. No h/o TIA.
Date of Operation : 17/10/2001 Date of Discharge 25/10/2001 Operation Notes Pre operative IABP was instituted for LV dysfunction and unstable angina. Midline sternotomy. Left internal carotid artery exposed. Proximal and distal control taken with surgiloop snare. Endareterctomy performed and defect repaired with venous patch. No shunt used as there was a good back flow and the stump pressure was 55 mmHg. Saphenous vein harvested from both legs and left thigh. Patient was heparinised (before CEA) and CPB established with Aortic and single two stage atrio-caval Consumer Complaint No.30 of 2002 20 cannula. Cross Clamp applied and cold blood cardioplegia given through ante grade and retrograde route. Reverse Saphenous Vein Graft anastomosed to PDA, OM1 & LAD. Using 7-0 prolene continuous sutures. And cardioplegia given down the graft and retrograde continuous cardioplegia. Proximal anastomosis of RSVG done on aorta using 6-0 prolene sutures. Patient was easily weaned off CPB. Hemostasis achieved. After placing pacing wires (A-V) and 2 mediastinal drainage tubes, wound closed in layers. Antiseptic dressing done and patient shifted to SICU on stable hemodynamics.
Operative findings -
- No pericardial effusion
- No LV aneurysm
- Gross LVH.
- Diffuse disease all vessels.
- Calcified atheromatous aorta
- Ulcerated atheroma left ICA
Course during stay -
Patient recovered smoothly with no neurological deficit and post op hospital stay was uneventful. CONDITION AT DISCHARGE :
Conscious, oriented, hemodynamically stable. No tacyarrythmia, afebrile. Orally taking and tolerating. Bowel habits normal and urine output adequate. Sternal wound healthy. Leg and neck wounds healthy."
46. Since the patient was a diabetic and since he was above 60 years of age, therefore, the recovery of the wounds sternal and others needed sometime to Consumer Complaint No.30 of 2002 21 recover. It could not be expected that the respondent hospital would have discharged the patient only after the sternal wound had fully recovered. Normally, the patients are discharged to save them from the hospital life and extra expenditure so that the recovery process, which normally runs longer is completed at home. Certain precautions and medicines are prescribed to speed up the recovery of the wound.
47. The version of the complainants that the respondent hospital should not have discharged the patient when his sternal wound was not yet recovered appears to be unacceptable. The patients are discharged after placing them on the way of recovery.
48. The medical record does not reveal if any medical negligence was committed by the respondent doctor or by other doctors of the respondent hospital while operating the patient on 17.10.2001 or at any time, thereafter. There is also no expert evidence to prove if any medical negligence was committed by the Doctors of the respondent hospital at the time of operating the patient on 17.10.2001. The medical opinion was taken from the board of doctors of the PGI who had also examined the medical record (except CD) and it was observed by the Medical Board as under : -
"Available records of Mr.Gobind Ram Arora were perused. He had coronary artery disease, carotid stenosis, diabetes mellitus, hypothyroidism. He underwent CABG and left carotid Endareterctomy with SVG patch. He thus had past surgical complications. Dr. Ajay Bahl will be commenting on the underlying cardiac disease. Dr.Harkant Singh will comment on the surgery and past surgical follow up and Dr.Rama Walia on the management of diabetes and hypothyroidism.
As per records Mr.Gobind Ram Arora presented with unstable angina and was found to have triple Consumer Complaint No.30 of 2002 22 vessel coronary artery disease and left internal carotid artery stenosis on angiography for which he was referred for surgery (angiography CD is not available for review). Surgery is the treatment of choice in this condition and was carried out.
A point that needs clarification is the documentation of vessel LVEF (52%) on angiography and severe LV dysfunction (LVEF 35%) on the past surgery discharge summary. Carotid and coronary angiography CDs may please be provided for review.
Management of diabetes was according to standard guidelines. On occasion the glycemic control was inadequate. For hypothyroidism, the patient was an usual thyroid hormone replacement.
Post CABG, patient had sternal wound dehiscence. Sternal would dehiscence is a known complication after CABG and is more common in diabetics.
Sd/-
Dr.Ajay Bahl Assistant Professor Department of Cardiology PGIMER, Chandigarh Sd/-
Dr.Harkant Singh Assistant Professor, Deptt. Of Cardiovascular & Thoracic Surgery P.G.I., Chandigarh Sd/-
Dr.Rama Walia Assistant Professor Deptt. Of Endocrinology, PGIMER, Chandigarh"
49. The board of doctors of the PGI no doubt had asked for the Carotid and Coronary Angiography CDs but these could not be made available as these Consumer Complaint No.30 of 2002 23 could not be traced in the record of the respondent hospital. In any case, after examining the medical record for the period from 2.10.2001 to 25.10.2001, the Board of Doctors of the PGI have not reported if the doctors of the respondent hospital had committed any medical negligence. Rather they have reported towards the end that post CABG, the patient had sternal wound dehiscence that is a known complication after CABG and was more common in diabetics.
50. The submission of the learned counsel for the complainants was that the respondent hospital has intentionally failed to provide the angiography CDs in order to conceal the medical negligence committed by them while operating the patient. It was further submitted that the respondents have taken the plea that the record including the CDs are destroyed after a lapse of 5 years but since the complainants had filed the complaint immediately after the death of the patient, therefore, the respondents were more required to retain the medical record of this case including the CDs. In this context, reference was made by the learned counsel for the complainants to the judgment of the Hon'ble Chhattisgarh State Consumer Disputes Redressal Commission, Raipur reported as "Anjali Shrivastava v. Dr.Sheela Pahlajani, I (2006) CPJ 67" in which it was held that where the case history of the patient was not preserved by the hospital, it amounted to deficiency in service and medical negligence. Reference was also made to the judgment of the Hon'ble National Commission reported as "Sukesh Jain v. Dr.Mukesh Jain & Ors IV (2009) CPJ 1 (NC)" in which also, it was held that where the documents/medical record is not preserved or maintained, it amounts to deficiency in service.
51. These submissions have been considered.
52. The entire medical record of the patient for the admission period from 2.10.2001 to 25.10.2001 has been produced by the respondent hospital. It has even been examined by the board of doctors of the PGI. Dr.Deepak Thapar, Cardiothesis Surgeon of the respondent hospital had filed a detailed affidavit dated 7.10.2010 and has specifically pleaded in para 7 of the affidavit that the entire Consumer Complaint No.30 of 2002 24 record was sent to the PGI which was also produced before the Hon'ble National Commission. The CD was never produced before the Hon'ble National Commission. Therefore, CD was not a part of the medical record which was produced before the Hon'ble National Commission before the PGI and before this Commission. In para 7 of the affidavit, it is pleaded that the present case was an old case and the respondents had made efforts to trace the CD but it could not be found.
53. So far as the judgments relied upon by the learned counsel for the complainants in Anjali Shrivastava's case (supra) and the judgment of the Hon'ble National Commission in Sukesh Jain's case (supra) are concerned, these are not applicable to the facts of the present case as the respondents have proved the entire medical record relating to the medical treatment of the patient. Merely because the CDs of angiography could not be produced, it could not be held that the respondents have not maintained the medical record.
54. There does not appear to be any ulterior motive on the part of the respondent hospital for holding back the CD when they have produced the entire record relating to the medical treatment of the patient in the PGI as also in the State Commission which was produced before the Hon'ble National Commission also.
55. The respondent hospital has also placed on the file medical literature as Annexures Ex.R2/4 and Ex.R2/5. It is specifically mentioned in the medical literature Ex.R2/5 that the risk factors for development of Mediastinitis Stenosis and Dehiscence was more in the patient with Diabetic Mellitus. Similar is the observations of the board of doctors of the PGI, Chandigarh that the complications after CABG is more common in diabetics. Therefore, the healing of sternal wound depends upon the body structure of each patient as also on the past history of the disease which he had prior to the surgery of heart artery bypass. Some unfortunate cases do occur but in all the cases medical negligence cannot be attributed against Consumer Complaint No.30 of 2002 25 the doctors who treat them unless the medical negligence is proved by the complainants by leading positive evidence.
56. The patient was getting the wounds dressed up every day by going to the respondent hospital after he was discharged on 25.10.2001. When the patient had gone on 30.10.2001, it was found that there was discharge from the sternal wounds i.e. wounds of chest. He was admitted in the respondent hospital. He remained admitted there from 30.10.2001 to 4.12.2001 when as per the summary discharge, the patient had left the hospital against medical advice.
57. The medical record of that period i.e. from 30.10.2001 to 4.12.2001 has also been produced in this Commission. The discharge summary has been produced by the complainants as Annexure C-5. It reads as under : -
"DISCHARGE SUMMARY ON REQUEST LEAVING AGAINST MEDICAL ADVICE MR. G R ARORA - A PLEASANT 65 YRS AGED MALE - UNDERWENT EMERGENCY CABG X 3 + LEFT CAROTID ENDARTERECTOMY WITH IABP SUPPORT ON 17/10/2001 FOR CAD. UNSTABLE ANGINA, TVD, IDDM, HYPERTENSION, LEFT VENTRICULAR DYSFUNCTION, LEFT INTERNAL CAROTID ARTERY STENOSIS AND OLD CEREBELLAR INFARCT. HIS POST OP RECOVERY WAS SMOOTH & HE WAS DISCHARGED WITH HEALTHY STERNAL WOUND ON 25/10/2001.
PATIENT WAS READMITTED ON 30/10/2001 WITH STERNAL DEHISCENCE. HE WAS MANAGED HERE WITH ASEPTIC DRESSING. HE HAS BEEN ADVISED PLASTIC SURGICAL REPAIR OF HIS STERNAL WOUND. HOWEVER Consumer Complaint No.30 of 2002 26 THE PATIENT DOES NOT WANT THE PROCEDURE TO BE DONE AND IS LEAVING AGAINST MEDICAL ADVICE."
58. The submission of the learned counsel for the complainants was that if the plastic surgical repair was required, it could have been done between the period from 30.10.2001 to 4.12.2001 when the patient remained admitted in the respondent hospital. It also amounted to medical negligence if it was not done by the doctors of the respondent hospital at the appropriate time.
59. This submission has been considered.
60. We find no merit in it. The doctors are the best persons to determine as to when the treatment is to be given and what treatment has to be given. On 30.10.2001, the problem of the patient was diagnosed as a case of sternal dehiscence Mediastinitis Stenosis. As discussed above, sternal dehiscence Mediastinitis is more common when the patient is diabetic.
61. After the patient was admitted in the respondent hospital on 30.10.2001, his problem was diagnosed as the status post CABG with sternal dehiscence with DM (Diabetic Mellitus). The entire medical record produced by the respondents clearly reveals that the medical treatment was started and the necessary tests were being conducted. The complainants have also reproduced the summary of medical record for the period from 30.10.2001 to 4.12.2001 as under :
-
"
30.10.2001 Daily dressing (Page-190) 03.11.2001 ASD increased to thrice daily (Page - 193) Page - 193 On page - 193, there is a mention of the notes of 2.11.2001, then 3.11.2001 and on page - 194, again there is a reference of 2.11.2001 and at page -
195 it is a noting of 3.11.2001.
03.11.01 Once again it has been advised that (page - 195) dressing to continue thrice daily 05.11.2001 De-vitalised tissue to be excised.
(Page - 195)
Consumer Complaint No.30 of 2002 27
06.11.2001 Continue dressing BD
(page - 199)
(Page - 201) Continue dressing thrice daily
12.11.01 Extubated wound better
(Page - 206)
13.11.2001 Continue dressing
(Page - 207)
14.11.2001 Minimal slough excised and debrided
Page - 208 Slough advised
10.11.2001 Slough excised
(Page - 209)
16.11.2001 Continue dressing
(Page - 210)
24.11.2001 Wound is better. Advised repair under
(Page - 218) GA/talk to patient and attendants. Not
ready for any procedure. Explained
the problems of not repairing at this
stage.
25.11.2001 Wound healthy, Patient and
(page - 220) attendants explained risk of repair.
Patient and attendants not willing at
all for any procedure.
27.11.2001 Daily dressing to continue
(Page - 222)
28.11.2001 Wound looks better. Explained again
(page - 223) the need for repair. Not willing at
their own risk
29.11.2001 Attendants want to take patient home.
(Page 224) Advised not to do so.
30.11.2001 Attendants again insisting on taking
(Page - 226) patient home. Advised against
moving patient at this stage. Advised
for repair of wound.
01.12.2001 Being planned for wound closure but
(Page - 228) attendants adamant for not getting it
done
03.12.2001 Attendants want to take patient home
(Page - 231) against medical advice. Advised risk
to patient of doing so.
04.12.2001 Left against medical advice.
(Page - 233)
"
62. Therefore, the efforts were being made by the doctors of the respondent hospital to medically treat the sternal wound by medicines and dressing and by debridement. When the sternal dehiscence Mediastinitis could not be treated properly, the things were being explained to the patient and his attendants. They even had advised for repairing the wound (of course by plastic surgery) but neither the patient nor his attendants were willing to undergo that procedure. The entries in the medical record made on 29.11.2001 and 30.11.2001 Consumer Complaint No.30 of 2002 28 show that the attendants of the patient were insisting for taking the patient home instead of leaving the patient at the discretion of the doctors who were well aware as to what was the best for recovery of the patient but since the patient and the complainants were not willing for the medical treatment proposed by the doctors of the respondent hospital, therefore, the doctors could not dare undertaking that treatment. Ultimately, on 4.12.2001, the complainants took the patient to their home against the medical advice.
63. Even, thereafter, the complainants continued taking the patient to the respondent hospital for dressing and treatment but the condition of the patient did not improve. Ultimately, on 13.1.2002, the doctors of the respondent hospital advised the complainants to re-admit the patient in the respondent hospital as they noticed copious foul smelling pus discharge with sternal dehiscence. The complainants got admitted the patient in the respondent hospital only on 14.1.2002 and the patient died in the respondent hospital on 30.3.2002. The entire medical record of that period has also been placed on the file. Some of the entries have been reproduced by the complainants in their written submissions which are reproduced as under : -
"
25.01.02 Wound better - slough removed.
(Page - 318) Plan for repair
28.01.02 Plastic Surgeon called
(Page - 324)
05.03.02 Patient had a sudden cardiac arrest
(Page - 374) at 8.40 am CPR done. Patient
revived immediately.
30.03.02 General condition grave. Unstable.
9Page - 399) Declared dead at 12.45 PM
"
64. We have not been able to found any merit in the submission of the learned counsel for the complainants if any medical negligence was committed by the doctors of the respondent hospital or by the respondent doctor while medically treating the patient in any of these 3 stages when the patient was admitted in the respondent hospital.
Consumer Complaint No.30 of 2002 29
65. The learned counsel for the complainants made reference to the judgment of the Hon'ble Supreme Court reported as "Kusum Sharma & Others v. Batra Hospital & Medical Research Centre & Others, 2010 AIR (SC) 1050" and the judgment of the Hon'ble Supreme Court reported as "V.Kishan Rao v. Nikhil Super Speciality Hospital and another (2010) 5 Supreme Court Cases 513". These judgments do not help the complainants at all. Rather certain principles were enunciated by the Hon'ble Supreme Court relating the medical negligence case in Kusum Sharma's case (supra) which read as under : -
"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 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 Consumer Complaint No.30 of 2002 30 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 of risk, but which he honestly believes as providing greater chances of success for the patient rather than a procedure involving lesser risk but 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.Consumer Complaint No.30 of 2002 31
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."
66. None of these principles are applicable to this case.
67. Moreover, the law has been settled by the Hon'ble Supreme Court in a number of judgments that the onus to prove medical negligence is on the respondents which they have to discharge like a criminal case. The onus to prove medical negligence is onerous as it is different from proving deficiency in service which could be presumed even from the document or facts and circumstances of a case.
Consumer Complaint No.30 of 2002 32
68. Moreover, it was held by the Hon'ble Supreme Court in the judgment reported as "MALAY KUMAR GANGULY v. SUKUMAR MUKHERJEE (DR.) & ORS." III(2009) CPJ 17 (SC) as under:-
"35. Charge of professional negligence on a medical person is a serious one as it affects his professional status and reputation and as such the burden of proof would be more onerous. A doctor cannot be held negligent only because something has gone wrong. He also cannot be held liable for mischance or misadventure or for an error of judgment in making a choice when two options are available. The mistake in diagnosis is not necessarily a negligent diagnosis.
69. It was also held by this Commission in the judgment dated 22.1.2008 passed in First Appeal No.1038 of 2000 "Partap Singh v. Sahib Nursing Home & Surgical Centre and others" that a doctor no doubt can play havoc with the life of another by medical negligence, but the doctor cannot be dubbed as negligent wherever the things go wrong because of God's will or for other factors. Finding fault with the doctor without any evidence would not only defame the medical profession which is otherwise very noble but the society will also lose the compassion of the saviour i.e. of the doctor who is considered next to God.
70. The next submission of the learned counsel for the complainants was that the respondents had obtained an exparte decree from the Court of Additional Civil Judge, Senior Division, SAS Nagar Mohali against the complainants for recovery of Rs.2,81,058.16 with interest and costs even when the complainants were face to face with the respondents either in this Commission or in the Hon'ble National Commission. No efforts were made by the respondents to effect service on the complainants in this case relating to the recovery suit filed by them illegally Consumer Complaint No.30 of 2002 33 against the complainants. Rather they had obtained the decree exparte from the Civil Court clandestinely.
71. This submission has been considered.
72. So far as the judgment dated 10.2.2010 passed exparte by the court of Additional Civil Judge, Senior Division, SAS Nagar, Mohali against the complainants and in favour of the respondents is concerned, the complainants would be at liberty to resort to appropriate remedy available to them to challenge the legality and validity of that judgment dated 10.2.2010 that is not the subject matter of decision in this complaint in which we are only called upon to determine the medical negligence on the part of the respondents while treating the patient. Therefore, this Commission cannot go into the merits of that decree.
73. In view of the discussions held above, we reach the conclusion that the complainants have not been able to prove any medical negligence on the part of the doctors of the respondent hospital or on the part of respondent No.2.
74. We find no merit in the present complaint and the same is dismissed.
75. The arguments in this complaint were heard on 21.2.2011 and the order was reserved. Now the order be communicated to the parties.
76. The appeal could not be decided within the statutory period due to heavy pendency of Court cases.
(JUSTICE S.N.AGGARWAL) PRESIDENT (AMARPREET SHARMA) MEMBER (BALDEV SINGH SEKHON) MEMBER March 01, 2011.
Paritosh