State Consumer Disputes Redressal Commission
Max Super Specialty Hospital vs Raj Kumar on 14 March, 2017
FIRST ADDITIONAL BENCH
STATE CONSUMER DISPUTES REDRESSAL COMMISSION,
PUNJAB SECTOR 37-A, DAKSHIN MARG, CHANDIGARH.
First Appeal No.171 of 2015
Date of Institution: 10.02.2015
Order reserved on:09.03.2017
Date of Decision : 14.03.2017
1. Max Super Speciality Hospital, Near Civil Hospital, Phase-VI,
SAS Nagar, Mohali, through its authorized representative.
2. Dr. R.S. Rai, Department of Urology, Max Super Specialty
Hospital, Near Civil Hospital, Phase-VI, SAS Nagar, Mohali.
.....Appellants/opposite parties
Versus
Raj Kumar son of Sh. Chunni Lal, resident of house no.234, Sidhrath
Nagar, Panipat City, Panipat, Haryana.
.....Respondent/complainant
First appeal against order dated
25.11.2014 passed by the District
Consumer Disputes Redressal
Forum, SAS Nagar, Mohali.
Quorum:-
Shri J. S. Klar, Presiding Judicial Member
Smt. Surinder Pal Kaur, Member Present:-
For the appellants : Sh. Vishal Gupta, Advocate
For the respondent : Sh. Rajesh Bansal, Advocate
.................................................
AND 2) First Appeal No.929 of 2015 Date of Institution: 19.08.2015 Order reserved on:09.03.2017 Date of Decision : 14.03.2017 Raj Kumar, resident of house no.234, Sidhrath Nagar, Panipat City, Panipat, Haryana.
.....Appellant/complainant First Appeal No.171 of 2015 2 Versus
1. Max Super Speciality Hospital, Near Civil Hospital, Phase-VI, SAS Nagar, Mohali, Punjab.
2. Dr. R.S. Rai, Department of Urology, Max Super Specialty Hospital, Near Civil Hospital, Phase-VI, Mohali, Punjab.
.....Respondents/opposite parties First appeal against order dated 25.11.2014 passed by the District Consumer Disputes Redressal Forum, SAS Nagar, Mohali.
Quorum:-
Shri J. S. Klar, Presiding Judicial Member Smt. Surinder Pal Kaur, Member Present:-
For the appellant : Sh. Rajesh Bansal, Advocate For the respondents : Sh. Vishal Gupta, Advocate ................................................. J.S KLAR, PRESIDING JUDICIAL MEMBER :-
By this common order, we intend to dispose of the above referred two first appeals, as they have arisen out of the same order dated 25.11.2014 of the District Consumer Disputes Redressal Forum, S.A.S. Nagar, Mohali (in short the 'District Forum), as such they can be disposed of together. The order shall be pronounced by us in main first appeal no.171 of 2015, which has been filed by opposite parties against above order, vide which, the complaint of complainant was allowed by directing OPs to pay a lump sum compensation of Rs.2 lakhs to the complainant for medical negligence, mental harassment and costs of litigation. The appellants of this appeal are OPs in the original complaint before the District Forum and respondent of this appeal is complainant therein First Appeal No.171 of 2015 3 and they be referred as such hereinafter, for the sake of convenience.
2. First appeal no.929 of 2015 has been filed by complainant now appellant against order dated 25.11.2014 of the District Forum, for enhancement of the amount of compensation.
The appellant of this appeal is complainant and respondents of this appeal are OPs in the complaint before the District Forum and they be referred as such hereinafter for the sake of convenience.
3. Complainant Raj Kumar filed complaint under Section 12 of the Consumer Protection Act, 1986 (in short "the Act") against the OPs on the averments that he felt pain in his stomach and he went to private ultrasound centre at Panipat on 27.11.2012, where he was diagnosed with right kidney stone. The complainant was attracted by the advertisement of OP no.1 hospital and hence preferred to take treatment there. The complainant went for medical check up on 31.01.2013 and he paid Rs.50/- as registration fee and he was referred to Dr.R.S. Rai, Department of Urology for check up, where he paid Rs.400/- as consultation fee. OP no.2 prescribed various tests to complainant, for which he deposited Rs.3350/-. The above said tests were conducted and complainant collected the reports on 01.02.2013. OP no.2 told the complainant that surgery would be conducted for removal of kidney stone, also known as renal calculus. No test of ultrasound or CT scans etc. were conducted to ascertain the exact problem, despite the fact that they were essential to ascertain the size of stone. The complainant was informed by OP First Appeal No.171 of 2015 4 that the stones could be removed easily by small surgery procedure known as 'percutaneous Nephrolithotomy' (PCNL). The OPs asked complainant for admission in the hospital on 04.02.2013 for his surgery. The complainant was admitted in the hospital on 04.02.2013 at about 10:00 AM and surgery was conducted by OP no.2 on him. He remained admitted in the hospital of OP no.1 for the next two days and was discharged on 06.02.2013 from OP no.1 hospital. The complainant was informed that stone (calculus) measuring 24mm x 27 mm has been removed from his right kidney by means of surgery. The discharge summary is appended with the complaint. It is apparent from discharge summary of OPs that kidney stones were broken and then removed from the kidney of the complainant. On 08.02.2013, the stents which were inserted during surgery of complainant were removed from his kidney. He experienced complications and fell ill thereafter and was again admitted in hospital on 11.02.2013. He had to spend huge amount on his treatment due to negligence committed by OPs and he was discharged on 13.02.2013 on the second time from OP no.1 hospital. The complainant was again called by OP no.1 hospital on 04.03.2013 for the removal of stent and nephrostomy, which was left behind on 13.02.2013 at the time of discharge and he paid Rs.11,000/- on the date of discharge i.e. 13.02.2013. The complainant again felt pain in his abdomen which continued on the higher side day by day. The complainant consulted private diagnostic centre, where he was informed that he has stone in his First Appeal No.171 of 2015 5 kidney. The complainant went to Max Super Specialty Hospital situated at Shalimar Bagh New Delhi, a chain of respondent no.1 hospital. The complainant intentionally had not disclosed the previous treatment taken by him from OP no.1 hospital. Hospital at Delhi conducted CT scan of complainant's kidney and found that there were still two stone measuring 8.4 mm and 4.4 mm. The OPs could not remove the stone from the kidney of the complainant completely and two stones were left behind in the procedure. The complainant consulted various doctors and it was informed that the kidney stones form/grow slowly over several months or years and are made of hard deposits of varicus minerals, including calcium, uric acid and oxalate and the stone cannot develop within a period of 1-2 months. The OPs were, thus, deficient in service towards complainant. The OPs never advised for any test to ascertain, whether stones were removed successfully or not. The OPs were negligent in rendering medical services to complainant. The complainant filed the complaint directing OPs to refund the amount of Rs.62,610/- paid as consideration for all aforesaid tests, procedures and treatment; further to pay Rs.2 lakhs as compensation on account of medical negligence; further to pay Rs.2 lakhs as compensation for pain and sufferings, harassment, mental agony and loss caused on account of deficient services rendered to him; further to pay interest @12% per annum on above amount; and to pay Rs.25,000/- cost of litigation to boot.
First Appeal No.171 of 2015 6
4. Upon notice, OP nos.1 and 2 filed joint written reply and contested the complaint of the complainant vehemently. Preliminary objections were taken by the OPs that: no case of the complainant is made out for any medical negligence on their part; the complainant was known case of bilateral renal stone disease and had undergone open surgery and per-cutaneous nephrolithotomy (PCNL) for clearance of renal stones in his left kidney sometime in 2012 in another hospital. The complainant was fully aware that he was having the problem of recurrence of renal stone in his kidney, which has been duly removed after multiple surgeries from his left kidney. For the first time, the complainant visited hospital of OP no.1 for checkup on 31.01.2013 alongwith ultrasound report dated 27.11.2012 from Bansal Diagnostic Centre, Sukhdev Nagar, Panipat, which has been done by Dr. Ankush Bansal, M.D. Radio Diagnosis. The complainant was found to be a case of non-obstructive right renal calculus and there was evidence of 17 mm ecogenic focus with post acoustic shadowing in middle calys (staghorn). The complainant was diagnosed as renal calculus by OP no.2 in the hospital of OP no.1. At the time of first time of his admission, OP no.2 diagnosed him as case of bilateral renal stone disease and examined him to be a case of right renal calculus and advised him for PCNL procedure. The complainant was evaluated clinically and after finding his vital parameters to be normal and with well healed scars of previous surgeries in the left flank and on the basis of investigation available with him at the time of checkup in OPD, which were done by different First Appeal No.171 of 2015 7 diagnostic centres outside the OP no.1 Hospital revealing 24x27 mm staghorn calculus on ultra-sound scan (USS) in the right kidney. On intravenous urography (IUV), there was good concentration and attraction of contrast media by both kidneys with evidence of staghorn calculus in bifid right kidney and specks of calcification in mid polar region of the same kidney. All the treatment modality including open surgery and PCNL, their advantages over each other were duly explained and discussed with the complainant. He opted to undergo PCNL for his right renal stone disease as his only request was to achieve complete clearance of stone, if possible. It was duly explained to complainant that some time during operation upon a patient, a certain situation arises like profuse bleeding, very small stone fragments, difficult location of stone fragments, then at that time, it is better to take decision in favour of life and safety of the patient and the complete clearance then becomes a secondary factor. He was taken for test including urea, serum creatinine, serum, blood sugar (rendum), urine routine and microscopy, HIV Test (I & II), hepatitis-B surface antigen, complete haemogram, peripheral smear and ESR, HCV IgG and ECG on 31.01.2013 and on 01.02.2013. The complainant thereafter underwent PCNL on right side under spinal anaesthesia on 04.02.2013 itself and maximum possible clearance was achieved. No significant residual fragments were seen on fluoroscopy and in the meantime, it was also noticed that there was profuse bleeding from the right kidney through the PCNL tract. It was duly discussed with the team of doctors including First Appeal No.171 of 2015 8 the anesthesiologist and it was decided to close the procedure in view of profuse bleeding, as no significant residual fragments were seen and it was best in the safety of the patient also. As a matter of abundant caution, a double J-stent (DJS) and nephrostomy catheter were placed in situ, PCNL wound was closed and dressed. The complainant had uneventful post operative recovery and check x-ray was done on 05.02.2013, which revealed DJS and nephrostomy in situ with dilated bowel loops. No significant/obvious residual fragments were seen and the patient having shown significant progress in his report operative recovery was discharged on 06.02.2013 with medical advice and further follow up. On 11.02.2013, the complainant came for checkup with problems of occasional fever with chills and rigor and an episode of haematuria (passing of blood in the urine). As the patient had recently undergone invasive urological procedure of staghorn calculus (infective stone) and had come all the way from Panipat as such in order to have close observation, he was advised admission for close observation and energetic management considering the possibility of post-PCNL urinary tract infection (UTI). On admission, his haematuria settled down and his general condition improved and as he became afebrile within 24 hours and as such he was discharged on 13.02.2013. His DJS was removed under local anaesthesia on 04.03.2013 and the procedure was uneventful. The complainant was reviewed by OP no.2 on 20.03.2013 and he was advised dietary precautions, importance of plenty of oral fluids and almost life-long First Appeal No.171 of 2015 9 follow up for recurrence of renal stone disease. The plea of complainant of medical negligence is not justifiable one against OPs. The overall estimated stone free rate following treatment is highest for PNL 78% and lowest for SWL 54%. The OPs followed up the standard and prescribed treatment guidelines and had tried to achieve complete clearance of the residual/staghorn calculus without putting the life of the complainant in danger or without putting his kidney at risk. The complainant was a known case of bilateral renal stone disease and had been operated upon twice at some other hospital for staghorn calculus of the left side and had undergone PCNL at OP no.1 hospital. Any medical negligence was vehemently denied by OPs on their part in this regard. The complaint was also contested even on merits on the above referred grounds by the OPs. OPs prayed for dismissal of the complaint by denying any medical negligence or deficiency in service on their part.
5. The complainant tendered in evidence affidavits Ex.CW- 1/1 and Ex.CW-1/2 with documents Ex.C-1 to C-12. As against it, OPs tendered in evidence affidavit Ex.OP-1/1 and documents Ex.OP-1 to OP-7 and closed the evidence. On conclusion of evidence and arguments, the District Forum allowed the complaint of the complainant. Dissatisfied with the above order, the OPs, now appellants have directed first appeal no.171 of 2015 and complainant has preferred first appeal no.929 of 2015 for enhancement of the amount of compensation.
First Appeal No.171 of 2015 10
6. We have heard the learned counsel for the parties at considerable length and have also examined the record of the case. Evidence on the record has been appraised by us with the able assistance of counsel for the parties to find out the point of medical negligence, if any, involved in this case or not. Affidavit of complainant in support of his case is Ex.CW-1/2 on the record. The ultrasound test report dated 27.11.2012 of complainant is Ex.C-1 on the record given by Bansal Diagnositic Centre. This report has established that right kidney of complainant measures 105 mm in length. There is evidence of 17 mm Echogenic focus with post acoustic shadowing in middle calyx (.?staghorn). Ex.C-2 is the invoice cum receipt dated 31.01.2013 for Rs.450/-. Ex.C-3 is the invoice cum receipt dated 31.01.2013 for Rs.3350/-. Ex.C-4 is the laboratory investigation report dated 31.01.2013 of complainant. Ex.C-5 is the inpatient bill (detail) of the complainant with regard to the amount paid to OP no.1 on 06.02.2013 for Rs.35,000/-, out of which Rs.869.39 was refunded to complainant. Ex.C-6 is the discharge summary of complainant issued by OPs which recorded the diagnosis as under:
"Rt Renal Calculi"; Brief history: 40 years old individual:
K/C/O Left renal calcullis (OPTRD), open surgery and PCNL in 2012 has got right renal calculus, No H/O any medical illness, Planned for PCNL, O/E; g/c fair, afebrile, vitals WNL, P/A; NAD, Xar KUB and IVU: both kidney functioning well with staghorn calculus in RK, USS:24x27 First Appeal No.171 of 2015 11 mm calculus in RK, Vitals: date 05.02.2013 temp F(C) 98.4, pulse 78, BP 120/90, pain 0, Operative notes: SPN-
OT Note 4.02.2013, 13:02, Local title: Urology OT note, Anaesth: Dr. Kamal/Dr. Suruchi, Asst; Mr. Dev. OP finding: meatus, urethra, vm, BN, B/U/O-h Calculus in RT renal PA renchyma, calyces clear, Rt PCNL done, calculi fragmented and retrieved, wound closed leaving behind DJS and Nephrostomy. Hospital course: patient is being discharged instable condition.
Ex.C-7 is invoice cum receipt dated 08.02.2013 for Rs.590/-. Ex.C-8 is the bill dated 13.02.2013 of purchase of medicines for Rs.880/-. Ex.C-9 is the discharge summary of complainant dated 13.02.2013 reproduced as under:
"Rt Renal Calculi"; Brief history: 40 years old individual:
K/C/O Left renal calcullis (OPTRD), open surgery and PCNL in 2012 has got right renal calculus, No H/O any medical illness, Planned for PCNL, O/E; g/c fair, afebrile, vitals WNL, P/A; NAD, Xar KUB and IVU: both kidney functioning well with staghorn calculus in RK, USS:24x27 mm calculus in RK, Vitals: date 13.02.2013 temp F(C) 98.8, pulse 82, BP 120/70, pain 0, Operative notes: SPN-
OT Note 04.02.2013, 13:02, Local title: Urology OT note, Anaesth: Dr. Kamal/Dr. Suruchi, Asst; Mr. Dev. OP finding: meatus, urethra, vm, BN, B/U/O-h Calculus in RT renal PA renchyma, calyces clear, Rt PCNL done, calculi First Appeal No.171 of 2015 12 fragmented and retrieved, wound closed leaving behind DJS and Nephrostomy. Investigations: All investigations reports were handed over to the patient."
Ex.C-10 is the advance receipt for Rs.11,000/- issued by OP hospital to complainant. Ex.C-11 is the investigation report of complainant dated 06.04.2013. Ex.C-12 is the medical literature placed on the record by the complainant touching on the procedure in hand.
7. OPs also led rebuttal evidence consisting of affidavit of Dr. R.S. Rai, Department of Urology Ex.OP-1/1. This witness in his affidavit deposed that complainant was known case bilateral renal stone disease and had undergone open surgery and per-cutaneous nephrolithotomy (PCNL) for clearance of renal stones in the left kidney sometime in 2012 in another hospital and he was fully aware of recurrence of renal stone in his kidney, which has been duly removed after multiple surgeries from his left kidney. This witness further deposed that for the first time, the complainant visited hospital of OP no.1 for medical checkup on 31.01.2013 alongwith ultrasound report dated 27.11.2012 from Bansal Diagnostic Centre, Sukhdev Nagar, Panipat, which has been done by Dr. Ankush Bansal, M.D. Radio Diagnosis. The complainant was found to be a case of non-obstructive right renal calculus and there was evidence of 17 mm ecogenic focus with post acoustic shadowing in middle calys (staghorn) and he was diagnosed as renal calculus by OP no.2 in the hospital of OP no.1. The complainant was evaluated clinically and after finding his vital parameters to be normal and with well First Appeal No.171 of 2015 13 healed scars of previous surgeries in the left flank and on the basis of investigation available with him at the time of checkup in OPD, which were done by different diagnostic centres outside OP no.1 Hospital, which revealed that 24x27 mm staghorn calculus on ultra- sound scan (USS) in the right kidney. On intravenous urography (IUV), there was good concentration and attraction of contrast media by both kidneys with evidence of staghorn calculus in bifid right kidney and specks of calcification in mid polar region of the same kidney. All the treatment modality including open surgery and PCNL, their advantages over each other were duly explained and discussed with the complainant. He opted to undergo PCNL for his right renal stone disease, as his only request was to achieve complete clearance, if possible. Some tests were conducted upon him like as urea, serum creatinine, serum, blood sugar (rendum), urine routine and microscopy, HIV Test (I & II), hepatitis-B surface antigen, complete haemogram, peripheral smear and ESR, HCV IgG and ECG on 31.01.2013 and on 01.02.2013. Thereafter, he underwent PCNL on right side under spinal anaesthesia on 04.02.2013 itself and maximum possible clearance was achieved. No significant residual fragments were seen on fluoroscopy and in the meantime, it was also noticed that there was profuse bleeding from the right kidney through the PCNL tract. It was decided to close the procedure in view of profuse bleeding as no significant residual fragments were seen and it was also found best in the safety of the patient. As a matter of abundant caution, a double J-stent (DJS) and nephrostomy First Appeal No.171 of 2015 14 catheter were placed in situ, PCNL wound was closed and dressed. The complainant had uneventful post operative recovery and check x-ray was done on 05.02.2013, which revealed DJS and nephrostomy in situ with dilated bowel loops. No significant/obvious residual fragments were seen and the patient having shown significant progress in his report operative recovery was discharged on 06.02.2013 with medical advice and further follow up. On 11.02.2013, the complainant came for checkup with problems of occasional fever with chills and rigor and an episode of haematuria (passing of blood in the urine). As the patient had recently undergone invasive urological procedure of staghorn calculus (infective stone) and had come all the way from Panipat as such in order to have close observation, he was advised admission for close observation and energetic management considering the possibility of post-PCNL urinary tract infection (UTI). On admission, his haematuria settled down and his general condition improved and as he became afebrile within 24 hours and as such he was discharged on 13.02.2013. His DJS was removed under local anaesthesia on 04.03.2013 and the procedure was uneventful. The complainant was reviewed by OP no.2 on 20.03.2013 and he was advised dietary precautions, importance of plenty of oral fluids and almost life-long follow up for recurrence of renal stone disease. Ex.OP-1 is the copy of face sheet of complainant showing the date of admission as 04.02.2013 and date of discharge as 06.02.2013 issued by OP no.1 hospital alongwith medical record. Ex.OP-3 is the medical literature First Appeal No.171 of 2015 15 on the record. Ex.OP-4 is the medical literature of Cambell's Urology Volume 4, Chapter 99: Surgical management of Urinary Lithiasis. Ex.OP-5 is the medical literature regarding surgery illustrated. Ex.OP-6 is the medical literature on factors affecting stone-free rate and complications of percutaneous nephrolithotomy for treatment of staghorn stone on the record.
8. From critical evaluation of above referred evidence on the record and on hearing respective submissions of counsel for the parties, we have come to the conclusion that as far as the point of medical negligence is concerned, the case has to be decided as per the "Bolam Vs. Friern Hospital Management Committee, (1957)1 WLR 582 reported by the National Commission in case titled as "St. Stephens Hospital Vs. Roshani Devi & others" IV (2013) CPJ-74 (NC). The law has been laid down in this authority that an important principle applied is whether the doctor adopted the practice (of clinical observation diagnosis including diagnostic tests and treatment) in the case that would be adopted by such a doctor of ordinary skill in accord with (al least) one of the responsible bodies of opinion of professional practitioners in the field. Where neither the required diagnostic tests were conducted nor the consequent medical treatment adopted -, as should have been adopted by any doctor of even ordinary skill as per standard professional management of such cases then it amounts to medical negligence. Medical negligence can be held where the doctor represented himself to be a qualified doctor and he has not been found to be so First Appeal No.171 of 2015 16 and where the doctor has departed from the standard medical protocol in giving treatment or taking precautions, it also falls in the category of medical negligence. The standard of proof required is the normal civil standard, on the balance of probabilities, which means more likely than not the criminal standard of beyond reasonable doubt. But the cases of professional negligence create particular problems; and in practice, it has to be higher standard of proof than for ordinary civil cases of negligence. The National Commission has held in case titled as "Sultana Ram Vs. B.K. Chawla (Dr.) and another" 2006(2) CPC-420 that cent percent success in clearance of stone is not possible. No medical negligence committed by the doctor was found and complaint was dismissed in the cited authority.
9. Now, we have to examine this point whether the standard medical practice has been departed from by the OPs in this case or not. We find that the onus to prove the medical negligence lies upon the complainant. There is nothing on the record that OP no.2 was not qualified surgeon or OP no.1 was not well equipped hospital. The standard medical practice has been adopted in this case by OP no.2 at OP no.1 hospital, as per the medical literature Ex.OP-3 and Ex.OP-4 on the record. Even the National Commission has held in "Sultana Ram Vs. B.K. Chawla (Dr.) and another" (Supra) that cent percent success in the removal of stone in kidney is not a case of medical negligence. The medical literature recognizes failure rate in the removal of stones and it is always not 100% success rate. First Appeal No.171 of 2015 17 Consequently, on this point as held by the National Commission in above authority, we hold no medical negligence on the part of OPs. On the point of qualification of doctors as well as following the standard medical protocol of treatment, we find no medical negligence on the part of OPs in this regard. We are fortified in this regard by law laid down by the Apex Court in case titled as "Kusum Sharma & others Vs. Batra Hospital & Medical Research Centre & others" 2010 AIR (SC) 1050. The Supreme Court of India has laid down the guidelines for medical negligence in this authority. The Apex Court also held in "Jacob Mathew Vs. State of Punjab"
2005(3) RCR (criminal)836 that medical practitioner is not liable to be held negligent simply because things went wrong from mischance or misadventure or through an error of judgment in choosing one reasonable course of treatment in preference to another. He would be liable only where his conduct fell below that of the standards of reasonable competent practitioner in his field. In view of above law laid down by the Apex Court, we find that the OPs followed the standard medical practice. Some time second operation is required and it is not medical negligence as held by West Bengal State Consumer Disputes Redressal Commission in case "Dr. Mrinmoy Nandi & another Vs. Sri Ashis Bhattacharjee" 2013(4) WBLR
621. We are in agreement with the findings of the District Forum that this is not a case where the doctor was either not qualified or has not followed the prevailing medical standard practice. First Appeal No.171 of 2015 18
10. The next limb of the argument of the appellant of first appeal no.929 of 2015 is that the doctor has not supplied the X-ray report to complainant nor brought it on the record proving that there was no mention of X-ray report dated 05.02.2013 conducted by the OPs regarding the relevant stone in the kidney, if any at post operative surgery. Our attention has been drawn to the report of expert body of doctors submitted by P.G.I. Chandigarh in this case. It is a part of the record and can be duly relied upon by us. The report of PGI Chandigarh is dated 25.01.2014 on the record. It has recorded that Raj Kumar patient was suffering from recurrent kidney stone disease. He has been treated at Max Super Speciality Hospital, Mohali OP no.1 under the care of R.S. Rai. Before the operation of PCNL for right kidney stone, he has been investigated by ultrasonography, X-ray KUB and IVU as recorded in the discharge summary. The outcome of PCNL for right kidney stone is not recorded in details in the discharge summary. It appears that there has been a communication gap between the operating team and the patient regarding whether the stone in his right kidney was completely cleared or there has been some residual stone fragments left behind in the kidney. The x-ray report conducted on post operative procedure on 05.02.2013 by OPs was not supplied to the PGI. The ground of the complainant is also that the alleged x-ray report conducted after procedure is neither mentioned in the discharge summary nor it has seen the light of the day. We agree with the finding of the District Forum on this point and it was First Appeal No.171 of 2015 19 essential for OPs to send X-ray report, if any, taken at post procedure to PGI for recording the correct finding. The complainant has also raised grievance of not mentioning of this X-ray report in the discharge summary. The X-ray report is also not placed on record by the OPs. In view of the facts and circumstances of the case, we can draw the safe inference that no such x-ray report was either conducted by OPs at all or if it so conducted, it had not seen the light of day and had been deliberately withheld by the OPs with some ulterior motive. It has not been mentioned in the discharge summary reports on the record that there was any remnant of the stone after procedure in the right kidney of the complainant. It is deficiency in service on the part of OPs as rightly recorded by the District Forum. We endorse the finding of the District Forum that X-ray report conducted on 05.02.2013 is not mentioned in discharge summary nor it was supplied by the OPs to complainant nor it was sent to PGI Chandigarh. The OPs are, thus, deficient in service protanto.
11. The complainant has preferred first appeal no.929 of 2015 for enhancement of the amount of compensation. We have examined the record of the case and find that on the point of qualification of doctors and following the standard medical practice, no medical negligence has been found on the part of OPs. Deficiency in service by OPs is on the point of suppression of X-ray report dated 05.02.2013 in this case. We find that the District Forum has suitably compensated the complainant by awarding a sum of Rs.2 lakhs for deficiency in service of OPs. X-ray report is vital First Appeal No.171 of 2015 20 document to prove whether any fragments remained after operation in the right kidney of the complainant or not. Withholding of this document from the expert body of the doctors of PGI or from the complainant or not producing it in the Consumer Forum do establish deficiency in service on the part of OPs. We find that appropriate compensation has already been awarded by the District Forum to complainant for this deficiency in service or unfair trade practice of OPs. We do not find any ground either to enhance it or to reduce it. The order of the District Forum awarding the amount of compensation is, thus, affirmed in this appeal.
12. As a result of our above discussion, we find no merit in first appeal no.171 of 2015, which has been filed by the OPs now appellants and the same is hereby dismissed. First appeal no.929 of 2015, which has been filed by the complainant now appellant of this appeal for enhancement of compensation is also without merit and the same is dismissed.
13. In First Appeal No.171 of 2015, the appellants had deposited an amount of Rs.25,000/- in this Commission at the time of filing the appeal and further deposited the amount of Rs.1,20,000/- in compliance with order of this Commission. Both these amounts alongwith interest, which accrued thereon, if any, be remitted by the registry to respondent no.1 of this appeal being complainant by way of crossed cheque/demand draft after 45 days from receipt of certified copy of this order. Remaining amount, if any due, shall be paid by OPs to complainant, as per the order of the District Forum. First Appeal No.171 of 2015 21
14. Arguments in above referred appeals were heard on 09.03.2017 and the orders were reserved. Certified copies of the orders be communicated to the parties as per rules.
15. 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 14, 2017 (MM)