State Consumer Disputes Redressal Commission
Dr. J.S.Sidhu vs Ashok Bhandari on 21 March, 2017
FIRST ADDITIONAL BENCH
STATE CONSUMER DISPUTES REDRESSAL COMMISSION,
PUNJAB SECTOR 37-A, DAKSHIN MARG, CHANDIGARH.
First Appeal No.1000 of 2015
Date of Institution: 03.09.2015
Order reserved on:20.03.2017
Date of Decision : 21.03.2017
Dr. J.S. Sidhu, c/o Parvati Devi Hospital carries on its business at
Ranjit Avenue, Amritsar having his residence at H.No.154, Shastri
Nagar, Amritsar.
.....Appellant/opposite party no.1
Versus
1. Ashok Bhandari son of late Sh. Khishi Ram Bhandari, resident
of House No.7, Mahindra Colony, Amritsar.
Respondent no.1/complainant
2. Parvati Devi Hospital through its owner/M.D./ Managing
carrying on its business at Ranjit Avenue, Amritsar.
3. Reliance General Insurance Company Limited, having its office
at SCO-122, Ranjit Avenue, opposite Amritsar Improvement
Trust Complex, Amritsar through its Branch Manager.
4. United India Insurance Company Limited, 59, Janpath
Connaught Place, New Delhi through its Manager.
.....Respondent nos.2-4/opposite party nos.2-4
First Appeal against order dated
22.07.2015 passed by the District
Consumer Disputes Redressal Forum,
Amritsar.
Quorum:-
Shri J. S. Klar, Presiding Judicial Member
Smt. Surinder Pal Kaur, Member Present:-
For the appellant : Sh. Puneet Sharma, Advocate
For respondent no.1 : Sh. Akhilesh Vyas, Advocate
For respondent no.2 : Sh. Balwinder Singh, Advocate
For respondent no.3 : Sh. Ranjeesh Malhotra, Advocate
For respondent no.4 : Sh. Satpal Dhamija, Advocate .................................................
2) First Appeal No.1001 of 2015 Date of Institution: 03.09.2015 First Appeal No.1000 of 2015 2 Order reserved on:20.03.2017 Date of Decision : 21.03.2017 Parvati Devi Hospital, A-Block, Ranjit Avenue, Amritsar through its authorized signatory.
.....Appellant/opposite party no.2 Versus
1. Ashok Bhandari son of late Sh. Khishi Ram Bhandari, resident of House No.7, Mahindra Colony, Amritsar.
Respondent no.1/complainant
2. Dr. Jagtesh Singh Sidhu, House No.154, Shastri Nagar, Amritsar.
3. Reliance General Insurance Company Limited, having its office at SCO-122, Ranjit Avenue, opposite Amritsar Improvement Trust Complex, Amritsar through its Branch Manager.
4. United India Insurance Company Limited, 59, Janpath Connaught Place, New Delhi through its Manager.
.....Respondent nos.2-4/opposite party nos.1,3&4 First Appeal against order dated 22.07.2015 passed by the District Consumer Disputes Redressal Forum, Amritsar.
Quorum:-
Shri J. S. Klar, Presiding Judicial Member Smt. Surinder Pal Kaur, Member Present:-
For the appellant : Sh. Balwinder Singh, Advocate For respondent no.1 : Sh. Akhilesh Vyas, Advocate For respondent no.2 : Sh. Puneet Sharma, Advocate For respondent no.3 : Sh. Ranjeesh Malhotra, Advocate For respondent no.4 : Sh. Satpal Dhamija, Advocate .................................................
AND
3) First Appeal No.1004 of 2015
Date of Institution: 04.09.2015
Order reserved on:20.03.2017
Date of Decision : 21.03.2017
Ashok Bhandari son of late Sh. Khishi Ram Bhandari, resident of House No.7, Mahindra Colony, Amritsar.
.....Appellant/complainant First Appeal No.1000 of 2015 3 Versus
1. Dr. J.S. Sidhu, c/o Parvati Devi Hospital, carrying on its business at Ranjit Avenue, Amritsar having his residence at H.No.154, Shastri Nagar, Amritsar.
2. Parvati Devi Hospital, through its owner/M.D./Manager, carrying on its business at Ranjit Avenue, Amritsar.
3. Reliance General Insurance Company Limited, having its office at SCO-122, Ranjit Avenue, opposite Amritsar Improvement Trust Complex, Amritsar.
4. Reliance General Insurance Company Limited, having its office at SCO-122, Ranjit Avenue, opposite Amritsar Improvement Trust Complex, Amritsar, through its Branch Manager.
5. United India Insurance Company Limited, 59, Janpath Connaught Place, New Delhi through its Manager.
.....Respondents/opposite parties First Appeal against order dated 22.07.2015 passed by the District Consumer Disputes Redressal Forum, Amritsar.
Quorum:-
Shri J. S. Klar, Presiding Judicial Member Smt. Surinder Pal Kaur, Member Present:-
For the appellant : Sh. Akhilesh Vyas, Advocate
For respondent no.1 : Sh. Puneet Sharma, Advocate
For respondent no.2 : Sh. Balwinder Singh, Advocate
For respondent no.3 : Sh. Ranjeesh Malhotra, Advocate
For respondent no.4 : Sh. Satpal Dhamija, Advocate ................................................ J.S KLAR, PRESIDING JUDICIAL MEMBER :-
By this common order, we intend to dispose of the above referred three connected first appeals, as they have arisen out of the order dated 22.07.2015 of the District Consumer Disputes Redressal Forum, Amritsar (in short 'the District Forum'). The order shall be pronounced in main first appeal no.1000 of 2015 titled as "Dr. J.S. Sidhu Vs. Ashok Bhandari & others", which has been filed by OP First Appeal No.1000 of 2015 4 no.1 against above order, as appellant, vide which, the complaint of the complainant was allowed against OP nos.1 and 2 by directing them to pay compensation to the tune of Rs.10 lakhs (Rs. Ten lakhs) i.e. Rs.5 lakhs each in equal shares, to the complainant. It was further ordered that OP nos.1 and 2 could claim this amount from OP nos.3 and 4 from their respective insurers, as per the terms and conditions of the insurance policies and further to pay Rs.5000/- as cost of litigation to the complainant. Appellant of this appeal is OP no.1 and respondent no.2 is the complainant and respondent nos.2- 4 are OP nos.2-4 in the original complaint before the District Forum and they be referred as such, hereinafter for the sake of convenience.
2. The appellant of first appeal no.1001 of 2015, being opposite party no.2 in the complaint, has directed this appeal against order dated 22.07.2015 of District Consumer Disputes Redressal Forum Amritsar. The appellant of this appeal is OP no.2 in the complaint, respondent no.1 of this appeal is complainant and respondent nos.2 to 4 are OP nos.1,3&4 in the original complaint before the District Forum and they be referred as such hereinafter for the sake of convenience. First appeal no.1004 of 2015 has been filed by the appellant for enhancement of claim amount. The appellant of this appeal is complainant in the complaint and respondents of this appeal are the OPs in the complaint and they be referred as such hereinafter for the sake of convenience First Appeal No.1000 of 2015 5
3. Complainant Ashok Bhandari instituted the complaint under Section 12 of the Consumer Protection Act, 1986 (in short, "the Act") against the OPs on the averments that his son Rupesh Bhandari was admitted at Parvati Devi Hospital Amritsar, OP no.2 on 02.07.2011 with complaint of high fever and increase in the level of SGOT and SGPT (lever enzymes) touching the level in thousands. OP no.1 Dr. J.S. Sidhu gave IV fluids of different types and certain antibiotics and injections namely augmentin of 1 gm etc. to patient Rupesh Bhandari after admitting him. At about 11:15 AM on 03.07.2011, on the next day of admission of patient, his condition got deteriorated. The complainant went to house of OP no.1 Dr. J.S. Sidhu, as he was absent from the hospital at that time. The complainant apprised him that the condition of his son was not good and he wanted to know about the nature and seriousness of disease of his son. OP no.1 advised complainant for second opinion of local expert Hepatologist, Dr. Harpreet Singh to satisfy himself. The complainant called Dr. Harpreet Singh, who came at about 2:30 P.M. at OP no.2 hospital for seeing the condition of the patient and said doctor examined the patient and advised that no medicines were required for the patient. The patient was required to have complete bed rest and further advice of tests of Hepatitis A, which was found positive and hepatitis E was found negative, as per report given by Nalanda Diagnostic Centre dated 04.07.2011. Despite the advice of Dr. Harpreet Singh superspecialist for giving no medicines to patient at that stage, OP no.1 gave numerous medicines on his own and he First Appeal No.1000 of 2015 6 also gave hepamerz and SYNS injections to the patient on the next day of his admission and several other medicines, which ought not to have been given to the patient by OP no.1. The above injections were given in 100 ml normal saline within very short interval of time i.e. three times within difference of 10-15 minutes in whole day in morning, afternoon and night, respectively. The said injections ought not to be given in less than 30 minutes per dose. The patient felt very uneasy, but OP no.1 did not bother about it and rather kept on experimenting by giving one after other medicines to patient. On the next day, same treatment was given to the patient i.e. three times within the difference of 10-15 minutes in whole day in the morning, afternoon and night respectively. On 05.07.2011, Dr. Harpreet Singh came to see the patient on request of the complainant and advised for no medicines, but OP no.1 continued giving the same treatment to the patient. On 06.07.2011, the condition of the patient became very serious and his condition further worsened minute after minute.
OP no.1 did not turn up despite repeated calls made by the complainant nor he attended even to a single call of the complainant. OP no.1 turned up in the evening and told complainant that condition of patient was very serious and further advised him to take the patient to some other tertiary centre, wherever the complainant liked. The complainant advised OP no.1 to shift the patient in ICU due to his worsening condition. OP no.1 told complainant that there ICU was not in working condition and it was locked and advised to shift the patient to Fortis Hospital Amritsar. The complainant paid First Appeal No.1000 of 2015 7 Rs.10,000/- to OP no.2 hospital, vide receipts no.42720 and 42769 worth Rs.5000/- each besides other expenses, such as on various tests or medicines. The complainant purchased the medicines from Amrit Medical Store. On 06.07.2011, at about 10:42, complainant reached Fortis Hospital Amritsar with patient, who was in semiconscious stage, high grade fever with vomiting. The patient was having hepatitis-A. The tests were conducted in Fortis Hospital Amritsar and summary was prepared. The case summary revealed the value of SGPT and SGOT of patient touching beyond the level of 1000 i.e. at 3079 & 1220 respectively. Patient was suffering from mild ascites, B/L pleural effusion and he was diagnosed as suffering from hepatitis-A, Hepatic Encephalopathy, acute renal failure. It was apprised to complainant that both kidneys of patient had failed, because urine output of the patient has not been measured even a single time at Parvati Hospital with Folis Cathedor. The complainant was then told that creatinine level of patient was also high and during four days of stay of patient in OP no.2 hospital, treating doctor did not get it done even a single time. The patient was kept in ICU for 39 days at Fortis Hospital, as doctors there told the complainant that the condition of patient was very much serious. The complainant spent Rs.11,92,036/- on the treatment of his above son in Fortis Hospital Amritsar. The patient was not suffering from any such disease as diagnosed at Fortis Hospital, when admitted in OP no.2 hospital as recorded in case summary. The condition of patient deteriorated to such an extent only due to reasons of the first day of his admission First Appeal No.1000 of 2015 8 in OP no.2 hospital. OP no.1 and paramedical staff thereat did not attend on the patent at regular intervals. OPs had not disclosed the complainant regarding serious condition of the patient and exact diagnosis of the disease from which patient was suffering. The OPs did not bother about the fact that due to increase in level of SGOT and SGPT, the liver of the patient was being affected badly and that was also affecting the kidneys of the patient, but doctor OP no.1 did not care a fig of all these facts and circumstances. The nephrology consultation was also not done by OPs during the stay of the patient thereat, which also ought to have been done, if the kidneys of the deceased were also involved. OP no.1 was the treating doctor at OP no.2 hospital and was not possessing the required degree in the field of hepatology/gastroenterology. OP no.1 played with precious lives of people. On 13.08.2011, son of complainant died leaving behind his wife and two daughters aged 10 years and 7 years old. The complainant sought necessary information regarding the medical record of his son since deceased from OPs, but they withheld the same for the reasons best known to them. The complainant served legal notice dated 14.06.2012 upon OPs to provide the required information, but to no effect. The complainant invoked remedy under RTI Act and solicited such information, vide his application dated 18.08.2012, but to no effect. The complainant alleged medical negligence on the part of OP nos.1 and 2, as referred to above and hence prayed for an amount of Rs.11,92,036/- paid at Fortis Escort Hospital Amritsar and Rs.10,000/- paid at OP no.2 hospital; further First Appeal No.1000 of 2015 9 prayed that OP nos.1 and 2 be directed to pay Rs.6 lakhs as compensation for their negligence; and to pay Rs.1 lakh as litigation expenses.
4. Upon notice, Op no.1 appeared and filed separate written reply and contested the complaint of the complainant vehemently. It was averred that Rupesh Bhandari son of complainant was admitted in OP no.2 hospital, vide admission code no.9618 on 02.07.2011 as a case of acute viral hepatitis. The patient was put on conservative management, after necessary examination and he was conscious, oriented and self voiding. He was treated with due care and diligence by OPs. His vitals were monitored regularly at a frequency of two hours. He was administered treatment, as per standard medical protocol with consultation of above Dr. Harpreet Singh. The complainant himself got the pathological tests at Real Diagnostic Centre on 01.07.2011 and on 04.07.2011. On 06.07.2011, the patient developed irritability, which was a sign of hepatic encephalopathy and which could further progress to fulminant hepatic failure. The complainant was apprised of the situation and he was advised to shift the patient to a higher centre, as the patient would require ventilator support, dialysis and even liver transplant and it would involve high costs and complainant was reluctant to shift the patient. OP no.1 telephonically contacted with Dr. H.P. Singh, Director of Fortis Escort Hospital regarding the status of the patient and the need to shift him to higher centre. OP no.1 acted as per advice of Dr. H.P. Singh of Fortis Hospital and patient was shifted to First Appeal No.1000 of 2015 10 Fortis Hospital Amritsar. During stay of patient at OP no.2 hospital, he was examined twice by Dr. Harpreet Singh gastroenterologist on 03.07.2011 and on 05.07.2011. The treatment at OP no.2 hospital was administered in consultation with above Dr. Harpreet Singh. Any medical negligence or unfair trade practice on the part of OP no.1 was vehemently denied. The complaint is alleged to be not maintainable. On merits, OP no.1 contested the complaint of the complainant. OP no.1 denied this fact that on 02.07.2011, the son of complainant Rupesh Bhandari was got admitted in OP no.2 hospital with a complaint of high fever as well as increase in level of SGOT and SGPT (liver enzymes). This fact was also denied by him that in the morning of next date of admission i.e. on 03.07.2011 at about 11:00 AM, the condition of the patient became deteriorated. Dr. Harpreet Singh was called by OPs and not by the complainant. This fact was also denied that on the advice of Dr. Harpreet Singh, the complainant got the tests conducted of patient i.e. hepatitis A and hepatitis E from Nalanda Diagnostic Centre on 04.07.2011. As per report, hepatitis A was found positive and hepatitis E was found negative in the patient. This fact was denied that despite advice of no medication by super specialist doctor, OP no.1 gave numerous medicines on his own and he gave one injection hepamerz and injection SYNS in 100 ml within very short interval of time on next day of admission and several other medicines, which ought not to have been given by OP no.1. This fact was denied that on 05.07.2011, Dr. Harpreet Singh came to see the condition of patient First Appeal No.1000 of 2015 11 on request of complainant and further advised for no medicines, which ought not to have been given by OP no.1. This fact was vehemently denied by OP no.1 that he told complainant that ICU in OP no.2 hospital was not in working condition and was lying locked. The true fact is that the ICU was very much functional and a patient was under treatment in the ICU during the alleged period. It was denied that on 06.07.2011 at about 10:42 pm, complainant reached Fortis Hospital Amritsar with patient in a semiconscious state, high grade fever with vomiting. It was denied by OP no.1 that all the tests of patient were conducted in Fortis Hospital and case summary was prepared and patient's SGPT and SGOT had reached beyond the level of 1000 i.e. 3079 and 1220 respectively. It was also denied that patient was suffering from fatty liver with thickened and oedematous gall bladder hepatitis, acute renal failure, mild ascites, B/L pleural effusion and patient was kept in ICU for 39 day at Fortis Hospital and complainant spent Rs.11,92,036/- on his treatment at the said hospital. It was further averred that patient was a case of acute fulminant hepatitis and developed hepatic encephalopathy, renal failure and septicemia which were known complications of acute fulminant hepatitis and had a very high mortality rate upto 80%. OP no.1 denied any medical negligence or unfair trade practice on the part of OP nos.1 and 2 and, thus, prayed for the dismissal of the complaint.
5. OP no.2 filed separate written reply by denying this fact that complainant is consumer of OPs. The complainant is debarred First Appeal No.1000 of 2015 12 from filing the complaint and the complaint is not maintainable. There is no proof of medical negligence of OPs with the complainant. The complainant has no locus standi to file the complaint. In the absence of post mortem report of the patient, alleged to have died, exact cause of death cannot be known and it cannot be attributed to any of the OPs. On merits, OP no.2 averred that Rupesh Bhandari patient was admitted on 02.07.2011 on reference and under consultation of OP no.1, Dr. J.S. Sidhu, vide admission code 9618. The patient was case of acute viral hepatitis. Treatment record of patient did not show anywhere with regard to deteriorated condition of the patient on 03.07.2011, as alleged. OP no.1 conducts OPD in the hospital of OP no.2 till 2 PM everyday and on 06.07.2011, he was very much in the hospital and the ICU of OP no.2 hospital was functional on 06.07.2011. Any deficiency in service or medical negligence on the part of OP nos.1 and 2 was denied in toto. OP no.2 prayed for dismissal of complaint by alleging the complaint to be false and frivolous.
6. OP no.3 filed its separate written reply by raising preliminary objection that there is no privity of contract between the complainant and answering OP, hence the complaint is not maintainable. It was averred that OP no.2 hospital was insured with it, vide Medical Establishment- Errors & Omission Liability Policy. It was denied that there was any medical negligence on the part of OP no.2. The complainant spent Rs.11,92,036/- on treatment of his son at Escort/Fortis Hospital Amritsar, in case any amount is found First Appeal No.1000 of 2015 13 payable by OP No.2, the same could only be fixed against above hospital. The complaint is alleged to be bad for non-joinder of necessary parties, i.e. Fortis Hospital Amritsar, where son of the complainant received treatment and remained admitted for a long period. Patient left his wife and two daughters aged 10 years and 7 years. In this case, mother of patient is also alive and she is also equally entitled to file the complaint, hence the complainant has no locus standi to file the complaint. On merits, OP no.3 controverted the averments of the complainant and prayed for dismissal of the complaint.
7. OP no.4 filed its separate written reply by averring that written reply filed by OP no.1 be treated as part of written reply of OP no.4. OP no.4 had issued professional indemnity medical establishment policy to OP no.1. The standard terms and conditions, with exclusion of this policy are applicable in the present case. OP no.4 averred that complainant is not entitled to ay amount of compensation and hence prayed for dismissal of the complaint.
8. The complainant tendered in evidence affidavit and documents Ex.C-1 to C-38, CA, CB and CB and closed the evidence. OP nos.1 and 4 tendered in evidence affidavit Ex.OP-1/A alongwith documents Ex.OP-1/1 to Ex.OP-1/9 and closed the evidence. OP no.2 tendered in evidence copy of resolution Ex.OP- 2/2 and closed the evidence. OP no.3 tendered in evidence affidavit and document Ex.OP-3/1 and Ex.OP-3/2 and closed the evidence. On conclusion of evidence and arguments, the District Forum First Appeal No.1000 of 2015 14 accepted the complaint of the complainant, as referred to above. Dissatisfied with the above order, OP no.1 has preferred first appeal no.1000 of 2015 and OP no.2 has directed first appeal no.1001 of 2015 against the same, whereas the complainant has filed first appeal no.1004 of 2015 for enhancement of compensation amount.
9. We have heard the learned counsel for the parties at considerable length and have also examined the record of the case. Ashok Bhandari complainant tendered his affidavit Ex.C-1 in evidence and supplementary affidavit Ex.C-2. He stated in his affidavit that his son Rupesh Bhandari was admitted at OP no.2 hospital on 02.07.2011 with complaint of high fever and increase in the level of SGOT and SGPT (lever enzymes) touching to the level of thousands. OP no.1 Dr. J.S. Sidhu gave IV fluids of different types and certain antibiotics and injections namely augmentin of 1 gm etc. to patient Rupesh Bhandari after his admission at OP no.2. At about 11:15 AM on 03.07.2011, the condition of the patient got worse. The complainant went to house of OP no.1 Dr. J.S. Sidhu, as he was not available in the hospital at that time. The complainant apprised him about the deteriorating condition of his son. He asked about the nature and seriousness of disease of his son from OP no.1. OP no.1 advised complainant for second opinion of local expert Hepatologist, Dr. Harpreet Singh. He further deposed that Dr. Harpreet Singh at about 2:30 P.M. came at OP no.2 hospital for seeing the condition of the patient and said doctor examined the patient and advised that no medicines were required for him. The patient was required to have First Appeal No.1000 of 2015 15 complete bed rest and further advice of test of Hepatitis A, which was found positive and hepatitis E, which was found negative, as per report given by Nalanda Diagnostic Centre dated 04.07.2011. This witness further testified that despite the advice of Dr. Harpreet Singh for no medicines at that stage, OP no.1 gave numerous medicines and also gave hepamerz and SYNS injections to the patient on the next day of admission of patient and several other medicines, which ought not to have been given to the patient by OP no.1 The above injections were given in 100 ml normal saline within very short interval of time i.e. three times within difference of 10-15 minutes in whole day in morning, afternoon and night respectively. The said injections ought not to be given in less than 30 minutes per dose. The patient felt very uneasy, but OP no.1 did not bother about it and kept on experimenting by giving one after other medicines to the patient. On the next day, same treatment was given to the patient i.e. three times within difference of 10-15 minutes in whole day in the morning, afternoon and night respectively. On 05.07.2011, Dr. Harpreet Singh came to see the patient on request of the complainant and advised for no medicines, but OP no.1 continued giving the same treatment to the patient. On 06.07.2011, the condition of the patient became very serious and his condition further worsened minute after minute. OP no.1 had not turned up despite repeated calls made by the complainant nor he attended even to a single call of the complainant. OP no.1 turned up in the evening and apprised complainant that condition of patient was very serious and First Appeal No.1000 of 2015 16 advised him to take the patient to some other hospital wherever the complainant liked. The complainant advised OP no.1 to shift the patient in ICU due to his worse condition. OP no.1 told complainant that there ICU was not in working condition and it was locked and further advised him to shift the patient to Fortis Hospital Amritsar. The complainant paid Rs.10,000/- to OP no.2 hospital, vide receipts no.42720 and 42769 worth Rs.5000/- each besides other expenses such as on various tests or medicines. The complainant purchased the medicines from Amrit Medical Store. On 06.07.2011, at about 10:42, complainant reached Fortis Hospital with patient, who was in semiconscious stage, high grade fever with vomiting. The patient was having hepatitis-A. The tests were conducted in Fortis Hospital Amritsar and summary was prepared. The case summary revealed the value of SGPT and SGOT of patient crossing the level of 1000 i.e. at 3079 & 1220 respectively. Patient was suffering from mild ascites, B/L pleural effusion and he was diagnosed as suffering from hepatitis-A, Hepatic Encephalopathy, acute renal failure. It was apprised to complainant that both kidneys of deceased had failed because urine output of the patient was not measured even a single time at Parvati Hospital with Folis Cathedor. The complainant was told that creatinine level of patient was also high and during four days of his stay in OP no.2 hospital, treating doctor did not get it done even a single time. The patient was kept in ICU for 39 days, as doctors at Fortis Hospital told the complainant that the condition of patient was very much serious. The complainant spent First Appeal No.1000 of 2015 17 Rs.11,92,036/- on the treatment of his above son in Fortis Hospital Amritsar. The patient was not suffering from any such disease, as diagnosed at Fortis Hospital, when admitted in OP no.2 hospital, as recorded in case summary. The condition of patient deteriorated to such an extent only due to negligence of OPs. Ex.C-3 is the patient record issued for Fortis Escort Hospital, Amritsar. Ex.C-4 is the case summary prepared at Fortis Hospital of above son of the complainant. Ex.C-5 is letter from complainant to Superintendent of OP no.2 hospital for supply of the record under regulation 1.3.2 of the Medical Council of India (MCI) 'Code of Medical Ethics and Regulations'. Ex.C-6 is the inpatient bill dated 13.08.2011 in the name of Rupesh Bhandari son of complainant for Rs.11,92,036/- issued for Fortis Escort Hospital. Ex.C-7 is the Death Certificate of Rupesh Kumar Bhandari showing his date of death as 13.08.2011. Ex.C-8 is the application for information under Section 6(1) of RTI Act. Ex.C-9 is the death summary report of Rupesh Bhandari issued by Fortis Hospital. Ex.C-10 is the notice served upon OP no.1 by complainant. Ex.C-11 to C-30 are bills for purchasing the medicines for the treatment of patient. Ex.C-31 is the photograph of Board of Dr. J.S. Sidhu, showing him as M.D. Physician & Gastroenterologist. Ex.C-32 to C-35 are the medical notes prepared by OP no.1 at OP no.2 hospital. Ex.C-A and C-B are the lab investigations of Rupesh Bhandari. Ex.C-36 is the general charges. Ex.C-37 is the nurses treatment chart. Ex.C-38 is the ultrasonography report of Mr. Rupesh dated 02.07.2011. Ex.C-39 is the report of Hepatitis A 1gm antibody; First Appeal No.1000 of 2015 18 anti HAV, 1gm of Rupesh Bhandari issued Nalanda Diagnostic Centre dated 04.07.2011 showing the result positive. Ex.C-40 is the another report of Hepatitis E showing result negative.
10. OP nos.1 and 4 also tendered in evidence affidavit of Dr. J.S. Sidhu Ex.OP-1/A on the record. This witness stated in his statement that Rupesh Bhandari S/o Ashok Bhandari was admitted in hospital of OP no.2 on 02.07.2011 on reference and under consultation of OP no.1, Dr. J.S. Sidhu, vide admission code 9618 as a case of acute viral hepatitis. The patient was treated with due care and diligence and he was put on conservative management. Pathological examinations of the patient were conducted in the laboratory of the complainant himself i.e. at Real Diagnostic Centre on 01.07.2011 and on 04.07.2011. The patient developed irritability on 06.07.2011, which was a sign of hepatic encephalopathy, which could further progress to fulminant hepatic failure. Treatment record of patient did not show anywhere with regard to deteriorated condition of the patient on 03.07.2011, as alleged. OP no.1 conducts OPD in the hospital of OP no.2 till 2 PM everyday and on 06.07.2011. He denied any medical negligence on his part in the treatment of the patient. Ex.OP-1/1 is the indoor patient record of Rupesh Bhandari showing his date of admission as 02.07.2011 and date of discharge as 06.07.2011. Ex.OP-1/2 is the degree certificate of bachelor of medicine & bachelor of surgery of Dr. J.S. Sidhu. Ex.OP-1/3 is the certificate of master of medicine in the name of Dr. J.S. Sidhu. Ex.OP-1/4 is the renewal certificate of OP no.1 by Punjab First Appeal No.1000 of 2015 19 Medical Council. Ex.OP-1/5 to Ex.OP-1/8 are the medical literatures on Fulminant Hepatic Failure. Ex.OP-1/9 is the copy of professional indemnity Dr.(other) policy. OP no.2 relied upon affidavit of Sunil Handa, Authorized representative of OP no.2 Ex.OP-2/1. He denied any medical negligence on the part of hospital OP no.2 in this case. OP no.2 also tendered in evidence copy of resolution Ex.OP-2/2 authorizing Sunil Handa to appear on its behalf. OP no.3 relied upon affidavit of Sanpreet Pahuja Ex.OP-3/1 on the record. Ex.OP-3/2 is the copy of Reliance Medical Establishment-Error and Omission Liability Policy Schedule. The case of OPs is that Rupesh Bhandari patient was treated as per standard medical protocol. It was also submitted that Kidney failure is the known complication of hepatitis A.
11. From appraisal of above referred evidence on the record and hearing the respective submissions of counsel for the parties, I find the negligence of OP nos.1 and 2 in this case in the treatment of Rupesh Kumar leading to his death, which is a proved fact on the record. Firstly, as argued by counsel for the complainant, there was no informed consent in this case of the patient for his treatment with OP nos.1 and 2. Our attention has been drawn to the consent form at page no.247 of the record of indoor patient record Ex.OP-1/1. We have examined the consent form carefully. No date has been put on it. Most of its columns are lying blank. There is no mention of any disease with its risk factors in the consent form as well. Only signature of father of the deceased are taken on it under the column First Appeal No.1000 of 2015 20 of patient's relative. No signatures of patient, who was in a conscious state at the time of his admission, as per own case of OPs, are taken on this consent form. There is no mention of any ailment recorded on it. We cannot make out from it that this is an informed consent of the patient. The National Commission held in case "Sree Chitra Tirunal Institute for Medical Sciences and Technology Versus Premeela & others" IV (2014)CPJ-488 (NC) that patient needs to be informed of all the common complications of BMV procedure so that she can decide whether, considering possible benefits, complications and risks involved, she wanted to subject her body to said procedure or not. There is no evidence of doctor performing BMV procedure having become nervous or overawed on account of procedure being watched by delegates attending the conference in the cited authority. The National Commission further held in this authority that doctor or hospital cannot be said negligent merely because patient could not be saved, despite best efforts made by them. Deficiency not proved except to extent that consent was taken from son-in-law of patient, thought it ought to have been taken personally from her. We, thus, conclude that there was no valid and informed consent of the patient for his treatment initiated by OP no.1 at the hospital of OP no.1. On this point, we find force in law laid down by Apex Court in case "Malay Kumar Ganguly Vs. Sukumar Mukherjee (Dr.) & others"
III(2009) CPJ-17(SC). The Apex Court has held in para no.164 and 166 of this authority that patient by and large are ignorant about disease or side and adverse effects of medicines. Ordinarily patients First Appeal No.1000 of 2015 21 are to be informed about admitted risk if any. If some medicine has some adverse effect or some reaction is anticipated, he should be duly informed thereabout. Law on medical negligence also has to keep up with advances in medical science, as to treatment as also diagnostics. On this point, OPs are medically negligent because they have not taken the valid and informed consent of the patient by explaining him the nature of disease and administering medicines therefor and resulting consequences.
12. Secondly, OPs are also negligent on this point that this fact came to their knowledge on the date of admission on 02.07.2011 that the patient was a case of Fulminant hepatic. In the written statement of OP no.1, he denied this fact that patient was admitted in OP no.2 hospital with complaint of high fever and increased level of SGOT and SGPT. It is alleged that he was a case of acute viral hepatitis by OPs. From the treatment record of patient Rupesh Bhandari, I find that OP no.1 himself recorded acute fulminant hepatic on 02.07.2011 on the date of admission of the patient. Once this fact came to notice of OP no.1 on 02.07.2011 that he was a patient of fulminant hepatic, then it was the solemn duty of OP nos.1 and 2 to call a nephrologist for consultation, when the involvement of the kidneys of the patient was there. No such nephrologist was called during all this period of the stay of patient at OP no.2 hospital. Kidney is the most prone area for being affected with fulminant hepatic and non calling of expert nephrologist for consultation constitutes medical negligence on the part of the OPs in First Appeal No.1000 of 2015 22 this case in my opinion. The medical literature placed on record also states that fulminant hepatic failure could have affected the kidney of the patient and no such precaution was taken by the OPs to protect the kidneys of the patient by consultation with expert nephrologist. On this point, OPs are held negligence by me.
13. The next point raising finger of negligence at OP no.1 is that he held out himself to be gastroenterologist to complainant. The complainant brought his son to OP no.1 on this assurance. Photograph Ex.C-31 has proved that OP no.1 Dr. J.S. Sidhu showed himself as M.D., Physician & gastroenterologist. He is merely M.D. (Master of Medicine). He has no degree of D.M. in gastroenterology, as made out by me on the record. If he did not hold any degree of D.M. of gastroenterology, the he has no right to pose himself as gastroenterologist. The counsel for the complainant produced before us the document of medical council of India dated 12.06.2014 taken under RTI application dated 20.05.2014, I find it is replied by Medical Council of India that the qualification of D.M. is essential for gastroenterologist to practice in the field of gastroenterology. OP no.1 was not D.M. in gastroenterology and his representing himself as gastroenterologist, as depicted in the above photographs, is also a case of deficiency in service on his part. We agree with the findings of the District Forum on this point. It is admitted in the statement of OP no.1 that the test regarding hepatitis A and E was advised by Dr. Harpreet Singh, when the patient developed signs and symptoms of fulminant hepatic and on that basis, he came to the First Appeal No.1000 of 2015 23 conclusion that patient might require ventilator support and dialysis and liver transplant. From the statement of OP no.1 dated 30.10.2014, it transpired that the symptoms of fulminant hepatic came to his notice on 06.07.2013 after advice of Dr. Harpreet Singh. He stands seriously contradicted on this point by the record prepared by him of the patient, wherein the disorder of acute fulminant hepatic came to the notice of this doctor on 02.07.2011, when he recorded this fact in the history sheet of the patient. The OPs are, thus, medically negligent on this point.
14. The next point of medical negligence of OPs is that complainant applied for the treatment record, which was not supplied to him, despite regulation of Medical Council of India in this regard. When the treatment record was not supplied to the complainant regarding the patient Rupesh Bhandari, then complainant served legal notice upon OPs pointing out that under regulation 1.3.2 of Medical Council of India that 'if any request is made for the medical records either by the patient/authorized attendants/legal authorities involved, the same may be duly acknowledged and documents shall be issued within the period of 72 hours. We find that OPs have not supplied the medical record to the complainant. There was no question of applying under RTI by the complainant, had the record been supplied to him. The next point of raising finger of negligence on OPs is that when the condition of the patient became serious on 06.07.2011 requiring ventilator support, ICU of OP no.2 was dysfunctional at that time. On this point, the complainant has so First Appeal No.1000 of 2015 24 testified this fact that ICU of OP no.2 was not functional, when the condition of the patient became serious and ultimately he was shifted to Escort Fortis Hospital Amritsar. OP nos.1 and 2 stated to the contrary before this Commission in their evidence, which is without any substance. There are no affidavits of any patients on the record, who were admitted in the ICU of OP no.2 at that time to prove their assertion. I have come to the conclusion that had the ICU of OP no.2 been functional, then the patient might not have been shifted to Escort Fortis Hospital for ventilator support. There was no proper arrangement by OP no.2 for treatment of kidney disease of patient which got damaged. As per the report of Ultrasonography dated 02.07.2011 issued by Dhillon Ultra Sound Scan Centre, the kidneys of the patient were normal in shape and size on 02.07.2011. The liver was also normal in shape and size showing enhanced echogenicity suggestive of mild fatty changes. No S.O.L was detected in it. Due to not handling the patient diligently by OPs at the time the patient was with them, the patient was rendered in semi conscious state with high grade fever with vomiting. He developed hepatitis A at the hospital of OP no.2 for which he was given conservative treatment there and he developed acute renal failure there, for which he was shifted to Fortis Escort Hospital. He had septicemia, renal failure and respiratory distress, as per death summary report Ex.C-9 prepared by Fortis Hospital. The complications arose to patient by non consultation with nephrologist by OPs in this case, when this fact was in the knowledge of OP no.1 First Appeal No.1000 of 2015 25 02.07.2011 that patient was a case of fulminant hepatitis as per the record prepared by OP no.1. OP no.1 continued giving the treatment to the patient without consultation with superspecialists of gastroenterology and nephrology, nor advised the complainant for shifting the patient to some competent tertiary centre on 02.07.2011 for his onward care.
15. As a result of my our above discussion, I hold that the District Forum rightly held OP nos.1 and 2 medically negligent and the findings of the District Forum are endorsed by me.
16. Now, we touch the point of compensation for which first appeal no.1004 of 2015 has been filed by the complainant seeking enhancement of compensation in this case. The complainant has alleged that he spent the amount of Rs.11,92,036/- on the treatment of his son at Fortis Escort Hospital and Rs.10,000/- on his treatment at OP no.2 hospital. Complainant proved Ex.C-6 on record, vide the inpatient bill for Rs.11,92,036/- issued by Fortis Escort Hospital, Amritsar. The complainant also placed on record bills for purchasing the medicines, when his son was admitted in OP no.2 hospital vide Ex.C-11 to C-28. The son of the complainant died due to perfunctory attitude of OP nos.1 and 2. There were no proper infrastructure with OP no.2 for admitting the patient in ICU. OP no.1 ascertained the patient to be a case of fulminant hepatitis on 02.07.2011, but did not seek any consultation of any nephrologist or gastroenterologist immediately nor referred him to higher centre for his treatment. The kidneys of the patient were normal as per First Appeal No.1000 of 2015 26 ultrasonographic report dated 02.07.2011. No urine output of the patient was measured by OP nos.1 and 2 which was essential for this ailment. The complainant discharged the initial onus of medical negligence and OPs failed to rebut it on the record. The young son of the complainant had died due to this negligence of OP nos.1 and 2 leaving behind his widow and minor daughters. This is a case justifying the enhancement of the amount of compensation. The complainant had to spend Rs.11,92,036/- at Fortis Hospital Amritsar and Rs.10,000/- at OP no.2 hospital, for the treatment of his son due to carelessness and medical negligence of OP nos.1 and 2. These amounts are liable to be refunded. In addition to that, I also burden OP nos.1 and 2 with compensation of Rs.5 lakhs for medical negligence and Rs.25,000/- as costs of litigation. The entire amount of Rs.11,92,036/- + Rs.10,000/- and an amount of Rs.5 lakhs as compensation and Rs.25,000/- as costs of litigation shall be paid by OP nos.1 and 2 to the widow, minor daughters of the deceased Rupesh Bhandhari and complainant in equal shares by depositing the amount of share in the names of minor daughters of deceased in the fixed deposit receipts till they become major in some nationalized Bank at Amritsar, whereas the amount of shares of widow of deceased and complainant be paid to them. OP nos.1 and 2 can claim the above amounts from OP nos.3 and 4, as per terms and conditions of the insurance policies.
17. As a result of my above discussions, I find no merit in first appeal no.1000 of 2015 filed by OP no.1 and another first First Appeal No.1000 of 2015 27 appeal no.1001 of 2015 filed by OP no.2 and the same are hereby dismissed. I partly accept first appeal no.1004 of 2015 filed by the complainant now appellant for enhancement of compensation, as ordered above by modifying the order of the District Forum, as referred to above. The above said amounts shall be paid by OP nos.1 and 2 to the widow, minor daughters of the deceased Rupesh Bhandhari and complainant in equal shares, as referred to above within 45 days from the date of receipt of certified copy of the order of this Commission.
18. The appellant of first appeal no.1000 of 2015 had deposited the amount of Rs.25,000/- with this Commission at the time of filing the appeal and further deposited the amount of Rs.1,25,750/- in compliance with order of this Commission. Both these amounts alongwith interest, which accrued thereon, if any, be remitted by the Registry to the District Forum below for depositing the amount of share in the names of minor daughters of deceased in the fixed deposit receipts in some nationalized Bank at Amritsar till they become major, whereas the amount of shares of widow of deceased and complainant be paid to them. The complainant shall furnish the complete particulars of widow and two daughters of deceased Rupesh Bhandari to the District Forum for strict compliance of this order. The District Forum shall strictly ensure the deposit of the share amount of compensation in the names minor daughters of deceased, as ordered above.
First Appeal No.1000 of 2015 28
19. The appellant of first appeal no.1001 of 2015 had deposited am amount of Rs.25,000/- with this Commission at the time of filing the appeal and further deposited Rs.3,25,000/- in compliance with order of this Commission. These amounts alongwith interest, which accrued thereon, if any, be remitted by the Registry to the District Forum below for depositing the amount of share in the names of minor daughters of deceased in the fixed deposit receipts in some nationalized Bank at Amritsar till they become major, whereas the amount of shares of widow of deceased and complainant be paid to them. The complainant shall furnish the complete particulars of widow and two daughters of deceased Rupesh Bhandari to the District Forum for strict compliance of this order. The District Forum shall ensure the deposit of the share amount of compensation in the names minor daughters of deceased.
20. Arguments in above referred appeals were heard on 20.03.2017 and the orders were reserved. Copies of the orders be communicated to the parties as per rules.
21. The appeals could not be decided within the statutory period due to heavy pendency of court cases.
(J. S. KLAR) PRESIDING JUDICIAL MEMBER (SURINDER PAL KAUR) MEMBER March 21, 2017 (MM)