Indian Kanoon - Search engine for Indian Law

14.     Learned counsel for the opposite parties have cited a decision of Hon'ble National Commission in the case of Master Abhishek Ahluwalia & Ors. vs. Dr. Sanjay Saluja & Ors.; III (2014) CPJ 290 (NC).  In the said case the Hon'ble National Commission has observed that whether to discharge or not to discharge patient, it is for treating doctor to decide and not for patient or attending person.  Due to tightness in plaster obstruction to flow of blood in veins and arteries of leg - Acute pain due to tightness of plaster only. Operation was performed after administering General Anesthesia.  Respondent No. 1-doctor did not see condition of patient personally before discharging him.  Onus of proof shift upon respondent No. 1 to explain as to how and when gangrene had developed.  Principles of res ipsa loquitor fully attracted.  In the said case, the Hon'ble National Commission has also observed by quoting a judgment Nizam Institute of Medical Sciences vs. Prasanth S. Dhananka and Others; III (2009) CPJ 61 (SC). It was held that once initial burden has been discharged by the complainant by making of a case of negligence on the part of the hospital or the doctor concerned, the onus then shifts on the hospital or to the attending doctors to satisfy the Court that there was no lack of care or diligence." In para 138 of the said judgment the Hon'ble National Commission has observed that on the basis of documentary evidence placed on record as well as admission made by respondent No. 1 had discharged the initial burden of making a case of negligence, therefore, under such circumstances there was no requirement of any expert opinion.  Learned counsel also placed reliance on Ashish Kumar Mazumdar vs. Aishi Ram Batra Charitable Hospital Trust and Ors.; II (2014) CPJ 5 (SC).   In this said case, the Hon'ble Apex Court has held that the hospital also should be held liable for not maintaining the necessary vigil in hospital premises to ensure safety of its patients.  Principle of res ipsa loquitor applied - in case of failure to take due care.  Learned counsel for the complainant has also placed reliance on Sunil Rathi (Dr.) & Anr. Vs. Rita Dey & Ors.; I (2007) CPJ 270.  In the said case, the State Commission, Madhya Pradesh, Bhopal has observed that absence of reasonable explanation from opposite party as to cause for said complication.  In case whether the patient developing infection at injection site - case of gangrene leading to amputation of hand.  Principle of res ipsa loquitor applicable.  Treating doctor alongwith nursing staff guilty of medical negligence.

17.     From the perusal of the documents filed by the complainant on record, it is very much clear that the complainant, age about 1 month 7 days was admitted in Doon Valley Hospital on 03.05.2006 for high grade fever with seizures due to HIE (Hypoxic Ischemic Encephalopathy) and Septicemia.  The complainant was treated at Doon Valley Hospital from 03.05.2006 up to 04.05.2006 and during this time admittedly intravenous drip/injection was given to the complainant by the doctors of opposite party No. 1. At the time of implanting drip/injection a bandage was also applied to prevent any injury to the patient.  The complainant was discharged by Doon Valley Hospital on 04.05.2006.  According to the opposite parties' version, the complainant was discharged from the hospital on the persistent request of the complainant's parents, but the complainant has alleged that the doctors of opposite party No. 1 discharged the complainant in hurried manner.  The complainant then taken by his parents to home at Rishikesh, but on deteriorating condition, his parents again brought back him to Dehradun and a colour Doppler was conducted by Dr. Sachin Suri on 06.05.2006. The colour Doppler Imaging of the Vessels of Right Upper Limb shows that there was no flow of blood in the Palmer Arch and Digital Arteries.  The Doppler findings suggestive of no flow seen in the Palmer Arch and Digital Arteries.  The complainant then taken to the PGI, Chandigarh by his parents and admitted in institute for further treatment.  It is mentioned on the Out Patient ticket (Paper No. 14) that a child of one month brought with Gangrene of all five digits of right upper limb. The child was admitted on 03.05.2006 (wrongly written 03.04.2006) for seizures in Doon Valley Hospital where he was administered some intravenous injection.  In PGI, Chandigarh, the complainant was treated and later on due to Gangrene in the right limb, the complainant was advised for the imputation of the hand.  Later on complainant's right hand was amputated and again complainant was treated for septicemia in Himalayan Institute Hospital Trust, Jolly Grant.  The documents filed by the complainant on record clearly indicates that the complainant, who was admitted in Doon Valley Hospital on 03.05.2006, was discharged on 04.05.2006, after a gap of only one day, i.e. 05.05.2006.  The complainant again brought back to Dehradun on 06.05.2006 and a colour Doppler Imaging of the Vessels of Right Upper Limb of the complainant was conducted at Suri Diagnostic and Imaging Center, where no flow of blood was seeing in the Palmer Arch of the right upper limb of the complainant.  Naturally this obstruction of flow in the vessels of right upper limb, was caused due to the intravenous drip/injection implanted alongwith tight bandage on the right upper limb of the complainant at Doon Valley Hospital.  There is no other cause except the intravenous drip/injection to cause Gangrene and obstruction of blood flow in the hand, palm and fingers of the right hand of the complainant.  There is no evidence on record to show that the complainant was ever admitted in the hospital of Dr. Suri or Dr. Sachin Suri ever treated him.  Moreover, after conducting colour Doppler of the right hand of the complainant, the Dr. Sachin Suri advised the parents of the complainant to go to PGI, Chandigarh for the treatment.  Therefore, there was no need to implead Dr. Sachin Suri or any other doctor in this case.  Citations placed before us by the learned counsel for the complainant are fully applicable in this case.  The opposite parties discharged the complainant on 04.05.2006 treating the complainant normal, is beyond our imagination.  Whether to discharge or not to discharge patient, it is for treating doctor to decide and not for patient or attending person.  On 03.05.2006 the patient-complainant was in critical condition, according to the opposite parties, even then the complainant was discharged by the opposite parties on the next day showing him absolutely in normal condition.  This indicates that the complainant was discharged by the opposite parties in a hurried manner.  The complainant had developed Gangrene in his right hand due to the injection/drip applied intravenous and the same right hand was later on amputated, therefore, principle of res ipsa loquitor in this case fully attracted. Coloured photographs of the complainant (Paper Nos. 27 to 29) also corroborates the facts that due to intravenous drip/injection and tight bandage applied on the right hand of the complainant, flow of blood was occluded, resulting Gangrene of all the five fingers.  The opposite parties have not filed any evidence in support of their contentions.  The only evidence filed by the opposite party No. 4-insurance company that the opposite party Nos. 2 and 3 are insured with the insurance company with effect from 26.05.2005 to 25.05.2006.  Medical opinion regarding Master Shivanshu-complainant received by this Commission from PGI, Chandigarh with a letter (Paper Nos. 118 to 119), in which PGI, Chandigarh has informed this Commission that as per the patient records furnished before the committee, it is noticed that the Medical events during the intervening period of the patient's treatment in the Doon Valley Hospital and the patient seen in the PGI are not available.  The time gape in between is around a month. In view of above, the Committee is of the opinion that it is very difficult to ascertain that the cause of gangrene of the limb is due to intra-arterial injection administered at Doon Valley Hospital.  Therefore, no definite opinion was given by PGI, Chandigarh in this case.  This report of PGI, Chandigarh indicates that there was a time gap of a month, but from the documents available on record, there is only a time gap of only 4 to 5 days, during the intervening period of patient's treatment in Doon Valley Hospital and the patient seen in PGI, Chandigarh.  However, principle of res ipsa loquitor is applicable in this case.