The duty of care in deciding what treatment to give and the administration of that treatment by medical professionals.

1. This first appeal has been filed under Section 19 of the Consumer Protection Act, 1986 against the order dated 12.8.2009 passed in Complaint Case No. 21 of 2009 by Punjab State Consumer Disputes Redressal Commission, Chandigarh (for short, ‘the State Commission’) whereby the complaint of the complainant was dismissed.

2. The brief facts:

Ms. Rashmi Singh (hereinafter referred as ‘the patient’) aged about 66 years of age, wife of Lt. Col. Surjit Singh (retd.) was admitted in Silver Oaks Hospital, Mohali/OP 1 under care of Dr. Akhil Bhargava/OP-2 on 12.1.2008 for the problems of loose motion and swelling of lower limbs. She was conscious and alert. On clinical examination and laboratory investigations, it was not a serious medical problem. The patient remained in the hospital upto 20.3.2008. During the treatment, on 26.1.2008 morning, she was given oxygen and later in the evening, the complainant/attendant noticed the swelling on her face and called for the duty doctor, who in turn called the specialist. On the advice of specialist, she was shifted to ICU and patient was put on life support and administered heavy doses of antibiotics. It was informed to the complainant and the attendants, that the patient had suffered renal failure, but as per her past reports, including ultrasound there was no renal problem. Thereafter, on 6.2.2008, Dr. Akhil Bhargava opined that patient had multi-organ failure and septicemia and issued a certificate that the patient’s condition was critical and put on the life support. Subsequently, patient developed Coma. There was no bedsore till that stage. The patient slowly developed the hospital borne infections. No attendant was allowed in ICU, therefore, it was the duty of medical staff in the ICU to provide physiotherapy, turning the patient at intervals and to take all precautions to avoid bedsore. But, due to failure ICU staff to take proper care, the patient developed bedsores. The staff there every time told that nothing to worry, as it was a minor issue. On 12.3.2008, patient recovered from coma and she was operated on 15.3.2008 for removal of dead skin at bedsore on the lower back and patient was shifted to normal room. The bedsore cavity was nearly 5 inches in diameter and 2-3 inches in depth. On 20.03.2008, hospital informed the complainant that the patient requires only nursing care, accordingly, she was discharged on the same day. It was alleged that patient was in critical stage due to deep bedsore, which had developed in the ICU and by that time, she had already suffered memory loss because of being in coma for about 40 days.

3. The nursing care at home for the bedsore was not manageable, the patient deteriorated further, therefore, on 26.3.2008 she was taken to Command Hospital, Chandimandir. She was treated there by Plastic Surgeon and Psychologist. In May, 2008, the Military hospital performed the surgery for 3½ hours to cover the bedsore, but patient expired on 1.6.2008. The cause of death was mentioned in the death certificate was “pre-renal Azetomia with bedsore”. It was alleged that due to the alleged deficiency in service and the lapses in the treatment, the patient died. The complainant filed a complaint before the State Commission, Punjab against the OPs for alleged medical negligence.

4. The OPs filed their written version and denied the negligence on their part. The OP-2 submitted that the treatment given was proper. The patient had previous history of Cancer and Diabetes. She was also a known hypertensive on medication. Previously, she had been operated for Laminectomy (Lumbar spine) and also had surgery in the right ankle. She was admitted in the hospital/OP-1 with the complaint of loose motions, increased frequency of urination with urgency, pain in lower back, region and nausea. After admission, she was examined by Gastroenterologist. For her abdominal complaints, she underwent Sigmoidoscopy and CECT of abdomen. Colonoscopy was also done with barium enema. She was als