State Consumer Disputes Redressal Commission
G.Syed Khan S/O.Late G.Nawaz Khan ... vs Dr.Desai Tippa Reddy, Desai Hospital on 26 June, 2013
BEFORE THE A BEFORE THE A.P.STATE CONSUMER DISPUTES REDRESSAL COMMISSION: AT HYDERABAD. F.A.No.17/2013 against C.C.No.26/2011 District Forum-I Chittoor Between 1. G.Syed Khan S/o.late G.Nawaz Khan 2. G.Shafiq Khan S/o.G.Syed Khan 3. G.Salma Fathima D/o.G.Syed Khan 4. G.Mohammed Siddiq Khan S/o.G.Syed Khan 5. G.Abdul Rehaman Khan S/o.G.Syed Khan The appellants 2 to 5 are minors, rep. by their father i.e. 1st appellant G.Syed Khan, aged about 56 years, R/o.Dr.No.4-400-B-12-6/9, Pyaranagar, Madanapalle, Chittoor District. Appellants/ Complainants And Dr.Desai Tippa Reddy, Desai Hospital, Near RTC Bus stand, Madanapalle Chittoor District. Respondent/ Opp.party Counsel for the Appellants : Mr K.Venkateswarlu Counsel for the Respondent: M/s.Md.Saleem QUORUM: SMT.M.SHREESHA, HONBLE Incharge President AND SRI T.ASHOK KUMAR, HONBLE MEMBER.
WEDNESDAY THE TWENTY SIXTH DAY OF JUNE TWO THOUSAND THIRTEEN Order (Per Smt.M.Shreesha, Honble Incharge President) *** Aggrieved by the order in C.C.No.26/2011 on the file of District Forum-I chittoor, the complainants preferred this appeal.
The brief facts as set out in the complaint are that the first complainant is the husband, complainants 2,4 and 5 are the sons and the third complainant is the daughter of late G.Naseema Fatima who was taken to OP hospital on 13-2-2010 at 10.45 am as she was suffering from fever. She underwent a blood test at Desai diagnostics and was diagnosed to be suffering from typhoid. On 14-2-2010 she was admitted as inpatient in OP hospital and he conducted several tests but the condition of the patient deteriorated yet she was discharged on 19-2-2010. Her condition become critical and on 20-2-2010 the complainants took her to St.Johns Medical College Bangalore and tried to admit her at 12.15 p.m. and she was diagnosed with complicated Malaria after blood tests and x-rays were taken and kept in hospital for two hours and gave initial treatment and as there was no response, they advised the first complainant to admit his wife in any Corporate hospital and the first complainant admitted her in Narayana Hrudayalaya, Bangalore as inpatient on 20-2-2010. After conducting all the necessary tests, including blood test, she was diagnosed to be suffering from Dengu Shock syndrome and made several efforts for improvement of her health but she did not respond and she died on 23-2-2010 The complainants submit that the Opposite party did not diagnose the fever properly and did not give proper treatment as a result of which late G.Naseema Fatima i.e. the patient herein died. A legal notice was sent on 21-4-2010 for which the opposite party replied on 12-5-21010 denying all allegations.
Hence the complaint seeking directions to the opposite party to pay Rs.10,00,000/- towards damages and costs.
Opposite party filed its written version stating that the O.P in their reply notice requested the complainants to send the outpatient card, the prescriptions and the investigation reports done as an inpatient in OP hospital together with investigation reports of St.Johns hospital, Bangalore and Narayana hospital but the complainant did not choose to send the same and therefore he cannot recollect the line of treatment given to the patient and prayed for dismissal of the complaint.
Based on the evidence adduced i.e. Exs.A1 to A10 and B1 to B3 and also the chief affidavits of the complainant and doctor in OP hospital and the pleadings put forward, the District Forum dismissed the complaint on the ground that there was no negligence.
Aggrieved by the said order, the complainant preferred this appeal.
The brief point that falls for consideration is whether there is any deficiency in service on behalf of the opposite parties and if the complainant is entitled for the relief claimed?
Both sides filed written arguments.
It is the complainants case that late G.Naseema Fatima was taken to OP hospital on 13-2-2010 and Ex.A1 is the out patient card evidencing the same and this out patient card shows that lab investigations with respect to Haemoglobin and Widal Test were done. Tab Falcego was given which is meant for Malaria along with an antibiotic and medicines for fever. Ex.A2 are the investigation reports in which widal test shows positive, the platelet count was Rs.2,50,000 lakhs cumm which reduced to 1,92,000 on the next day. It is the further case of the complainants that the OP kept the patient from 14-2-2010 to 19-2-2010 and did not give proper treatment and when the patient became serious on 20-2-2010, i.e. after discharge from OP hospital on 19-2-2010, the patient was taken to St.Johns hospital Bangalore and thereafter admitted in Narayana Hrudayalaya where she was diagnosed to be suffering from Dengue Shock Syndrome and she died on 23-2-2010.
We would like to address ourselves to whether the OP doctor had taken into consideration, the platelet counts while treating the patient?
On 16-2-2010 the platelet count was Rs.2,50,000/- on 17-2-2010 it was 1,92,000/- and thereafter there are no test reports filed with respect to platelet count.
It is not in dispute that the patient was taken to St.Johns Medical college, Bangalore on 20-2-2010 evidenced under Ex.A4 and she was in a state of sepsis and complicated Malaria with severe dehydration and vomiting. Ex.A6 is the death summary of the patient of Narayana Hrudayalaya which shows that she had a history of fever since 8 days, she was 35 years old, did not have any history of blood allergies or any other pre-existing disease and her lab investigation reports showed that her platelet count was 31,000 cumm on 20-2-2010 and it further dropped to 28,000/- on 21-2-1010. The haemoglobin level was also low at 8.3 gm/dl. The serology of Dengue IgM shows positive and it is apparent on the face of record that the opposite party did not choose to conduct any test for Dengue fever but admittedly treated her for typhoid as the widal test was positive and submits in his version that the patient was also treated for cerebral Malaria. It is the case of the OP that the patient improved on these lines of treatment and recovered by 18-2-2010 and she was discharged only on the first complainants insistence. Her BP and respiration and temperature were normal on the date of discharge and that he is not sure for want of knowledge as to what happened in the next 26 hours to warrant the patients death.
The contention of the appellant/OP that he has asked in their reply notice to send all the relevant records and the complainant did not chose to do so and therefore he could not recollect the line of treatment is unsustainable as we observe from the record that the complainants in their legal notice Ex.A8, have clearly stated the dates of admission and discharge in their legal notice. In fact it is the OPs case that he discharged the patient on 18-2-2010 whereas it is the case of the complainants that the patient was discharged on 19-2-2010. Ex.A1 record shows clearly that there was a prescription for 19-2-2010 but no where has he stated any precautions as she was in a state of sepsis nor did he state about taking/advising the patient to a higher hospital. The record clearly shows that the patient was in the hospital till 19-2-2010 and therefore the contention of the respondent doctor that she was discharged on 18-2-2010 and that there was a gap of 26 hours in approaching a higher medical institution is unsustainable.
We observe from the record that in Narayana Hrudayalaya hospital, Ex.A6, she was treated for Dengue fever. There is no discharge summary filed by the OP hospital to show the exact line of treatment given except for Ex.A1, OP card. In the patients history of Narayana Hrudayalaya hospital as per the certificate given by Dr.Siva Prasad with respect to the treatment done in the hospital, it is clearly stated as follows:
Presented with h/o fever since 8 days H/o sore throat since last 4 days No H/o. chest pain No h/o burning micturation No h/o. vomiting, jaundice, cough From the aforementioned state of the patient, it is clear that she has reached the hospital, in a state of septic shock and it is for the OP to explain as to how the patient has been discharged without the prognosis being explained to the patient or her attendants. The opposite party ought to have referred her for better management when the patient was still suffering from fever instead of discharging her on 18-2-10 and stating that the ground for discharge is the first complainants insistence. The duty of care which the doctor ought to have taken herein is to explain the prognosis to the complainants herein that there could be other complications involved and sent her to a higher hospital for better management is explained in Dr.Laxman Balkrishna Joshi v. Dr.Trimbak Bapu Godbole and Anr. reported in (1969) I SCR 206. If sepsis has set in during the period from 14th to 18th when the patient was inpatient in his hospital, it is laid down in Savitha Garg v. National Heart Institute reported in Supreme Court and National Commission on Medical Negligence and Insurance under Consumer Protection= IV, (2004) CPJ 40 (SC), that burden of proof shifts to the doctor to explain if his treatment is as per standards of normal medical parlance. In the instant case, the doctor did not file the discharge summary or treatment record in detail, evidencing that he has taken due care and caution and exercised reasonable degree of skill. He himself has admitted the patient for typhoid and cerebral Malaria, Dengue IgM test was never taken though the Haemoglobin levels were 8.0 gms% on 16-2-2010 and 8.8 gm% as on 17-2-2010 as the platelets has also fallen from 2,50,000/- to 1,92,000/-, also discharging a patient without proper prognosis amounts to negligence. The patient admittedly reached the next hospital in a state of septic shock. In the absence of any documentary evidence to support the contention of the doctor that he has diagnosed the fever correctly or that he has undertaken proper treatment in accordance with normal medical parlance as contemplated under the Bolam test reported in Mc.Nair J. in Bolam v. Friern Hospital Management Committee (1957) 2 All ER 118, 121 now widely known as the Bolam test, we are of the considered view that there is negligence on behalf of the OP, for which the complainants are entitled for compensation. As the patient is a house wife of 35 years old and wife of first complainants and mother of other complainants, we are of the considered view that her family lost her love and affection and also for the loss of services of the housewife, an amount of Rs.3,00,000/- would meet the ends of justice together with costs of Rs.5,000/-.
In the result this appeal is allowed and the order of the District Forum is set aside and the complaint is allowed directing the OP to pay Rs.3,00,000/- to the complainants herein out of which the first complainant who is the husband is to be paid an amount of Rs.1,00,000/- and from the balance Rs.2,00,000/-, Rs.50,000/- to each of the children and the minors amounts are to be kept in fixed deposit till they attain majority and this amount along with interest is to be paid to the minors after they attain majority together with costs of Rs.5,000/-. Time for compliance four weeks.
Sd/-INCHARGE PRESIDENT.
Sd/-MEMBER.
JM Dt.26-6-2013.