National Consumer Disputes Redressal
Dr. K. Vidhyullatha vs R. Bhagawathy on 25 January, 2005
Equivalent citations: I(2006)CPJ136(NC)
ORDER
S.N. Kapoor, Presiding Member
1. This appeal is directed against an order of the Andhra Pradesh State Consumer Disputes Redressal Commission, Hyderabad, in C.D. No. 21 of 1992 dated 9.2.2001 directing the opposite party appellant to pay a sum of Rs. 1,00,000 towards damages and Rs. 50,000 spent on dialysis and other medical and hospital charges totalling to Rs. 1,50,000 with interest @ 12% p.a. from the date of complaint till the date of payment.
2. The facts giving an occasion to this appeal are in brief as under:
Smt. R. Bhagawathy (the complainant) approached Dr. K. Vidhyullatha of the Latha Hospital, Gajuwaka, Vishakhapatnam, on account of pain in her abdomen. Dr. K. Vidhyulatha after examining diagnosed the disease as abdominal hysterectomy after using the prescribed medicines for about 3 or 4 months. There was no improvement. As advised by Dr. K. Vidhyullatha she was operated upon on 13th December, 1990. One bottle of A + blood group was transfused. The complainant suddenly felt extremely uneasy and despite complaints the second opposite party did not pay any heed. Urine also stopped on 13th December, 1990 and she started passing blood. On 17th December, 1990 when her condition became serious she was shifted to Seven Hills Hospital, Vishakhapatnam. There the doctors found that the complainant was administered mismatched blood as the complainant's blood group was O+. Acute renal failure occurred. Intravascular haemodialysis was done and she survived. It is claimed that due to carelessness and negligence on the part of the second opposite party Dr. K. Vidhyullatha the complainant had to face serious setback in health, spent huge amounts, suffered mental agony and haemolysis. She issued notice dated 15th May, 1991 and claimed Rs. 4.00 lakh but without any success. Ultimately, she filed complaint.
3. The opposite parties denied the allegations that she visited second opposite party appellant as such conducting hysterectomy did not arise. She approached during 1986-87 for appendicitis operation which was successfully done. In nutshell, the opposite parties denied each and every allegation made by the complainant and claimed that there was neither any deficiency of service nor they were liable to pay any compensation.
4. The State Commission considered the following three points:
(1) Whether the second opposite party conducted abdominal hysterectomy on the complaint on 12.12.1990?
(2) Whether she transfused one bottle of A+ group of blood to the complainant and consequently there was renal failure of the complainant?
(3) If so, to what relief the complainant is entitled to?
5. The State Commission after considering the evidence came to the conclusion that there was no proven deficiency on the part of Dr. K. Ramakrishna and only second opposite party was squarely responsible for the trauma suffered by the complainant.
6. Having heard the parties' Counsel at considerable length and seeing the record and the documents filed by the parties, we find that there is more than sufficient corroborative pieces of evidence against the appellant to show that she (sic) (Smt. R. Bhagawathy) was admitted for operation on 13th December, 1990, given one bottle of A+ group of blood and later on referred to the Seven Hills Hospital. These facts are corroborated not only by the evidence of the complainant and her husband but also the circumstances. Firstly, there is no reason for the complainant to state anything without any reason against the appellant Dr. K. Vidhyullatha. There could not be any denial that the complainant was taken to Seven Hills Hospital. The referral which is denied by the appellant gives the tell-tale story about the circumstances in which the reference was made. The appellant's husband denied the writing and signature on the reference made. It is not very unusual in view of the fact that defence mechanism response is always to save ones own skin. That letter indicates that abdominal hysterectomy was done on 13th December, 1990. Haemolysis was found, blood urea was 135 mg. That referral was made to Dr. Murari Krishna Rao Garu who was none but a Nephrologist. Dr. K.M.K. Rao was the Urologist in Seven Hills Hospital. It is further stated that according the statement of appellant she did not know Dr. K. Murali Krishna Rao and she heard of Dr. B. Subba Rao, Urologist, in Seven Hills Hospital but she claimed that she did not know much about him. She did not remember whether the blood grouping of blood sample of the complainant was done in the laboratory attached to her hospital in December, 1990. She admitted that Latha Hospital was not equipped with the facilities to carry out investigations when haematuria developed in 1990. Depending upon the results of the investigation if it becomes necessary haemodialysis would have to be done by Urologist. During the years 1989-90 Seven Hills Hospital might have had haemodyalisis facilities. She did not know whether at that time any other hospital at Visakhapatnam was during that facility. She denied that she referred the complainant to Seven Hills Hospital because she developed complications.
7. Dr. K. Ramakrishna in his cross-examination stated thathysterectomy operation subsequently performed on the complainant was not done by him and he was in no way concerned with the said operation. He was not present when that (hysterectomy) operation was performed on the complainant. He did not know whether blood was required when hysterectomy operation was performed on the complainant. He admitted that it was true when there was internal bleeding during operation of after operation blood-transfusion would become necessary. The most interesting part of his cross-examination is that he did not know whether the appellant his wife performed hysterectomy operation on the complainant Smt. R. Bhagawathy. He denied the suggestion that when the complainant developed complication because of mis-matching of blood administered to her at the time when she was operated by the appellant, he wrote the referral letter to Dr. K. Murali Krishna of Seven Hills Hospital and that his wife signed that letter.
8. The appellant also stated that she did not know the name of technician who worked in that laboratory in December, 1990. She has also just feigned ignorance on the pretext of loss of memory whether the blood grouping on the complainant was done in the laboratory attached to their hospital in December, 1990 or not.
9. The way the appellant and the husband of the appellant and one of the opposite parties answered speaks volumes about the questionable testimony of the appellant and her husband for the circumstances are speaking themselves very loudly against them.
10. It may be mentioned that there was no reason for any person to forge the referral and no specific reason of professional jealousy, etc. has been alleged.
11. Dr. B. Subba Rao supported the case of the complainant and stated that when he was working in Seven Hills Hospital as Nephrologist, Mrs. Bhagavathy was brought to the Seven Hills Hospital with a referral letter from Latha Hospital, Gajuwaka, Vishakhapatnam to Dr. K. Murali Krishna Rao, Consultant Urologist who was working at that time in the same hospital for evaluation of haematuria and acute renal failure following abdominal hysterectomy after 1 unit of A positive blood transfusion on the first postoperative day. The referral letter was signed by Dr. P.S. Krupakar, CMO of BHPV, Vishakhapatnam Dr. Vidyulatha, Obstetrician and Gynaecologist of that hospital. Mrs. Bhagavathy was admitted under his care. Investigations revealed severe renal failure and, enlarged and echogenic kidneys. The diagnosis of acute renal failure due to intravascular haemodialysis and she was discharged on 21st January, 1991. In his cross-examinationhe stated that he came to know that the operation was performed at Latha hospital at Gajuwaka near Vishakhapatnam. Kidney failure could be detected by blood test. From ultrasound report (Exhibit A-5) dated 17th December, 1990 it is apparent that the kidneys were normal. Blood group of the complainant was found 'O' positive on the repeated tests conducted immediately after the complainant was brought to Seven Hills Hospital 24 hours thereafter and 48 hours thereafter. According to Dr. B. Subba Rao transfusion of 400 ml of blood of a different group to a person will not change the original blood group of that person. However, since Dr. Subba Rao did not know Dr. K. Vidyulatha, he could not recognize her signature from Exhibit A-6.
12. From the evidence on record, there is no complaint about the negligence in conducting hysterectomy operation. The only complaint against the appellant was that the blood group of 'A' positive was transfused, haemolysis developed and urine stopped, and despite the complaint made the appelant did not bother. It is apparent from the statement of the complainant and her husband and the circumstances that the complainant was referred to the Seven Hills Hospital at the instance of the appellant and her husband after hysterectomy operation and development of haemolysis and passing of the blood. The high blood urea indicated renal failure which was ultimately found to be acute.
13. In the overwhelming circumstances mentioned hereinabove, the conduct of the appellant and her husband was bald denial, non-production of the medical record indicates the guilty consciousness on the part of the appellant on one hand and this guilt has been substantially established by the complainant and her witnesses. This is further corroborated by the fact that Annexure A-1 appears to be written by a technician of Latha Hospital. The blood group was 'A' positive and haemoglobin was 10.4 gms. It is apparent that the blood test was done at the instance of the appellant. It was submitted by the learned Counsel for the appellant that if the haemoglobin was 10.4 gms. there was no need to transfuse blood. "Yes" to a certain extent he is right but it conveniently ignores the fact that the complainant stated that blood had passed after the operation and consequently blood would have been required to be transfused. This negates the submission that the blood was not needed to be transfused. There was certainly something wrong in blood matching for there were three blood reports as stated by Dr. Subba Rao indicating that the patient complainant was having 'O' positive blood group. We accept the complainant's version and that 'A' blood group was administered though the complainant having 'O' positive blood group. It would indicate the fault of the technician in testing the blood. The appellant and her husband are undisputedly the owners of the hospital. The appellant transfused the blood consequently she could not escape the responsibility of the failure of technician in the hospital and in transfusing the blood of 'A' positive blood group. In Harjot Ahluwalia (Minor through his parents) v. Mis. Spring Meadows Hospital and Ors., II (1997) CPJ 98 (NC), the Hon'ble Supreme Court has observed:
That the staff attending on the patient discharge their duties and work on the patient under the control, guidance and supervision of the consultant/doctor under whose treatment, care and supervision the patient is admitted.
14. It may further be mentioned that if the complainant was not able to pass urine after surgery then the principle of res ipsa loquitur would be attracted and deficiency in service would stand proved. Consequently, the appellant cannot escape the blame for deficiency in medical services. There could again be no doubt that administering blood of 'A' positive group to a patient having 'O' positive blood group would certainly amount to deficiency in service. The acute renal failure occurred due to intra-vascular haemolysis.
15. It was not suggested to Dr. Subba Rao that it was not due to administration of 'A' positive blood group to a patient having 'O' positive blood group. In this light, it is apparent that the acute renal failure was caused due to intra-vasular haemolysis caused by administration of 400 mgs. blood of 'A' positive to the complainant.
16. Coming to the compensation part, as has been mentioned earlier, the complainant claimed a sum of Rs. 3,50,000 by way of compensation for loss of amenities, loss of life span, etc. and together with a sum of Rs. 50,000 towards past and future medical expenses. It was alleged that the complainant was not fit for conjugal rights and she was condemned to a perpetual misery due to carelessness and negligence on the part of the opposite party appellant.
17. In so far as allegation that the complainant was not fit for conjugal rights and she is condemned to a perpetual misery due to carelessness and negligence on the part of the opposite party appellant, we would just like to say that there is no evidence from the side of the complainant that hysterectomy was not necessary in the circumstances. In which the complainant allegedly suffered the continuous abdominal pain. As such this part of the allegation has to be ignored while awarding compensation.
18. In evidence which has been produced about the expenditure on medical treatment, there is no documentary evidence about the expenditure incurred by the husband of the complainant. It is also stated that the complainant's husband was employed with Bharat Heavy Plate and Vessels Limited, Vishakhapatnam, as Upper Division Clerk and the appellant was an authorized medical attendant to treat the patients employees of BHPV Ltd. and their family members. R. Venkata Rao also stated the same lines. The appellant also admitted that she was panel doctor of BHPV Ltd. in about 1991. It would lead to an irresistible influence that the payments would have been made by the employer of the complainant's husband. There was acute renal failure as stated by Dr. Subba Rao. She was required to be put on dialysis on 7 or 8 times on every alternate day. Haemodialysis is a painful and complicated procedure keeping the patient as well as his attendants on tenterhooks and on toes. This procedure continued for a period from 17th December, 1990 till 21st January, 1991, i.e., nearly about a month.
19. While it is true as submitted by the learned Counsel for the appellant that the compensation could not be awarded on the basis of mere allegation. But amount of compensation in almost all cases is decided on the basis of fair estimation. While we think that for the mental tension and agony and acute renal failure, the learned State Commission might have justifiably estimated the total compensation amounting to Rs. 1,00,000, for we take the expenditure of Rs. 1,000 per day for haemodialysis it would not exceed Rs. 15,000 plus overhead expenses ranging from 7,000 to Rs. 7,500 in all. We feel that in the aforesaid circumstances, it would be appropriate to award a sum of Rs. 1,00,000 in all as compensation with interest @ 9% p.a. from the date of complaint till the date of deposit of a sum of Rs. 1,50,000. The complainant shall be entitled to receive the amount of Rs. 1,50,000 (sic) which is said to have been deposited with the Commission along with interest which would have accrued thereon and adjust the same towards the amount payable as aforesaid. With the aforesaid modification, the appeal stands disposed of.