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NATIONAL CONSUMER DISPUTES REDRESSAL COMMISSION, NEW DELHI
J.M. Malik, Presiding Member, Dr. S.M. Kantikar, Member
Chief Medical Officer, Yashoda Hospital —Appellant
versus
D. Uma Devi & Ors. —Respondents
First Appeal No.1149 of 2014
(Against the Order dated 05/08/2014 in Complaint No. 1/2009 of the State Commission Andhra Pradesh)
Decided on 11.4.2016
Counsel for the Parties:
For the Appellant:Mr. B. Ram Mohan Reddy, Advocate
For the Respondent:Mr. Y. Rajagopala Rao, Advocate
IMPORTANT POINT
Compensation has to be within certain broad guidelines and within certain broad parameters.
Headnote:Consumer Protection Act, 1986—Sections 17, 19 and 21—Medical services—Medical negligence—Death of patient after long suffering—Propofol has a narrow therapeutic window and a small increase in dosage may cause a patient to progress from deep sedation to a state of general anesthesia—It was an unethical act of OP—In addition, ERCP procedure was not followed by OP doctors as per standard guidelines, Propofol was administered without monitoring and caution—Cardiac arrest was not managed properly and patient suffered coma—It is a case of medical negligence—Compensation cannot be calculated in a perfect mathematical sense, cannot be precise and accurate, but has to be within certain broad guidelines and within certain broad parameters—Amount of compensation enhanced from Rs.10 Lakhs to Rs.47 Lakhs. (Paras 13 to 22)
Result: Appeal disposed of.
Anaesthesiologist, are like aeroplane pilots, are essentially 99% of the time in a “watchful waiting mode”. It is when an untoward event occurs that they are called into action, their level of alertness, skill and response is critical. It is not the drug Propofol itself that is the culprit for it is an effective and fast acting anesthetic agent. It is the monitoring of the patient and the ability of an attentive physician to promptly act with the necessary staff and equipment that can make the difference between life and death.
Michael Jackson and Joan Rivers both lost their lives secondary to the anesthetic agent, Propofol...!!
1. Mr. D. Sadasiva Reddy, hereinafter referred as a patient, was suffering from Jaundice. He got admitted in Yashoda Hospital, Hyderabad/opposite party No. 1 on 13.5.2008. He was advised ERCP (Endoscopic Retrograde Cholangio- Pancreatogrpahy) with CBD endoscopy. Accordingly, on 14.5.2008, during ERCP procedure, the doctors administered anesthesia, which resulted in to fatal complications in the patient, therefore ERCP procedure was abandoned. The patient was brought out of the Operation Theatre in an unconscious (comatose) state. He never recovered from coma. The hospital authorities informed that, the patient would come back as normal within 5 days but, he became brain dead. The OP 1 attributed this sorry state of affairs to the sudden cardiac arrest while conducting ERCP procedure.
2. Thereafter, OP refused to treat and decided to discharge the patient. Smt. D. Uma Devi, his wife, the complainant approached Human Rights Commission, which directed the OP to extend the treatment till 21.1.2009 and also directed the complainant to approach Consumer Commission for redressal of her grievances under Consumer Protection Act, 1986. After long struggle of 2 ½ years, the patient died on 12.10.2010.
3. Therefore, alleging medical negligence of OP hospital which was responsible for the pathetic condition of the patient, the complainant filed a complaint before the State Commission, Hyderabad against Yashoda Hospital/OP 1.
4. The State Commission allowed the complaint and directed the OP- 1 to pay Rs.10 lakhs with interest @9% per annum from the date of filing of the complaint with Rs.10,000/-, as costs.
5. Aggrieved by the impugned order, both the parties filed cross appeals before this Commission. The complainant filed FA 1169/2014 for enhancement of compensation whereas; the OP filed FA 1149/2014 for dismissal of the complaint.
6. We have heard learned counsel for both the parties. The main question which swirls around the controversy is, “whether doctors at OP hospital followed the standard guidelines during ERCP procedure and whether the dose of anesthesia administered was correct?”
7. Learned counsel for OP raised objections on the expert report of Dr. Mahender Vyasabattu. He submitted that, Dr. Vyasabattu is neither a competent nor qualified to give such expert opinion. The expert opinion from the Osmania Medical College, mentioned that ACLS guidelines were followed by the doctor at OP 1. There was no negligence.
8. The rival arguments by the learned counsel for the complainant that, the State Commission has not ordered any expert committee, but it was the OP itself which constituted the expert committee. The expert committee did not consist of any gastroenterologist. The counsel contended that the compensation awarded by State Commission awarded is on lesser side, as the salary of deceased was Rs.21,000/-, he was about 42 years of age at the time of death.
9. To understand the procedure, we have perused the guidelines issued by Royal College of Anesthetists during ERCP, are reproduced as under:
“The Royal College of Anaesthetists, London issued the following guidelines for the use of Propofol Sedation for Adult patient undergoing Endoscopic Retrograde Cholangio-pancreatogrpahy (ERCP) and other Complex Upper GI Endoscopic Procedures.
At the present time in the UK, the administration and monitoring of propofol
