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NATIONAL CONSUMER DISPUTES REDRESSAL COMMISSION, NEW DELHI
Dr. S.M. Kantikar,Presiding Member and Dinesh Singh, Member
Smt. Shobha Agarwal & Ors. —Complainants
Versus
The Escorts Heart Institute & Research Center
Ltd. & Ors. —Opp.Parties
Consumer Case No. 168 of 2003
Decided on 21.8.2020
For Complainant :Mr. G. N. Purohit, Sr. Advocate with Mr. Siddharth Gautam, Advocate
For Opposite Parties :Mr. Sanjeev Puri, Sr. Advocate with Mr. Kamal Kumar, and Ms. Pragya Puri, Advocates
IMPORTANT POINT
Compensation allowed for failure of judicious and timely use of treatment options for management of unstable angina.
Headnote:
Consumer Protection Act, 1986 – Section 21 : Consumer Protection Act, 2019 – Section 58 – Medical Negligence – Deficiency in service in cardio angioplasty – Death claim – Scope – Admittedly, the Angioplasty revealed very significant blocks in all the three coronary vessels, which requires immediate coronary revascularisation – Deceased patient needed emergency cardiac intervention either by Angioplasty or By-pass surgery – It was a fit case for emergency by-pass surgery than Angioplasty – Even scheduled Angio-plasty was delayed for 3½ hours – Patient was suffering from unstable angina and Triple Vessel Disease – Accepted standard of medical care procedure not followed – Deficiency and negligence on part of opposite parties found – Compensation of Rs. 25 lakh with interest @ 8 % p.a. from date of death of patient allowed – Directions issued. (Paras 10 to 22)
Result: Complaint allowed.
ORDER
Dr. S. M. Kantikar, Presiding Member—In the medical practice there are inherent potential conflicts of interest, which are not necessarily wrong or reprehensible. However, the Cardiologists’ primary obligations in these contexts are to serve the best interests of the patients, above those of groups, institutions, and self-interests. The doctor’s skill, expertise and knowledge is needed to reach the common man. From day today practice it is an issue whether an angioplasty-stent procedure for planned surgical revascularization is chosen because it is in the patient’s best interest, or to increase the number of compensable interventions. The patients need to regain the trust, and the medical profession needs to re-establish its integrity.
The Facts:
On 30.05.2000, Mr. Sharad Kumar Aggarwal (since deceased, herein referred to as ‘the patient’) from Jabalpur, for his some cardiac ailments, got admitted in The Escorts Heart Institute & Research Centre Ltd. - the OP-1 (herein referred to as ‘the EHIRC- Hospital’) at New Delhi. He underwent Stress test, ECHO, Tread Mill Test (TMT) and Angiography. There was no coronary artery blockage. The Ejection Factor (EF) was 35% and Global Hypokinesia was noted. The patient was discharged on 03.06.2000 with followed up advice. Thereafter, at Jabalpur, patient was under regular check-up from one Cardiologist. The patient’s EF was improved to 58%. The patient suffered some chest discomfort on 28.08.2001 and hospitalised in Anant Nursing Home at Jabalpur. Dr. Sanjay Nema, Cardiologist examined the patient and diagnosed it as “unstable angina”. He advised for immediate Coronary Angiography from higher centre EHIRC at New Delhi, and an urgent appointment was sought at OP-1 hospital from Dr. Ashok Seth (OP-2), the Senior Consultant Cardiologist and the Chief of the Cath Lab and interventional Cardiology. On the next day 29.08.2001, the patient was taken from Jabalpur to Nizamuddin by train with necessary life support equipment. The patient was accompanied by Dr. Rajendra Aggarwal, his one Cardiologist friend from Nagpur. On 30.08.2001 morning they reached Nizamuddin railway station and by ambulance, the patient was taken to the OP-1 hospital at around 8 AM. The Cardiologist Dr. Ashok Seth (OP-2) examined patient at 10 AM and advised Coronary Angiography (for short ‘CAG’). As asked by OP-2, the patient’s attendants deposited advance sum of Rs. 1.5 lakh at OP-1. Dr. Rajendra Agrawal requested to OP-2 to perform Angiography by himself but at around 12.30 PM it was performed by another Cardiologist on the instructions of OP-2. Thereafter, in the evening, as called by the OP-2, the patient’s wife along with Rajkumar Agarwal, A.K. Bansal and Dr. Rajendra Agarwal met OP-2. He told them that Angioplasty is to be done next day early morning and there was no need of by-pass surgery. Dr. Rajendra Agrawal asked OP-2 why Angioplasty was not done during Angiography procedure itself, but OP-2 replied that as he was busy in OPD today (i.e. 30.08.2001), it was posted for tomorrow and assured that the patient was in stable condition, nothing to worry. The accompanying person Dr. Rajendra Agarwal requested OP-2 as to whether he may be allowed to be present during the procedure of Angioplasty and also to stay in emergency ward with the patient, but same was denied by the OP-2 and assured that everything would be all right when the patient is in the hands of experts and in a good hospital. He suggested Dr. Rajendra Agarwal to go back to Nagpur, no need of stay.
2. On the next day i.e. 31.08.2001 the Angioplasty was posted at 2.00 PM. Complainants alleged that the patient was not provided a proper room or bed throughout night on 30.08.2001, but patient was kept in lobby of emergency ward on the stretcher (trolley). On 31.08.2001, the patient was to be shifted to Cath Lab at 2 PM, but without assigning any reason the Angioplasty procedure was delayed up to 6 PM. Later on it was learned that one unscheduled VIP case was
