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NATIONAL CONSUMER DISPUTES REDRESSAL COMMISSION
R.C. Jain, Presiding Member and Anupam Dasgupta, Member
KETHIRI SAI REDDY - Appellant
Versus
APOLLO HOSPITALS AND ANR. - Respondents
First Appeal No. 11 of 2004 from Order dated 13.10.2003 in CD No. 110 of 1998 of Andhra Pradesh State Consumer Disputes Redressal Commission, Hyderabad
Decided on : 27-04-2010
Mr. V. Gourisankara Rao, Advocate, for the Appellant; Mr. P.S. Narasimha, Senior Advocate with Mrs. K. Radha Rao, Advocate, for the Respondent
The main legal point established in the judgment is the standard of care expected of a physician in diagnosing and treating a patient, including the duty to consider further diagnostic tests, accurately record patient information, conduct necessary pre-surgery investigations, and provide the agreed-upon facilities.
Headnote:
Medical Negligence - Medical Negligence - [Indian Medical Association v. V.P. Shantha and Ors., I (1995) CLT 81 (SC)=(1995) 6 SCC 651, Jacob Mathew v. State of Punjab and Anr., (2005) 6 SCC 1, Martin F. D'souza v. Mohd. Ishfaq, (2009) 3 SCC 1] - The court discussed the alleged medical negligence and the diagnosis and treatment of Guillain Barre Syndrome (GBS) and cervical spondylosis myelopathy (CSM). The court found no medical negligence in the diagnosis and treatment of GBS but held the doctor negligent for not considering further diagnostic tests for the complainant's repeated complaints of shoulder/neck pain and for not recording the complainant's spondylotic changes in the discharge summary. The court also found negligence in the pre-surgery investigations not including examination of the blood sugar level and in not providing a room with the type of facility paid for. The court awarded a lump sum compensation of Rs. 2 lakh to the complainant, payable jointly and severally by the hospital and the doctor.
Fact of the Case:
The complainant alleged medical negligence and deficiency in service on the part of the hospital and the attending neuro physician for misdiagnosing his disease as Guillain Barre Syndrome (GBS) instead of cervical spondylosis myelopathy (CSM) and delaying the surgery. The State Commission found no medical negligence but awarded compensation for deficiency in service.
Finding of the Court:
The court found no medical negligence in the diagnosis and treatment of GBS but held the doctor negligent for not considering further diagnostic tests for the complainant's repeated complaints of shoulder/neck pain and for not recording the complainant's spondylotic changes in the discharge summary. The court also found negligence in the pre-surgery investigations not including examination of the blood sugar level and in not providing a room with the type of facility paid for.
Issues: The main issue was the alleged medical negligence and deficiency in service on the part of the hospital and the attending neuro physician for misdiagnosing the disease and delaying the surgery.
Ratio Decidendi: The court held that while there was no medical negligence in the diagnosis and treatment of GBS, the doctor was negligent for not considering further diagnostic tests for the complainant's repeated complaints of shoulder/neck pain and for not recording the complainant's spondylotic changes in the discharge summary. The court also found negligence in the pre-surgery investigations not including examination of the blood sugar level and in not providing a room with the type of facility paid for.
Final Decision: The court awarded a lump sum compensation of Rs. 2 lakh to the complainant, payable jointly and severally by the hospital and the doctor.
ORDER
Anupam Dasgupta, Member - Aggrieved by the order dated 13.10.2003 of the Andhra Pradesh State Consumer Disputes Redressal Commission, Hyderabad (hereafter, the State Commission ) in complaint case No. 110 of 1998 filed by him, the original complainant (hereafter, the complainant ) has come up in this appeal.
2. (i) Before the State Commission, the complainant alleged medical negligence/deficiency in service on the part of the Apollo Hospitals, Hyderabad (opposite party, OP 1 and respondent 1 in this appeal) and the attending neuro physician at OP 1, Dr. Srikant Jawalkar (OP 2) in (initially) misdiagnosing his disease as Guillain Barre Syndrome (GBS), instead of significant compression of the spinal cord by the C5-C6 vertebra, i.e., cervical spondylosis myelopathy (CSM) from which he was actually suffering and consequently (i) causing him physical pain and mental tension for five months from mid-December 1997 to mid-May 1998, apart from infructuous expenditure on treatment of the misdiagnosed GBS and (ii) delaying the surgery that he had to undergo for his CSM, as a result of which his post-surgery recovery was adversely affected. He also alleged deficiency in service on the part of OP 1 because he was scheduled for surgery on 18.5 1998 without checking his blood sugar level (which was too high for surgery) and despite that he was sent to the operation theatre from where he had to be sent back. He further alleged that, as an in-patient, he was provided a room in which the air conditioner (a/c) did not function though he had paid for a room with a/c and this caused him bed sores, recovery from which took several weeks. For these deficiencies in service by the O.Ps. he claimed compensation of Rs. 18 lakh and costs.
(ii) After considering the pleadings, medical records, evidence of two doctors produced by the complainant as independent experts and the medical literature produced by the a parties, the State Commission found that there was no medical negligence on the part of the O.Ps. However, it partly allowed the complaint holding the O.Ps. deficient in service in providing a room without appropriate air-conditioning facility despite charging the complainant therefore and awarded compensation of Rs. 30,000 on that count with interest @ 12% per annum from the date of the complaint till actual payment.
(iii) The complainant's appeal is thus against the State Commission's finding on the alleged medical negligence and his prayer is for enhancement of the compensation. The O.Ps. have, however, not appealed against the order of the State Commission.
3. We have heard Mr. V. Gourisankara Rao, learned Counsel for the complainant and Mr. P.S. Narasimha, learned Senior Advocate for the O.Ps.
Arguments of Counsel for the parties
4. (i) On the basis of the medical record and evidence of OP 1 Hospital as well as that of the two expert doctors, Mr. Rao has argued that after the complainant's admission to OP 1 Hospital in the early hours of 13.12.1997, OP 2 did not pay any heed to the cervical spine x-ray of the complainant taken on 13.12.1997 and hastily diagnosed him with GBS without first ruling out CSM. Even while the treatment prescribed by OP 1 for GBS was in progress during the in-patient stay of the complainant from 13.12.1997 to 10.1.1998 at the OP 1 Hospital, he complained repeatedly of neck/shoulder pain. However, no attention was paid to this by OP 2. Instead, after the 5-day course of a highly expensive injection of 'sandoglobulin , physiotherapy was advised which further aggravated the complainant's condition of CSM. The complainant's neck/shoulder pain continued during the period after his first discharge from OP 1 in January, 1998 which he brought to the notice of OP 2 during his subsequent consultations as an outdoor patient at OP 1. After his second in-patient treatment at OP 1 Hospital during 27-30.3.1998 on the advice of OP 2, the complainant again went back to OP 2 with the complaint of continuing severe neck/shoulder pain on
