National Consumer Disputes Redressal
Dr. A. K. Basu vs Kalikinkar Ghosh on 28 March, 2019
Author: R.K. Agrawal
Bench: R.K. Agrawal
NATIONAL CONSUMER DISPUTES REDRESSAL COMMISSION NEW DELHI REVISION PETITION NO. 182 OF 2018 (Against the Order dated 26/10/2017 in Appeal No. 210/2016 of the State Commission West Bengal) 1. DR. A. K. BASU BASU'S CLINIC, NANDALAL BASU SARANI, COLLEGEPARA, SILIGURI WEST BENGAL ...........Petitioner(s) Versus 1. KALIKINKAR GHOSH C/O. PRAFULLA KUMAR GHOSH, FULBARI, POST OFFICE, SATELLITE, TOWNSHIP DISTRICT-JALPAIGURI-734015 WEST BENGAL ...........Respondent(s)
BEFORE: HON'BLE MR. JUSTICE R.K. AGRAWAL,PRESIDENT HON'BLE MR. DR. S.M. KANTIKAR,MEMBER For the Petitioner : Mr. AnindyaBasu, Advocate Mr. Prasanta Banerjee, Advocate Mr. Amit Kumar Saha, Advocate For the Respondent : In person Dated : 28 Mar 2019 ORDER DR. S. M. KANTIKAR, MEMBER
1. This revision petition has been filed under Section 21(b) of the Consumer Protection Act, 1986 against the Order dated 26.10.2017 passed in first appeal No. A/210/2016 by West Bengal State Consumer Disputes Redressal Commission, Kolkata (for short, 'the State Commission') whereby the State Commission dismissed the appeal of the doctor and upheld the order dated 10.02.2016 of the District Consumer Disputes Redressal Forum, Siliguri (for short, 'the District Forum').
2. The briefly stated that, Smt. Rita Ghosh (herein-after-referred as 'the patient') complainant - Kalikinkar Ghosh's wife consulted the petitioner - opposite party /Dr. A. K. Basu on 25.02.2013 for complaint of per vaginal severe bleeding. The opposite party diagnosed it as an Incomplete abortion, therefore he performed Dilatation and Curettage ( D & C) under general anaesthesia (GA) in his Basu clinic at Siliguri and patient was discharged on same day. Thereafter, patient had continuous abdominal pain and again on 12.03.2013, complainant took his wife the opposite party-doctor, who after examination, advised for TORCH test and prescribed some medicines and asked for urgent Ultrasonography (USG) of whole abdomen. Thereafter, patient approached Dr. M. A. Khalid with the USG report. He diagnosed it as 'Ruptured Ectopic Pregnancy' about size 37 X 23 mm. Thereafter, complainant took his wife to Dr. Pulak Kr Saha, at Prayas Medicare. He confirmed it as a tubal pregnancy and performed Right salpingectomy operation (removal of fallopian tube) on 18.03.2013, but could not save the pregnancy. She was discharged on 20.03.2013. Complainant alleged that opposite party should not have conducted D & C, then the baby (foetus) could have been saved. Being aggrieved by the alleged negligent treatment from the OP-doctor, the complainant filed a complaint before the District Forum.
3. In the written version, the opposite party denied the allegations. It was submitted that, based on physical/clinical examination and USG report patient was diagnosed as a case of incomplete abortion. On the same day i.e 25.02.2013, D & C was performed. It was 4 weeks pregnancy and at that stage USG did not detect ectopic pregnancy. Admittedly, it was detected on 16.03.2013 i.e. at about seven weeks of pregnancy. As per the medical literature, the ectopic pregnancy can only be detected by USG only after six weeks of pregnancy. The opposite party further submitted that the procedure of D&C was confined to uterine cavity only whereas ectopic pregnancy is outside the uterine cavity which commonly occurs in the fallopian tube. The D & C is not a risk factor of ectopic pregnancy. The State Commission wrongly held that after D & C procedure pregnancy can't retain/exist.
4. On the basis of pleadings and evidence District Forum allowed the complaint and directed the opposite party to pay total sum of Rs.2,31,380/- along with cost of Rs.10,000/- to the complainant.
5. Being aggrieved, the opposite party filed first appeal before the State Commission and it was dismissed. Against the impugned order, the OP filed the instant revision petition.
6. We have heard the learned counsel for petitioner and the respondent argued in person. We have perused the medial record and relevant medical literature on the file. The discharge certificate of OP/Basu clinic revealed that the patient was admitted on 25.02.2013 for bleeding-incomplete abortion, therefore Dr. A. K. Basu-OP performed D & C under GA. Then, patient was advised proper antibiotics and TORCH test. According to the prescription dated 12.03.2013 of M/s Chitta Sindhu Medical Hall , the patient was examined by Dr. Khaled. The USG performed on 16.03.2013, was reported as ? ruptured ectopic pregnancy. It was a suspicion, therefore patient took another opinion from Dr.Pulak Kr Saha and it was again confirmed as ectopic pregnancy with the help of USG performed at BBS Mediscanners. Therefore, Dr.Pulak performed right salpingectomy and confirmed histopathologically as tubal pregnancy.
7. To know about Ectopic pregnancy- it's causes ,signs ,symptoms and diagnosis we have gone through medical text from Shaws textbook on Gynecology, (17th edition) , Williams Obstetrics( 24th edition).
An ectopic pregnancy occurs when a fertilized egg implants and grows outside the main cavity of the uterus. Ectopic pregnancy occurs in the fallopian tube in over 95% of cases is called Tubal pregnancy. In that most to occur is the ampulla (70.0%) then isthmus and the fimbria. Other locations for ectopic pregnancies are rare: abdominal, ovarian or cervical.
Detection by USG for ectopic pregnancy in early weeks ( before 6 weeks) is very difficult. In some cases, the diagnosis of ectopic pregnancy can be made after a single measurement of HCG in combination with transvaginal ultrasound, if the HCG is above the discriminatory zone and transvaginal ultrasound shows no evidence of an intrauterine pregnancy and the presence of findings that suggest an ectopic pregnancy.
8. We have given our thoughtful consideration to the arguments, the medical text from standard medical books (supra) and the documents on file. The main question to decide is whether there was deficiency in service from the OP to diagnosis the ectopic pregnancy or whether it was a misdiagnosis? According to the medical literature clinically and ultrasonologically early detection and ectopic pregnancy before six weeks is difficult. In the instant case, the patient had pain in abdomen and bleeding. USG report dated 25.2.2013 did not show evidence of ectopic pregnancy. The decision to perform D & C was taken by OP after proper investigations. In our view, OP treated the patient as standard reasonable practice. It is pertinent to note that, the ectopic pregnancy was detected after 7th week of pregnancy. Therefore, in our considered view, it was neither deficiency nor a misdiagnosis from the OP.
9. It should be borne in mind that D & C performed by OP was for the bleeding/incomplete abortion, the procedure was only confined to uterine cavity. Thus, it is ridiculous to confer that because of D & C patient had developed tubal/ectopic pregnancy. It is medically impossible. We also note that, as a precaution the OP-doctor, after D & C advised antibiotics for 10 days and to detect cause of abortion TORCH test was advised. It was an accepted standard of care and practice in the instant case.
10. Based on the foregoing discussion, we do not find that OP committed either negligence or deviation from reasonable standard practice. Both the fora have erred to appreciate the concept of ectopic pregnancy and also the D&C procedure. We set aside the orders of both the fora below and allow this revision petition; consequently the complaint is dismissed.
There shall be no order as to cost.
......................J R.K. AGRAWAL PRESIDENT ...................... DR. S.M. KANTIKAR MEMBER