State Consumer Disputes Redressal Commission
Ashok Kumar vs M/S Pragma Hospital on 4 May, 2015
2nd Additional Bench
STATE CONSUMER DISPUTES REDRESSAL COMMISSION, PUNJAB
DAKSHIN MARG, SECTOR 37-A, CHANDIGARH
Consumer Complaint No. 52 of 2010
Date of institution: 20.7.2010
Date of Decision: 4.5.2015
Ashok Kumar C/o Dabra Trading, Gidarbaha, Distt. Bathinda.
.....Complainant
Versus
1. M/s Pragma Hospital, Bhatti Road, Bathinda, through it's
Authorised Officer / Person.
2. Dr. G.S. Gill, C/o Pragma Hospital, Bhatti Road, Bathinda.
3. United India Insurance Co. Ltd., through its Divisional Manager,
54, Janpath, Connaught Place, New Delhi - 110 001
(arrayed as per order dated 23.12.2010)
.....Opposite Parties
Consumer Complaint under Section 17 of the
Consumer Protection Act, 1986.
Quorum:-
Shri Gurcharan Singh Saran, Presiding Judicial Member
Shri Jasbir Singh Gill, Member
Mrs. Surinder Pal Kaur, Member
Present:-
For the complainant: Sh. Sumit Salhotra, Advocate for
Sh. Atul Sharma, Advocate
For the OPs : Sh. Vaibhav Narang, Advocate
2
CONSUMER COMPLAINT NO. 52 OF 2010
Gurcharan Singh Saran, Presiding Judicial Member
ORDER
The complainant has filed this complaint under the Consumer Protection Act, 1986(in short 'the Act') against the opposite parties(in short the OPs) on the allegations that he is resident and citizen of District Gidderbaha in the State of Punjab, therefore, the complaint is maintainable before the State Commission, Punjab whereas the OPs are a super speciality hospital and claims to run the following departments:-
"a) Cardiology
b) Neurology
c) Obstetrics & Gynaecology
d) Cardiovascular & Thoracic Surgery"
2. The complainant was leading a normal life, aged about 61 years plus. On 3.4.2008, he visited the OPs in a routine Urine examination and Echocardiography and preliminary report as per the Ops indicated that he was suffering from coronary artery disease with mild hypokinesia in LCX territory EF = 50% LV Diastolic Dysfunction, NO, MR, TR, AR, PR. It was alleged that fear psychosis was created by the OPs. He again visited with the Ops for regular check up on 25.7.2008 and on examination, it was found as under:-
"Diagnosis : DT, HT, CAD- AWMI PTCA+Stenting to RCA Route : Right Radial Artery Hardware : 6FJL3.5, 6FJR 3.5 Contrast : Omnipaque LMCA : Normal Dividend in TO LAD & LCX 3 CONSUMER COMPLAINT NO. 52 OF 2010 LAD : Proximal LAD has severe disease LCX : Distal LCX (small vessel) has severe disease RCA : Proximally RCA 100% Blocked Advice : PTCA+Stenting to RCA Vessel Lesion : Proximal RCA 100% Blocked : Proximal LAD severe disease : Distal LCX Severe Disease"
4. On the same day, he was operated and OPs remarked that there was a good flow achieved and specially remarked that the stenting was successful. Two stents were placed on the effective area of his heart and as per the observation of the Ops, the complainant was suffering from "Distal LCX severe disease and his RCA was 100% blocked" and as per the report of the Ops, surgery was successfully performed as "PTCA + Stenting to RCA and the client was managed with LMWH, GP 11b/111a and NTG other supportive drugs". For all these services, the Ops charged a sum of Rs. 1,47,000/- in addition to the other expenses and charged roughly Rs. 1,50,000/- and apart from that he also suffered monetary expenses of Rs. 75,000/- on other cumulative expenses on account of travelling medication and other support. However, he was not feeling well after the surgery. He again approached the Ops and they showed their inability and had indirectly referred the complainant for a second opinion and other medication, therefore, the complainant sought the second opinion from M/s Fortis Hospital, Phase VIII, Mohali. Whereafter in the preliminary investigation, the complainant was advised to undergo bypass surgery because planting of stent in 4 CONSUMER COMPLAINT NO. 52 OF 2010 the RCA was not even advisable at that stage and planting of stent was of no use and was not remedial measure at stage one itself. The quality of the stent was poor, outdated, over sized and not of required size. Since the complainant was advised bypass surgery, therefore, he had undergone bypass surgery by grafting as his RCA was 100% blocked and no effective measures were taken by the Ops to control this problem. Placement of stent had not granted any relief and placement of RCA was not called for. The complainant had to spend a sum of Rs. 5 lacs on account of surgery and Rs. 2.50 lacs indirectly. It was alleged that the Ops were not definite in their services. Hence, the complaint was filed with a direction to the Ops to pay a sum of Rs. 15 lacs on account of direct monetary losses suffered by the complainant, Rs. 6 lacs on indirect expenses, Rs. 5 lacs on expenses to be suffered in future alongwith interest and Rs. 5 lacs for inconvenience and mental harassment and costs of litigation.
5. The complaint was contested by the Ops, who filed written reply taking preliminary objections that the complaint is wholly misconceived, groundless, frivolous, vexatious and scurrilous to the knowledge of the complainant, therefore, liable to be dismissed; there is no specific, scientific and justified allegations with regard to the negligence or deficiency in services against the OPs; the complaint is not supported by any medical expert opinion, the complainant has not approached the Hon'ble Commission with the support of any expert opinion, the complainant is claiming exorbitant amount without any basis, just to waste the valuable time, harass and defame the Ops and that the complaint is totally false, fabricated, wrong and baseless; 5 CONSUMER COMPLAINT NO. 52 OF 2010 the complaint is bad for non-joinder of United India Ins. Co. Ltd. as OP No. 2 is covered with professional indemnity Policy No. 040100/46/08/35/00000316 for the period 24.4.2008 to 23.4.2009. The patient was properly examined, investigated and treated by Op No. 2 as per the prescribed norms of general practice. The complainant was well informed about the quality, infrastructure and hospital facilities with Op No. 1. OP No. 2 is well qualified doctor. The complainant has hypothetically enhanced the claim over Rs. 20 lacs wherein the direct monetary losses have been claimed Rs. 15 lacs and indirect expenses Rs. 6 lacs whereas in para No. 5 of the complaint, the complainant has specifically mentioned that he spent Rs. 5 lacs on account of surgery etc, directly and Rs. 2.5 lacs indirectly.
6. In the factual matrix, it was submitted that the patient Ashok Kumar was seen by Dr. G.S. Gill OP No. 2 on 3.4.2008 by first time. He was a known case of Diabetes and Hypertension and was taking treatment from Fortis Hospital since 2007. His blood test, urine test and Echocardiography were done and treatment was started on OPD basis. He again visited on 9.4.2008 in the OPD and was advised that he was better and then he again visited on 26.5.2008 and on 25.7.2008 at around 4.00 p.m., he had chest pain alongwith sweating and consulted a local doctor at Gidderbaha and his BP was 60mmHg systolic and BP was unrecordable and some injections were given. He was immediately brought in the Emergency Department and he was diagnosed acute inferior wall MI with hypotension (BP 70mmHg Systolic). The seriousness of the patient 6 CONSUMER COMPLAINT NO. 52 OF 2010 was discussed with the attendants/relatives of the patient and they were offered the choice between primary PTCA and Thrombolysis. However, before the attendants could decide, the condition of the patient deteriorated and he developed complete heart block. The attendants gave consent for primary PTCA and CAG revealed RCA 100% blocked, therefore, primary PTCA and stending to RCA was done and patient was recovered and was discharged on 28.7.2008 in a satisfactory condition. Then the patient visited the OPD on 7.8.2008 and 8.9.2008 when he was asymptomatic, he again visited the OP on 27.10.2008 with the complaint of breathing difficulty and was checked by OP No. 2. On 28.10.2008, son of the patient called upon OP No.
2. The report of CAG revealed focal restenosis in LAD & RCA stents and was advised to give 2nd opinion. Same pleas were reiterated in parawise reply to the complaint. It was submitted that the allegations alleged in the complaint are false and frivolous. The treatment was given to the patient according to the medical standard. No case of medical negligence has been made out by the complainant. The complaint is without merit and it be dismissed.
7. The parties were allowed to lead their evidence.
8. In support of his allegations, the complainant had tendered into evidence his affidavit Ex. CW-A, routine medical report Ex. C-1, reports Exs. C-2 & 3, receipts Ex. C-4, report Ex. C-4/A, reports Ex. C-5. On the other hand, OPs had tendered into evidence affidavit of Dr. G.S. Gill Ex. RW-1, policy Ex. R-1, detail of qualification Ex. R-2, treatment record Ex. R-3, medical literature Ex. R-4, approvals Ex. R-5.
7CONSUMER COMPLAINT NO. 52 OF 2010
9. We have gone through the written arguments submitted by Mr. Atul Sharma & Associates, Advocate for the complainant and have heard Mr. Vaibhav Narang, Advocate for the OPs and have carefully gone through the allegations alleged in the complaint, written reply filed by the Ops, evidence and documents on the record.
10. The counsel for the OPs has argued that the complaint filed by the complainant does not fall within the pecuniary jurisdiction of this Commission. The jurisdiction of this Commission can be invoked only in case the claim made out is more than Rs. 20 lacs to Rs. 1 crore and that the complainant has made the complaint more than Rs. 20 lacs on hypothetical grounds. In para No. 17 he has calculated a sum of Rs. 15 lacs as direct monetary loss, Rs. 6 lacs as indirect monetary losses, Rs. 5 lacs to be suffered in future, Rs. 5 lacs for inconvenience and litigation expenses. Whereas in para No. 4(j) of the complaint, it has been mentioned that OP No. 1 had charged Rs. 1,47,000/- for the operation and Rs. 1,50,000/- approximately for other expenses and Rs. 75,000/- as cumulative expenses and in para No. 5 with reference to the Fortis Hospital, he has referred Rs. 5 lacs on surgery and Rs. 2.50 lacs as indirect expenses. Ex. C-1 is the document vide which Rs.850/- were paid, vide Ex. C-4 a sum of Rs. 1,47,000/- was paid. There is another receipt dated 29.10.2008 issued by Fortis Hospital of Rs. 400/- and another bill of Rs. 2,05,813/- paid to the Fortis Hospital. No further bill has been produced on the record. The total of these bills comes to Rs. 3,54,063/-. It has not been explained in the complaint, how a sum of Rs. 1,50,000/- was spent on other expenses and Rs. 75,000/- 8 CONSUMER COMPLAINT NO. 52 OF 2010 plus on other cumulative expenses and how Rs. 2,50,000/- were spent by the complainant while taking the treatment in Fortis Hospital, therefore, without giving the proper details, the indirect expenses or cumulative expenses cannot be counted for. Therefore, the complaint filed by the complainant is itself contradictory stating Rs. 15 lacs as direct monetary loss whereas according to para 4(j), he spent Rs. 1,47,000/- with OP Hospital, Rs. 5 lacs in Fortis Hospital. In the complaint, he says that Rs. 6 lacs were spent on indirect expenses whereas in para No. 4J, he has referred Rs. 1,50,000/- and Rs. 75,000/- and Rs. 2,50,000/- in para No. 5. Moreover, mere reference of any expenses in the pleading is not sufficient till some specific evidence comes on the record, how the amount was spent on taking the treatment. If this amount is taken alongwith compensation of Rs. 5 lacs as claimed in the complaint, it comes to less than Rs. 20 lacs. In the written arguments, submitted by the counsel for the complainant he has not given any explanation how it calculated the amount and how the amount comes more than Rs. 20 lacs to attract the jurisdiction of this Commission. Even orally counsel for the complainant was unable to convince this Commission, how the expenses computated by exceeded Rs. 20 lacs. We are of the opinion that the claim of the complainant, even if it succeeded, does not exceed Rs. 20 lacs and does not fall within the pecuniary jurisdiction of this Commission.
11. Since this Commission does not have the jurisdiction to entertain this complaint, therefore, it is not desirable to give the findings on merits of the complaint.
9CONSUMER COMPLAINT NO. 52 OF 2010
12. Accordingly, the consumer complaint filed by the complainant is dismissed as this Commission does not have the jurisdiction to entertain the complaint for want of jurisdiction; with liberty to the complainant to file the complaint, if so advised, with an appropriate Forum.
13. The period spent while pursuing the complaint before the Commission is excluded for the purpose of limitation as per the law laid down by the Hon'ble Supreme Court in case "Trai Foods Ltd. v. National Insurance Co. and others", (2004) 13 SCC 656.
14. The arguments in this consumer complaint were heard on 24.4.2015 and the order was reserved. Now the order be communicated to the parties as per rules.
15. The consumer complaint could not be decided within the statutory period due to heavy pendency of Court cases.
(Gurcharan Singh Saran) Presiding Judicial Member (Jasbir Singh Gill) Member May 4, 2015. (Surinder Pal Kaur) as Member