National Consumer Disputes Redressal
A. Jeyaseelan (Dr.) vs Anandan And Ors. on 2 February, 2006
Equivalent citations: 2(2007)CPJ101(NC)
ORDER
Rajyalakshmi Rao, Member
1. The present appeal is filed by Dr. A. Jeyaseelan against the order dated 25.5.2004 passed by the State Consumer Disputes Redressal Commission, TamilNadu atChennai in Original Petition No. 199/97 filed by the complainant/ respondent No. 1, Mr. Anandan, for medical negligence and deficiency in service, which was allowed and the appellant was directed to pay a sum of Rs. 2,15,000 as compensation with Rs. 2,000 as costs.
2. Brief facts of the case are:
Complainant (respondent No. 1) brought his daughter - A. Selvi (hereinafter referred to as the patient) to the hospital of the appellant on 7.5.1996 with a day old fever, headache and pain. The appellant after diagnosing that it could be probably viral fever, administered paracetamol injection and gave tablet along with Amoxcilin and advised to bring her next day. Although the respondent No. 1 informed the appellant that his daughter was normal, the appellant seems to have insisted to bring her back to the appellant's hospital and then she was administered dextrose saline drip. After instructing the untrained nurse to administer drip, the appellant left the hospital to his other clinic. Within a few minutes of the administration of the drips, the patient developed shivering. The staff nurse called the appellant over phone and informed him of the condition of the patient. Appellant advised over phone to give some tablets. After taking the tablets the patient began to lose her eye sight and became semi-conscious and her pulse rate also dropped. The nurse informed the appellant about the same and then he reached the hospital and after seeing the deteriorating condition of the patient, he advised respondent No. 1 to take her to the 2nd respondent's hospital, i.e., City Tower Hospital for further treatment and gave a letter for the same.
3. Respondent No. 2 put the patient on oxygen immediately and gave some tablets and injections but her condition did not improve and became serious. At that time, "the patient was unconscious and was not responding to stimuli. Pupils were normal in size and reacting to light. Temperature was 103° F, pulse rate was 100/mt, just felt, blood pressure 70/?, Cardiovascular system was S1, S2 + -Tachycardia - respiratory system - Bilateral crepitations present; abdomen - soft; central nervous system moving all four limbs, no neck stiffness, incontinence of urine and motion present. No history of poison intake". The patient had developed high grade intermittent fever with profuse sweating and severe headache. History of rigor and vomiting present since morning on 8.5.1996 and subsequent loss of consciousness. Immediately on admission after noting the condition, emergency medical treatment was started. She was given 5% GNS I.V. drip and provided with injection Mol 1 amp I.M.; injection Deriphylline 1 amp I.V., injection Decadron 2 cc. I.V., continuous nasal oxygen, throat suction. Subsequently, the patient vomited blood tinged vomitus twice and it was managed by fixing Ryles tube aspiration, administering injection Ranitin 1 amp I.V. and injection Botropase 1 amp. I.V. Subsequently, the patient developed seizure and 25% Dextrose 100 ML I.V. was given. After admission, the patient was examined by Dr. P. Padmanabhan, M.D. Consultant Physician.The patient had profuse tongue bleeding. He explained the serious condition of the patient to the relatives of the patient and advised to transfer the patient to Intensive Medical Care Unit attached to a bigger institution for further management. Till then he advised to continue the supportive management. In view of the high grade intermittent fever with severe headache, profuse sweating and vomiting with seizures and subsequent loss of consciousness and profuse tongue bleeding, the following clinical diagnosis were considered?" Meningitis (Brain fever) ? Cerebral Malaria".
4. The patient was discharged from the respondent No. 2 hospital at 12.50 a.m. and was transferred by ambulance to the respondent No. 3 hospital. At the time of discharge the general condition of the patient was "Patient disoriented, pupils normal and reacting to light, temperature 98° F, B.P. : 90/64 mm and respiratory rate was 30/mt."
5. At the time of admission at the Vijaya Health Centre, the patient was afebrile, disoriented, temperature 97° F, pulse rate 112/ mt. BP 90/60 mm. Hg., Respiratory rate 32/mt.
6. The respondent No. l's daughter was admitted in the 3rd opposite party's hospital at 1.50 p.m. on 8.5.1996. At the time of admission she was in a very serious condition and she was in an unconscious state. She was referred to by the 2nd opposite party hospital with possibility of meningitis or poisoning or cerebral malaria. On examination the patient was afebrile disoriented, sub-normal temperature 97° F -reflexes exaggerated. The patient was bleeding from the oral cavity and from the sites blood was taken for investigation. Blood pressure dropped further and the patient started gasping. She was incubated and connected to the ventilator and started on injection Dopamine and intravenous fluids. In spite of treatment, the patient's blood pressure dropped. The patient was bleeding from the endotracheal tube. The lab investigation showed platelet count at 45,000, prothrombin - non-stop, bleeding time - non-stop, clotting time - more than 15 minutes, FDP - 1.6 to 3.2 mg/it. The patient was transfused with one unit of O+ve blood. The patient did not improve. The patient's condition deteriorated further. CPR was done for 1 hour and the patient could not be revived. It was diagnosed that the patient had disseminated intravascular coagulation with septicemia.
7. State Commission held that there is deficiency in service, negligence and lack of care on the part of the appellant and directed to pay a sum of Rs. 15,000 towards medical treatment and sum of Rs. 2,00,000 towards mental agony which amounts to total of Rs. 2,15,000. Further, the State Commission held that the condition of the patient was serious when she was admitted in the respondent No. 2 hospital and also in the hospital of respondent No. 3. It held that administration of drips has caused the adverse effect on the patient.
8. Learned Counsel for the appellant argued that the appellant with bona fide intentions treated the patient on a complaint of vomiting, headache, fever and dehydration and after examination as a first aid measure a paracetamol injection and dextrose saline drip was given. It is averred that in general private practice in a small clinic the prescriptions with medication are given to patient only and hence no record or case sheet was maintained. The patient was treated on 8.5.1996 from 9.00 a.m. to 9.45 a.m. and, thereafter, the patient was treated by respondent Nos. 2 and 3. Learned Counsel for the appellant contended that respondent Nos. 2 and 3 should not be held responsible. It is contended that the appellant performed his best and referred the patient to respondent No. 2 hospital for further medical attention and hence, there is no deficiency of service in treating the patient.
9. Learned Counsel for the respondent No. 2 contended that on 8.5.1997 the patient was admitted to their hospital at 10.55 a.m. The patient was in an unconscious stage and the general condition was very serious at the time of admission itself. It is also contended that necessary treatment was given after patient was examined by Dr. P. Padmanabhan, M.D., Consultant Physician. Dr. Padmanabhan explained the serious condition of the patient to the relatives and advised to transfer the patient to Intensive Medical Care Unit attached to a bigger institution for further management. Till then he advised to continue the supportive management. In view of high grade intermittent fever with severe headache, profuse sweating and vomiting with seizures and subsequent loss of consciousness and profuse tongue bleeding the following clinical diagnosis were considered:
Meningitis and Cerebral Malaria
10. The patient was discharged at 12.50 a.m. on 8.5.1996 and transferred by ambulance to the 3rd respondent in Intensive Medical Care Unit, Vijaya Health Centre. At the time of discharge general condition of the patient was recorded as follows:
Patient disoriented, pupils - Normal and reacting to light Temp - 98F B.P. : 90/64 mm of Hg.
Respiratory rate 30/mt
11. He further contended that from the record it is clear that the patient's condition was not aggravated by the treatment of the 2nd respondent and in fact there was a little improvement in general condition after the emergency medical treatment was given.
12. It is submitted that there was no negligence, deficiency in service and irresponsible treatment on the part of the 2nd respondent and that utmost care was given to the patient. It is submitted that the complainant has not specifically stated that as to how the 3rd respondent is responsible or was negligent and that the allegation was general in nature. It is submitted that elaborate and expensive treatment was carried in their hospital and the records produced themselves show that they have done everything possible to save the patient. It is also argued that the complainant himself signed the letter of consent (Exhibit P-3) wherein it has been stated that his daughter was admitted on 1.50 p.m. and the chances of recovery was remote and he had decided to keep the patient for treatment and was prepared to pay the expenditure necessary for it.
13. We heard both the parties and perused the record carefully. As for the 2nd and 3rd respondents, we have no reason to disagree with the findings of the State Commission. It is clear on the face of the record that the patient was brought in to the 2nd respondent in a serious condition and also to the 3rd respondent for similar serious condition and they had done best treatment possible considering the fact that the patient's health had already deteriorated at the time of admission in both these hospitals. As for the appellant, it is clear from the death certificate produced by Vijaya Health Centre that the cause of death was "Disseminated intravascular coagulation septicemia".
14. It is clear that the patient did not have Meningitis or Cerebral Malaria. It is apparent from the fact that when the patient was brought in to the appellant's Nursing Home and after the administration as first aid measures of a paracetamol injection and after dextrose saline drip was given, patient's condition deteriorated. It is also seen that the appellant has not taken proper care in giving the drip and that the complication arose after giving the drip. Appellant has also failed to explain why he insisted to bring back the daughter of the complainant to the hospital even though the complainant informed him that his daughter was normal. It is also surprising that in such cases why he administered dextrose saline drip. No explanationis given for this. After instructing the nurse, the appellant went away to another Nursing Home and on the first call made by the nurse gave some instructions on the phone. It was only when the second call was made by the nurse, he rushed to the hospital to see the patient.
15. In our opinion, the sudden deterioration in the patient's condition after the administration of the saline drip and the casual treatment given by the appellant over phone when the patient developed fits and consequently resulted into untimely death. This conduct of the appellant in not attending the patient at the first call and administering of the saline drip is the cause of deterioration of the health of a young girl of aged about 19 years. Further, the State Commission has rightly held that the cause of death is septicemia which arose during the treatment of the appellant. Appellant has not maintained the record of the treatment and has not explained as to why the condition of the patient deteriorated so rapidly after administration of the drip. The death of 19 years old young girl has caused deep anguish to the father and family and the compensation awarded by the State Commission is just and reasonable. Hence, we do not find any reason for us to interfere with the order of the State Commission.
16. In view of the above discussion, the appeal is dismissed with costs of Rs. 2,000 to be paid to the respondent No. 1 by the appellant and the order of the State Commission be complied within two months from the date of this order.