State Consumer Disputes Redressal Commission
Shambhu Nath Shah vs Medical Superintendent, Jain Hospital ... on 14 December, 2023
FA NO.346/2015 D.O.D.: 14.12.2023
SAMBHU NATH. VS. JAIN HOSPITAL
IN THE DELHI STATE CONSUMER DISPUTES REDRESSAL
COMMISSION
Date of Institution: 21.07.2015
Date of Hearing: 04.10.2023
Date of Decision:14.12.2023
FIRST APPEAL NO.-346/2015
IN THE MATTER OF
SHAMBHU NATH SHAH
NATURAL FATHER OF INJURED BABY SURBHI
S/O SH. DAHADI SHAH
VILLAGE - BADA LAUKAIRIA,
POST YADAV CHOPPER
DISTT. PASCHIM CHAMPARAN,
BETTIAH, BIHAR
...Appellant in person
VERSUS
1. MEDICAL SUPERINTENDENT
JAIN HOSPITAL, 177-178,
JAGRITI ENCLAVE, NEW DELHI - 110 002
VIKAS MARG,
(Through: Mr.Shreshtha Kumar, Advocate)
2. DR. PANKAJ JHA,
NEURO SURGEON,
JAIN HOSPITAL,
177-178, JAGRITI ENCLAVE,
VIKAS MARG,
NEW DELHI - 110002
3. DR. ABHINAV GUPTA
DISMISSED PAGE 1 OF 12
FA NO.346/2015 D.O.D.: 14.12.2023
SAMBHU NATH. VS. JAIN HOSPITAL
NEURO SURGEON, ,
JAIN HOSPITAL,
177-178, JAGRITI ENCLAVE,
VIKAS MARG,
NEW DELHI - 110 002
(Through: Mr.Shreshtha Kumar, Advocate)
4. UNITED INDIA INSURANCE COMPANY LTD.
54, JANPATH, CONNAUGHT PLACE
NEW DELHI 110001.
...Respondents
CORAM:
HON'BLE JUSTICE SANGITA DHINGRA SEHGAL
(PRESIDENT)
HON'BLE MS. PINKI, MEMBER (JUDICIAL)
Present: Mr. Sambhu Nath, Appellant in person
Mr. Shreshtha Kumar, counsel for the Respondent No.1 & 3
None for the Respondent No.2 & 4
PER: HON'BLE JUSTICE SANGITA DHINGRA SEHGAL,
PRESIDENT
JUDGMENT
1. The facts of the case as per the District Commission record are:
"This complaint has been filed with the allegation that the minor daughter of the complainant fell from the first floor on 19/02/2012. She received head injuries She was first taken to ESI Hospital at Sector- 24, NOIDA She was referred to the Jain Hospital where she was attended by Dr Pankaj Jha: On 20/02/2012, Dr. Abhinav Gupta admitted her into emergency department. After CT scan on 22/02/2012, brain injuries operation was advised. The bone removed from the head and shifted to DISMISSED PAGE 2 OF 12 FA NO.346/2015 D.O.D.: 14.12.2023 SAMBHU NATH. VS. JAIN HOSPITAL stomach and it was told that another operation will be required after two months for fixing the bone into the brain. She was discharged on 27/02/2012 On 08/03/2012 she was taken to the Hospital for removal of the stitches but some more stitches were put and it was told that the wound is raw. It was observed that some discharge was coming from fresh stitches. She was taken to the Hospital and again some stitches were put. On 15/03/2012 another operation of "Cranioplasty was done. She was discharged on 20/03/2012 and advised to come up on 30/03/2012 for removal of stitches but on reaching home sho was suffering from fever. She was taken to the Hospital on 25/03/2012 and on 26/03/2012 She was again admitted to the Hospital and discharged on 04/04/2012. Dr. Abhinav Gupta referred the patient to the Plastic surgeon and dressing daily but there was no relief to the injured and finally Jain Hospital refused to entertain the patient. She was taken to AIIMS on 17/05/2012. She was treated and admitted on 19/07/2012 for another operation and infected bone flat was removed which was due to the negligence of the concerned Doctors of Jain Hospital, it is a case of gross negligence and of providing deficient services at the Jain Hospital that the patient got physical as well as mental and financial loss and harassment. The complainant has prayed for Rs. 20,00,000/- as compensation with pendente lite interest and cost of litigation.
Respondent No. 1, Jain Hospital, filed the reply wherein it is alleged that this Hospital is a Multi-specialty hospital and having a renowned Neuro Centre. The allegations in the complaint are false and frivolous. The complaint was filed before Delhi Medical Council against Dr. Abhinav Gupta for alleged medical negligence. The committee constituted by Delhi Medical Council. examined the case of the patient and the respondent and vide its order dated 06/05/2013 the complaint was dismissed holding that treatment at Jain Hospital was as per accepted professional practices. When DISMISSED PAGE 3 OF 12 FA NO.346/2015 D.O.D.: 14.12.2023 SAMBHU NATH. VS. JAIN HOSPITAL Baby Surbhi was admitted in: ICU her general condition was very poor, she was grossly anaemic thinly built and poorly-nourished. She was drowsy, having swelling the head with multiple abrasion and painful restriction of movement of left lower limb. CT scan was done on 20/02/2012: right frontal fracture with normal brain parenchyma conservative therapy was given. She was attended by Dr. AK Jain Neurologist. She, being anaemic blood transfusion was done Orthopaedic opinion was taken for the fracture of both bones of left leg Patient had seizures on 21/02/2012 She was managed and her condition remained stable for two days. Her condition was deteriorating. On examination it was found that she had diffuse oedema with haemorrhagic blush along the tentorium with effacement of 4th ventricle & compression/ mass effect over the brainstem (evidence of imminent coning). On the basis of scan, emergency decompressive craniotomy of the patient to save the life was necessary. After taking the consent the surgery was performed. During the surgery the scalp was found to be thin and lacerated and abraded. On craniotomy it was found that the dura was very tense and bulging, thin subdural hematoma was drained. The brain bulged out due to the diffuse brain swelling. Expansile duraplasty with precranium flap was done. The bone flap was placed in a pocket made in the abdominal wall after washing with antibiotic saline. She was shifted to ICU after 36 hours. She became conscious, alert, started taking orally. She was discharged on oral medication on 27/02/2012. She was unable to walk due to POP cast over her left leg for fractures in her left lower limb There was no discharge from the operative site. She was seen in OPD after few days and stitches were removed. During this period she had recurrent seizures. To control recurrent seizures, it was decided to excise any herniated/scarred brain tissue to control the recurrent seizures, cranioplasty was done. She was again admitted to the hospital on DISMISSED PAGE 4 OF 12 FA NO.346/2015 D.O.D.: 14.12.2023 SAMBHU NATH. VS. JAIN HOSPITAL 15/03/2012 The flap was redrawn from the abdomen and bone was fixed with cranial plates and screws. The scalp was difficult to close due to peculiarity in the frame of constitution of the patient. The stitches were difficult to hold. The post operative period was uneventful. On 25/03/2012, she had high grade fever and difficulty in speech. She was duly attended and seizures were controlled. The child responded to medication very well. The complainant father was advised go to a higher centre anticipating that plastic surgery may be required such as the flap rotation facility & it was not available at the hospital. Rest all the allegations have been denied. Dr. Abhinav Gupta and Respondent No. 2. Dr. Pankaj Jha, have also filed reply more or less on the same facts as in the WS of Respondent No 1. United India Insurance Company has also been made a party. In their WS they have denied their liability."
2. The District Commission after taking into consideration the material available on record passed the order dated 24.12.2014, whereby it held as under:
"Heard the Ld. Counsel and perused the record. This fact is not disputed that the Baby Surbhi was treated at Jain Hospital on referral from ESI Hospital, NOIDA. It is an admitted fact that she has suffered a broken leg and head injuries. The CT Scan done at the Jain Hospital shows that she received serious head injuries. She was operated at the Jain Hospital after taking the necessary permission from the father of the Baby. The voluminous record of the Jain Hospital shows that she was properly attended pre and post operation There is nothing on record to substantiate the allegation of the complainant that the procedure adopted DISMISSED PAGE 5 OF 12 FA NO.346/2015 D.O.D.: 14.12.2023 SAMBHU NATH. VS. JAIN HOSPITAL by the doctors in treating Baby Surbhi was not as per the established norms or they committed any negligence in performing the operation or in pre and post operative treatment The entire matter has been examined by Delhi Medical Council Executive Come which includes as chairman Dr. A.K Aggrawal, Vice President, Dr. Vinay Aggrawal, and Members, Dr. Manoj Singh, Dr. N.B. Kamath, Dr. P.K Upadhyay and its Secretary Dr. Girish Tyagi, and order dated 08/05/2013 was issued. Perusal of the order of the Delhi Medical Council shows that Dr. Abhinav Gupta not only operated the patient but has successfully handled the complications. Treatment has been given to Baby Surbhi as per accepted practices The Medical Council has not found any negligence in the treatment of Baby Surbhi She was referred to the higher medical contro, for the purposes of Plastic surgery, It has been mentioned in the documents of the Jain Hospital that her parietal bone was very weak. The complainant has concealed this fact that this matter has already been subject of scrutiny by Delhi Medical Council Section 26 of the CPA disentitles the complainant for any relief even if we ignore the finding of the Delhi Medical Council There is no evidence which could prove that Dr. Abhinav Gupta committed negligence in treating Baby Surbhi. In view of the clear findings recorded by the Executive Committee of Delhi Medical Council, we don't find any merit in this complaint, it deserves dismissal and it is accordingly dismissed."
DISMISSED PAGE 6 OF 12
FA NO.346/2015 D.O.D.: 14.12.2023
SAMBHU NATH. VS. JAIN HOSPITAL
3. The Appellant has challenged the aforesaid order on the ground that the District Commission erred in observing that due to the negligent conduct and careless treatment at the hands of the Respondent- Hospital, a bone from the brain of the his daughter-Baby Surbhi (hereinafter referred to as the "patient") was displaced in the course of the operation and the said bone was shifted to the stomach of the patient. It is further submitted that due to the said lapse on the part of the Respondent, the patient had to face severe pain, bleeding and weakness for more than 3 months. Secondly, it is submitted that the Appellant approached the Respondents with the complaint of injuries to the head and legs of the patient. However, by exercising very low care in performing the surgical procedure, the Respondents have misplaced a vital bone from the brain to the stomach of the patient, thus indicating the very low level of care in the treatment advanced to the patient. Reliance has been placed upon :
4. The Respondents No.1-3 have filed their joint reply and have stated therein that the present Appeal if false and frivolous in so much so that patient was treated as per the standard medical protocol and there was no negligence in the surgery performed. It is further submitted that the Respondent No1.-Hospital is a multi-speciality hospital duly registered with the Directorate of Health Services and has a staff of highly qualified and experienced doctors and para medical staff.
Pressing the aforesaid contentions, the Respondents have prayed that the Appeal be dismissed.
5. We have perused the material available on record and heard the Appellant and the counsel for the Respondent No.1 & 3.
DISMISSED PAGE 7 OF 12
FA NO.346/2015 D.O.D.: 14.12.2023
SAMBHU NATH. VS. JAIN HOSPITAL
6. The only question that falls for our consideration is whether the treating doctor misplaced a vital bone during the surgery.
7. Here, we deem it appropriate to refer to the order dated 06.05.2013 passed by the Delhi Medical Council through its Executive Committee, the relevant extract is reproduced hereunder as-
"it is observed that the patient was treated at Jain Hospital as per the accepted professional practices in such cases, hence it is the decision of the Executive Committee that prima-facie no case of medical negligence is made out on the part of Dr. Abhinav Gupta, in the treatment admistered to the Complainant's daughter, Baby Surabhi Kumari at Jain Hospital. Complaint stands disposed."
8. Here, we deem it pertinent to remark that the whole case of the Appellant revolves around the contention that the Respondents have misplaced a vital bone from the brain to the stomach of the patient, thus indicating the very low level of care in the treatment advanced to the patient.
9. However, a perusal of the record makes it clear that during the surgery the scalp was found to be thin, lacerated and abraded. On craniotomy it was found that the dura was very tense and bulging. It came 1 cm above the bony defect. On opening the dura, thin subdural hematoma was drained. The brain bulged out due to the diffuse brain swelling. All anti edema measures were given. Expansile duraplasty with precranium flap was done. It was difficult to approximate the scalp edges due to the brain swelling and abraded traumatized scalp. The bone flap was placed in a pocket made in the abdominal wall after DISMISSED PAGE 8 OF 12 FA NO.346/2015 D.O.D.: 14.12.2023 SAMBHU NATH. VS. JAIN HOSPITAL thorough washing with antibiotic saline. In view of imminent rupture of the thin fragile scalp with history of brain hemiation with under- lying CSF, it was decided to excise any herniated/ scarred brain tissue to control recurrent seizures and do an early cranioplasty with patients own bone flap with plate and screws for fixation.
10. It is further clear from the record that Duraplasty was done followed by cranioplasty with patients bone flap retrieved from the abdomen. The bone was fixed with cranial plates and screws.
11. After this patient was seen in OPD and stitches were removed. The scalp wound had not healed completely but there was no infection. The overlying skin showed scarring and was thin. At this point the respondent mo. 3 advised the complainant, i.e., father of patient to go to a higher centre anticipating that plastic surgery may be required such as flap rotation. Facilities for plastic surgery were not available or approved by ESI at the answering respondent Hospital.
12. Therefore, the contention of the Appellant that a vital bone from the brain was placed in the abdomen is wholly misconceived.
13. Another plea has been taken by the Appellant that the Appellant approached the Respondents with the complaint of injuries to the head and legs of the patient. However, Respondents owing to their negligence and low level of treatment, performed a surgical intervention which was not needed
14. The facts of the case reveal that the Appellant brought the patient aged 7yrs/ Female, on 20.02.2012 at 1:45 am at the Respondent-Hospital, referred by ESI Hospital, Noida with alleged history of fall from 1st floor on 19.02.2012 at around 8 pm. There was history of recurrent vomiting, loss of consciousness, swelling over head with painful DISMISSED PAGE 9 OF 12 FA NO.346/2015 D.O.D.: 14.12.2023 SAMBHU NATH. VS. JAIN HOSPITAL restriction of movement of left lower limb following the fall. She was admitted under care of the Respondent No.2-Dr. Pankaj Jha (Neurosurgeon). The patient was found to be grossly anaemic, thinly built and poorly nourished. The patient was conscious but drowsy, pulse 102/min, BP 100/60 mmHg. temp 100 F, Glassgow Coma Scale (GCS), E3V2M6, Pupil B/L equal and reacting to light. Plantars were bilaterally flexor. Local examination showed Swelling over the head with multiple abrasion and painful restriction of movement of left lower limb. CT (head) was done on 20.02.2012 at the time of admission reported as right frontal fracture with normal brain parenchyma. Patient was started on conservative therapy for head injury as advised by the Respondent No.2-Dr. Pankaj Jha.
15. A perusal of the record further reveals that in the evening of 22.02.2012 a fresh CT Head was advised and on examination the patient was found to have GCS - E2V1M4, unequal pupil left pupil 5mm sluggishly reacting to light, patient had right hemiparesis and plantars were B/L extensor. CT head of 22.02.2012 showed diffuse edema with hemorrhagic blush along the tentorium with effacement of the 4th ventricle & compression/ mass effect over the brainstem (evidence of imminent coning).
16. Here, it is to be noted that from the aforementioned facts, it is clear that on clinical examination as well as findings on CT scan, the patient was in critical condition and needed immediate surgical intervention. As is evident from the record, the Respondent No.-3 advised an emergency decompressive craniotomy for the patient as a life saving measure in consultation with Dr. A. K. Jain.
DISMISSED PAGE 10 OF 12
FA NO.346/2015 D.O.D.: 14.12.2023
SAMBHU NATH. VS. JAIN HOSPITAL
17. It is to be noted further that the Appellant was explained about the critical condition of the patient and was apprised about the life saving surgery. It was only after obtaining detailed informed consent in vernacular language (Hindi) that the patient was taken up for surgery.
18. It is clear from the record that the patient was treated as per standard medical protocol and there was no deviation from the standard medical procedure. Patient was given full course of antibiotics and discharged on 04.04.2012 in stable condition. At time of discharge the patient was afebrile, conscious alert, the wound was dry with no discharge.
19. It is to be noted here that on a thorough perusal of the record, we fail to find any cogent evidence or satisfactory material to substantiate the allegations as raised by the Appellant. In the instant case, it may be mentioned here that the Appellant have led no evidence of experts to prove the alleged medical negligence except his own affidavits. The experts could have proved if any of the doctors in the Respondent- hospital providing treatment to the patient were deficient or negligent in service. A perusal of the medical record produced does not show any omission in the manner of treatment. On the Contrary, the Respondents have placed on record the opinion of the medical board constituted by the Delhi Medical Council which makes it abundantly clear that there is no medical negligence in the present case. Our view is further fortified by the aforesaid opinion of the Delhi Medical Council.
20. It is pertinent to remark here that the Appellant has concealed the fact that this matter has already been subject to scrutiny by the Delhi Medical Council. Section 26 of the Consumer Protection Act, 1986 DISMISSED PAGE 11 OF 12 FA NO.346/2015 D.O.D.: 14.12.2023 SAMBHU NATH. VS. JAIN HOSPITAL disentitles the Complainant for any relief even if we ignore the findings of the Delhi Medical Council.
21. Therefore , we see no reason to depart from the reasons given by the District Commission and fail to find any cause or reasons to interfere with the findings of District Commission. Consequently, we uphold the order dated 24.12.2014 passed by the District Consumer Dispute Redressal Commission (East), Saini Enclave, New Delhi-110092. Consequently, the present Appeal stands dismissed with no order as to costs.
22. Application(s) pending, if any, stands disposed of in terms of the aforesaid judgment.
23. The judgment be uploaded forthwith on the website of the commission for the perusal of the parties.
24. File be consigned to record room along with a copy of this Judgment.
(JUSTICE SANGITA DHINGRA SEHGAL) PRESIDENT (PINKI) MEMBER (JUDICIAL) Pronounced On:
14.12.2023 DISMISSED PAGE 12 OF 12