State Consumer Disputes Redressal Commission
Suma vs Dr.Koshy Thanki on 30 January, 2015
Daily Order KERALA STATE CONSUMER DISPUTES REDRESSAL COMMISSION SISUVIHARLANE VAZHUTHACAUD THIRUVANANTHAPURAM APPEAL NO.504/12 JUDGMENT DATED :30.01.2015 (Appeal filed against the order in CC.No.341/2006 on the file of CDRF, Kollam order dated : 10.05.2012) PRESENT SRI.K.CHANDRADAS NADAR : JUDICIAL MEMBER SRI.V.V.JOSE : MEMBER APPELLANTS 1. Suma W/o.Babu @ Nazarudheen, Kalyani Mandiram, Jenakia Nagar - 267, Pattathanam.P.O Ayathil, Kollam 2. Arya.S. Babu, D/o.Babu, Kalyani Mandiram, Jenakia Nagar - 267, Pattathanam.P.O Ayathil, Kollam 3. Akash.S.Babu, S/o.Babu, Kalyani Mandiram, Jenakia Nagar - 267, Pattathanam.P.O Ayathil, Kollam 4. Sasidharan.K (Expired) F/o.Babu Kalyani Mandiram, Jenakia Nagar - 267, Pattathanam.P.O Ayathil, Kollam 5. Arifa, M/o.Babu, Kalyani Mandiram, Jenakia Nagar - 267, Pattathanam.P.O Ayathil, Kollam (By Adv.Sri.C.S.Rajmohan) Vs RESPONDENT Dr.Koshy Thanki, Dr.Thanky Memorial Clinic, Railway Station Road, Kollam (By Adv.Sri.M.C.Suresh & Adv.Sri.Narayan.R) JUDGMENT
SRI.K.CHANDRADAS NADAR : JUDICIAL MEMBER Appellants were the complainants in CC.No.341/2006 in the CDRF, Kollam. The complainants were the wife parents and children of deceased Babu @ Nazarudheen. The complainants alleged that on 29.08.2006 deceased Babu felt body pain and fever. He met the opposite party a doctor at about 9.30 am and the opposite party prescribed medicines, after diagnosing that deceased was suffering from viral fever. The opposite party advised him to come back if he vomited. On the same day at about 7 pm Mr.Babu reported the doctor with the complaint of vomiting. The opposite party administered an injection and directed the patient to take rest for three days. The fourth complainant who accompanied the patient enquired whether any laboratory test was necessary. But that request was not considered by the opposite party. On 01.09.2006 the patient again approached the opposite party as his condition did not improve. The first opposite party again prescribed medicines and sent to the patient back. On 02.09.2006 the patient again met the opposite party his condition did not improve. But the opposite party suggested the patient to take rest however the patient was taken to Sankars Hospital, Kollam and as referred by the doctors at Sankars Hospital the patient was admitted in the KIMS Hospital, Thiruvananthapuram. On detailed examination it was diagnosed that the patient had viral fever with secondary bacterial infection and ARDS. Treatment was started to contain the infection but on 04.09.2006 at about 5.30 am the patient died due to sepsis syndrome with multi organ failure. Alleging that the opposite party did not diagnose the actual ailment of the patient and there was wrong diagnosis of viral fever and hence wrong treatment was given to the patient, the complainants alleged deficiency in service on the part of the opposite party doctor and claimed compensation of Rs.10,000,00/- (Rupees. Ten Lakhs).
2. Before the consumer forum the opposite party filed version and contended that there was no deficiency in service on his side. The opposite party admitted that on 29.08.2006 deceased Babu had approached him with complaints of fever and body pain. On clinical examination the patient was found to have fever only. The deceased disclosed the opposite party that he was under treatment by another physician for hypertension and hypercholesterolaemia. Since there was no other clinical symptom or findings and the patient was having only fever paracetamol stemitil and chlorpheneramine were prescribed and the patient was advised to take complete bed rest. On the same day at 7.p.m while the opposite party was closing his clinic, the patient came again and informed the opposite party that he had vomited twice. Immediately, the opposite party directed the patient to approach a hospital having inpatient facility and other infrastructure. The patient promised to go to another hospital but insisted that the opposite party should give some medicines for the time being to stop vomiting. Hence the opposite party administered antiemetic injection to stop vomiting. On 01.09.2006 the patient again came to the clinic of the opposite party and informed him that the fever of the patient had subsided and his vomiting tendency had stopped but complained of mild body pain. On examination he was found to be normal and there was improvement in his condition. As requested by the patient the opposite party prescribed medicines for body pain and vitamin tablets and prescribed bed rest but to the surprise of the opposite party the patient came on the next day with complaints of severe tiredness and the first appearance of the patient itself prompted the opposite party to direct the patient to approach a major hospital for further investigation and treatment. The patient was asked to go to Sankars Institute of Medical Sciences, Kollam. It is learnt that the patient was taken to Sankars Institute of Medical Sciences from where he was referred to KIMS Hospital, Thiruvananthapuram and subsequently he died due to viral fever with secondary bacterial infection and ARDS. ARDS is a clinical syndrome of rapid on set characterized by severe dyspnoea (breathlessness), hypoxemia ( decreased oxygen level in blood ) usually leading to respiratory failure. It is secondary to several reasons one of them being viral infection later developing into pneumonia. On 29.08.2006 the patient had viral fever only. His condition improved subsequently, but developed bacterial infection subsequently and the opposite party is in no way responsible for the secondary bacterial infection. The complaint was devoid of merit.
3. Before the consumer forum, the first complainant gave evidence as PW1. One of the doctors who treated the patient in the KIMS Hospital was examined as PW2. Exts.p1 to P12 were marked on the side of the complainants. Ext.X1 series are the treatment records produced form the KIMS Hospital, Thiruvananthapuram. The opposite party deposed before the forum as DW1. No document is produced on his side. The consumer forum finding no deficiency in service on the part of the opposite party dismissed the complaint. Hence the appeal. The question that arises for consideration is whether the conclusions of the consumer forum can be sustained.
4. The only allegations against the opposite party doctor on the basis of which the complaint is founded are that the opposite party did not diagnose the actual ailment of deceased Babu that the diagnosis of viral fever was wrong and consequently no proper treatment was given to the patient and thus there was deficiency in service on his part. It may be mentioned at once that erroneous diagnosis need not necessarily be negligent diagnosis. There is no allegation that the opposite party was not a qualified doctor. Admittedly, he was running a small clinic where there was no facility for treatment as inpatients. The clinic was not equipped for conducting advanced diagnostic tests. It was in the above background deceased Babu admittedly approached the opposite party on 29.08.2006 at 9.30 am with complaints of fever and body pain. Clinical symptoms were consistent with viral fever. It was accordingly medicines were prescribed by the opposite party as per ext.P1 prescription. The patient was asked to report back in case there was tendency for vomiting. On the same day at about 7 pm the patient reported that he had vomited twice and accordingly the opposite party prescribed medicine to stop vomiting. On 01.09.2006 the patient reported that the fever had subsided and vomiting had stopped but complained of mild body pain. Medicines were prescribed to reduce body pain. On the next day the patient complained of severe tiredness. The opposite party immediately asked the patient to approach a major hospital. It is seen from Ext.P5 that the patient went to sankar shashtyabda Memorial Hospital, Kollam at 9.30 am on 02.09.2006. It is pertinent to mention that the patient then complained of fever myaligia, nousea and yelloish discoloration of urine for four days. At 7.30 pm, on the same day the patient was referred to a higher centre for evaluation and management Admittedly, he was brought to the Kerala Institute of Medical Sciences, Thiruvananthapuram on that day itself. Ext.P11 is the certificate of death issued from the KIMS Hospital. The medical records from the KIMS Hospital are produced and marked as Ext.X1 series. From Ext.P11 it can be seen that deceased Babu was suffering from viral fever with secondary bacterial infection and ARDS. The cause of death was sepsis syndrome with multi organ failure.
5. The question is whether there is evidence to show that there was erroneous diagnosis of the ailment as viral fever. In this regard, the only available expert evidence is that of PW2, one of the doctor's who treated the deceased at the KIMS Hospital. He was the head of department of internal medicine there. According to him the infection was likely from the date when the fever started. Few days after starting of fever bacterial infection can develop. So on the clinical symptoms reported to the opposite party the diagnosis of viral fever can not at all be said to be erroneous. As mentioned earlier even on 02.09.2006 he complained of fever and vomiting apart from tiredness. So the initial diagnosis made on 29.08.2006 cannot be said to be erroneous. It appears that no advanced diagnostic test was necessary at that stage. When the opposite party was convinced that the condition of the patient was not improving, he promptly directed him to approach a higher centre for appropriate treatment. The patient approached the opposite party after knowing fully well that it was a small clinic without any inpatient treatment facility. Even the records produced from the KIMS Hospital show that the patient suffered from viral fever. The only thing is, he developed secondary bacterial infection and consequent complications. According to PW2, only in 30 - 40 percent cases the details of the bacteria causing sepsis syndrome can be found out on conducting tests. He was of the opinion that even if diagnostic tests were done at the first opportunity, the chances of saving the patient were title. PW2 was also of the opinion that the initial treatment for viral fever could be given by the opposite party if he was convinced that the patient was suffering from viral fever. It is unnecessary to prescribe antibiotics. It is difficult to find out even if investigations were done at the initial stage whether secondary bacterial infection has developed. PW2 is of the definite opinion that there is no evidence of negligence on the part of the opposite party. It is also pertinent to notice that whether there was deficiency in service or negligence on the part of the opposite party is to be decided with reference to a medical expert of reasonsbale standards and not of the very highest or the lowest. There is absolutely no evidence to show that the opposite party in treating deceased Babu fell below the standard of an expert of reasonable standards. It follows that there is no error in the conclusion of the consumer forum that the complainants have failed to establish deficiency in service on the part of the opp.party.
Therefore, the appeal fails and is accordingly dismissed but without costs.
K.CHANDRADAS NADAR : JUDICIAL MEMBER
V.V.JOSE : MEMBER
Be/
KERALA STATE
CONSUMER DISPUTES
REDRESSAL COMMISSION
SISUVIHARLANE
VAZHUTHACAUD
THIRUVANANTHAPURAM
APPEAL NO.504/12
JUDGMENT
DATED :30.01.2015
BE/