State Consumer Disputes Redressal Commission
Mr. Ranjit Sanghavi vs Cumballa Hill Hospital And Heart ... on 31 March, 2015
Daily Order BEFORE THE HON'BLE STATE CONSUMER DISPUTES REDRESSAL COMMISSION, MAHARASHTRA, MUMBAI Complaint Case No. CC/04/134 1. MR. RANJIT SANGHAVI 1401/2, SAPNA APTS, SENT MOTISHAH LANE, BYCULLA, MUMBAI-10. ...........Complainant(s) Versus 1. CUMBALLA HILL HOSPITAL AND HEART INSTITUTE AND ORS. 93/95, AUGUST KRANTI MARG, MUMBAI-36. ............Opp.Party(s) BEFORE: Shashikant A. Kulkarni PRESIDING MEMBER Narendra Kawde MEMBER For the Complainant: Complainant in person For the Opp. Party: Dr.G.N.Shenoy-A.R. for the opponents ORDER Per Mr.Narendra Kawde Member
Complainant has filed this consumer complaint through C.A. Shri Girish Chandmal Lodha against the opponents alleging deficiency of service against all the opponents for medical negligence. Opponent no.1 is a Hospital whereas opponent no.2 is a visiting Cardio Surgeon and opponent no.3 is Consultant Cardiologist attached to the O.P.1's Hospital. O.P.4 is a statutory authority and a formal party.
2. The case as put up by the complainant is summarized hereinafter:-
Complainant approached the opponent no.1 hospital for chest pain on O.P.D. basis on 18/11/2002 and subsequently admitted for further investigation and treatment on 22/11/2002. Tread Meal Stress test was carried out in the O.P.1's hospital on 18/11/2002, which was found strongly positive for inducible ischaemia. Further required dignosis tests were carried out and it was found that three arteries were blocked, which necessitated to carry out coronary angiography on 25/11/2002. After evaluation of the patient it was advised to undergo angioplasty for the 3 arteries of the heart. Angioplasty was to be carried out by opponent no.2 i.e. Dr.S.Mathew. Since Dr.Mathew is a visiting interventionist cardiologist, it was posted for the procedure under Dr.Mathew on 28/11/2002. Main grievance of the complainant is though only three stents were inserted in the arteries, the OP no.1 has charged for 4 stents with total hospitalization bills estimated to Rs.6,20,884/-. Complainant reluctantly settled the bill as a package bill. However, complainant's request for refunding of extra charges for 4th unused stent was turned down by the opponent no.1 without any satisfactory reply whatsoever. It was the confirmed notion of the complainant that O.P.no.1 and the associated doctors along with staff have cheated the complainant being a layman. Aggrieved thereby, the complainant filed this consumer complaint claiming an amount of Rs.50 lakhs together with costs.
3. All the opponents have appeared by filing their written version opposing claim and contentions of the complainant. On behalf of opponent no.1 i.e. hospital one Dr.Ram K.Narayan Dy.Medical Director verified the written version stating that at the request of the complainant the emergent treatment of coronary angiography and angioplasty was carried out under the overall supervision and care of Dr.S.Mathew O.P.no.2 who is eminent interventional visiting cardiologist. Undisputedly, Tread Meal Stress test followed by angiography necessitated to carry out procedure of angioplasty with insertion of stent in three major arteries of the heart of the patient. One of the stent which was being guided into place was distorted and rendered unusable. The 4th stent was immediately inserted in place of the distorted one by removing it very promptly. The damaged stent was returned to brother of the complainant who himself is a DOCTOR. Charges for availing the different types of services like AC Deluxe room, nursing services were fully explained in advance to the complainant. Complainant has availed by extending his consent the facilities during the hospital stay for which the charges were levied and paid by the complainant. Coronary artery stent used in coronary angioplasty is a very delicate and minute device which is carefully threaded into the blood vessels of the heart during the stent insertion procedure. Since it is a blind procedure, distortion of stent, removal thereof and replacing the same is a standard procedure followed in the treatment of protocol.
4. Opponent no.2 more or less filed his written version supporting the stand taken by O.P.no.1 hospital. This O.P. has seen the complainant first time after admission to the hospital and prior to the angioplasty procedure of the O.P.no.1 hospital. Complainant was suffering from chest pain for which he was required to undergo certain diagnostic tests. Tread Meal Stress Test was strongly positive and, therefore, angiography was carried on 25/11/2002 by O.P.no.3. Considering blockage in the arteries complainant was scheduled for angioplasty which was carried out by him on 28/11/2002. One of the stents in the procedure of angioplasty was damaged while performing the procedure in cathlab. O.P.no.2 removed the damaged stent and inserted the another one without any adverse event, and the relatives of the complainant including brother of the complainant who is a doctor were explained. Post operative recovery of the patient was uneventful. Extra cost involved for the damaged stent was required to be paid by the complainant and there was no whisper or murmur when explained to the patient's relatives. The best possible procedure and treatment in the interest of the patient carried out by him and went uneventfully. The post angioplasty, Tread Meal Stress Test was found to be NEGATIVE for inducible ischemia. The patient is leading the good life after angioplasty. About charges of hospitalization this O.P. has nothing to do as he is a visiting interventionist cardiologist.
5. O.P.no.3 is attached to O.P.no.1's hospital. More or less written version filed by O.P. nos.1&2 is supported by this O.P.no.3. Angiography and other related tests and the post operative recovery procedure was under the close supervision of this opponent. O.P.no.3 denied levying charges for 4th stent without being utilized. One of the stents which comes premounted on a balloon moved away from the balloon on to the shaft of the balloon catheter while during the process. After realization the stent was removed from the premounted position, retrieved dexterously retrieved out of the catheter which resulted damage in the stent. As a witness to the procedure carried out under the supervision of O.P.no.3, OP no.3 has reiterated the facts and circumstances leading to damage to a stent. Standard protocol of the procedure was followed during the stent implantation angiography and angioplasty.
6. Complainant appeared party in person through out the proceeding. Power of attorney holder did not appear and plead the case nor the complainant advanced any argument except stating that matter be decided on its own merits. The only submission during the course of hearing advanced by the complainant was that angioplasty was not necessitated yet the opponent collectively decided to go ahead and inserted three stents in the arteries. No explanation whatsoever was given to the complainant justifying the procedure. Instead of charging for three stents which were actually used the O.P.no.1 has recovered charges for the unused stent.
7. Dr.G.N.Shenoy Learned A.R. appearing on behalf of all the opponents submitted that it was with the consent of the complainant with history of chest pain required procedures were carried out and ultimately it was found that three arteries of the complainant were blocked as per the diagnostic test. Complainant was duly explained the risk and consequences if corrective steps were not taken including angiography followed by angioplasty. Complainant has duly consented on record to proceed further as per the medical advice. Consent of the complainant recorded is available in the complaint compilation. Standard procedure and protocol treatment was strictly adhered to while dealing with this patient. As explained by O.P.nos.2&3 who are renowned cardiologists only three stents were required to be inserted. However, the third stent got damaged in the process of angioplasty which was required to be retrieved with insertion of other one. The damaged stent was handed over to the relative of the complainant who is a doctor himself. Since in the process one stent was damaged but the opponent no.1 was required to charge for all the four stents (4-1=3).
8. As per the standard protocol of the "coronary artery stenting-likely complications" process are explained in Chapter 15 of the said authority. One of the possibility is failure of the stent in process. Since the procedure is complicated, no surgeon can guarantee against failure of stent. The allegations of the complainant are after thought as the failure of one stent was explained to the relatives and also about the charges to be paid. Complainant has not adduced any expert medical evidence to substantiate his allegations to prove that the procedures carried out by O.P.nos.2&3 were not necessitated. According to Dr.Shenoy, O.P.nos.2&3 have followed due procedure in the interest of patients well being and not just to make money out of the treatment. Moreover, pre-angioplasty and post-angioplasty, Tread Meal Stress Test report would show that complainant's Stress Level was found to be negative in the test carried out 08/01/2003 (post procedure of angioplasty). All the facilities availed by the complainant were well within his knowledge as charges required to be paid were explained in advance. Therefore, no grievance can be made after thought.
9. Having regard to facts and circumstances, we find that complainant did not adduce expert medical evidence to substantiate the allegations as rightly pointed out on behalf of the opponents to establish that the angioplasty was not necessitated. On perusal of the record and Hospital record, we do not find any record to show that any grievance was made by the complainant about charging for 4 stents instead of 3 (actually used plus one damaged) and even for hospital charges. On the contrary, complainant preferred to continue to visit O.P.no.1's hospital for follow up post angioplasty without making any grievance. It is for the consumer complainant to discharge the initial burden attributing medical negligence against the opponents by adducing tangible /reliable documentary evidence. Undisputedly the complainant was suffering from unstable angina which necessitated the opponents to carry out further diagnostic tests for logical conclusion to take corrective measures. The complainant failed to discharge the initial burden. It is unimaginable that for want of corrective medical measures taken by the opponent nos.2&3 what fate the complainant would have met. We are convinced from the text material relied upon by the opponents and the written versions and affidavit of evidence, that they have taken corrective measures as were necessitated in the best interest of the complainant. It is necessary to observe that the angioplasty procedure was carried out in the year 2002, since then the complainant is in his good and mobile health.
10. In view of the aforesaid observations, we find no substance /merit in the consumer complaint. Hence complaint deserves to be dismissed.
ORDER
1. Consumer Complaint stands dismissed.
2. Parties to bear their own costs.
3. One set of complaint compilation be retained and rest of the sets be returned to the complainant. [ Shashikant A. Kulkarni] PRESIDING MEMBER [ Narendra Kawde] MEMBER