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NATIONAL CONSUMER DISPUTES REDRESSAL COMMISSION, NEW DELHI
V.K. JAIN, PRESIDING MEMBER, B.C. GUPTA, MEMBER
Convenient Hospitals Ltd. & Ors. - Appellants
Versus
Shankar Lal & Ors -Respondents
First Appeal No. 136 of 2008
Decided on : 19-08-2014
Advocate Appeared:
For the Appellants :Mr. Amit Tatke, Advocate.
For the Respondent:Mr. S.K. Sharma and Mr. Ritesh Khare, Mr. S.M. Tripathi, Advocate.
The court emphasized the importance of obtaining valid consent from the patient before commencing a treatment and the need for doctors to disclose the nature and procedure of the treatment, its purpose, benefits, and risks to the patient.
Headnote:
Consent - Medical Negligence - Angiography and Angioplasty - [KEYWORD] - Medical Negligence - Angiography and Angioplasty - Indian Medical Council Act, 1956, Consumer Protection Act, 1986 - The court discussed the acts of negligence attributed by the complainants to the appellants, the consent obtained from the patient, the justification for the procedure, the treatment during hospitalization, discharge, medicated stent, and the cause of death. The court found the appellant negligent in treatment of the patient, to the extent stated, but the complainants failed to establish that the death of the patient occurred due to the acts and negligence on the part of the appellant. The court awarded a lump sum compensation to the complainants and directed the appellants to refund the cost of treatment and pay compensation to the complainants.
Fact of the Case:
The deceased was admitted to a hospital for coronary angiography and angioplasty, which resulted in complications and ultimately led to her death. The complainants alleged negligence on the part of the doctors and the hospital and claimed refund of the treatment charges and damages.
Finding of the Court:
The court found the appellant negligent in treatment of the patient, to the extent stated, but the complainants failed to establish that the death of the patient occurred due to the acts and negligence on the part of the appellant. The court awarded a lump sum compensation to the complainants and directed the appellants to refund the cost of treatment and pay compensation to the complainants.
Issues: The issues included the consent obtained from the patient, the justification for the procedure, the treatment during hospitalization, discharge, medicated stent, and the cause of death.
Ratio Decidendi: The court held that the appellant was negligent in treatment of the patient, to the extent stated, but the complainants failed to establish that the death of the patient occurred due to the acts and negligence on the part of the appellant.
Final Decision: The court awarded a lump sum compensation to the complainants and directed the appellants to refund the cost of treatment and pay compensation to the complainants.
ORDER :
Mr. Justice V.K. Jain, Presiding Member-Smt. Sheela Bhargava (hereinafter referred to as the deceased) was attending to her son, Shri Ram Bhargava, one of the complainants, who was admitted in the Convenient Hospital Ltd. She was suffering from high blood pressure and diabetes. She got herself checked from Dr. Vinod Somani on 11.3.2002, who advised her to be admitted in the hospital as an indoor patient, for undertaking coronary angiography. On the basis of several investigations conducted in the hospital, the ailments of the patient were diagnosed as under:
(i) Mild concentric left ventricular hypertrophy;
(ii) Diastolic dysfunction present;
(iii) Good LV systolic function LVEF 60%;
(iv) Hypertensive disease.
The case of the complainants is that the appellant No. 3, Dr. Somani wrongfully noted that the deceased had been referred by another doctor namely, Dr. A. Chaudhary and advised PTCA (Percutaneous Transluminal Coronary Angioplasty) with stent in LAD, and without obtaining consent and without explaining the alternative remedies available to the patient, angioplasty was performed on 14.3.2002. This is also the case of the complainant that the angiography and angioplasty resulted in complications such as Thrombosed Groin Haematoma and false passage in right femoral artery which developed into a pseudoaneurysm, and was later closed on the same date by adopting probe pressure technique. The deceased was discharged on 18.3.2002. The deceased expired on way back to her home in District Sagar in Madhya Pradesh on 21.3.2002. The postmortem of the deceased revealed that she had multiple subcutaneous haemorrhages in her abdomen, thigh and groin on right side of her body which was a result of leakage from the ruptured blood vessels. Alleging negligence on the part of the doctors and the hospital, the complainants claimed refund of Rs. 1,57,214 which they had paid to them, besides Rs. 15,00,000 towards damages.
2. The complaint was resisted by the respondents inter alia on the grounds that the patient was in a bad health and was in a condition of breathlessness, suffocation, high tension and pain in chest when she was admitted in the hospital for coronary angiography and related checkups. It was admitted in the reply that the patient was recommended PTCA with stent in LAD but it was claimed that the procedure and complications of the operation were explained to the patient and her family members all of whom were influential persons in the locality, and they gave free and unconditional consent to perform the procedure.
In the reply it was also alleged that angioplasty requires use of catheter through a small hole in the thigh groin area and subcutaneous haemorrhages are common and would have healed by appropriate medication that was prescribed to the patient at the time of discharge. It was further claimed that the condition of the patient was stable and her coronary profusal was normal at the time she was discharged. The respondent denied the allegation of the complainants that the clots around the blocked stent were dislodged by heavy doses of anti-coagulants which caused haemorrhages of the thigh groin. The respondents also claimed that they could not be blamed for the stent getting blocked after seven days of the procedure.
It was further claimed in the reply that besides a long standing history of diabetes and hypertension, the patient had classical symptoms of coronary artery disease and the indication of investigation showed that coronary angiography was essential. Coronary angiography showed single vessel disease with 80% blockage of LAD. The treatment of choice for single vessel LAD disease with blockage of more than 80% is angioplasty with stenting, which is considered to be the safest procedure. According to the respondents they had also explained to the family about the recurrence of the angioplasty including the rare possibility of mortality. The respondents also filed a CD whereby the whole process of angiography and angi
