National Consumer Disputes Redressal
Dr. Kusum Sabharwal vs Sangeeta Aggarwal & Anr. on 11 January, 2018
NATIONAL CONSUMER DISPUTES REDRESSAL COMMISSION NEW DELHI REVISION PETITION NO. 2058 OF 2013 (Against the Order dated 05/03/2013 in Appeal No. 833/2010 of the State Commission Delhi) 1. DR. KUSUM SABHARWAL C/O TARAVATI RAMGOPAL MEHRA CHARITABLE MEDICAL CENTRE, PLOT NO-8, PATPARGANJ, NEAR NAVNITI APTS, I.P EXTN, DELHI - 110092 ...........Petitioner(s) Versus 1. SANGEETA AGGARWAL & ANR. W/O SANDEEP AGGARWAL, R/O 34 PACHMAHAL APTS, 47 I.P EXTN, PATPARGANJ, DELHI - 110092 2. TARAVATI RAMGOPAL MEHRA CHARITABLE , FOUNDATION MEDICAL CENTER, THROUGH ITS MANAGER/ DIRECTOR/ADMINSTRATIVE HEAD, PLOT NO-8 PATPARGANJ, NEAR NAVNITI APTS. I.P EXTN, DELHI - 92 3. UNITED INIDA INSURENCE CO. LTD. 54 JANPATH , CONNAUGHT PLACE, NEW DELHI - 110001 ...........Respondent(s)
BEFORE: HON'BLE MR. DR. B.C. GUPTA,PRESIDING MEMBER HON'BLE MR. DR. S.M. KANTIKAR,MEMBER For the Petitioner : Ms. Ginny Jetley Rautray, Advocate with Ms. Bhawna Pal, Advocate For the Respondent : For the Resp.No.1 : Mr. Sandeep Aggarwal, Husband of Resp.No.1 For the Resp.No.2 : NEMO For the Resp.No.3 : Mr. Maibam N. Singh, Advocate Dated : 11 Jan 2018 ORDER DR. S. M. KANTIKAR, MEMBER
1. This revision petition has been filed under Section 21(b) of the Consumer Protection Act, 1986 against the order dated 5.3.2013 passed in first appeal No. 833 of 2010 by Delhi State Consumer Disputes Redressal Commission (in short, 'the State Commission') whereby the appeal of Dr.Kusum Sabharwal and the insurance company, was dismissed and the order of the District Consumer Disputes Redressal Forum (East) Saini Enclave, Delhi directing the OPs to pay compensation of Rs.1,50,000/- alongwith costs of Rs.5,000/-, was upheld.
2. The brief facts are that on 15.3.2008, the complainant, Sangeeta Aggarwal approached Tarawati Ramgopal Mehra Charitable Medical Centre (herein referred as 'medical centre')/OP-1 and consulted Dr. Kusum Sabharwal/OP-2. After examination, ultrasound study (USG) and pregnancy test, it was found that the patient had pregnancy. The patient wanted to get her pregnancy terminated. Accordingly, after written consent, Medical Termination of Pregnancy (MTP) was performed by OP-2 at OP-1/Medical Centre on the same day. The patient was discharged with medication. After 15 days, the patient visited the OP-2 again, with the complaint of abdominal pain. USG was performed at OP-1 by the Sonologist Dr. Rajesh Malhotra. It was reported as normal, therefore, patient was treated symptomatically and advised to consult immediately in case of any problem again. But, the complainant had pain in abdomen and uneasiness after MTP. It was alleged that OP 2 ignored her complaints and also failed to diagnose the root cause of pain, also declined to meet the complainant and her husband. Therefore, on 28.3.2008, the complainant and her husband consulted another Gynecologist, who advised to go back once again to the same doctor for further thorough check-up and advise. Accordingly, on 31.3.2008, the complainant again consulted OP-2, who referred her for USG and thereafter without proper examination, she was sent back to the home. On 1.4.2008, the complainant fell down in her house and she was taken immediately to St. Stephen Hospital in critical condition. There, she was diagnosed as a case of "Ruptured Ectopic Pregnancy Right Side". The UPT showed positive for pregnancy. She underwent emergency surgery and blood clots about 200 ml. were removed. She was discharged from St. Stephen Hospital on 8.4.2008. The complainant alleged that OP-2 had not performed MTP properly on 15.3.2008, therefore, she had to suffer the further consequences with physical strain and mental agony. Thus, the complainant filed a complaint before District Forum and claimed Rs. 20 lakhs as a compensation.
3. Both the OPs filed their written version and denied the allegations. OP-1 contended that this centre is a charitable centre and does not make any profit, therefore, the complainant is not a consumer. OP-2 had not been employed by OP-1 for providing any medical services as she is a visiting consultant only. The medical treatment was the choice of the complainant, accordingly, she opted to consult Dr. Kusum Sabharwal/OP-2. The OP-2 filed separate written statement and denied the allegation of carelessness or negligence. It is submitted that OP-1 is an authorized centre of Government of India for MTP. The MTP was legally performed after conducting all necessary tests. On 28.3.2008, the complainant consulted Dr. Meghna Kulkarni, who also did not think about ectopic pregnancy. Even the repeat USG done on 31.3.2008 did not visualize ectopic pregnancy. Thus, it was not a negligence or deviation from the standard medical practice. OP-3/United India Insurance Co. Ltd. also filed a written version before the District Forum and submitted that the professional indemnity cover for OP-2 was in force during 6.3.2008 to 5.3.2009. There was no negligence on the part of OP-2, therefore, there shall not be any liability on OP-3.
4. On the basis of averments and evidence, the District Forum allowed the complaint and directed the OPs-1 and 2 to pay Rs.1,50,000/- as a compensation and Rs. 5,000/- as a costs. Being aggrieved by the order of District Forum, OPs 1 and 2 preferred first appeal before State Commission. The State Commission dismissed the appeal. Therefore, against the order of State Commission, OP 2/Dr. Kusum Sabharwal filed this revision petition.
5. We have heard the learned counsel for both the parties. Learned counsel for the petitioner submitted that there was no negligence or carelessness on the part of OP-2 in the treatment of complainant. Per contra, the learned counsel for the complainant submitted that as per expert medical opinion from GTB hospital, there was a lapse and negligence on the part of OP-2. Counsel brought our attention to the report of Medical Superintendent, GTB Hospital vide dated 4.1.2010, which is reproduced below:
"Patient underwent D&C under general anesthesia on request for MTP at 6 weeks of amenorrhea on 15.3.09 at Tarawati Ramgopal Mehra Cheritable, Foundation Centre, Delhi.
As per records of procedure was uneventful and patient was discharged on the same day Details of D & C procedure and whether products obtained or not are not available from records.
2 weeks post MTP i.e. 28.3.09 examination by a private practitioner whom she consulted for pain in the right lower abdomen, revealed bulky uterus with tenderness in right adexa. Diagnosis of ectopic pregnancy was not entertained and she was treated with antibiotics only 3 days further to this ultrasound done on 31.3.09 by first team at MTP centre gave an impression of bulky uterus with normal adnexa. However, no details of clinical examination are available in the records.
Within the next 24 hours patient had to be admitted at St. Stephen's Hospital on 1.4.09. USG done here revealed right chronic ruptured ectopic pregnancy for which emergency laparotomy was done. Hemoperitoneum of 200 cc approx.. drained and right ruptured ectopic pregnancy was diagnosed.
Patient underwent right salpingectomy and specimen apparently sent for histopathology, however, report is not available on record.
The committee is of the opinion that it is a case of right ectopic pregnancy as confirmed by laparotomy findings."
6. We have perused the medical record and the expert medical opinion from GTB Hospital, also gave our thoughtful consideration to the arguments advanced by learned counsel for both the parties. It is an admitted fact that on the basis of USG and urine pregnancy test, the patient was carrying six weeks of pregnancy. After MTP done on 15.3.2008, the patient had off and on pain in abdomen. She had consulted OP-2 and Dr. Meghna Kulkarni. As per the prescription, the patient was advised medicine like Misoprost 200 and Becosules. In our view, OP-2 and also Dr. Meghna Kulkarni clinically examined the patient and recorded that uterus was bulky but both were failed to rule out the post MTP causes for bulky uterus with tenderness in the right adnexa. They have failed to diagnose or to consider possibility of Ectopic pregnancy but blindly advised the patient for antibiotics. It is quite surprising that on 31.3.2008, at OP-1/Medical Centre, the Sonologist, Dr. Rajesh Malhotra performed USG of the patient but, he also missed the diagnosis of right tubal pregnancy despite the clinical findings of bulky uterus. The medical record clearly revealed us that on 1.4.2009, the patient was admitted in St. Stephen Hospital as an emergency. The USG revealed right Chronic Ruptured Ectopic Pregnancy. Accordingly, she was operated as an emergency. Considering those events, we are of the view that the OP-2, Dr. Meghna Kulkarni and the Sonologist, Dr. Malhotra were deficient in their duty of care. They have not properly assessed the post MTP status of the patient despite the patient had complaints of pain in abdomen. OP-2, who is a qualified Gynecologist failed to send D & C material to confirm whether it was the products of conception (pregnancy). Thus, it was just a casual approach by the consultant at OP-1/centre. As per medical literature, it is bounden duty of the doctors or surgical specialists that any surgical specimen should be studied for histopathological examination for confirmation of diagnosis and further management. In our view, the treatment given by OP-2/doctor was not as per standard of practice. Even the expert opinion from GTB Hospital is not at rescue of the OPs.
7. Thus, in our view, it is clear that it was a failure to diagnose Ectopic pregnancy by OP-2 as well as Sonologist, Dr. Rajesh Malhotra. The OP-2 performed D & C on clinical assessment and thereafter, the follow up of post MTP patient, was not proper. Thus, it was not a standard of practice but it was a breach in the duty of care.
8. On the basis of foregoing discussion, we do not find any merit in the impugned order passed by the State Commission, which allowed just and proper compensation. There is no merit in the revision petition. Accordingly, it is dismissed.
...................... DR. B.C. GUPTA PRESIDING MEMBER ...................... DR. S.M. KANTIKAR MEMBER