National Consumer Disputes Redressal
Amit Rai & 2 Ors. vs Medica Magadh Hospital & 6 Ors., on 10 May, 2024
NATIONAL CONSUMER DISPUTES REDRESSAL COMMISSION NEW DELHI CONSUMER CASE NO. 248 OF 2013 1. AMIT RAI & 2 ORS. S/o late Shri S. N. P. Rai, 2-B/173, Windermere, Andheri (East), MUMBAI. ...........Complainant(s) Versus 1. MEDICA MAGADH HOSPITAL & 6 ORS., (A Unit of Magadh Health Point (P) Ltd.) Through its Director, Rajender Nagar, Road No. 28, PATNA - 800016. 2. DR. AMIT KUMAR SINHA, C/o Maghad Hospital (A Unit of Maghad Health Point (P) Ltd.) Rajender Nagar, Road No. 28, PATNA - 800016. 3. M/S. PATLIPUTRA BLOOD BANK, Through its Authorised Representative, Opp. PMCH, ENT Outdoor, Ashok Rajpath, Bakipur, PATNA - 800004. 4. RED CROSS BLOOD BANK, Through its Authorised Representative, Indian Red Cross Society, Bihar State Branch, North Gandhi Maidan PATNA 5. ROCKJAND HOSPITAL, (A unit of Rockland Hospital Ltd.) Through its Managing Director, B-33-34, Qutub Institutional Area, NEW DELHI - 110016. 6. DR. M. P. SHARMA, C/o Rockland Hospital, (A unit of Rockland Hospital Ltd.) B-33-34, Qutub Institutional Area, NEW DELHI - 110016. 7. DR. B. P. SINGH, C/o Roackland Hospital, (A unit of Rockland Hospital Ltd.) B-33-34, Qutub Institutional Area, NEW DELHI - 110016. ...........Opp.Party(s)
BEFORE: HON'BLE MR. JUSTICE RAM SURAT RAM MAURYA,PRESIDING MEMBER HON'BLE BHARATKUMAR PANDYA,MEMBER
FOR THE COMPLAINANT : MR. K.K. RAI, SENIOR ADVOCATE WITH
MR. S.K. PANDEY, ADVOCATE
MR. ANSHUL RAI, ADVOCATE
MR. AWANISH KUMAR, ADVOCATE
MR. CHANDRASEKHAR A.C., ADVOCATE
MR. SREOSHI CHATTERJEE, ADVOCATE
MS. MEDHA TANDON, ADVOCATE
MR. ANUPAM JAIN, ADVOCATE FOR THE OPP. PARTY : FOR THE OPP. PARTIES-1 &2 : MR. SANDEEP KAPOOR, ADVOCATE
FOR THE OPPOSITE PARTY-3 : MR. SANJEER KUMAR VERMA, ADVOCATE
FOR THE OPPOSITE PARTY-4 : NEMO
FOR THE OPP. PARTIES- 5 TO 7 : MR. MAROOF AHMAD, ADVOCATE
Dated : 10 May 2024 ORDER
1. Heard Mr. K.K. Rai, Senior Advocate, assisted by Mr. S.K. Pandey, Advocate, for the complainants, Mr. Sandeep Kapoor, Advocate for OPs-1 & 2, Mr. Sanjeev Kumar Verma, Advocate for OP-3 and Mr. Maroof Ahmad, Advocate for OPs-5 to 7. None appeared for OP-4.
2. Amit Rai, Smt. Mala Pandey and Smt. Rambha Rai have filed above complaint, praying to award (i) Rs.4/- crores, as compensation for financial loss, mental agony and physical attrition caused to them; (ii) Rs.212081/- with interest @ 18% per annum from 30.03.2011, as the amount paid for hospitalization both at Patna and New Delhi; (iii) litigation cost; and (iv) any other relief which is deemed fit and proper in the fact and circumstances of the case.
3. The complainants stated that complainants-1 & 2 are brother and sister respectively and complainant-3 is their mother. Late S.N.P. Rai (hereinafter referred to as "the patient") was husband of complainant-3 and father of complainants-1 & 2. On 30.03.2011, when the patient went on morning walk, he met with an accident and sustained acetabular fracture resulting in severe internal bleeding. He was admitted in Magadh Hospital (OP-1) on 30.03.2011 at 7:27 hours, wherein blood transfusion was done on 30.03.2011 and 31.03.2011 under supervision of Dr. Amit Kumar Sinha (OP-2), apart from other treatment. The blood was brought from Patliputra Blood Bank (OP-3) and Red Cross Blood Bank (OP-4). The patient was discharged on 25.05.2011 at 18:39 hours from the hospital and brought to his residence in Patna. In the first week of July, 2011, the colour of the eyes of the patient was changed to yellow. The doctors advised him for blood test. The sample for blood test of the patient was taken on 12.07.2011. In the blood test report dated 13.07.2011, the patient was suffering from Hepatitis-B. Prior to his admission in OP-1 hospital, the patient was not having the infection of Hepatitis-B. He got the infection due to negligence of OPs-1 & 2, in transfusing infected blood without test, using infected syringe and other unhygienic practices in the hospital. The blood banks (OPs-3 & 4) did not follow the guidelines of Drug Controller General and supplied infected blood to OP-1. Hepatitis B virus is transmitted in people by direct blood-to-blood contact or semen and vaginal fluid of an infected person. Modes of transmission are the same as those for the human immunodeficiency virus (HIV), but Hepatitis B virus is 50 to 100 times more infectious. Unlike HIV, the Hepatitis B can survive outside the body for at least 7 days. During this period, the virus can still cause infection, if it enters the body of a person, who is not protected by the vaccine. Common modes of transmission are (i) perinatal (from mother to baby at birth), (ii) early childhood infections (in apparent infection through close interpersonal contact with infected household contacts), (iii) unsafe injection practices, (iv) unsafe blood transfusions, (v) unprotected sexual contact. The incubation period of the Hepatitis B virus is 90 days but can vary from 30 to 180 days. The virus may be detected 30 to 60 days after infection and persists for variable period of time. Human blood is covered in the definition of 'Drug" under Section 3(b) of the Drugs and Cosmetics Act, 1940. Drug Controller General of India has issued guidelines for the blood banks, under which, blood bank is required to have an area of 100 square meters for its operations and an additional area of 50 square meters for preparation of blood components. It shall consist a room each for (i) registration and medical examination with adequate furniture and facilities for registration and selection of donors; (ii) blood collection (air-conditioned); (iii) blood component preparation. (This shall be air-conditioned to maintain temperature between 20 degree centigrade to 25 degree centigrade); (iv) laboratory for blood group serology (air-conditioned); (v) laboratory for blood transmissible diseases like Hepatitis B, Syphilis, Malaria, HIV-antibodies (air-conditioned); (vi) sterilization-cum-washing; (vii) refreshment-cum-rest room (air-conditioned) and (viii) store-cum-record. It further requires that each blood unit shall also be tested for freedom from Hepatitis B surface antigen and Hepatitis C virus antibody VDRL and malaria parasite and results of each testing shall be recorded on the level of container. OP-3 and 4 did not follow the guidelines of Drug Controller General of India in collecting, preserving and supplying the blood, from its blood bank. It was duty of OP-2 to ensure that the blood that he was administering to the patient, was free from infection. Thus, there is collective negligence of OPs-1 to 4. Due to infection of hepatitis-B, the condition of the patient deteriorated and he was admitted in Rockland Hospital (OP-5) on 14.07.2011 at 12:15:24, where he was treated by Dr. M.P. Sharma and his junior Dr. B.P. Singh (OPs-6 & 7). The patient was discharged on 02.08.2011 with the advice to inform OP-7 about the progress in the health of the patient and OP-7 also gave his mobile number to complainant-1. On 06.08.2011 at about 15:00 hours, as the patient felt some uneasiness, complainant-1 called OP-7 on his mobile number and told him about his condition. OP-7 ignoring the fact that the patient was suffering from Hepatitis-B and was also diabetic casually advised to take crocin tablet and have rest. On same day, at about 18:00 hours, when the blood pressure of the patient started falling, complainant-1 again called OP-7 and told him about his condition. OP-7 advised him to immediately rush to the hospital. The patient was again admitted on 06.08.2011 at 21:53 hours, in Rockland Hospital (OP-5) in the ICU, where he was kept on ventilator. The doctors informed that the patient had suffered a heart attack on 07.08.2011 at about 3:00 hours and expired at about 6:57 hours. As per hospital record, the cause of the death was cardiac arrest. In the bill dated 07.08.2011, the Rockland Hospital has also charged for visit of Dr. M.P. Sharma on 06.08.2011, who had not seen the patient. Dr. M.P. Sharma himself told complainant-1 that he had not seen the patient on 06.08.2011. When the patient was suffering from acute infection of Hepatitis-B and was a chronic patient of diabetes, the Rockland Hospital should not have discharged the patient on 02.08.2011. Due to death of the patient the complainants suffered immense trauma and financial loss as he had a sound knowledge of share market and was actively involved in share trading with complainant-1. Due to mental trauma, complainant-1 could not do share-trading for almost one year. The complainants sent a legal notice dated 25.06.2013 to the OPs seeking damages of Rs.4/- crores and Rs.212081/- towards medical expenses with interest @ 18% per annum. An amount of Rs.277073/- was reimbursed by the insurance company. OP-4 replied to the legal notice, vide letter dated 17.07.2013 stating that it had supplied 2 units of blood on 31.03.2011 after getting it tested and the blood was non-reactive. However, OP-4 did not supply the test report of the blood supplied to the complainants. Then the complainants filed the present complaint on 06.08.2013.
4. The opposite parties contested the complaint by filing the written version. OP-1 & 2 filed their written reply on 18.12.2013 stating that OP-1 is a reputed hospital and an unit of Magadh Health Point Pvt. Ltd. The hospital complies with every statutory guidelines and directions with all care and full devotion. OP-2 is a qualified Doctor and took due care applied his all skill, experiences and knowledge during treatment of the patient. The patient was admitted in the hospital on 30.03.2011 at 7:27 hours with fracture of acetabular which was very complicated in nature. There was also internal bleeding as such the attendants were advised to bring the blood for transfusion. The complainants brought the blood from OPs-3 & 4 and OPs-1 & 2 had no role in procurement of the blood. They take care of proper sterilization and cleanliness in the hospital and there is no chance that the blood got infection in the hospital. It is not the duty of OP-1 & 2 to have pathological test of the blood before transfusion. It is the duly of the blood bank to conduct investigation and pathological test before supply of the blood. The duty of the hospital is to match the blood group before transfusion which has been done properly and carefully. Blood transfusion was done on 30th & 31st March, 2011 and the patient was discharged on 25th May, 2011. During this period, there was no symptom of blood infection like jaundice or Hepatitis-B. There is possibility that the patient could have received infection after discharge from the hospital. There is no evidence to show that there was negligence on the part of OP-1 & 2 and they have been arrayed as opposite parties with ulterior motive and for undue advantage. Blood transfusion was done on 30.03.2011 and 31.03.2011. The patient was discharged on 25.05.2011. Hepatitis B was detected on 13.07.2011 and the complaint was filed on 06.08.2013, which is time barred.
5. Opposite party-3 filed its separate written version on 19.12.2013 stating that OP-3 is a reputed blood bank and complies with the every statutory guidelines and directed with all due care and full devotion and follows the guidelines of Drug Controller General of India. The complainant-1 came to OP-3 on 30.03.2011 and requested for the blood as per patient's blood sample, supplied from the hospital. There was shortage of the blood of Group-A+ in the Blood Bank. Due to shortage of A+ blood, OP-3 asked the complainant-1 bring some donors which could not be done. Then, OP-3 itself arranged some voluntary donors for donating the blood. The blood as well as the donors were properly investigated/screened before supply to the complainant-1. The infection might have caused due to some other reason. OP-3 never induced the complainants to get blood from its Blood Bank. There is no deficiency in service on its part. Blood was supplied on 30.03.2011 and the complaint was filed on 06.08.2013, which is time barred.
6. Opposite party-4 filed the written statement dated 18.03.2015 stating that Red Cross Blood Bank was a part of Indian Red Cross Society and Hon,ble the Governor of State of Bihar is the President of Bihar branch of Indian Red Cross Society. OP-4 is scrupulous in scrutinizing before collecting and supply the blood. It follows the guidelines issued by the Drug Controller General. The patient was transfused the blood obtained from other sources prior to OP-4. Infection might have been caused due to other reasons such as infected syringe, transmission from person already infected, operation or other surgical procedure etc. There is no evidence to show that the blood supplied by OP-4 was infected. There is possibility that the patient might have suffered Hepatitis B before treatment in the hospital (OP-1). There is no privity of contract between the complainants and OP-4 as OP-4 issued the blood on the requisition of Dr. Mukesh Kumar of Magadh Hospital. Blood supplied by OP-4 was donated by Mr. G. Kiran Kumar and Mr. Ram Niwas Tiwary, who in their blood donation forms stated that they were not suffering from any medical complication. The blood collected by OP-4 is always tested with HIV, HCV, BHsAg (Hepatitis-B), VDRL and Malaria. All these tests were conducted and it was found that the blood was non-reactive and it was safe. The blood supplied to the complainants was Blood Unit Nos.8700 and 8701. A register of all these tests is also maintained by OP-4 which is annexed with the reply. There is no deficiency in service on its part. Blood was supplied on 31.03.2011 and the complaint was filed on 06.08.2013, which is time barred.
7. Opposite parties-5 to 7 filed their common written statement dated 16.02.2015. They stated that for the first time the patient was admitted to their hospital on 14.07.2011 and the attendant informed that he was suffering from fever and passing yellow urine for the last seven days and loss of appetite for five days. His Hepatitis-B test done outside was positive. The patient also had history of UTI since 2 months and fracture of right lower limb 4 months back. He was also diagnosed with acute viral Hepatitis-B, Diabetic (taking insulin injection), Hyponatremia taking Cardivas, breathlessness etc. He was treated conservatively and Hyponatremia was corrected under Dr.P.K.D. Shah (Sr. Consultant Endocrinology), for his diabetes management. After treatment when his condition became stable, he was discharged on 02.08.2011 and advised to take medicines regularly and contact in case of emergency on phone no.011-41222222. He was also prescribed RBS monitoring pre-meals at 10:00 pm by glucometer and come for review after one week with reports of KFT, LFT and after 5 months do HBV DNS (Quantitative). Again on 06.08.2011 around 22:15 hours, when the patient was admitted he was having acute Hepatitis B, Diabetic, Hypertensive, breathlessness, pain in the abdomen, distended and tense abdomen. Icterus was present and there was yellowness in the whole skin and bilateral pitting edema of both legs. The patient was put on Oxygen and given inotropic support but he was not maintaining proper saturation and the blood pressure continued to fall. He was intubated and put on the ventilator on 07.08.2011 at about 4:00 hours. His condition was further deteriorated and BP continued to fall. He was also given active CPR and other injections/medicines but his saturation continued and blood pressure to fall and un-recordable, pupil became dilated and declared dead about 6:57 hours. In spite of best efforts made by OP-5 to 7, the patient died on 07.08.2011. The cause of death was due to cardiac arrest and secondary factor could be many as in the present case, it is Septicaemia, DM, Hypertension and Multi organ failure etc. Dr. M.P. Sharma was Head of Gastroenterology department of OP-5. On 06.08.2011, necessary medication was done by OP-7 through the telephonic supervision of OP-6 and such in the bill it was reflected. As per own allegation, the patient got blood infection in the hospital of OP-1, no cause of action has arisen against OP-5 to 7.
8. The complainants filed separate rejoinders to the replies of the opposite parties. The complainants filed the Affidavit of Evidence of Amit Rai. The complainants along with Affidavit of Amit Rai dated 09.09.2013 and 18.03.2024 filed computation of income and Income Tax Returns of Amit Rai. Opposite parties-1 & 2 filed the Affidavit of Evidence of Gopal Khemka. Opposite party-3 filed the Affidavit of Evidence of Shivendra Mohan. Opposite party-4 filed the Affidavit of Evidence of Dr. Binay Bahadur Sinha. Opposite parties-5 to 7 filed the Affidavit of Evidence of Dr. Renu Siwas. All the parties have filed their written arguments.
9. The complainants alleged that the patient had suffered with the infection of Hepatitis-B in the hospital of OP-1 during his treatment from 30.03.2011 to 25.05.2011, due to negligence of OP-2, in transfusing infected blood without test, using infected syringe and other unhygienic practices in the hospital. The transfused blood was supplied from the blood banks OPs-3 & 4 and transfused on 30.03.2011 and 31.03.2011. OP-3 and 4 did not follow the guidelines of Drug Controller General of India, in collecting, preserving and supplying the blood, from its blood bank. As such OPs-1 to 4 are jointly liable for causing infection Hepatitis-B to the patient. In order to prove the allegation, the complainants have filed Blood Test Report of the patient dated 13.07.2011 conducted by Patliputra Pathology & X-ray Clinic, Patna (Annexure-C-2).
10. We have considered the arguments of the counsel for the parties and examined the record. A perusal of the report dated 13.07.2011 shows that method of test was "Immunochromatography Hepatic". In paragraph-3 of this report, it has been noted that 'hepatic' will indicate the presence or absence of Hepatitis-B surface antigen in the specimen and should not be used as the only basis for the diagnosis of Hepatitis. So far as the medical records of OP-5 to 7, are concerned, they proceeded on the basis of this report and did not obtain any other report of the patient to confirm Hepatitis-B. The counsel for the OP-1 and 2 produced medical literature of Hepacard, in which, at clause-3 on the heading of Limitation of the Procedure, mentioned that this is only a screening test. All reactive samples should be confirmed by confirmatory test. Therefore for a definitive diagnosis, the patient's clinical history, symptomatology as well as serological data, should be considered. The result should be reported only after complying with above procedure. Clause-5 mentioned that false positive results can be obtained due to presence of Rf antibodies, patient with auto-immune disease, liver problems, renal disorders and antenatal samples. Centre for Disease Control and Prevention recommends for use of the triple panel test, which includes Hepatitis-B surface antigen (HBsAg), antibody to Hepatitis B surface antigen (Anti-HBs) and total antibody to Hepatitis B core antigen (total anti-HBc) (HBsAg). The final diagnosis should be based on a co-relation of test result with other clinical findings. Incubation period of Hepatitis-B virus is 60 days, while in present case, it was noticed after 103 days of blood transfusion. There was no confirmatory test in respect of Hepatitis-B. At the time of admission in the hospital of OP-1 on 30.03.2011, the age of the patient was 70 years and he had history of diabetes and hypertensive. As such, it is not proved that the patient suffered from Hepatitis-B during 30.03.2011 to 12.05.2011 in the hospital of OP-1.
10. A perusal of medical record as produced by OP-1, shows that Blood Unit Nos.450, 451, 452, 453 and 456 were supplied by Patilputra Blood Bank (OP-3) on 30.03.2011. Time of supply of these units were noted from 15:30 hours to 21:20 hours. There are some difference in respect of particulars between the slip attached to blood unit and reply/evidence of OP-3. In such circumstances, entries in the slip attached with blood unit are reliable. On the basis of short duration between time of collection and time for supply, it has been argued that test for Hepatitis B was not done. OP-3 has stated that complainant-1 came to OP-3 on 30.03.2011 and requested for the blood as per patient's blood sample, supplied from the hospital. There was shortage of the blood of Group-A+ in the Blood Bank. Due to shortage of A+ blood, OP-3 asked complainant-1 bring some donors which could not be done. Then, OP-3 itself arranged some voluntary donors for donating the blood. The blood as well as the donors were properly investigated/ screened before supply to the complainant-1. From above allegations it is proved that there was emergency for transfusion of blood to the patient. Therefore, the blood donors, registered with OP-3 were called on 30.03.2011 and blood were collected, investigated/screened and supplied on the same day. Only on the basis of short duration in collection and supply no inference can be drawn that the blood was not screened. Blood Unit Nos.8700 and 8701 were supplied by Red Cross Blood Bank (OP-4) on 31.03.2011. There is nothing on record to say that OP-3 and 4 did not follow the guidelines of Drug Controller General of India as issued to the blood banks.
11. Allegations against OP-5 to 7 are that (i) at the time of discharge from the hospital on 02.08.2011, Bilirubin level of the patient was 23.69 and 13.41, although the patient was suffering from severe comorbidities and diabetes, he was callously discharged; although the patient was suffering from Hepatitis-B and was also diabetic, ignoring it OP-7 has casually advised to take crocin tablet and have rest on 06.08.2011 and although Dr. M.P. Sharma had not attended the patient on 06.08.2011 and 07.08.2011 but his charges have been included in the bill.
So far as the allegation that at the time of discharge from the hospital on 02.08.2011, Bilirubin level of the patient, is concerned, the patent was on oral medical. If the doctor considered that there was no need to retain the patient in hospital, then it can at the most be an error in judgement and not negligence. OP-7 has stated that on 06.08.2011, he had been informed on telephone that the patient had fever and uneasiness. He advised the attendant to bring the patient to the hospital for examination and give crocin to reduce the fever, which was considered to be safest. Complainant-1 talked with OP-7 on 06.08.2011 at 15:00 hours, while patient was brought to the hospital at about 21:00 hours. Thus the complainants took unreasonable time to bring the patient to the hospital. OP-5 to 7 have stated that on 06.08.2011, necessary medication was done by OP-7 through the telephonic supervision of OP-6 and such in the bill, the charges of OP-6, which is Rs.1040/- was reflected.
12. Otherwise also, cause of action arose on 13.07.2011 against OPs-1 to 4 while cause of action arose on 02.08.2011 against OPs-5 to 7 and the present complaint was filed on 06.08.2013. So far as allegation that ignoring the condition of the patient, OP-7 has casually advised to take crocin tablet and have rest on 06.08.2011. OP-7 has been stated that on telephone, the attendant was advised to bring the patient to the hospital for examination and give crocin to reduce the fever, which was considered to be safest. Thus no negligence on 06.08.2011 by OP-7 is not proved. In respect of billing, necessary medication was done by OP-7 through the telephonic supervision of OP-6 and such in the bill, the charges of OP-6, which is Rs.1040/- was reflected. Excess billing is not a negligence. Section 24-A of the Consumer Protection Act, 1986 provides 2 years limitation for filing consumer complaint, from the date of cause of action. The complaint is barred by limitation and no application for condonation of delay has been filed as such the complaint is liable to be dismissed as time barred.
O R D E R
In view of above discussions, the complaint is dismissed.
..................................................J RAM SURAT RAM MAURYA PRESIDING MEMBER ............................................. BHARATKUMAR PANDYA MEMBER