The main legal point established in the judgment is that a reasonable degree of skill and knowledge and a reasonable degree of care is expected from doctors, and negligence cannot be attributed to a doctor as long as they perform their duties with reasonable skill and competence.

ORDER

Mr. N.P. Kaushik, Member (Judicial) - The appellant has impugned the orders dated 05.04.2006 passed by the Ld. District Forum-VII, Sheikh Sarai, New Delhi-110017. Vide impugned orders Ld. District Forum dismissed the complaint filed by the father and other LRs of the deceased Deepak Singh.

2. Facts in brief of the case are that the deceased Deepak Singh was admitted to Escorts Hearts Institute and Research Centre (in short the 'OP-1') on 31.07.2001. Prior to this, he was treated for in some Railways hospital where he was diagnosed with Pulmonary Thromboembolism. In OP-1 hospital, tests like echo, ultrasound and angiography were conducted. Vital organs were found normal. On 04.08.2001 deceased had internal bleeding. The complainants in their complaint in the District Forum had expressed their doubts on conducting of the mechanical breakdown of the thrombus with the help of catheter. The complainants had alleged that overdose of drugs led to internal bleeding and ultimately the death.

3. Defence raised by the OPs in their written version was that at the time of admission, the patient was suffering from massive bilateral Pulmonary Thrombo Embolism. Respiratory rate and heart rate were high and oxygen level was low to the extent of 77.5%. Angiography revealed high Pulmonary Artery Systolic Pressure (PASP) of 70 mm Hg with dilated RA/RV. On 01.08.2001 Pulmonary Artery Catherisation was carried out. It confirmed that the patient was suffering from massive bilateral pulmonary thromboembolism. Patient was prescribed injection Streptokinase 75,000 u/hr, and Injection Reopro 5 ml bolus IV, followed by 4-5 ml in 250 ml @ 17 ml/12hr. Patient was also put on injection dobutamine infusion. Monitoring and adjustment of the injection was done keeping in view the blood pressure. On 03.08.2001, the patient developed marked respiratory distress with cyanosis. Repeated echo revealed high lung pressure. X-ray showed increased area of pleural reaction. Patient was put on ventilator and dose of Streptokinase was increased. Injection Heparin was continued. On 04.08.2001 patient had an episode of bradycardia. Traces of blood in the stomach were observed in gastric lavage. There was a sudden increase in the level of carbon dioxide and a fall in the level of oxygen. Heart rate decreased. Blood pressure fell down abnormally. Despite Cardio-Pulmonary Resuscitation, the patient died at 12:45 a.m. on 05.08.2001. Ld. District Forum on going through the pleadings and evaluating the evidence, observed that the deceased did not die on account of any omission or commission tantamounting to negligence on the part of the treating doctors.

4. Perusal of the complaint shows that the complainants have alleged that the procedures on the deceased were conducted recklessly and negligently. During the course of arguments before the Ld. District Forum, Ld. Counsel appearing for the Complainant had relied upon the medical text reading that the concurrent administration of the Heparin and Streptokinase was not advisable. Streptokinase results in lowering blood pressure. In case of complications it is required to be stopped. Allegation of the complainants is that despite blood pressure having fallen down, doctors continued with the drugs Streptokinase and Heparin. This not only caused bleeding but also lowered the blood pressure to a level resulting in death.

5. Ld. District Forum observed that the treating doctors continued with the combination of Streptokianse and Heparin as the patient was suffering from acute Massive Pulmonary embolism. Gastric lavage was found to be clear. Ld. District Forum further observed that the doctors administered the medicines fit for clot dissolving.

6. The controversy raised by the parties before the Ld. District Forum and in this Commission is that as to whether the concurrent use of Streptokianse and Heparin was absolutely prohibited. Ld. Counsel for the appellant/complainant Sh. A.K. Kaushal Advocate has taken this Commission through a