State Consumer Disputes Redressal Commission
Dr.L.Vidya Sagar Reddy, Md vs Badam Agaiah S/O Shankaraiah And Others on 8 November, 2012
BEFORE A.P STATE CONSUMER DISPUTES REDRESSAL COMMISSION AT HYDERABAD F.A.No.422 OF 2011 AGAINST C.C.NO.119 OF 2008 DISTRICT FORUM WARANGAL Between: Dr.L.Vidya Sagar Reddy, MD General Physician, Reg.No.46502 Authorized LIC Examiner, Pavan Nursing Home, Nekkionda Road Narsampet Village & Mandal Warangal District Appellant/opposite party A N D 1. Badam Agaiah S/o Shankaraiah Aged about 58 yrs, Occ: Agriculture 2. Badam Praveen S/o Agaiah aged about 35 years, Occ: Business 3. Badam Anil S/o Agaiah aged about 31 years, Occ: Business 4. Badam Ranjit S/o Agaiah Aged about 28 yrs, Occ: Business All are R/o Abbapur Village Mulugu Mandal, Warangal Dist. Respondents/complainants Counsel for the Appellant M/s V.Gourisankara Rao Counsel for the Respondent M/s T.Sridhar QUORUM: SRI R.LAKSHMINARASIMHA RAO, HONBLE MEMBER
AND SRI THOTA ASHOK KUMAR, HONBLE MEMBER THURSDAY THE EIGTH DAY OF NOVEMBER TWO THOUSAND TWELVE Oral Order (As per Sri R.Lakshminarasimha Rao, Honble Member) ***
1. The opposite party is the appellant. The respondent filed complaint seeking for direction to the appellant to pay an amount of `10,00,000/- towards damages and interest thereon and costs.
2. The case of the respondents is that first respondents wife was admitted to the appellants hospital on 26.12.2007 with the complaint of fever and as the appellant had not administered proper treatment, the respondents pressurizes the appellant to refer the patient to higher centre whereon on 31.12.2007 the appellant referred the patient to Rohini Hospital, Hanamkonda where the doctors diagnosed her suffering from cerebral malaria and she was treated in Rohini Hospital till 9.01.2008 and thereafter on the advice of the doctors while being shifted to Hyderabad ,she died on the way on 10.01.2008. The respondents got issued notice claiming compensation from the appellant on 19.05.2008 and thereafter filed complaint claiming the same amount of `10,00,000/-.
3. The appellant resisted the claim on the premise that on 26.12.2007 the deceased came to the appellant with compliant of fever and the appellant treated her as out-patient and prescribed some medicine. She consulted the appellant again on 28.12.2008 and was admitted to the nursing home of the appellant and she was treated till 31.12.2007. The appellant conducted all the required tests and the appellant advised the patient to go to higher centre and on request of the second respondent he admitted her in his nursing home. On clinical examination and basing on the reports, the appellant suspected the patient to have suffered from viral infection and mentioned in the medical record as suspected case of Dengue as the disease was periodically treated from September, 2006 till Jaunaury,2007.
4. The patient came to the appellant with complaint of fever, hypertension, diabetes mellitus on 26.12.2007 and the appellant prescribed some medicine and advised her to consult doctor Venkatrajam of Rohini Hospital who is her regular adviser and the second respondent refused to take the patient to doctor venkatrajam and they went back to their home and again she consulted the appellant with the complaints of hypertension and drowsy condition and as the patient is a known case of hypertension and diabetes mellitus, the appellant refused to admit her in his nursing home. On request of the respondent no.2, the appellant admitted the patient in his nursing home and he tried his best to control hypertension and fever and on 29.12.2007 he advised the second respondent to shift the patient to higher centre for better treatment.
5. The appellant contended that the tests conducted on 31.12.2007 at Rohini Hospital would show that the condition of the patient was normal on that date and on subsequent dates. The reports of Rohini Hospital would show that the appellant is not responsible for the death of the patient. The respondents had not opted for post mortem examination of the deceased to know the cause of death of the patient. The respondents made a speculative, baseless and fictitious claim. The respondents have no cause of action to file the complaint. Hence, the appellant prayed for dismissal of the complaint.
6. The first respondent was examined as PW1 and doctor Venkatrajam of Rohini Hospital as PW2 and Dr.E.Ashok Kumar was examined as PW3 ExA1 to A26 had been marked. On the side of the appellant, the appellant examined himself as RW1 and the case sheet was marked as ExB1.
7. The District Forum allowed the complaint on the premise that the appellant committed medical negligence while administering treatment to the first respondent s wife and there was deficiency in service on the part of the appellant in treating the patient at his hospital. The District Forum awarded an amount of Rs.5,00,000/- in favour of the respondents.
8. Aggrieved by the order of the District Forum, the opposite party has filed appeal contending that no doctor opined that there was medical negligence on the part of the appellant in administering treatment to the first respondents wife and that the patient had not taken further treatment after leaving Rohini Hospital and that the patient was a known case of coronary artery disease, hypertension and diabetes mellitus. It is contended that the appellant is a highly qualified doctor and he had administered proper treatment to the patient.
9. It is contended that at the time of discharge, the condition of the patient was normal. It is contended that the appellant is a highly qualified doctor and the patient was a known case of coronary artery disease, hypertension and diabetes mellitus and was on regular treatment at Warangal.
10. The point for consideration is whether the appellant rendered deficient service in administering treatment to the first respondents wife?
11. The appellant disputed the date of admission of the first respondents wife in his hospital on 26.12.2007. He has stated that the patient along with her son, the second respondent consulted him on 26.12.2007 with the complaint of high fever and he prescribed some medicine whereon they left for their home. The respondents stated that the patient was treated as in-patient in the appellants hospital from 26.12.2007 till 31.12.2007. The respondents in their notice had referred to admission of the patient on 26.12.2007 in the appellants hospital. In the notice it was referred to the admission of the patient on the advice of the appellant in his hospital and her being diagnosed with suffering from Dengue.
12. The appellant in his reply to the notice of the respondents denied any treatment administered to the patient as in-patient and stated that he had treated her as in-patient from 27.12.2007 till 31.12.2007. Thus, the appellant denied administering of any medical treatment to the patient either on 26.12.2007 or on27.12.2007. In the backdrop of the rival contentions, the prescriptions issued by the appellant would show that the appellant administered treatment to the patient from 26.12.2007 and not from 28.12.2007 as contended by him as also the appellants harping on collection of fee for four days in terms of the contents of the case sheet would not assist his case. The prescriptions dated 26.12.2007, 28.12.2007, 29.12.2007, 30.12.2007 and 31.12.2007 read as under:
26.12.2007
1. Inj Neurobion
2. Dispovan needle
3. Gepan
4. Resource Diabetic Powder
5. Megamost
6. Traxto
7. Zincad 28.12.2007
1. Cefobact Inj
2. Merideca
3. Resource Diabetic Powder
4. Glenter
5. Megamost
6. Nicardia
7. Zincad
8. Emigo 29.12.2007
1. Merideca
2. Olmeter
3. Zincad
4. Cefobact 30.12.2007
1. Neruppg
2. Olmeter
3. Megamost
4. Aceroc-P 31.12.2007
1. Cefobact Inj
2. Gepan
3. Vomikimu
4. Nerup P
5. Megamost
6. Nootraplum
7. Aceroc-p
13. The treatment administered to the patient as in-patient is reinforced by the Hematology Cell Analyzer Test Report and Urine Examination Report issued on 26.12.2007 by Rithwik Clinical Laboratory being conducted by the appellant. The appellant in his reply dated 4.06.2008 has totally denied administering of any treatment either as inpatient or outpatient to the first respondents wife. He has stated in his reply that:
It is submitted by my client that your client by name Badam Agaiah S/o Shekharaiah R/o Abbapur Village, mulug mandal, Warangal District got issued the notice through you by representing false allegations. As such my client denied all the allegations made in your notice. It is true that yhour clients wife by name Badam Jyothi was joined in my clients Hopsital for treatment. My client conducted tests like ESR, RBS, and CBP and gave appropriate medicine from 28.12.2007 to 31.12.2007 only for 72 hours but not from 26.12.2007 to 31.12.2007 as alleged in your notice
14. Thus the contention of the appellant that he treated the patient from 28.12.2007 is not tenable and not from 26.12.2007 is not tenable.
15. The appellant has stated that during the course of the patients stay at his hospital, he got conducted necessary tests and administered proper medicine. In support of his claim the appellant refers to the medical record of the patient issued by Rohini Hospital. We do not consider it a proper defence to contend that the subsequent treatment administered at Rohini Hospital would support the contention of the appellant that he rendered the treatment in accordance with the protocol prescribed therefor. The case sheet filed by the appellant pertaining to the patient would show that he diagnosed her with known case of Coronary Artery Disease/Hypertension/Diabetes Mellitus and present history of fever for about five days prior to the date of her admission and abdominal pain with vomiting two days prior to her admission in the hospital of the appellant.
16. The contention of the appellant is that the second respondent requested him to administer treatment for the last two days i.e., 30th and 31st December, 2007 on the premise that the doctors at Hanamkonda would not be available on the said two days. It is the plea of the respondents that the appellant in a negligent manner came to the conclusion that the patient was suffering from dengue. The appellant in his cross examination has stated as under:
To know the dengue fever platelet count test is one of the tests. I have conducted same test to the patient. But I have not mentioned the same in my case sheet i.e., Ex.B1. Witness adds the original documents for the tests conducted to the patient taken by the patients attendants. Platelet count came in CBP (Complete blood Picture) and RBS and Urine exam. The count of platelets mentioned in Ex.A7. The platelet counts are 1,45,000. The normal range of platelet count are 1,50,000 to 3,00,000.
17. He has further stated that I treated the patient only for dengue, I suspected the patient as dengue fever that is the reason I recommended for higher centre.
18. The statement of the appellant if considered in the backdrop of his reply dated 4.6.2008, it would indicate that the appellant has rendered deficient in service while treating the patient till she was discharged from the hospital on 31.12.2007. This fact is reinforced by the evidence of Dr.G.Venkatrajan of Rohini Hospital who had stated that after the patient was admitted in Rohini Hospital they had administered medicine till 6.1.2008, to the patient and that the patient was suffering from fever for about 5 days of her admission in Rohini Hospital and also she was incoherent and irritable at the time and the lab investigations and clinical examination concluded that she was suffering from cerebral malaria. The statement of PW2 would support the case of the respondent that the appellant was negligent in coming to the conclusion without any proper basis that the patient was suffering from dengue.
19. Dr.E.Ashok Kumar, the then Superintendent of MGM, Hospital, Warangal has stated that the patient suffered from fever, malaria, cerebral malaria, diabetes, hypertension, IHD, ARDS and metoblicencypholopahty and she died of cerebral malaria and multiple organ dysfunction and the main cause for complication was cerebral malaria added with hypertension, diabetes and IHD and that they would mention the laboratory reports in the case sheet of the patient. He has stated that in the case sheet issued by the appellant, the appellant has not mentioned pathology reports nad clinical reports of the patient as also any of her other test reports. The statement of PW3 would also support the case of the respondents that the treatment to the patient during the course of her stay at the appellants hospital was not to the prescribed standard or in accordance with the protocol prescribed thereof. He has stated that the appellant failed to review the status when there was no response to his treatment from the patient. Viewed from any angle, the deficiency in service on the part of the appellant is established and the appellant failed to rebut that he was not negligent nor rendered deficient service to the patient.
20. The District Forum has awarded a sum of `5 lakh as compensation to the respondent. At the time of awarding compensation several parameters are to be taken into consideration such as the past history of the patient and the response she had given to the treatment of the appellant as also the patients immunity and other such factors. Admittedly, the patient was a known case of hypertension, diabetes mellitus and IHD. The other complications cannot be attributed to the treatment administered by the appellant except that he had proceeded to treat her on the premise that she was suffering from dengue and when she failed to respond to the treatment, he had not made any effort to review the treatment and the status of the patient. A patient suffering from various diseases is prone to develop complications in case she is attacked with such disease as cerebral malaria .
21. The Honble Supreme Court in State of Gujarath vs Shantilal Mangaldas AIR 1969 SC 634. held the compensation to mean..In ordinary parlance the expression compensation means anything given to make things equivalent; a thing given to or to make amends for loss recompense, remuneration or pay, it need not therefore necessarily in terms of money. The phraseology of the Constitutional provision also indicates that compensation need not necessarily be in terms of money because it expressly provides that the law may specify the principles on which, and the manner in which , compensation is to be determined and given . If it were to be in terms of money along, the expression paid would have been more appropriate.
22.
The Supreme Court held that the compensation to be awarded is to be fair and reasonable. In Charan Singh vs Healing Touch Hospital and others 2000SAR(Civil) 935 the Apex Court stressed the need of balancing between the compensation awarded recompensing the consumer l and the change it brings in the attitude of the service provider. The Court held While quantifying damages , consumer forums are required to make an attempt to serve ends of justice so that compensation is awarded, in an established case, which not only serves the purpose of recompensing the individual, but which also at the same time aims to bring about a qualitative change in the attitude of the service provider. Indeed calculation of damages depends on the facts and circumstances of each case. No hard and fast rule can be laid down for universal application. While awarding compensation, a Consumer Forum has to take into account all relevant factors and assess compensation on the basis of accepted legal principles, on moderation. It is for the Consumer Forum to grant compensation to the extent it finds it reasonable, fair and proper in the facts and circumstances of a given case according to established judicial standards where the claimant is able to establish his charge.
23. The appellant has suggested to the doctor of Rohini Hospital who was examined as PW2 that some of the complications arose as a result of excessive administration of fluid at Rohini Hospital.
The respondents had not added the doctors of Rohini Hospital as party to the complaint. The respondents have not subjected the patients body for post-mortem examination in order to know cause of her death. All the factors would mitigate the degree of magnitude of deficiency in service on the part of the appellant. Taking into consideration of the aforementioned facts in addition to various other factors, the amount granted as compensation `5 lakh in favour of the respondents being on higher side and the amount is, as such liable to be reduced to a sum of `1,00,000/-.
24 In the result the appeal is allowed. The order of the District Forum is modified.
The opposite party is directed to pay an amount of `1,00,000/- to the complainants with interest @ 7.5% per annum from the date of filing of the complaint till payment. The parties shall bear their own costs. Time for compliance four weeks.
MEMBER MEMBER Dt.08.11.2012 KMK*