State Consumer Disputes Redressal Commission
Smt B.Laxmi Devi ,W/O. Late ... vs Managing Director , Medwin ... on 13 April, 2011
BEFORE THE A BEFORE THE A.P.STATE CONSUMER DISPUTES REDRESSAL COMMISSION : HYDERABAD FA.402/2009 against C.D.No.297/2002, District Forum-I, Hyderabad. Between: Smt B.Laxmi Devi , W/o. late B.Ganapathi, Aged about 37 years, R/o.H.No14/87, Sainathpuram , Near High School, Mydukur Post, Cuddapah District. Appellant/ Complainant And Managing Director , Medwin Hospitals, 100, R.R.Towers, Chirag Ali Lane , Hyderabad 500 001. Respondent/ Opp.party Counsel for the Appellant : M/s.K.Visveswara Rao Counsel for the Respondent : M/s. K.Chaitanya CORAM:THE HONBLE JUSTICE SRI D.APPA RAO, PRESIDENT AND SMT. M.SHREESHA, HONBLE MEMBER
WEDNESDAY THE THIRTEENTH DAY OF APRIL, TWO THOUSAND ELEVEN.
Oral Order (Per Smt.M.Shreesha, Honble Member.) *** Aggrieved by the order in C.D.No.297/02 on the file of District Forum-1, Hyderabad,0 the complainant preferred this appeal.
The brief facts as set out in the complaint are that the complainants husband one Mr.B.Ganapathi was suffering from stomach pain and on 26.1.2000 consulted the local doctors and got relief. But when it recurred on 13.4.2000 they were advised by Warehousing Officers to go to Medwin, the opposite party herein. The complainants husband joined the opp.party hospital on 14.4.2000 and was in the hospital for a period of 10 days and numerous tests were conducted. On 21.4.2000 four liters of water was given to the patient to conduct some tests but after giving the water no special doctor attended to the patient till 11 am. on 23.4.2000, inspite of requests on 22.4.2000 and the patient was forced to suffer the pain till 23.4.2000. Thereafter the nurse inserted a pipe in nose and green and yellow colour liquid came out.
But the sister stopped the above system and the patient was shifted to ICU and was declared dead by 8 am. on 24.4.2000. The complainant submits that the patient died only because of the doctors negligence and no treatment given to the patient from 21.4.2000 7 p.m to 23.4.2000 11 a.m. The complainant submits that he has two children aged 17 years and 15 years and her husband was earning Rs.9000/- per month having 18 years more service but died an untimely death due to the negligence of the opp.party for which she seeks Rs.4,90,000/- towards compensation and Rs.5000/- towards costs.
Opp.party filed counter admitting that the complainants husband was admitted in opp.party hospital as per the reference of Central Warehousing Authorities on 14.4.2000 and was in hospital till 24.4.2000. The complainants husband was suffering from severe pancreatitis and multi organ failure with abdomen pain intermittently collcky with vomitings and weight loss of 6 Kgs in 3 months. The relevant investigations were done to diagnose the actual problem. From admission on 14.4.2000 to 16.4.2000 acute pain in abdomen and vomitings were managed and controlled with IV fluids and other intravenous medicines by the doctors and nursing staff. Basic blood tests like CBP, LFT, Blood urea and creatinine, Serum electrolytes, Abdominal X ray, ECG, ultrasound of the abdomen were carried out. Endoscopy and Colonoscopy were also conducted on 17.4.2000. A barium meal was followed up on 19.4.2000 and ERCP was done on 21.4.2000 which test confirmed that the abdominal pain was pancreatitis.
On 17.4.2000 two liters of water was given with Peglec Powder and not four liters on 21.4.2000 as claimed by the complainant. This medicine was given to clean the bowel before colonoscopy. The patient was attended to by frequent visits by specialist doctors but he has relapse of severe pain on 22.4.2000 which required a Nasal Gastric Tube and as his condition did not improve, he was shifted to AMC intensive care unit on 23.4.2000 at 11 a.m. Opp.partty denies that there was no special doctor available and contends that the Case Sheet reveals the details of time and line of treatment. They also deny that during the 10 days stay in the hospital the complainants husband was put to unnecessary tests. Opp.party submits that the patient died inspite of their best efforts and this could have happened any where in cases of acute severe pancreatitis and there is no negligence on their behalf and seek dismissal of the complaint with costs.
The District Forum based on the evidence adduced i.e. Exs. A1 to A5 and B1 dismissed the complaint.
Aggrieved by the said order the complainant preferred this appeal.
Heard both sides and also perused their written arguments.
The facts not in dispute are that the complainants husband was referred by Central Warehousing Authorities on 14.4.2000 to opp.hospital for complaint of stomach pain and was in hospital till 24.4.2000. It is the complainants case that during this period of 10 days, the opp.party had made the patient undergo unnecessary tests and investigations and even though the reports were negative, on 21.4.2000 opp.party doctors gave the patient 4 liters of water to be consumed for conducting further tests and thereafter nobody attended the patient inpsite of several requests till 11a.m. on 23.4.2000. The nurse inserted a pipe in the nose and some green and yellow colour liquid came and thereafter the doctor shifted the patient to Intensive Care Unit and the patient died at 8 a.m. on 24.4.2000. Ex.A4 is the Discharge Summary filed by the complainant which evidences the entire line of treatment given by the respondent/opp.party. It clearly states that basic blood tests were done and UGI Endoscopy and Colonoscopy with ERCP was done on 21.4.2000 which detected stricture of 3 cm. long in the body of pancreas. A diagnosis of chronic pancreatitis was made. Pancreatic duct was drained well and post ERPC procedure was uneventful. At 7 p.m. on 21.4.2000 the patient complained of severe upper abdominal pain and vomitings. The Serum Amylase and Pancreatic Amylase was found to be grossly elevated and once again on 23.4.2000 at 11 a.m. the patient complained of abdominal pain and was immediately shifted to AMC. We observe from this Discharge Summary and Ex.B1 Case Sheet that the patient was taken care of with requisite antibiotic and IV fluids and also put on ventilator support with the required medication. The Case sheet also depicts the treatment given timewise but ultimately the patient developed Bradycardia and died. We observe from the record Ex.B1 Case Sheet that the patient was diagnosed with chronic pancreatitis which has high mortality rate and died due to multi organ failure. We rely on the judgement of Apex Court in TARUN THAKORE v. Dr.NOSHIR M.SHROFF in O.P.No.215/2000 dated 24-9-2002 reported in Landmark judgements on Consumer Protection P-410 held as follows:
The duties which a doctor owes to his patient are clear. A person who holds himself out ready to give medical advise and treatment impliedly undertakes that he is possessed of skill and knowledge for the purpose. Such a person when consulted by a patient owes him certain duties, viz., a duty of care in deciding whether to undertake the case, a duty of care in deciding what treatment to give or a duty of care in the administration of that treatment. A breach of any of those duties gives a right of action for negligence to the patient. The practitioner must bring to his task a reasonable degree of skill and knowledge and must exercise a reasonable degree of care. Neither the very highest nor a very low degree of care and competence judged in the light of the particular circumstances of each case is what the law requires In INDIAN MEDICAL ASSN. v. V.P.SHANTHA (1995) 6 SCC 651 the court approved a passage from Jackson and Powell on Professional Negligence and held that The approach of the courts is to require that professional men should possess a certain minimum degree of competence and that they should exercise reasonable care in the discharge of their duties. In general, a professional man owns to his client a duty in tort as well as in contract to exercise reasonable care in giving advise or performing services.
Supreme Court then opined as under:
The skill of medical practitioner differs from doctor to doctor. The very nature of the profession is such that there may be more than one course of treatment which may be advisable for treating a patient. Courts would indeed be slow in attributing negligence on the part of a doctor if he has performed his duties to the best of his ability and with due care and caution. Medical opinion may differ with regard to the course of action to be taken by a doctor treating a patient, but as long as a doctor acts in a manner which is acceptable to the medical profession and the court finds that he has attended on the patient with due care, skill and diligence and if the patient still does not survive or suffers a permanent ailment, it would be difficult to hold the doctor to be guilty of negligence.
LAXMAN BALKRISHNA JOSHI vs. DR.TRIMBAK BAPU GODBOLE AND ANR. reported in (1969) I SCR 206 is another landmark judgement on medical negligence. In this case the death of the patient was caused due to shock resulting from reduction of the fracture attempted by doctor without taking the elementary caution of giving anaesthesia to the patient. In this case the Court discussed the duty of care a doctor should undertake and observed as follows :
a) A duty of care in presiding whether to under the case.
b) A duty of care what treatment to be given.
c) A duty of care in the administration of that treatment.
In the instant case the material on record establishes that the opp.party had taken due care and caution in diagnosing the disease and administering the treatment. The contention of the appellant/complainant that unnecessary investigations were done between 14.4.2000 and 24.4.2000 is unsustainable in the light of the Case sheet and also the notings of the results of the tests which depicts that Endoscopy, Colonoscopy and N.ERCP were done which proved conclusive of chronic pancreatis and by no stretch of imagination can the conduction of these tests be construed as unnecessary. It is also pertinent to note that from the averments in the very complaint itself, the patient was suffering from stomach pain from 26.1.2000 i.e. 3 months prior to the admission in the opp.party hospital (14.4.2000) and therefore it cannot be construed that it was only due to the negligent action of the opp.party the patient died. In the patients history itself it is stated that the patient was suffering from abdominal pain from 3 months. Even the contention of the appellant/complainant that the patient was given four liters of water and thereafter no doctor came to visit the patient is not substantiated by any documentary evidence. We find force in the contention of the counsel for the respondent/opp.party that barium meal test was done on 19.4.2000 ( which is evidenced on page 19 of Case Sheet), for which the liquid was supposed to be taken which is a prerequisite for the test. Page 21 of the Case Sheet is a diagnostic report of Serum Amylase and pancreatic amylase which clearly depict abnormally out of range results which further goes to show that the diagnosis done by the respondent/opp.party hospital of Acute pancreatitis, is correct. As the material on record clearly evidences that the respondent/opp.party has followed standard line of treatment as per normal standards of medical parlance, and also keeping in view that the complainant has failed to establish any negligence on behalf of the respondent/opp.party we see no reason to interfere with the well considered order of the District Forum.
In the result this appeal fails and is accordingly dismissed. No costs.
PRESIDENT MEMBER Pm* Dt.
13.4.2011