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NATIONAL CONSUMER DISPUTES REDRESSAL COMMISSION, NEW DELHI
J. M. Malik, Presiding Member, Dr. S. M. Kantikar, M.D., Member
Dr. R.K. Sharma —Petitioner
versus
Smt. Murttiya Devi —Respondent
Revision Petition Nos. 1262 & 3205 of 2009
Decided on 15.10.2014
Counsel for the Parties:
For the Petitioner:Mr. S. Nand Kumar, Advocate with Mr. Parivesh Singh, Advocate Dr. R. K. Sharma (In Person).
For the Respondent:Mr. Syed Ali Ahmed, Advocate with Mr. Pravin Kumar, Advocate.
IMPORTANT POINT
If the disease, diagnosed was similar to the actual disease suffered by the patient and both diseases require similar therapy, there will be no medical negligence on the part of the doctor.
Headnote:Consumer Protection Act 1986—Section 2(1)(g), 12 ,15 and 21—Medical Negligence—Deficiency in service on the part of the doctor—The complainant took her husband to OP for treatment who diagnosed the disease as of tuberculosis and put him to 9 months treatment—However, he did not improve. Then, he was taken to Bhawali Sanitarium where the doctor expressed possibility of some other disease—The doctors at V.P. Chest Institute, New Delhi diagnosed him as case of Sarcoidosis in advanced stage—He died in the said hospital—The District Forum allowed the complaint and directed payment of Rs. 1 lac. and cost of Rs. 1,000/-— Against the said order appeal filed by the OP and also by the complainant for enhancement-Both appeals dismissed by State Commission-Held, the diseases Tuberculosis and Sarcoidosis are quite similar and these patients receive repeated course of anti tubercular therapy (ATT)—Held no negligence on the part of OP. The petition allowed and complaint dismissed. (Paras 2, 9, 10, and 14)
Facts of the Case:
The husband of the complainant was suffering from chest problem and was diagnosed as a case of tuberculosis and he was put on 9 months treatment but there was no improvement. The complainant then consulted the doctors at Bhawali Sanitorium but he was referred to AIIMS, New Delhi but he could not be admitted in the said hospital and he was taken to V.P. Chest Institute, New Delhi, where the doctors diagnosed him as a case of Sarcoidosis, in advanced stage. The patient died in the said hospital. Alleging deficiency in service complaint filed by his wife.
Finding of the Court:
From the perusal of WHO medical literature on Treatment of Pulmonary Tuberculosis, Harrison’s Text Book of Internal Medicine, and few research articles on Tuberculosis and Sarcoidosis from National and International Journals, it was found that the distinguishing Sarcoidosis from pulmonary tuberculosis can sometimes be a great challenge to physicians, especially in developing countries where there is high prevalence of tuberculosis. Due to the marked clinic-radiological similarity of these entities and high prevalence of tuberculosis, thee patients, receive repeated courses of anti-tubercular therapy (ATT) while lung damage continues to progress. Recently, adding to the diagnostic difficulty, there are also several reports of coexistence of Sarcoidosis and tuberculosis in the same patients. Both diseases present with constitutional symptoms of fever, malaise, weight loss, and fatigue. Respiratory symptoms are common to both diseases. A combination of clinical, radio logic, and laboratory tests are used to make a diagnosis of Sarcoidosis. Therefore, there was no negligence on the part of the petitioner/OP. There was medical negligence. Revision petition of OP allowed.
Result: Petition allowed.
Dr. S.M. Kantikar, Member—Several medical literatures reveal that, “Tuberculosis is caused by Mycobacterium tuberculosis. It is also, a possible aetiological agent in Sarcoidosis has been point of debate since many years and has been studied thoroughly. Recent advances in immunologic and molecular techniques have strengthened the association between mycobacteria and sarcoidosis”.
1. This order will decide the above said two revision petitions. The facts are drawn from Revision Petition No. 1262 of 2009.
2. The complainant, Smt. Murttiya Devi took her husband, Shri Ramvriksh Gupta to Dr. R. K. Sharma, the opposite party on 29.12.2003 for the treatment. The opposite party/doctor diagnosed him as a case of tuberculosis and put him on 9 months’ treatment by giving anti-tuberculosis drug. Even after 8 months, there was no improvement. The OP/doctor advised for sputum test, which was negative for T.B. The complainant thereafter consulted the doctors of Bhawali Sanitorium, Nainital, who expressed the possibility of some other lung disease and not tuberculosis. Thereafter, the doctor referred the patient to AIIMS, New Delhi but the complainant has not succeeded to get the patient admitted in the hospital. Therefore, she admitted her husband, in V. P. Chest Institute, New Delhi on 20.10.2004. After investigation, the doctors diagnosed him as a case of “Sarcoidosis” in advanced stage. Subsequently, the patient died, on 30.11.2004 in the said hospital. The complainant alleged that the opposite party/doctor has not diagnosed the patient properly and continued the medicines of anti-tuberculosis without conducting proper tests. Therefore, it was the deficiency in service and medical negligence. Hence, the complainant filed a complaint before the District Forum, Udham Singh Nagar.
3. The District Forum allowed the complaint and ordered the opposite party to pay a sum of Rs.1,00,000/- as compensation and Rs.1000/- towards costs.
4. Aggrieved by the order of District Forum, both the parties filed cross appeals before the State Commission. Dr. R. K. Sharma-OP filed first appeal No. 03/2007 for dismissal of complaint, while First appeal bearing No. 04/2007 has been filed by the complainant, for enhancement of compensation awarded by the District Forum.
5. The State Commission dismissed both the appeals. Hence, both the parties approached this Commission by filing two separate revision petitions. Revision Petition No. 1262 of 2009 has been filed by Dr. R. K. Sharma challenging the medical negligence and the Revision Petition No. 3205 of 2009 has been filed by the complainant for enhancement of compensation.
6. Heard the learned counsel for both the parties, along with the complainant and the OP doctor who are also present in person.
7. The OP Dr. R. K. Sharma submitted that, after detailed history, clinical examination of the patient, advised X-ray chest and blood investigations; arrived the diagnosis of Pulmonary Tuberculosis. Hence, started the Anti-Tubercular Therapy (ATT). He further submitted that, within one month, the patient gained weight i.e. there was improvement in the health of patient. The patient was under his treatment for 7½ months and during follow-up periodical X-ray chest was performed along with blood tests. The X-ray reports obtained from Dr. B. M. Goel on 26.4.2004 and 17.8.2004 also revealed pulmonary tuberculosis. As the X-ray dated 17.8.2004 did not show improvement in the lungs, hence advised A.F.B. (Acid Fast Bacilli) culture test was advised, which was negative. Then, the OP referred the patient to Rajan Babu T. B. & Chest Hospital, New Delhi but the patient did not go there. He went to Bhawali Sanitorium where Dr. D. C. Punera expressed the possibility of either of three diseases i.e. T.B. /Sarcoidosis/L.C. In three successive days AFB Sputum test was done at Bhawali Sanatorium, Nainital, which was Negative. Thereafter, the patient was referred to AIIMS for further evaluation but, he went to V. P. Chest Institute
