State Consumer Disputes Redressal Commission
Sanjay Kumar vs Dr. Rajeev Chauhan on 15 January, 2010
STATE CONSUMER DISPUTES REDRESSAL COMMISSION UTTARAKHAND
DEHRA DUN
CONSUMER COMPLAINT NO. 22 / 2004
Sanjay Kumar S/o Sh. Bhagmal Singh
R/o Mohalla Bhoop Singh, Jaspur
C/o Arun Medical Store, Jaspur
District Udham Singh Nagar
......Complainant
Versus
1. Dr. Rajeev Chauhan S/o Sh. Udaiveer Singh
Urmila Nursing Home, Chowk Bazar
Jaspur, District Udham Singh Nagar
2. Dr. R.K. Sarraf, Acting Medical Superintendent
Community Health Centre, Jaspur
District Udham Singh Nagar
3. Dr. A.K. Goel, Goel Diagnostic Laboratory
Ramnagar Road, Kashipur
District Udham Singh Nagar
4. Dr. Rajeev Babu
C/o Vivekanand Hospital and Research Centre
Moradabad
5. The New India Assurance Company Limited
through Branch Manager, Moradabad
6. Vivekanand Hospital and Research Centre
(Under Auspices of Moradabad Charitable Trust
& Health Research Centre), Swami Vivekanand Road
Opposite Govt. Polytechnic, Moradabad
......Opposite Parties
Sh. J.P. Kansal, Learned Counsel for the Complainant
Sh. K.K. Goyal, Learned Counsel for Opposite Party No. 1
Sh. M.K. Kohli, Learned Counsel for Opposite Party Nos. 4 and 5
None for Opposite Party Nos. 2, 3 and 6
Coram: Hon'ble Justice Irshad Hussain, President
C.C. Pant, Member
Smt. Kusum Lata Sharma, Member
Dated: 15/01/2010
2
ORDER
(Per: C.C. Pant, Member):
This consumer complaint was filed on 19.05.1999 by the complainant against the opposite parties alleging medical negligence in the treatment of his wife Smt. Pratima.
2. The sequence of events which led to filing of the consumer complaint are as follows:
3. The wife of the complainant aged about 22 years started vomiting on 05.04.1999 and was taken to Community Health Centre, Jaspur. The opposite party No. 2 - Dr. R.K. Sarraf asked the complainant to get the Serum Bilirubin of the patient tested, which was done by opposite party No. 1 - Dr. Rajeev Chauhan of Urmila Nursing Home. The clinical report found the Serum Bilirubin as 9.67. Accordingly, Dr. R.K. Sarraf diagnosed the patient as a case of jaundice and gave treatment. The opposite party No. 2 was consulted on 12.04.1999, who advised the patient to continue the same treatment. When the complainant observed that there was no improvement in patient's condition, he again consulted the opposite party No. 2 on 20.04.1999. The opposite party No. 2 - Dr. R.K. Sarraf advised to get the Serum Bilirubin of the patient tested once again. The test was again done by opposite party No. 1 and he reported the Serum Bilirubin as 9.34. On the basis of the report, the opposite party No. 2 advised to continue the treatment. However, the condition of the patient got deteriorated. This time, the complainant consulted Dr. R.K. Singh of the Community Health Centre, who advised to get the Serum Bilirubin of the patient tested from some other pathological laboratory as the earlier reports might be incorrect. The complainant got the Serum Bilirubin of the patient tested from 3 opposite party No. 3 - Dr. A.K. Goyal, who reported it as 25.6%. Dr. R.K. Singh, finding that there was a vast difference in the clinical reports, prescribed medicines for a day and advised the complainant to take patient to Vivekanand Hospital and Research Centre, Moradabad
- opposite party No. 6. The complainant took his wife to Moradabad, where Dr. Rajeev Babu of Vivekanand Hospital and Research Centre
- opposite party No. 4 examined the patient and commented that the condition of the patient was very critical. He got various tests in hospital's pathological laboratory done including the test for Serum Bilirubin. The Serum Bilirubin came out to be 24. Dr. Rajeev Babu also suspected that the earlier clinical reports of Urmila Nursing Home might be incorrect. The opposite party No. 4 started the treatment of the patient, which continued upto 03.05.1999. On 03.05.1999, the opposite party No. 4 told the complainant that the condition of the patient got deteriorated too much and advised to take her to All India Institute of Medical Sciences, New Delhi. The complainant took her immediately to A.I.I.M.S., where she died on 04.05.1999. The grief stricken husband - complainant has, thus, filed this consumer complaint alleging therein that the initial negligence was made by Dr. Rajeev Chauhan - opposite party No. 1, who had given a wrong report in respect of patient's blood test. The complainant has also alleged that Dr. Rajeev Babu - opposite party No. 4 had also made medical negligence in the treatment of his wife. The complainant has prayed that the opposite parties be directed to pay sum of Rs. 20,00,000/- together with interest @18% p.a.
4. None appeared on behalf of opposite party Nos. 2, 3 and 6. We have heard the learned counsel for the complainant and opposite party Nos. 1, 4 and 5 and perused the record.
45. The main contention of the complainant is that the opposite party No. 1 - Dr. Rajeev Chauhan had made negligence while doing the blood test for Serum Bilirubin of the patient and had given a false report. The learned counsel for the complainant had submitted an interrogatory for opposite party No. 1 (Paper No. 136). Through this interrogatory, the learned counsel wanted to prove that the opposite party No. 1 was not competent to carry out the blood test for Serum Bilirubin and he was not properly trained to operate the computerized machine ATOM 388. The learned counsel had asked the doctor to furnish a true photocopy of the certificate indicating that he was properly trained by the Ranbaxy Company for operating the said computerized machine. The learned counsel also asked the doctor to give details of tests, which were necessary to be carried out in respect of the patient for Hepatitis-B disease. In reply to the interrogatories, Dr. Rajeev Chauhan submitted the answers (Paper Nos. 144 to 145). In his reply, the doctor has stated that the representatives of the company demonstrate the operation of the machine and no certificate regarding the training as such is issued to the doctors. In respect of the necessary tests for Hepatitis-B, the doctor has stated that as soon as the patient is suspected of having jaundice (Hepatitis), the patient is asked to get various tests done. Serum Bilirubin is one of them, which shows the level of jaundice, but does not reflect upon severity of the disease. The doctor has further stated that Hepatitis-B is the most dangerous type of hepatitis, which can be confirmed by the test called "Australia Antigen". S.G.P.T. is one of the most important and easily available tests indicating the actual severity of liver illness. The doctor has also said that the other tests, which may be carried out for such patients, are S.G.O.T., Alkaline phosphatase, Total proteins (Albumin, Globulin, A.G. ratio), Prothrombin, Hb%, TLC, DLC, Urine R/M etc. The doctor has also clarified that these tests, which are collectively known as Liver Function Test, were done on 5 complainant's wife nearly 15 days after the onset and confirmation of disease. During the period, neither the patient, nor the treating doctor knew the extent of liver involvement in patient or that she was suffering from Hepatitis-B. The opposite party No. 1 has concluded his reply with the comment that proper treatment was not given to the patient. The learned counsel for the complainant has, thus, tried to prove that the opposite party Nos. 2 and 4 failed to give proper treatment to the patient. Further, on the behest of Dr. R.K. Singh of Community Health Centre, Jaspur, the blood test of the patient was carried out by opposite party No. 3 - Dr. A.K. Goyal of Goyal Diagnostic Laboratory on 22.04.1999 and the Serum Bilirubin was found to be 25.6%. The same test, which was carried out on 20.04.1999 by opposite party No. 1 - Dr. Rajeev Chauhan on the behest of opposite party No. 2 - Dr. R.K. Sarraf had revealed Serum Bilirubin as 9.34. The learned counsel for the complainant, thus, urged that the clinical test reports dated 05.04.1999 and 20.04.1999 given by Dr. Rajeev Chauhan were false and, therefore, the opposite party No. 1 had made negligence in diagnosing the severity of the disease. The opposite party No. 2 was equally responsible because he did not take note of the fact when he was consulted on 12.04.1999 that the condition of the patient was deteriorating. Like Dr. R.K. Singh, he should have suspected something serious, but the opposite party No. 2, making negligence in treatment, advised to continue the treatment.
6. The learned counsel for the complainant, in respect of the medical negligence made by opposite party No. 4, has submitted that he took his wife to Vivekanand Hospital and Research Centre, Moradabad on the advice of Dr. R.K. Singh, who had suspected something serious than jaundice. The patient was admitted in the hospital on 24.04.1999. The learned counsel pointed out to Paper No. 105, which is a photocopy of the "Indoor Case Record" of the 6 Vivekanand Hospital and Research Centre in respect of the patient Smt. Pratima. Under the column "diagnosis", the doctor has clearly mentioned the disease as "Hepatitis-B with Acute Pancreatitis". On perusing the said paper, it appears that various tests were done on the patient including "Australian Antigen". The complainant's version is that his wife remained admitted in Vivekanand Hospital and Research Centre upto 03.05.1999, but her condition instead of improving, got deteriorated. On 03.05.1999, when her condition became very critical, the opposite party No. 4 advised him to take her to A.I.I.M.S., New Delhi. He took his wife to A.I.I.M.S. immediately, where she died the next day. The complainant has alleged that the opposite party No. 4, who is an employee of opposite party No. 6, had not given proper treatment to the patient. The treating doctor knew from very first day of admitting the patient in the hospital that she was suffering from Hepatitis-B combined with Acute Pancreatitis. When the condition of the patient became beyond control, the complainant was asked to take her to A.I.I.M.S. and was forced to write on the hospital's record that, "ges ;gka fdlh Mk0 ,oa deZpkjh ls dksbZ ijs"kkuh ugh gSA vius ethZ ls vius ejht dks ys tk jgs gSA".
7. In defence, the learned counsel for the opposite party No. 4 has pleaded that the patient had developed the disease Hepatitis-B with Acute Pancreatitis only after 01.05.1999 when her condition got deteriorated and the treating doctor and hospital got the re-investigation done on the patient. Only after the re-investigation reports on 03.05.1999, the doctor could know that she was suffering from Hepatitis-B with Acute Pancreatitis. Before commencing the treatment for the disease, the complainant removed the patient from the hospital on his own will. The learned counsel, pointing out to Paper No. 105, argued that the complainant's action is well proved by the hospital's note under the column "operative procedure as LAMA, 7 i.e. left against medical advice" and also by the complainant's own acknowledgement in this respect that he was taking his wife on his own will. The learned counsel, thus, urged that the complainant himself had discontinued the treatment and, therefore, he can not allege that the opposite party No. 4 or the hospital had made any medical negligence in the treatment of his wife.
8. We can not accept these pleas because, as suggested by Dr. Rajeev Chauhan, Australian Antigen test is carried out for the confirmation of Hepatitis-B and the hospital's record also record that the patient was diagnosed as a case of Hepatitis-B. The hospital's record clearly shows that the above test was carried out after admitting the patient in the hospital and under the column "diagnosis", it is also clearly mentioned that it was a case of "Hepatitis-B with Acute Pancreatitis". The learned counsel for the complainant had also submitted an interrogatory for the opposite party No. 4 - Dr. Rajeev Babu, which is at Paper No. 135. Dr. Rajeev Babu's reply to the said interrogatories is at Paper No. 139. In reply to question No. 6 - "Was the patient at the time of his (her) admission suffering from Fulminate Hepatitis-B", the doctor has replied "No". In reply to question No. 7, the doctor has stated that the patient developed severe pain in abdomen and "hypertension" on 03.05.1999. She was re-investigated and the reports showed that she had developed "Acute Pancreatitis". According to Dr. Rajeev Babu, he had given necessary treatment to the patient, but her husband (attendant) left the hospital against the medical advice. This reply is not consistent with what the hospital's record show. Just to put a veil on the negligence made by the treating doctor, it is being said that the patient had developed acute pancreatitis on 03.05.1999. The complainant has repeatedly submitted in his complaint that his wife's condition went on deteriorating. On 12.04.1999, when he consulted 8 Dr. R.K. Sarraf, he advised to continue the treatment instead of advising for fresh clinical tests, as was advised by Dr. R.K. Singh on 22.04.1999. Even on 20.04.1999, the opposite party No. 2 did not bother to see as to why the condition of the patient was deteriorating and relied upon the report of the opposite party No. 1. As soon as the test was done by Dr. A.K. Goyal - opposite party No. 3, the Serum Bilirubin of the patient was found as 25.6% and that was consistent with the investigation report of Vivekanand Hospital and Research Centre. So it was a well based reasoning that Serum Bilirubin can not rise so rapidly within two days. It was 9.34 on 20.04.1999 as per the report given by opposite party No. 1 and 25.6% on 22.04.1999 as per the report given by the opposite party No. 3. The report of opposite party No. 6 also revealed that Serum Bilirubin as 24 on 24.04.1999. It was Dr. R.K. Singh of the Community Health Centre, Jaspur who had smelled something serious and had advised to take the patient to Vivekanand Hospital and Research Centre. The opposite party No. 1 has submitted evidence at Paper No. 118, which is an opinion sought from Dr. Nakshatra Agarwal of R.S. Diagnostic & Research Centre, Kashipur. Dr. Nakshatra Agarwal has said that very high level of Serum Bilirubin may be caused by various diseases including severe hepatitis. He has further stated that the Serum Bilirubin level is dependent on several factors and, therefore, can rise rapidly within 24-48 hours. This opinion is not supported with any medical literature and, therefore, we can not rely on it.
9. Considering all the facts and circumstances of the case, we are of the view that the opposite party No. 1 - Dr. Rajeev Chauhan; opposite party No. 2 - Dr. R.K. Sarraf and opposite party No. 4 - Dr. Rajeev Babu did not appreciate the gravity of the patient's condition which was deteriorating. The vast difference in clinical reports dated 05.04.1999 and 20.04.1999 given by opposite party No. 1, report 9 dated 22.04.1999 given by opposite party No. 3 and report dated 24.04.1999 given by opposite party No. 6, clearly indicate that the reports given by opposite party No. 1 were not reliable. Either the testing machines had a defect or the persons handling the machine had not taken proper care in carrying out the blood tests of the patient. These days, when the cases of Hepatitis or Hepatitis-B are rapidly increasing, the doctors should examine each and every case of jaundice most carefully. In the case of the wife of the complainant, the opposite party Nos. 1, 2 and 4 failed to do so. We reject the plea of the opposite party No. 4 that the complainant had taken away his wife from the hospital on his own will. A person, whose wife's condition was getting deteriorated day by day and who had reached almost the end point of her life, is quite natural to get bewildered in such a situation and he can write anything on hospital's record if the hospital forces him to do so. Instead of making arguments with the hospital personnel, his priority was to save his wife. Therefore, in our opinion, medical negligence made by opposite party Nos. 1, 2 and 4 is well proved on record. The story of the deceased lady started on 05.04.1999 and lasted on 04.05.1999. Even if it was a case of Hepatitis-B from the very beginning, a month's time was sufficient for improvement, but due to the negligence of the doctors mentioned above, her condition went bad to worse and sailed her to the end point of her life. It is such a pathetic case where words would fail to console the grief stricken husband of the deceased, whose married life was deserted within two years of the marriage. It is such an agonised case where any judgment, in whatsoever words it is delivered, would fail to heal up the wounds of the complainant and at the same time, no compensation, of whatever amount it be, can compensate the loss suffered by the complainant. Even then this Commission is making an attempt to assess a reasonable and just amount of compensation. The complainant has claimed sum of Rs. 20,00,000/- plus interest, but 10 we find that at some place (Paper No. 16 para 4), the complainant has himself submitted that the claim is an exaggerated one. Considering this view of the matter, we find that the complainant is entitled to Rs. 2,50,000/- as compensation in this case. Considering the contributory negligence of opposite party Nos. 1, 2 and 4, it is held that opposite party No. 1 shall be liable to pay Rs. 25,000/-; opposite party No. 2 shall be liable to pay Rs. 25,000/- and opposite party No. 4 shall be liable to pay Rs. 2,00,000/- to the complainant. The opposite party No. 4 has Doctor's Indemnity Insurance Policy from opposite party No. 5 (The New India Assurance Company Limited) w.e.f. 12.11.1998 to 11.11.1999 and, therefore, the said insurance company has also to be held liable jointly and severally with the opposite party No. 4 to pay the amount of compensation payable by opposite party No. 4.
10. In view of above, the consumer complaint is partly allowed. The opposite party Nos. 1 and 2 are directed to pay to the complainant sum of Rs. 25,000/- (Rupees Twenty Five Thousand) each and the opposite party Nos. 4 and 5 are directed, either jointly and severally, to pay to the complainant sum of Rs. 2,00,000/- (Rupees Two Lacs). The amount of compensation shall be paid to the complainant within a period of sixty days from the date of this order, failing which the amount shall be payable together with simple interest @6% p.a. from the date of the order till the date of actual payment. No order as to costs.
(SMT. KUSUM LATA SHARMA) (C.C. PANT) (JUSTICE IRSHAD HUSSAIN) K