State Consumer Disputes Redressal Commission
Dr. Kirpal Singh vs Amarjeet Multispeciality Hospital on 2 May, 2016
FIRST ADDITIONAL BENCH
STATE CONSUMER DISPUTES REDRESSAL COMMISSION,
PUNJAB SECTOR 37-A, DAKSHIN MARG, CHANDIGARH.
First Appeal No.1084 of 2012
Date of Institution: 16.08.2012
Date of Decision : 02.05.2016
1. Dr. Kirpal Singh, aged about 60 years, son of late Sh. Balwant
Singh.
2. Mrs. Gurjit Kaur, age about 56 years, wife of Dr. Kirpal Singh, both
residents of House No.46, Dyal Nagar, Jalandhar, District
Jalandhar.
...Appellants/Complainants
Versus
1. Amarjeet Multispeciality Hospital, G.T.B. Nagar, near Guru Ravi
Dass Chowk, Jalandhar owned by Mrs. Amarjeet Singh.
2. Dr. Navjot Singh Dahyia, Administrator of the Hospital owned by
OP no.1.
3. Dr. Rajesh Khurana, Duty Doctor of the said hospital, presently
working at Malhotra Hospital, no.14, Waryam Nagar, Vasant
Vihar Road, Jalandhar.
.....Respondents/Opposite Parties
First Appeal against order dated
15.05.2012 passed by the District
Consumer Disputes Redressal Forum,
Jalandhar.
Present:-
For the appellants : Sh. H.S. Thiara, Advocate
For respondents no.1&2: None
For respondent no.3 : Sh. Sunil Salhotra, Advocate
............................................
2) First Appeal No.1097 of 2012
Date of Institution: 21.08.2012
Date of Decision : 02.05.2016
Amarjeet Multispeciality Hospital, G.T.B. Nagar, near Guru Ravi
Dass Chowki, Jalandhar owned by Mrs. Amarjeet Singh.
.....Appellant/Opposite Party No.1
Versus
1. Dr. Kirpal Singh, son of late Sh. Balwant Singh, residents of
House No.46, Dyal Nagar, Jalandhar.
First Appeal No.1084 of 2012 2
2. Mrs. Gurjit Kaur wife of Dr. Kirpal Singh, residents of House
No.46, Dyal Nagar, Jalandhar.
.....Respondents no.1&2/Complainants
3. Dr. Navjot Singh Dahyia, Administrator of the Hospital owned by
OP no.1.
4. Dr. Rajesh Khurana, Duty Doctor of the said hospital, presently
working at Malhotra Hospital, no.14, Waryam Nagar, Vasant
Vihar Road, Jalandhar.
.....Respondents no.3 & 4/Opposite Parties no.2 &3
First Appeal against order dated
15.05.2012 passed by the District
Consumer Disputes Redressal Forum,
Jalandhar.
Present:-
For the appellant : None
For respondents no.1&2 : Sh. H.S. Thiara, Advocate
For respondent no.3 : Ex-parte
For respondent no.4 : Sh. Sunil Salhotra, Advocate
.................................................
AND
3) First Appeal No.1209 of 2012
Date of Institution: 12.09.2013
Date of Decision : 02.05.2016
Dr. Rajesh Khurana, Duty Doctor with M/s Amarjeet Multispeciality
Hospital, G.T.B. Nagar Near Guru Ravi Dass Chowk, Jalandhar.
.....Appellant/opposite party no.3
Versus
1. Dr. Kirpal Singh, son of late Sh. Balwant Singh, residents of
House No.46, Dyal Nagar, Jalandhar.
2. Mrs. Gurjit Kaur wife of Dr. Kirpal Singh, residents of House
No.46, Dyal Nagar, Jalandhar.
.....Respondents no.1&2/Complainants
3. M/s Amarjeet Multispeciality Hospital, G.T.B. Nagar, Near Guru
Ravi Dass Chowk Jalandhar owned by Mrs. Amarjeet Singh.
4. Dr. Navjot Singh Dahyia, Administrator of the Hospital owned by
opposite party no.1.
.....Respondents no.3&4/Opposite parties no.1&2
First Appeal against order dated
15.05.2012 passed by the District
Consumer Disputes Redressal Forum,
Jalandhar.
Quorum:-
First Appeal No.1084 of 2012 3
Shri J. S. Klar, Presiding Judicial Member
Shri. V.K. Gupta, Member Present:-
For the appellant : Sh. Sunil Salhotra, Advocate For respondents no.1&2 : Sh. H.S. Thiara, Advocate For respondents no.3&4 : None ................................................ J.S KLAR, PRESIDING JUDICIAL MEMBER :-
By this common order, we intend to dispose of the above referred three connected first appeals, as they have arisen out of the same order of the District Consumer Disputes Redressal Forum, Jalandhar (in short 'the District Forum') dated 15.05.2012. The order shall be pronounced by us in main first appeal no.1084 of 2012 titled as "Dr. Kirpal Singh & another Vs. Amarjit Multispeciality Hospital & others".
2. The appellant of first appeal no.1084 of 2012 (complainants in the complaint) have directed this appeal against respondents herein (opposite parties in the complaint) for enhancement of compensation awarded by the District Forum, vide order dated 15.05.2012.
3. First appeal no.1097 of 2012 has been filed by the appellant of this appeal (opposite party no.1 in the complaint) against the respondents no.1&2 herein (the complainants in the complaint) and against respondents no.3 & 4 of this appeal (the opposite parties no.2 & 3 in the complaint), assailing order dated 15.05.2012 of District Consumer Disputes Redressal Forum Jalandhar, vide which, the complaint of the complainant was accepted against OPs no.1 First Appeal No.1084 of 2012 4 and 3 by directing them to pay compensation of Rs.1,00,000/- jointly and severally and dismissed qua OP no.2.
4. First appeal no.1209 of 2012 has been filed by the appellant of this appeal (opposite party no.3 in the complaint) against respondents no.1&2 of this appeal (the complainants in the complaint) and respondents no.3 & 4 herein (opposite parties no.1 and 2 in the complaint), challenging order dated 15.05.2012 of District Consumer Disputes Redressal Forum, Jalandhar, vide which, the complaint of the complainant was accepted against OPs no.1 & 3 and dismissed qua OP no.2.
5. The complainants have filed the complaint under Section 12 of the Consumer Protection Act, 1986 (in short, "the Act") against the OPs on the averments that In the month of January 2010 son of complainants late Tajinder Pal Singh complained of breathlessness, dry cough and chest congestion etc., which resulted into change of voice and swelling of face. Dr. Kirpal Singh complainant no.1, the father of Tajinder Pal Singh is himself a physician, initially examined him clinically and treated him and also consulted various doctors and finally it was revealed that patient was suffering from Thymoma. It was further averred that Tajinder Pal Singh was immediate by taken to Rajiv Gandhi Cancer Institute and Research Centre at New Delhi on 24.02.2010. The patient was medically examined by the specialist medical doctors of said hospital and found that patient was suffering from Precursor T-cell Lymphoblast Lymphoma which is sort of cancer. Tajinder Pal Singh was admitted there on 02.03.2010 and First Appeal No.1084 of 2012 5 Dr. Dinesh Bhurani M.D., Haemato-Oncologist & Hematologist specialist treated the patient and confirmed the diagnose and he advised chemotherapy as UKALL-XII Protocol. The schedule prescribed by the said doctor was duly observed and accordingly the 1st dose of induction chemotherapy with inj. Daunorubicin and inj. Cytocristine was given on 03.03.2010 with prehydration, posthydration and antiemetics. The patient tolerated chemotherapy well and was discharged in good general condition on 05.03.2010. Tajinder Pal Singh since dead was again taken to Rajiv Gandhi Cancer Institute, Delhi on 10.03.2010 and 2nd dose of induction chemotherapy was given in day care. The patient visited in OPD of above hospital on 24.03.2010, 27.03.2010 and 29.03.2010 and some tests were conducted. Tajinder Pal Singh was again admitted in the above hospital on 29.03.2010 and after treatment, the patient was discharged in stable condition on 31.03.2010. The condition of Late Tajinder Pal Singh had improved a lot and he responded well to the medical treatment given at above hospital by the specialist doctors. The doctors advised that the follow-up treatment could be conducted at any place as convenient to the patient as per UKALL- XII Protocol schedule. Late Tajinder Pal Singh had recovered considerably from the disease, as per the CT Scan report dated 12.04.2010. As per advice of doctors of above hospital, the patient was taken to Mohan Dai Oswal Cancer Treatment & Research Foundation, Ludhiana on 20.04.2010 for phase II (week 5-9) treatment and admitted there on 20.04.2010 and was discharged on First Appeal No.1084 of 2012 6 22.04.2010. It was further alleged that in the meantime; OP no.3 came into contact with complainant no.1. OP no.3 was then working at Amarjeet Multispeciality Hospital at Jalandhar and claimed himself to be medical Oncologist & Hematologist with fellowship in clinical oncology & Hemto-Oncology from Tata Memorial Hospital, Mumbai and he assured the complainants that he was competent to treat such type of patients and had already treated a number of such patients. Complainant no.1 took late Tajinder Pal Singh to OP no.3 for follow-up Post Therapy treatment and shown the various reports regarding the treatment given to the patient by Rajiv Gandhi Cancer Institute Delhi for follow up of the treatment. After scrutinizing the report, discharge summaries, CT scan reports and UKALL-XII protocol, OP no.3 assured the complainants that he would administer the prescribed injections and medicines, as detailed in protocol and also assured that he was well versed with the line of treatment to be given and also guaranteed that the hospital was well equipped to handle such treatment. Late Tajinder Pal Singh was admitted in the hospital of OP no.1 on 21.06.2010, where OP no.3 was working as a duty doctor for the treatment of patients of oncology. According to protocol, MTX 12.5 mg was advised to inject in intrathecal of the patient, but OP no.3 had given this dose 1.2 gm, which was 100 times more than the prescribed dose. Another inj. Methotrexate I/V 600 mg was advised in divided doses and it was also instructed in the protocol that the G.F.R. should be tested after 1st dose, but without following the instructions, OP no.3 given 2nd First Appeal No.1084 of 2012 7 dose of 54-mg instead of 600 mg, which was 9 times higher than prescribed dose. The above doses were given to the patient Tajinder Pal Singh, since deceased without testing G.F.R. and lack of required/essential equipments, efficient and qualified staff and mandatory infrastructure, which was required for treatment of such type of patients. It was further averred that patient was administered various injections, syrups with other medicines and also various clinical tests were conducted, but the condition of the patient deteriorated and became serious. OP no.3 assured the complainants that treatment was going on as per protocol. On 01.07.2010, OPs told the complainants that the patient had developed serious complications and was not responding to the treatment and the situation was beyond their control to handle such complications and hence advised to shift the patient from their hospital to any other hospital. The complainants took Late Tajinder Pal Singh to Mohan Dai Oswal Cancer Hospital at Ludhiana in critical condition and the patient was admitted there on 02.07.2010. The concerned doctors asked complainant no.1 to produce the case record maintained by the OPs and complainant no.1 rushed to Jalandhar and requested Hospital authorities of OP no.1 to deliver the record. The Manager was hesitant to deliver the record, but ultimately handed it over to complainant no.1. The said record showed number of cuttings and over-writings on the doses of the aforesaid injections. After examining the patient and record, doctors of Mohan Dai Hospital verbally told complainant no.1 that the condition of the patient had First Appeal No.1084 of 2012 8 deteriorated due to overdose of the injection Methotrexate and other medicines and due to poor post chemotherapy treatment and referred the patient to higher Centre i.e Jaslok Cancer Hospital, Mumbai for further treatment, because the treatment was beyond their control. Accordingly; the patient was discharged on 05.07.2010. Tajinder Pal Singh was taken to Jaslok Hospital Mumbai on 07.07.2010, where number of tests were conducted, but the patient could not survive and died on 09.07.2010 at 12:20 A.M. at Jaslok Hospital & Research Centre, Mumbai due to multi dysfunction with febrile neutropenia. The complainants have alleged medical negligence on the part of OPs, because OP no.3 is not a qualified doctor of above treatment and he was confused with the exact dose to be administered to patient and OP no.1 hospital have no mandatory equipment for administering the dose and other infrastructure, which was mandatory. The complainants have, thus, prayed that OPs be directed to pay Rs.20,000,00/- alongwith interest from the date of filing the complaint till the date of realization for medical negligence.
6. Upon notice, OP no.1 appeared and filed separate written reply and contested the complaint of the complainant vehemently. It was averred in preliminary objections that complainants have not given the name and address of the person through whom they wanted to implead OP no.1. The complainants wrongly impleaded OP no.1, through Mrs. Amarjeet Singh with giving any description. It was further averred that she has no concern with First Appeal No.1084 of 2012 9 OP no.1. The complainants have not approached the Forum with clean hands and complaint has been filed with malafide intention and is not maintainable. On merits, OP no.1 further pleaded that complaint could be filed through competent authorized representative of OP no.1 only, who should be conversant with the facts of the case. Any medical negligence was vehemently denied by OP no.1 on the part of OP no.1. The answering OP controverted the other averments of the complainants and prayed for the dismissal of the complaint.
7. OP no.2 filed his separate written reply and contested the complaint of the complainant vehemently. It was averred in preliminary objections by OP no.2 that complaint is bad for misjoinder and non-joinder of the parties. OP no.2 is not the administrator of OP no.1 hospital. OP no.2 is only employee of OP no.1, being orthopedic surgeon. OP no.2 is not connected in any manner with administration of OP no.1. It was further pleaded that complainants never met with him for consultation for treatment of his son. The complainants unnecessarily dragged OP no.2 in litigation just to tarnish his professional image. It was further averred that complainants themselves treated Tajinder Pal Singh for almost three months in consultation with various doctors after detecting his disease and thereafter getting his treatment from Rajiv Gandhi Cancer Institute at Delhi for about one month and thereafter two and half months treatment from Mohan Dai Oswal Cancer Hospital at Ludhiana and finally at Jaslok Hospital and Research Centre, First Appeal No.1084 of 2012 10 Mumbai in July 2010. Tejinder Pal Singh was kept admitted in OP no.1 hospital just for one week. Any medical negligence or deficient service was denied on the part of OP no.1 and 2. OP no.2 prayed for the dismissal of the complaint of the complainants by controverting the averments regarding medical negligence.
8. OP no.3 filed his separate written reply and contested the complaint of the complainant. It was averred in preliminary objections that complainants filed the complaint on cooked up story. The complaint is alleged to be false and frivolous and is not maintainable. It was further averred that complainants are not the consumers under the Act and no scientific, specific and justified allegations regarding medical negligence or deficient service have been made out in the complaint by the complainants. The complaint is not supported by any medical expert opinion, as per settled law by the Apex Court in case titled as "Martin F D'Souza Vs. Mohd. Ishfaq" that it is essential to annex medical expert opinion before a notice is issued to the doctor/hospital in order to enable the Courts/Consumer Forum to see whether prima facie a case of medical negligence is made out or not. There is no expert evidence on the record to prove any medical negligence against the OPs. The complaint has been filed by the complainants without any support of scientific literature in this regard. The complainants have not impleaded Rajiv Gandhi Cancer Institute & Research Centre, Sector V, Rohini, Delhi, ii) Mohan Dai Oswal Cancer Treatment & Research Foundation, GT Road, Sherpur, By Pass Ludhiana, ii) Fortis Hospital First Appeal No.1084 of 2012 11 (details of addressed to be given by the complainants) and iv) Jaslok Hospital & Research Centre, Mumbai (details and other particulars to be provided by the complainants) as a parties, where Tajinder Pal Singh was taken and treated. OP no.3 is a well accredited doctor in this line of profession. On merits, OP no.3 denied any medical negligence or deficient service on his part. It was further pleaded that no material has been brought out by the complainants of medical negligence. Patient was taken to Rajiv Gandhi Hospital at Delhi on 24.02.2010, as per complainants, but the patient was taken to said hospital on 13.02.2010, as per incomplete discharge ticket issued by the said hospital. It was further alleged that Tajinder Pal Singh was admitted in Mohan Dai Oswal Hospital on 20.04.2010 and was discharged on 22.04.2010 (within two days), whereas the treatment duration for the phase 2 was one month (week 5), according to the protocol (UK-ALL X11). The complete details were not provided by the complainants where the rest of treatment was given to the patient. OP no.3 was working in the hospital of OP no.1, but no document has been placed on record for any deficiency service was provided. It was further pleaded that OP no.1 hospital is well equipped with all such facilities. The complainants are trying to make out a case from a chart prepared by the secondary nursing staff, who probably has miswritten 'gm' instead of 'mg'. The written remarks do not attribute any cause committed by OP no.3 and secondly the answering OP is a very experienced and able doctor and he cannot even think of committing such act in his dreams to deviate from the First Appeal No.1084 of 2012 12 protocol or procedure involved in the matter. The medication or the medicine in the procedure was injected intrathecally in the patient. No such methodology or apparatus is available to induce 100 times more medicine than the one prescribed in the protocol. Infact, it is not humanely possible to induce such amount of medication via intrathecal. An error of the lower nursing staff while writing the data on a piece of sheet could not come to any assistance of the complainants. There is no document to prove that cause of death was due to overdose of medicine. The answering OP attended on the deceased with utmost care, caution and skills and performed the procedure with reasonable degree of skill and knowledge. The survival rate in these kind of diseases (cancer) in India is about 30- 40%. Tajinder Pal Singh could not be saved due to typical disease. OP no.3 controverted the other averments of the complainants and prayed for the dismissal of the complaint.
9. The complainants tendered in evidence affidavit Ex.C- 1/A alongwith documents Ex.C-1 to C-9 and closed the evidence. As against it, OPs no.1 & 2 tendered in evidence affidavits Ex.OP-A and Ex.OP-B and closed the evidence. OP no.3 tendered in evidence affidavit and document Ex.R-3 and R-4. OP no.3 tendered in evidence affidavit Ex.OP-C alongwith documents Ex.O-1 to Ex.O-47 and closed the evidence. On conclusion of evidence and arguments, the District Forum accepted the complaint of the complainant, as referred to above. Dissatisfied with the order of the District Forum First Appeal No.1084 of 2012 13 Jalandhar three above referred separate appeals have been preferred against the same.
10. We have heard the learned counsel for the parties and have also examined the record of the case. Evidence on the record is required to be examined by us to decide the controversy in this case. Affidavit of Dr. Kirpal Singh Ex.C-1/A is on the record. He deposed in his affidavit the averments, as pleaded in the complaint by him instead of writing a detailed affidavit. Complainant no.1 Kirpal Singh swore the averments contained in complaint as true. Ex.C-1 is the discharge summary of Tejinder Pal Singh issued by Rajiv Gandhi Cancer Institute & Research Centre, Delhi. The brief summary of the case is recorded as under:
" The parient is 28 years old normotensive, nondiabetic male presented in Medical Oncology Department with past h/o breathlessness, dry cough, change of voice and swelling of face since two months. He was evaluated at Fortis Hospital at Jalandhar. Biopsy showed thymoma. He received 18Gy/6 days since 03.02.2010. He came to RGCI on 13.02.2010 with c/o breathlessness.
On examination, PS 1, fully oriented, afebrile, vitals; stable, CNS/Chest/CVS/P/A/:NAD.
Work up: Review of outside slide (16/02/2010): Precursor T-cell lymphoblastic lymphoma. IHC showed tumor cells express LCA, First Appeal No.1084 of 2012 14 TdT, CD3, and CD2. Immunohistochemical stain with CK (Polyclonal CK) fails to demonstrate epithelial element in the biopsy tissue.
Bone Marrow Aspiration (20/02/2010): Mildly hypercellular marrow with trilineage haematopoiesis and no abnormal cells. PET CT (24/02/10): No metabolically active residual/recurrent disease. Metabilically inactive morphological abnormality in mediastinum.
The UKALL-XII PROTOCOL is as under:
Induction Phase 1 (week 1-4) Inj MTX 12.5 mg on Day 1 (Intrathecal with CSF sampling) (Date: ) Inj Daunorubicin 60mg/m2 Day 1,8,15,22 (Date: ) Inj Vincristine 1.4 mg/m2 (max 2) Day 1,8,15,22 (Date: ) Tab Dexona 10mg/m2 Day 1-5, Day 11-15 (Date: ) Inj Leunase 10,000U Day 17-26 (Date: ) BMA & Biopsy on Day 28 or after blood counts recover (Date: ) Phase II (week 5-9) (TLC>3000 & PLT>1,00,000) (Start irrespective of BMA report) Inj Cyclophosphamide 650 mg/m2 in 250 ml NS IV x 30 mins Day 1,15 & 29 (Date: ) Inj ARA-C75 mg/m2 IV in 100ml NS Day1-4, 8-11, 15-18, 22-25 (Date: ) Tab 6MP 60mg/m2 Day 1-28 First Appeal No.1084 of 2012 15 Inj MTX 12.5 mg Day 1,7,14 & 21 (Intrathecal), CSF examination (Date: ) Intensification Week 11-14 (TLC>3000 & PLT>1,00,000) Inj Methotrexate 3mg/m2 Day 1,8,22 with leucovorin rescue day 1,8 (Delay next dose if TLC & Platelets count are less, GCSF may be given) Inj Leunase 10,000 IU (IM) on Day 2,9 (Date: ) Dose modification of MTX GFR>50ml/min normal dose 10-50 ml/min half dose <10 ml/min do not give CNS RT: 24Gy/12# with inj Ara-C 50mg (Intrathecal) weeklyx4 doses over 16-19 days (Date: ) Ex.C-3 is the copy of Discharge Summary of Tajinder Pal Singh by Mohan Dai Oswal Cancer Treatment & Research showing present complain(s) as K/C O lymphoblastic lymphoma, patient came here for chemotherapy and going well. Treatment given: CCT was given on 19.04.2010, Inj Cystar 160 mg S/C OD, Inj Endoxan, Tab 6MP 125 mg, Inj Methydtroate. Couse in Hospital satisfactory. Advice at Discharge: Tab 6MP 125 mg OD 5days, Inj cystar 160 mg S/C OD *2 days, Tab roles 20 mg OD *7 days, Tab periset 8mg BD * 3days After 24 hours of CCT. Ex.C-4 is the copy of case record of Tajinder Pal Singh by Amarjit Multispeciality Hospital OP no.1 and name of doctor incharge recorded in it as Dr. Rajesh Khurana (M.D.) OP First Appeal No.1084 of 2012 16 no.3. The treatment sheet prepared by the hospital of OP no.1, where OP no.3 was employed, recorded DNS-500 ml (I/V (over 2 hrs) at 6 AM, T.T-MTX 1.2gm (send pt. to minor O.T at 10:45AM) was given. The submission of OP no.3 is that this treatment record has been prepared by some nurse, which cannot be binding upon OP no.3. We do not find any force in it, because OP no.3 is employed as doctor with OP no.1 and this hospital record of OP no.1 cannot be without any substance on the file, we reject this submission of OP no.3 that it was prepared by some nurse and would not of any consequence. The discharge summary by Mohan Dai Oswal Cancer Hospital of Tajinder Pal Singh Ex.C-5 is on the record. The death certificate of Tajinder Pal Singh is Ex.C-6 proving that he died on 09.07.2010. The prescription slip prepared by OP no.3 Dr. Rajesh Khurana, M.D. dealing with Medical Oncologist & Hematologist fellowship in Clinical Oncology & Hemto-Oncology from Tata Memorial Hospital Mumbai is Ex.C-7 on the record.
Certain medications have been provided on this slip Ex.C-7. Ex.C-8 is the copy of visiting card of OP no.3 showing the name of OP no.1 hospital as cancer cure clinic and OP no.3 shown as MD, Medical Oncologist & Hematologist. Ex.C-9 is the copy of pamphlet of OP no.1 hospital with name of Dr. Rajesh Khurana OP no.3 regarding important risk factors of cancer. The submission of counsel for the complainants before us is that Dr. Rajesh Khurana OP no.3 was not holding a degree of M.D. Medical Oncologist & Hematologist and without holding such requisite qualifications; he gave treatment to First Appeal No.1084 of 2012 17 Tajinder Pal Singh deceased by giving over-doses of T.T.MTX 1.2 gm and injections instead of prescribed doses of these medicines, vide Ex.C-2, which shows medical negligence on his part.
11. OPs relied upon affidavit of Arvinder Kaur wife of Amarjeet Singh Ex.OP-A on the record that she has no concern with OP no.1 hospital. She further deposed that her husband Amarjeet Singh since died worked with OP no.1 hospital during his life time. The complainants wrongly impleaded her without any cause of action. Ex.OP-B is the affidavit of Dr. Navjot Singh Dahyia. He stated in this affidavit that he is orthopaedic surgeon and employee of OP no.1. He further stated that Amrinder Kaur was wife of his doctor colleague, who worked with him. Amrinder Kaur is a house wife not the owner of OP no.1. This witness has stated that neither she is administrator not has got any concern with treatment given by Tajinder Pal Singh in the hospital. The material evidence on the record is affidavit of Dr. Rajesh Khurana OP no.3 Ex.OP-C. This witness has stated that Tajinder Pal Singh was treated in Rajiv Gandhi Cancer Institute at Delhi, Mohan Dai Oswal Cancer Hospital at Ludhiana and Fortis Hospital and Jaslok Hospital at Mumbai, details thereof were to be provided by the complainants. He further stated that he is a well-accredited doctor in this line of profession and complaint has been filed just to defame him. He placed on record his credentials by means of copies of self attested certificates Ex.O-32 to O-46 on the record. From perusal of his degree Ex.O40, it is proved that he is Bechelor of Medicine and bachelor of surgery, First Appeal No.1084 of 2012 18 which he passed in the year 1997 from University of Mysore. He is, thus, proved MBBS doctor, as per degree O-40. Ex.O-46 is the copy of certificate of registration in the name of OP no.1 issued by The Rajasthan Medical Council, Jaipur. O-40 is the copy of recommendation of Dr. Rajesh Khurana by Tata Memorial Centre, as he joined as a Junior Registrar III in the Department of Medical Oncology at the Tata Memorial Hospital, Mumbai in January 2004 and worked till October 2005. O-42 and O-43 certificates issued by Ameri Cares India to the effect that Dr. Rajesh took the lead in academic programmes and conferences and he is an active member of two important Indian Oncology Societies- ICON and ISMPO. O-41 is copy of recommendation of Dr. Rajesh Khurana for clinical fellowship/attachment Programme in the Department of Medical Oncology by Dr. Naresh Somani, MD (Medicine), DM (Oncology) of Bhagwan Mahaveer Cancer Hospital & Research Centre, J.L.N. Marg, Jaipur-17 India. O-37 is the copy of testimonial of Dr. Rajesh Khurana issued by Bhagwan Mahaveer Cancer Hospital & Research Centre. O-38 is the copy of experience certificate of OP no.3 issued by Bhagwan Mahaveer Cancer Hospital & Research Centre.O-36 is the copy of attending certificate of training program in Pain & Palliative Care by Tata Memorial Centre Mumbai. O-35 is the copy of experience certificate of OP no.3 as Junior Medical Oncologist from 01.11.2005 to 26.12.2006 issued by Patel Hospital Pvt. Ltd. Jalandhar. O-34 is the copy of certificate issued by Rungta Hospital Jaipur in favour of OP no.3 that he worked in the hospital as junior First Appeal No.1084 of 2012 19 resident doctor from November 1998 to October 1999. O-33 is the copy of academic certificate of Rajesh Khurana. O-32 is the copy of internship certificate of OP no.3 on the record. This certificate has proved that he passed final MBBS examination of the University of Mysore and satisfactorily completed the compulsory rotating internship (one year programme) as a resident intern from 25.09.1997 to 06.11.1998. This certificate issued by Jagadguru Sri Shivarathreeshwara Medical College. Ex.O-1 to O-14 are the reports of Tajinder Pal Singh deceases. Ex.O-30 is the overview of lymphoblastic leukemias/lymphomas are neoplasms of precursor T cells and B cells or lymphoblasts. Identification of prognostic factors for patients with lymphoblastic lymphoma has been inconsistent in part because of the lack of a clear distinction between acute lymphoblastic leukemia (ALL) and lymphoblastic lymphoma, as well as distinguishing between adult and pediatric cases. Based on the potential for early treatment intensification, identification of reliable prognostic factors for clinical trial risk stratification is crucial.
12. From careful evaluation of above referred evidence on the record and hearing the respective submissions of counsel for the parties, we find substance in the contention of counsel for the complainants that Dr. Rajesh Khurana OP no.3 proclaimed himself to be specialist doctor in oncology. This assertion on the part of OP no.3 has not been proved on the record in our view. OP no.3 has not placed on record any M.D. Degree in oncology proving him to be specialist doctor in oncology. He is merely a bachelor in medicine First Appeal No.1084 of 2012 20 and bachelor in surgery, as per evidence, as discussed above. No doubt he has been given some experience certificates and credentials by some hospitals, where he worked as junior resident. As far as the point that he was a specialist in oncology is concerned, the same has not been proved on record in this case by him. The averment of complainants that he is not a specialist doctor is established on the record, because OP no.3 could not dislodge this evidence by means of contrary evidence that he is specialist in oncology and did his master's degree in that branch of medicine/treatment. OP no.3 has been proclaiming himself to be MD doctor and this fact is abundantly clear on the record, as per the documents Ex.C-4, the indoor patient file and Ex.C-8 and C-9. OP no.3 has, thus, no authority to write himself a specialist being MD doctor to dabble with the patients of cancer. He is supposed to represent his true qualifications to the patents. Had he been a specialist doctor in oncology, he must have produced on record his degree to this effect. The District Forum has, thus rightly recorded findings that he is not a specialist doctor as he has not obtained his MD degree in oncology from any recognized University or Institute in the Country.
13. The District Forum also recorded findings of negligence on the part of OP no.3 on the ground that he gave over doses of the drug to Tajinder Pal Singh. On this point, the submissions of both sides have been duly considered by us, we find weightage in the contention advanced at bar by counsel for the complainants. From First Appeal No.1084 of 2012 21 the UKALL-XII Ptotocol, vide Ex.C-2 in phase II, Inj MTX 12.5mg day-1, 7, 14 & 21 were prescribed. Here as per the record prepared by OP no.1 under the supervision of OP no.3 with regard to the treatment provided to Tajinder Pal Singh, it is recorded in Ex.C-4 that T.T.-MTX 1.2gm was administered to the patient. The counsel for OP no.3 could not establish that under any protocol IT-MTX 1.2gm, which is quite higher dose as compared to 12.5 mg was prescribed for Tajinder Pal Singh. The submission of counsel for OP no.3 is that it is due to clerical error in the record prepared by the staff nurse. Whatever the case may be; this is the record prepared by OP no.1 and OP no.3 was the doctor in control and this record cannot be ignored by us. The District Forum has, thus, rightly observed that OP no.3 gave overdoses of the above medicines, which is nine times higher than prescribed dose. We do not find any illegality or material irregularity in the findings recorded by the District Forum, because OP no.1 hospital is vicariously responsible for the deficient and negligent act of OP no.3. The District Forum has rightly imposed the compensation of Rs.1 lakh on OP no.1 and 3 by excluding or discharging the liability of OP no.2 in this case. We are in agreement with the findings of the District Forum under challenge in this case. There is no reason to interfere with the order of the District Forum in the appeal.
14. As a result of our above discussion, we find no merit in first appeal no.1084 of 2014 filed by the complainants for enhancement of compensation and first appeal no.1097 of 2012 filed First Appeal No.1084 of 2012 22 by OP no.1 and first appeal no.1209 of 2012 filed by OP no.3 and all the three appeals are hereby dismissed.
15. The appellant of first appeal no.1097 of 2012 had deposited the amount of Rs.25,000/- with this Commission at the time of filing the appeal. This amount alongwith interest, which accrued thereon, if any, be remitted by the Registry to respondents no.1 and 2 of this appeal in equal share by way of a crossed cheque/demand draft after the expiry of 45 days.
16. The appellant of first appeal no.1209 of 2012 had deposited the amount of Rs.25,000/- with this Commission at the time of filing the appeal. This amount alongwith interest, which accrued thereon, if any, be remitted by the Registry to respondents no.1 and 2 of this appeal in equal share by way of a crossed cheque/demand draft after the expiry of 45 days.
17. Arguments in above referred appeals were heard on 28.04.2016 and the orders were reserved. Copies of the orders be communicated to the parties as per rules. The appeals could not be decided within the statutory period due to heavy pendency of court cases.
(J. S. KLAR)
PRESIDING JUDICIAL MEMBER
May 02, 2015 (V.K. GUPTA)
MM MEMBER