State Consumer Disputes Redressal Commission
Balwinder Singh vs Dr. Sonia Gupta on 3 July, 2025
STATE CONSUMER DISPUTES REDRESSAL COMMISSION,
PUNJAB, CHANDIGARH.
First Appeal No. 92 of 2020
Date of institution : 11.02.2020
Reserved on : 06.06.2025
Date of Decision : 03.07.2025
Balwinder Singh, aged about 30 years son of Gurnam Singh, resident
of Lalewala, Tehsil Talwandi Sabo, District Bathinda (Punjab).
...Appellant/Complainant
Versus
1. Dr. Sonia Gupta, Medical Officer, Civil Hospital, Talwandi Sabo,
District Bathinda.
2. Raman Kaur, Nurse, Civil Hospital, Talwandi Sabo, District
Bathinda.
3. Civil Surgeon, Civil Hospital, Talwandi Sabo, District Bathinda
(Deleted vide order dated 03.11.2020)
4. Health & Family Welfare, Punjab, Mini Secretariat, Sector 9,
Chandigarh, through its Principal Secretary, Room No. 227, 2nd Floor,
Mini Secretariat, Sector 9, Chandigarh, Punjab
5. The Oriental Insurance Company Limited, Bathinda, through its
Manager (Insurer of Dr. Sonia Gupta).
...Respondents/Opposite Parties
First Appeal under Section 41 of the
Consumer Protection Act, 2019 against the
order dated 12.12.2019 passed by the District
Consumer Disputes Redressal Commission,
Bathinda in C.C. No. 47 of 2017.
Quorum:-
Hon'ble Mrs. Justice Daya Chaudhary, President
Mr. Vishav Kant Garg, Member
1) Whether Reporters of the Newspapers may be allowed to see the Judgment? Yes/No
2) To be referred to the Reporters or not? Yes/No
3) Whether judgment should be reported in the Digest? Yes/No First Appeal No. 92 of 2020 2 Present:-
For the appellant : Ms. Dhivya Jerath, Advocate
For respondent No.1 : Sh. Binderjit Singh, Advocate
For respondent No.2 : Sh. Vivek Singla, Advocate
For respondent No.3 : Deleted vide order dt. 03.11.2020
For respondent No.4 : None
For respondent No.5 : Sh. B.S. Taunque, Advocate
VISHAV KANT GARG, MEMBER :
Appellant/Complainant-Balwinder Singh has filed the
present Appeal to challenge the impugned order dated 12.12.2019 passed by the District Consumer Disputes Redressal Commission, Bathinda (in short, "the District Commission"), whereby the Complaint filed by the Complainant had been dismissed.
2. It would be apposite to mention here that hereinafter the parties will be referred, as were arrayed before the District Commission.
3. Briefly, the facts of the case as made out by the Appellant/Complainant in the Complaint filed before the District Commission are that Veerpal Kaur, the wife of the Complainant was pregnant and on 23.09.2016, due to labour pain, she alongwith her mother went to Civil Hospital, Talwandi Sabo at about 7.30 am where OPs No.1&2 after examining her, had informed that she was going to deliver the child within few minutes and was admitted. They informed that there was no medical complications in the delivery. During this process, they obtained her signatures on some blank papers and also demanded Rs.10,000/- for the said procedure. Within 30 minutes of her admission, she gave birth to a baby girl. It was alleged that in the morning of 24.09.2016, OPs No.1&2 had informed that suddenly the condition of the wife of the Complainant First Appeal No. 92 of 2020 3 was deteriorated due to some latent disease and referred the case of Veerpal Kaur to Faridkot Medical College. However, intentionally they had not informed him that the condition of the patient had deteriorated due to negligence of Dr. Sonia Gupta-OP No.1 as she had caused acute kidney injury upon the patient during the process of surgical delivery (LSCS). OP No.2 had accompanied Veerpal Kaur in an Ambulance when the patient was shifted to Medical Hospital, Faridkot. OP No.2 had further demanded Rs.5,000/- on the way to Medical Hospital, Faridkot but they had refused to pay the same. However, OP No.2 had refused to go to Faridkot and in the way get off from the Ambulance at Bathinda. Said Veerpal Kaur was admitted by the Complainant in Guru Gobind Singh Medical College & Hospital, Faridkot at 12.30 pm. On examination by the Doctors at Faridkot, they found some acute kidney injury caused by OP No.1 during the surgery. There was no improvement in the health of Veerpal Kaur during the period from 24.09.2016 and 25.09.2016, therefore, the Complainant had decided to take her to some higher medical institute at Ludhiana and got discharged her from the said Hospital. He took the patient to SPS Hospital, Ludhiana on 26.09.2016 and got admitted there. Due to acute kidney injury, the condition of Veerpal Kaur was not improved and on 31.10.2016, she had expired. As per the Death Summary of SPS Hospital, Ludhiana, the cause of death of the patient was Post LSCS and Acute Kidney Injury.
4. It was further alleged that OP No.1 and OP No.2 were responsible for the kidney injury to Veerpal Kaur caused due to the carelessness and negligence in performing the surgery. Such negligent act on the part of the OPs No.1&2 caused mental tension, agony, botheration, harassment, loss of love and affection to family. The Complainant had First Appeal No. 92 of 2020 4 been facing a lot of difficulties in upbringing his children after the death of Veerpal Kaur. Stating the act of the opposite parties to be a case of 'deficiency in service', 'unfair trade practice' and also a case of 'medical negligence', it was prayed in the Complaint that for such an act, he be granted a compensation to the tune of Rs.10 lakh with interest @ 12% p.a. He had also demanded Rs.22,000/- towards the litigation expenses.
5. During the course of proceedings, the Counsel for the Complainant had suffered a statement for deleting the name of OP No.3 from the array of parties, hence, the name of OP No.3 was deleted.
6. Upon issuance of notice in the Complaint to OPs No.1, 2, 4 & 5, OP No.4 had not appeared, therefore, OP No.4 was proceeded against ex-parte. However, the Opposite Parties No.1, 2 & 5 had filed their separate written statements.
7. OP No.1 in her written statement had raised the preliminary objection to the extent that the Complainant was not covered under the definition of 'Consumer' because the patient had taken the treatment from Government Hospital, without paying any consideration. It was pleaded that she being the employee of Punjab Government, her relationship as Employer-Employee has no direct dealing with the patient. The inquiry was conducted by the Hospital Board of Talwandi and it was found that there was no 'negligence', 'unfair trade practice' or 'deficiency in service' on the part of the OP No.1. Therefore, the Complaint was misconceived and groundless, hence, unsustainable in the eyes of law. It was filed just to harass and defame the reputation of OP No.1 and to extort money from her through illegal means. With regard to his allegations, the Complainant has failed to give any specific and scientific evidence against OP No.1. First Appeal No. 92 of 2020 5 There was no negligence on the part of OP No.1 had been proved by the Inquiry Board in its finding. OP No.1 had already purchased the 'Professional Indemnity Policy' and as such, was insured under the same. If any liability was fastened upon her, in those circumstances, the Insurance Company was liable to indemnify the same.
8. On merits, it was pleaded that Veerpal Kaur-patient came in emergency situation in the Hospital having Labour Pains. In the enquiry, it was revealed that she was having previous history of LSCS. As alleged, no assurance was given to the family of the patient regarding delivery without any complications. Whereas on examination, it was found that again LSCS was required to be performed to save the life of the mother and child. She had done LSCS with due diligence, prudently, with utmost care & caution and due to that healthy child was born. In the post-operative process, the patient had remained stable. However, later on the duty staff had found decrease in urine output, therefore, various Clinical/Laboratory tests were got conducted and after discussion and examination of reports, it was decided to refer the patient to Higher Institute for better management. After examining the clinical/laboratory reports Exs.C-7 to C-9 relative of the patient, namely, Udham Singh and husband of the patient were informed regarding the problem in kidney and liver due to infections of blood, shortage of platelets and high White Blood Cell (WBC), high serum creatinine and serum bilirubin-T, to which they had acknowledged the same vide Ex. C-11. She had not touched kidney part during the surgery. Moreover, actually the kidney injury was not due to surgery. It was further denied regarding any signatures obtained on blank papers of the Complainant or patient had denied of any money from them. As all the treatments given to the patient were free of charge as she had availed the First Appeal No. 92 of 2020 6 services of Government Hospital, hence, neither the patient nor the Complainant falls under the definition of 'Consumer'. There was no medical negligence on the part of OP No.1 during LSCS surgery and healthy baby was born. It was prayed that the Complaint being false and frivolous, be dismissed and the Complainant be directed to pay Rs.10,000/- under Section 26 of the CP Act, 1986 for filing false and vexatious Complaint.
9. OP No.2 in her written statement had also raised the preliminary objections to the extent that the Complaint was not maintainable. The Complainant had no cause of action or locus-standi to file the Complaint. The Complainant had not paid any charges to OPs No.1&2 for delivery or Caesarean process of Veerpal Kaur, as she had taken the free treatment at Government Hospital. On 23.09.2016, OP No.2 was on night duty and her duty hours were from 6.00 pm to 8.00 am of 24.09.2016. When the LSCS upon Veerpal Kaur was done in the morning, she was not on duty. All the allegations levelled against her were false and baseless.
10. Further averred that OP No.1 had got conducted clinical tests upon Veerpal Kaur in emergency on 24.09.2016 after on examining the reports of the duty staff. The said test reports indicated that the patient had suffered with the severe kidney and liver problem (Exs. C-7 & C-8). Thereafter, the attendants of the patient were informed regarding the said problem and they had acknowledged the same vide Ex. C-11 and OP No.1 had referred the patient to GGS Medical College, Faridkot for better treatment. It was specifically denied that she accompanied the patient in the Ambulance. So the allegations to leave the Ambulance in between at Bathinda has no basis. It was prayed that as OP No.2 had not played any First Appeal No. 92 of 2020 7 role in the delivery or during the shifting of the patient at GGS Medical College, Faridkot, hence, the Complaint be dismissed against her.
11. OP No.5-The Oriental Insurance Co. Ltd. in its written statement had stated that the intricate questions of law and facts were involved in the Complaint, which requires voluminous documents for adjudication of the controversy whereas the proceedings under the Consumer Protection Act are summary in nature. The treatment provided to the patient was free of cost as such, she did not fall under the definition of 'Consumer'. It was pleaded that if any liability was fastened, the same was required upon the State of Punjab and not on OP No.1 because she was an employee of Punjab Government and OP No.5 was not liable to pay any compensation on behalf of OP No.1. There was no privity of contract between the State of Punjab and OP No.5, therefore, there was no liability of OP No.5, hence, dismissal of the Complaint was prayed for.
12. After considering the contents of the Complaint and the replies thereof filed by the different Opposite Parties as well as on hearing the oral arguments raised on behalf of all the sides, the Complaint filed by the Complainant was dismissed by the District Commission vide order dated 12.12.2019. The relevant portion of said order as mentioned in Para-41 is reproduced as under:
"41. For the reasons recorded above, the net conclusion is that the complainant has failed to prove any negligence on the part of opposite parties. Thus, the complaint is hereby dismissed without any order as to cost."
13. The aforesaid order dated 12.12.2019 passed by the District Commission has been challenged by the Appellant/Complainant by way of filing the present Appeal by raising a number of arguments. First Appeal No. 92 of 2020 8
14. Ms. Dhivya Jerath, Advocate, learned Counsel for the Appellant has submitted that Veerpal Kaur having suffered labour pain approached the Civil Hospital, Talwandi Sabo on 23.09.2016 at 7.30 am. There she delivered the child through LSCS but OP No.1-Dr. Sonia Gupta caused her Acute Kidney Injury (AKI) in performing the LSCS negligently and carelessly. On account of such an act her condition was deteriorated and OP No.1 referred her to GGS Medical College & Hospital, Faridkot. However, during stay in the Hospital at Faridkot on 24.09.2016 & 25.09.2016, there was no improvement in the condition of the patient, therefore, the Complainant got discharged the patient from the said Hospital for taking her to some higher medical institute at Ludhiana. She remained admitted in SPS Hospital, Ludhiana during the period 26.09.2016 to 31.10.2016 but her condition did not improve due to injury (AKI) caused by OP No.1 during surgery. Lastly on 31.10.2016, Veerpal Kaur died. From the medical record/card it was proved that Veerpal Kaur was not suffering from any complication/disease during pregnancy. She was quite physically fit. It was only due to negligence of OP No.1, kidney injury had been suffered by her during LSCS. The District Commission wrongly ignored the document/medical Card (Ex. C-15), wherein it was clearly mentioned that Veerpal Kaur was not suffering from any problem at the time of pregnancy and the said fact had also been proved from Ultra Sonography Report dated 08.05.2016 (Ex. C-46). The objection raised by the OPs that the Complainant had not paid any consideration for the delivery/treatment of his wife has no legs to stand because for admission and medical tests of the patient, the Complainant had deposited the fee demanded by the OPs. The District Commission has failed to appreciate the medical record available on the file wherein it was proved that Urine First Appeal No. 92 of 2020 9 output of the patient started decreasing and the same was an indication of AKI but OP No.1 did not explain as to how a previously healthy person acquire such disease after some hours of operation. It was clear that the patient developed Jaundice, which can only be developed at a later stage of Sepsis. Sepsis was a post operation infection. These facts clearly show the medical negligence of OPs No.1&2 in treating Veerpal Kaur. The impugned order passed by the District Commission was based on non- application of mind as well as ignoring the documents proving the negligence of the OPs. The District Commission wrongly relied upon the inquiry reports of the Board and exonerate the OPs No.1&2 from the allegations of medical negligence. It was prayed that the Appeal be accepted and the impugned order be set-aside.
15. On the other hand, Sh. Binderjit Singh, Advocate learned Counsel for the Respondent No. 1 has submitted that the Complainant has availed the services of OPs No.1,2 & 4 free of cost as OPs No.1&2 were working in Civil Hospital, which was run by the Punjab Government. Not even a single receipt of any payment made with regard to the admission/treatment had been annexed by the Complainant, as such, neither the Complainant nor Veerpal Kaur falls within the definition of 'consumer'. The judgment of the District Commission, Bathinda dated 03.06.2014 in C.C. No. 529 of 04.12.2013 relied upon by the Complainant had already been set-aside by this Commission vide order dated 12.05.2016 in F.A. No. 1173 of 2014. It was held by this Commission that if nothing was paid by the Complainant towards the treatment in Government Hospital, the Complainant was not a 'Consumer' of the OPs because only on paying the consideration the Complainant falls within the definition of 'consumer'. The Complainant had neither lead any document on the file, First Appeal No. 92 of 2020 10 which revealed any kind of medical negligence on the part of OP No.1 nor lead any expert evidence in support of his allegations. Rather the three Medical Boards constituted, held the act of OP No.1 justified and proved that there was no medical negligence on the part of OP No.1 in treating Veerpal Kaur. OP No.1 had performed LSCS diligently, prudently and with utmost care and caution due to which healthy child was born. After LSCS, patient remained stable. On noticing medical/clinical reports, it was found that some tests were above/below the normal level, she had immediately referred her to higher medical center for better management because Talwandi Sabo was primary level health institute. Such an act was not any kind of medical negligence on the part of OP No.1. No money was demanded from the patient or from his relatives and the Complainant failed to lead any kind of evidence in this regard and levelled baseless allegations to put pressure on the OPs No.1&2 for extorting money and defame their reputation. Even the team of 9 Doctors Medical Board constituted, working under various authorities, opined that cause of death appears to be HELLP Syndrome with Septic Shock with Multi-organ involvement and not found any kind of medical negligence during the treatment. In the Appeal also the Complainant has failed to flash any document which may prove medical negligence on the part of OP No.1. It was prayed that the Appeal being without any merit, be dismissed.
16. Sh. Vivek Singla, Advocate, learned Counsel for Respondent No. 2/OP No.2 has argued that Respondent No.2 had played no role in the delivery process of Veerpal Kaur. Veerpal Kaur was admitted at 7.30 am on 23.09.2016 and delivered healthy child within 20 minutes after her admission. Duty of OP No.2 was in night shift on 23.09.2016 and when she was taking round in the ward at 10.00 pm, she noticed that urine First Appeal No. 92 of 2020 11 output of the patient Veerpal Kaur was less and she informed this fact to OP No.1. Lateron OP No.1 came and checked the patient. During this night urine output of the patient remained less so OP No.1 got conducted clinical tests of the patient in emergency. When OP No.1 noticed that test reports of the patient was not upto mark, she referred the patient to GGS Medical College & Hospital, Faridkot for further management. OP No.2 had only gave the treatment as advised/instructed by OP No.1. No specific allegation of medical negligence was levelled by the Complainant upon OP No.2. As the duty hours of OP No.2 had finished at 8.00 am on 24.09.2016, hence, she did not accompany the patient in Ambulance. So the demand of Rs.5,000/- as alleged by the Complainant on the way to Faridkot is baseless and wrong. Said allegations were levelled by the Complainant with ill intention, to unnecessary involve the OP No.2 in the controversy and put pressure upon her to extort money. When the things turned out to be complicated then the Complainant with bad intention involved the medical practitioners into the allegations of medical negligence to receive compensatory amount from them. No allegations of medical negligence were levelled upon OP No.2, hence, the Appeal against her be dismissed.
17. Sh. B.S. Taunque, Advocate, learned Counsel for Respondent No.5 has argued that the treatment provided to the patient was free of cost, hence, she was not 'Consumer' of Respondent No.5. There was no privity of contract between the Complainant and Respondent No.5. It was pleaded that if any liability fastened, the same was upon the State of Punjab and not on OP No.1 because she was an employee of Punjab Government. OP No.5 had entered an agreement with OP No.1 only but not liable to pay any compensation on behalf of OP No.1, if any First Appeal No. 92 of 2020 12 medical negligence found on her part during the medical services provided on behalf of Punjab Government Hospitals.
18. We have heard the oral arguments of the learned Counsel for the parties and have also carefully perused the impugned order passed by the District Commission, written arguments submitted by the parties and all the relevant documents available on the file. We have also gone through the judgments cited by both the parties.
19. Undisputedly Veerpal Kaur, patient along with his family members approached Civil Hospital, Talwandi Sabo in the morning of 23.09.2016 due to labour pain. OP No.1 after examining Veerpal Kaur admitted her. Earlier child of Veerpal Kaur was delivered through LSCS method. Seeing the condition of the patient, OP No.1 decided that to save the life of the mother and child, LSCS was required to be performed. Successful surgery of LSCS was done and healthy child was born. After surgery the patient remained stable but in the night shift, Nurse-OP No.2 noted that the urine output of the patient was decreased and informed OP No.1. OP No.1 examined the patient and clinical tests of the patient were got conducted. After examining the reports of various tests, when report of some of the tests were not normal and noted that the patient was suffering with the problem of Jaundice, it was decided to refer the patient to higher center for better management and immediately referred her to GGS Medical College & Hospital, Faridkot on 24.09.2016 in the morning.
20. Thereafter, the patient remained admitted in Medical College, Faridkot for two days i.e. 24.09.2016 and 25.09.2016 but when the Complainant noticed no improvement in the condition of the patient, he had decided to take her to SPS Hospital, Ludhiana. In SPS Hospital, First Appeal No. 92 of 2020 13 Ludhiana the patient remained admitted from 26.09.2016 till death on 31.10.2016 but the Doctor's there were unable to save her life.
21. The allegations of the Complainant were that during LSCS, the OP No.1 Doctor was negligent during surgery, which caused kidney injury to the patient, due to which her condition deteriorated speedily and she was forced to refer to higher medical institute i.e. GGS Medical College & Hospital, Faridkot. Said fact was clearly reflected in Admission Papers dated 24.09.2016 of GGS Medical College & Hospital, Faridkot wherein under the Column 'Diagnosis', it was mentioned 'Post LSCS Acute Kidney Injury along with Sepsis ? HELPP'.
22. In reply to the said allegations, OP No.1 stated that during LSCS she did not touch Kidney Part. Said Acute Kidney Injury was not related to the surgery. It was pleaded that whole treatment was provided to the patient with due diligence, prudently and with utmost care & caution and after LSCS, the patient remained stable. When duty staff noted about decreased Urine Output. Various tests were got conducted and on examining found that some tests not upto mark, she had immediately decided to refer the patient to higher centre as Tablwandi Sabo was primary level health institute. With regard to her allegations, the Complainant had failed to lead any specific and scientific record, which proves the negligence of OP No.1. Three Inquiry Boards constituted to examine the controversy in question, found no medical negligence on the part of OP No.1.
23. OPs No.1&2 also raised the objection that the Complainant did not fall under the definition of 'Consumer' as whole treatment was provided to the patient 'free of cost' in the Government Hospital and they First Appeal No. 92 of 2020 14 being a Government Employee were protected under Employer-Employee Relationship from personal liability.
24. With regard to objection of the OPs No.1&2 regarding 'Consumer' on the ground that the Complainant did not pay any consideration for availing their services, being the Government Employees, serving at Civil Hospital, Talwandi Sabo, which was being run by the Punjab Government at 'no cost' for providing the health services to the residents of Punjab, we have examined the documents annexed on the case file by the Complainant. Only in Ex. C-19 i.e. Fee Slip issued by GGS Medical College & Hospital, Faridkot, an amount of Rs.10/- was mentioned as 'Slip Fee' but on none of document issued by Civil Hospital, Talwandi Sabo, receipt/entry regarding receiving of any amount was mentioned. Therefore, it is clear that in Civil Hospital, Talwandi Sabo, the patient/Complainant did not pay any amount for availing the services of said Civil Hospital. However, there is no doubt that in the Consumer Protection Act, for falling under the definition of 'Consumer', for buying or availing any kind of services, person/consumer needs to pay any consideration. But with regard to specific objection that if a person availed medical services rendered by the Government Hospital and Private Hospitals 'free of charge', as to whether he/she was covered under the definition of 'consumer' or not, this question had been thoroughly dealt by the Hon'ble Supreme Court in case III (1995) CPJ 1 (SC) "Indian Medical Association Versus V.P. Shantha & Ors.", and held that both such entities are excluded by virtue of their business model from exclusionary clause in 2(1)(o) of the CP Act but finally held that the persons who are rendered free service are the "beneficiaries" and as such come within the First Appeal No. 92 of 2020 15 definition of "Consumer" under Section 2(1) (d) of the Act." The relevant paras No.43 & 44 of the judgment are as under:-
"43. The other part of exclusionary clause relates to services rendered "free of charge".
The medical practitioners, government hospitals/nursing homes and private hospitals/nursing homes (hereinafter called "doctors and hospitals") broadly fall in three categories:-
(i) Where services are rendered free of charge to everybody availing of the said services.
(ii) Where charges are required to be paid by everybody availing of the services; and
(iii) Where charges are required to be paid by persons availing of services but certain categories of persons who cannot afford to pay are rendered service free of charges.
There is no difficulty in respect of the first two categories. Doctors and hospitals who render service without any charge whatsoever to every person availing of the service would not fall within the ambit of 'service' under Section 2(1)(o) of the Act. The payment of a token amount for registration purposes only would not alter the position in respect of such doctors and hospitals. So far as the second category is concerned, since the service is rendered on payment basis to all the persons, they would clearly fall within the ambit of Section 2(1)(o) of the Act. The third category of doctors and hospitals do provide free service to some of the patients belonging to the poor class but the bulk of the service is rendered to the patients on payment basis. The expenses incurred for providing free service are met out of the income from the service rendered to the paying patients. The service rendered by such doctors and hospitals to paying patients undoubtedly falls within the ambit of Section 2(1)(o) of the Act.
44. The question for our consideration is whether the service rendered to patients free of charge by the doctors and hospitals in category (iii) is excluded by virtue of the exclusionary clause in Section 2(1) (o) of the Act. In our opinion the question has to be answered in the 'negative'. In this context it is necessary to bear in mind that the Act has been enacted "to provide for the protection of the interests of "consumers" in the background of the guidelines contained in the Consumer Protection Resolution passed by the U.N. General Assembly on April 9, 1985. These guidelines refer to "achieving or maintaining adequate protection for their population as consumers" and "encouraging high levels of ethical conduct for those engaged in the protection and distribution of goods and services to the consumers". The protection that is envisaged by the Act is, therefore, protection for consumers as a class. The word "users" (in plural), in the phrase `potential users' in Section 2(1) (o) of the Act also gives an indication that consumers as a class are contemplated. The definition of `Complainant' contained in Section 2(b) of the Act which includes, under clause
(ii), any voluntary consumer association, and clauses (b) and (c) of Section 12 which enable First Appeal No. 92 of 2020 16 a complaint to be filed by any recognised consumer association or one or more consumers where there are numerous consumers, having the same interest, on behalf of or for the benefit of all consumers so interested, also lend support to the view that the Act seeks to protect the interests of consumers as a class. To hold otherwise would mean that the protection of the Act would be available to only those who can afford to pay and such protection would be denied to those who cannot so afford, though they are the people who need the protection more. It is difficult to conceive that the legislature intended to achieve such a result. Another consequence of adopting a construction, which would restrict the protection of the Act to persons who can afford to pay for the services availed by them and deny such protection to those who are not in a position to pay for such services, would be that the standard and quality of service rendered at an establishment would cease to be uniform. It would be of a higher standard and of better quality for persons who are in a position to pay for such service while the standard and quality of such service would be inferior for person who cannot afford to pay for such service and who avail the service without payment. Such a consequence would defeat the object of the Act. All persons who avail the services by doctors and hospitals in category (iii), are required to be treated on the same footing irrespective of the fact that some of them pay for the service and others avail the same free of charge. Most of the doctors and hospitals work on commercial lines and the expenses incurred for providing services free of charge to patients who are not in a position to bear the charges are met out of the income earned by such doctors and hospitals from services rendered to paying patients. The Government hospitals may not be commercial in that sense but on the overall consideration of the objectives and the scheme of the Act it would not be possible to treat the Government hospitals differently. We are of the view that in such a situation the persons belonging to "poor class" who are provided services free of charge are the beneficiaries of the service which is hired or availed of by the "paying class". We are, therefore, of opinion that service rendered by the doctors and hospitals falling in category (iii) irrespective of the fact that part of the service is rendered free of charge, would nevertheless fall within the ambit of the expression "service" as defined in Section 2(1) (o) of the Act. We are further of the view that persons who are rendered free service are the "beneficiaries" and as such come within the definition of "consumer" under Section 2(1) (d) of the Act."
25. Said settled law was followed in a number of judgments by the Hon'ble National Commission as well as State Commissions. Hon'ble National Commission in "Sailesh Munjal & Anr. Versus All India Institute of Medical Sciences & Ors.", III (2004) CPJ 93 (NC), following the above observation held that "keeping the aforesaid principles in mind, it First Appeal No. 92 of 2020 17 cannot be disputed that apart from registration fee, respondent Institute (AIIMS) recovers various amounts such as Hospital charges, diagnostic charges, etc. from the patients." Therefore, it is clear that these Hospitals charged consideration on different accounts from their patient. In view of above observations, it is held that certainly the 'patient' and the 'Complainant' falls within the category of 'beneficiaries' and considered as 'Consumer' in the present case. The judgments relied upon by the learned Counsel for Respondent No.1 are not helpful in the present circumstances because in these judgments, the Complainant/Petient was Government Servant and availed free medical services from Government Hospital.
26. Now the issue for consideration is as to whether the Complainant was able to prove any kind of medical negligence in the treatment of OP No.1. The Complainant had relied upon document Ex. C-6 i.e. Admission Case File of Veerpal Kaur (pg. 74) wherein under the column 'Diagnosis', it is mentioned 'Post LSCS Acute Kidney Injury along with Sepsis ? HELPP'. From the said writing, the Complainant alleged that during the LSCS, OP No.1 had caused acute kidney injury to Veerpal Kaur-patient and when she was unable to control such injury, she referred the patient to GGS Medical College & Hospital, Faridkot. This is the prime allegation levelled by the Complainant in the whole of the Complaint.
27. To examine such allegations, primarily we looked after the OT Notes of Veerpal Kaur prepared by Dr. Sonia on 23.09.2016 at 7.50 am. It is clear from said document that the same were prepared after conducting the LSCS because it is clear that the Complainant himself stated that he visited the OP-Hospital at 7.30 am. In the said OT Notes (pg. 63), it was mentioned as under by Dr. Sonia:-
First Appeal No. 92 of 2020 18
"Abdomen opened in layers, Lower uterine caesarean done, alive female baby born at 7.50 am, on 23/9/16 weighing 2.8 kg, Cord clamped cut, cry immediate. Uterus stitched in layers after PP, IUCD insertion. Complete haemostasis achieved. U.O. clear. No complication."
28. From the above operation notes, it is clear that nowhere the said Doctor had mentioned any type of injury to kidney during LSCS and she had clearly mentioned in the end of her notes 'No Complication'.
29. Now with the help of Wikipedia, we have made efforts to find out the medical term of 'Acute Kidney Injury'. In this regard, it was mentioned as under:-
"Acute Kidney Injury (AKI) previously called as "Acute Renal Failure (ARF)". Causes of AKI are classified as either prerenal (due to decreased blood flow to the kidney), intrinsic renal (due to damage to the kidney itself), or postrenal (due to blockage of urine flow).
Prerenal causes of AKI include sepsis, dehydration, excessive blood loss, cardiogenic shock, heart failure, cirrhosis and certain medications like ACE inhibitors or NSAIDs. Intrinsic renal causes of AKI include glomerulonephritis, lupus nephritis, acute tubular necrosis, certain antibiotics and chemotherapeutic agents. Postrenal causes of AKI include kidney stones, bladder cancer, neurogenic bladder, enlargement of the prostate, narrowing of the urethra, and certain medications like anticholinergics. The diagnosis of AKI is made based on a person's signs and symptoms, along with lab tests for serum creatinine and measurement of urine output. Other tests include urine miscroscopy and urine electrolytes. Renal ultrasound can be obtained when a postrenal cause is suspected. A kidney biopsy may be obtained when intrinsic renal AKI is suspected and the cause is unclear.
30. The above medical literature clearly reveals that the diagnosis of AKI can be recognized based on a person's signs and symptoms and Lab Tests for serum creatinine and measurement of urine output. In the present case, it is revealed that when the nursing staff had noticed that the First Appeal No. 92 of 2020 19 urine output of the patient was 'on lower side' and the colour was 'deep yellow', they had informed OP No.1, who after examining the patient, had suggested some tests like Hematology, Biochemistry and Urine Examination. Said tests clearly revealed that the ratio of WBC, PLT, Serum Creatinine, Serum Bilirubin, SGOT, SGPT were not in 'normal range'. In the Urine Examination, colour of the Urine was disclosed as 'Deep Yellow', which was a matter of concern. Therefore, seeing all these aspects, the OP No.1 had opined that the patient had suffered with some other problem from the past and the same had no link with the treatment of LSCS. The same might not be controlled in the Civil Hospital, Talwandi Sabo, being a primary level health institute and immediately it was decided to refer the patient to the higher institute for better management. From the above facts, it is clear that the OP No.1 when noticed that the tests of the patient were not normal, she was referred to GGS Medical College & Hospital, Faridkot. The medical literature provided by the Counsel for the Complainant i.e. 'Indian Journal of Nephrology' also suggest that 'the diagnosis of AKI is based on the serum creatinine increase'. As mentioned above, the test of the patient was not in normal range. Said literature had further suggested that the renal diseases during pregnancy was not uniform and was highly variable and validated (authenticated) definition of the same has not been established. AKI is a rare complication of pregnancy. Therefore, as per the said literature AKI incident was an incident, which had happened rarest in the pregnancy issues. There was no document available on the record or revealed by the Complainant, which can prove that during LSCS process any cut had been done to the kidney part and such an act was negligence on the part of OP No.1.
First Appeal No. 92 of 2020 20
31. On thorough perusal of the Grounds of Appeal, we find that the Appellant had alleged that the District Commission had not considered the real facts of the case, passed the order on the basis of assumptions and presumptions and relied on Medical Board's opinion. The District Commission had wrongly exonerated the OPs No.1&2 from any liability, whereas in some documents, word 'injury' had been specifically mentioned. Said approach of the District Commission was wrong, illegal and unjustified. The District Commission had not considered the fact that due to negligence of OP No.1, the Appellant/Complainant had suffered mental tension, agony and harassment and children of the Appellant had suffered a loss of love and affection of their mother.
32. We have perused the impugned order. It reflects that it was detailed and speaking order. From para nos. 36 to 40 of the impugned order, the District Commission had discussed every issue one by one and had held that the Complainant was required to allege any particular negligence on the part of the treating Doctor i.e. OP No.1 by producing evidence with regard to the same. Said issue had been dealt with by the District Commission in detail and Acute Kidney Injury does not mean any physical injury to kidney, no medical negligence was proved against OP No.1. The Complainant had specifically levelled the allegations that during LSCS, OP No.1 had given cut to the kidney part of the patient-Veerpal Kaur but failed to prove such fact on record.
33. Also the grievance of the Complainant had already been examined by 3 different Medical Boards, report of which were Ex. C-58, Ex. OP-1/3 and on pages 275 to 278 (9 Members), which were expert in medical field and all the Boards had opined that there was no negligence on the part of the treating Doctor i.e. OP No.1 and staff in treating the First Appeal No. 92 of 2020 21 patient-Veerpal Kaur. Ex. OP-1/11 (pages 275-278) is the report prepared by Medical Board consisting of 9 Doctors, who were expert in their field. All these 9 Members were working in different institutions i.e. some Members working at SPS Apollo Hospital, Ludhiana and Children Hospital, Bathinda, being an independent body. Said Authority after examining the complete medical record also opined that there was no evidence available of any type of 'medical negligence' on the part of OP Nos.1&2. It is no doubt that no expert evidence has been produced by the Complainant to prove that the LSCS operation was conducted by OP No. 1 not according to medical standards/protocol. OP No. 2 in her reply had specifically mentioned that she had looked after the patient in the Hospital only during her night shift till the time she was referred to GGS Medical College, Faridkot and had not gone in Ambulance with the patient. As OP No.2 has only provided the medical assistance to the patient as advised by OP No.1 and the Complainant had failed to point out any specific negligence on her part. The allegations of the Complainant had properly been rebutted by the OPs No.1&2 through medical record and were able to prove the fact that there was no medical negligence on their part. The Complainant failed to prove any kind of negligence in the treatment given to the patient by OPs No.1&2, hence, his allegations are rejected.
34. Regarding the allegations of demand of Rs.10,000/- by OP No.1 for conducting the procedure and Rs.5,000/- by OP No.2, seems like demanding bribe by them, were of totally different nature and not related to controversy involved under Consumer Protection Act. If the Complainant wants to prove these allegations against the OPs No.1&2, he is required to avail any other appropriate remedy available with him regarding the said First Appeal No. 92 of 2020 22 grievance as the allegations of bribe cannot be adjudicated/considered under the jurisdiction of Consumer Protection Act.
35. In view of the above discussion, it is clear that the order of the District Commission is detailed one and the Complainant had failed to prove any kind of medical negligence on the part of the Respondents/OPs- Doctor & Staff. Therefore, the present Appeal being devoid of any merit is hereby dismissed and the order of the District Commission is upheld.
36. Since the main case has been disposed off, so all the pending Miscellaneous Applications, if any, are accordingly disposed off.
37. The Appeal could not be decided within the statutory period due to heavy pendency of Court Cases.
(JUSTICE DAYA CHAUDHARY) PRESIDENT (VISHAV KANT GARG) MEMBER July 03, 2025.
as