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NATIONAL CONSUMER DISPUTES REDRESSAL COMMISSION, NEW DELHI
R.K. Agrawal, President and Dr. S.M. Kantikar, Member
Vinod Kumar Dhanda – Complainant
versus
Batra Hospital & Medical Research Centre and Ors. – Opp. Parties
Consumer Case No.529 of 2014
Decided on 9.2.2021
For the Complainant:Mr. Kshitij Sharda, Advocate
For the Opp. Party Nos.1 to 3:Mr. Bipin K. Dwivedi and Mr. Balwant Choubey, Advocates
For the Opp. Party No.4:Mr. Maibam N. Singh, Advocate
For the Opp. Party No.5:Mr. A.K. Prasad, Proxy Counsel for Dr. Sushil Gupta, Advocate
IMPORTANT POINT
“No surgeon can assure that outcome of any surgery would be beneficial.
Headnote:
Consumer Protection Act, 1986 – Sections 21(a)(i) and 2(1)(g) : [Consumer Protection Act, 2019 – Sections 58 and 2(11)] – Medical Negligence – Death claim – Scope – Case of complainant that his mother deed due to failure of proper treatment of Afrial Fibrillation prior to the debridement of bedsore surgery – There was allegedly no proper consultation amongst doctors, the doses of crucial medicines were not given and RT insertion was done without the informed consent – Patient was 87 years old – Cardiac surgeon was consulted as soon as the bluish discoloration of the does noted – Admittedly, it was a case of Atrial Fibrillation – However, the complainant misconceived about its treatment aspects associated with the bedsore in the petition – No deviation found on part of Opposite Party No. 2 who performed the debridement surgery in two stages – No negligence or dereliction of duty of care found on part of treating doctors/Hospital.
Held: We have perused the entire material on record inter alia the treatment record of different hospitals wherein the patient took the treatment. We have perused the medical literature filed by both sides. The case of the Complainant was that his mother – the patient died in the Opposite Party No. 1 Hospital due to failure of proper treatment of Atrial Fibrillation prior to the debridement of bedsore surgery. There was no proper consultation amongst the doctors, the doses of crucial medicines were not given and RT insertion was done without the informed consent.
We note from the medical record that the 87 years old female patient was admitted in the Opposite Party Hospital for treatment of infected bedsore. In the past, she was treated for her multiple health ailments like arterial thromboembolism, constipation, malnourished state and loss of appetite, intestinal motility disorder, hiatus hernia and weakness and dementia. She also suffered from collapsed vertebra with generalized osteopenia and diverticulum of 2nd part of duodenum. She was treated for Atrial Fibrillation up to 05.12.2011 but there is no record that she consulted any Cardiologist and after 05.12.2011 she was taking Dilzem. It is apparent from the record that the patient was admitted in PSRI on 08.10.2012 and discharged on 13.10.2012. Nothing was mentioned in the advice about the medicine Dilzem. She was again admitted on 21.11.2012 to PSRI and discharged on the same day. Even the discharge summary did not show any reference of medicine Dilzem, it means for one week she was not taking Dilzem. Thereafter, on 23.11.2012 she was admitted in Aasholok Nursing Home for one day, wherein she was not given any Dilzem. Thereafter, the patient admitted in the Opposite Party No. 1 Hospital in the midnight of 23rd / 24th Nov. 2012. The Physician examined her and ECG was taken, the symptoms of AF were found. The patient, though fully conscious and oriented was not accepting orally. Since for healing of bed sore high protein diet and adequate nutrition was needed. On 26.11.2012, the Physician and gastroenterologist examined the patient and found that the pulse rate was high. The treating doctor advised few investigations, but same were refused by the attendant (Complainant). However, based on Clinical signs, the Physician prescribed Dilzem 30 mg twice daily and from 27.11.2012 morning Dilzem 120 mg once daily.
We further note that at the time of admission, the patient had bedsore in the Sacral region with sluffing of skin and seropurulent discharge. Her pulse was 100 per minute and O2 saturation was 96%. As she was a known case of CAD, high doses of IV fluid were not given. Such patients need a high protein diet for recovery; therefore Ryle’s tube feeding was advised. The feeding was done in upright position as recorded in the progress note. There were no side effects of the Ryle’s tube like regurgitation and / or aspiration.
It is pertinent to note that the Cardiac Surgeon was consulted as soon as the bluish discoloration of the toes noted. The Cardiac Surgeon possesses competency and the vasculature of the organs. He examined the patient and advised treatment accordingly. As the drug Acitrom takes longer onset of action, therefore, Pletoz, an antiplatelet agent was used. It is an accepted practice for any major surgery. The blood thinners were avoided because it may cause uncontrollable oozing of blood.
Admittedly it was the known case of Atrial Fibrillation, however, the Complainant misconceived about its treatment aspects associated with bedsore in the instant patient. We do not find any deviation of practice by the Opposite Party No. 2, who performed the debridement surgery in two stages for the severely infected sacral bedsore. It is pertinent to note that for prevention of the stroke and other thromboembolic episodes from AF, the treating doctor consulted the Cardiologist / Cardiac Surgeon, who advised proper doses of Dilzem, Acitrom & Pletoz (antiarrhythmic and anticoagulant / anti platelet drug). We further note that the patient developed cardiac arrest, therefore immediately Code blue was announced and Cardiologist attended. It was documented as per NABH protocols which were strictly followed in the Hospital. In our view it was the reasonable care at that situation. It was neither deficiency nor dereliction of duty of care from the treating doctor or hospital. We would like to rely upon the recent judgement of Hon’ble Supreme Court in the case S. K. Jhunjhunwala Vs. Dhanwati Kaur and Anr., (2019) 2 SCC 282, wherein it was held that a doctor or surgeon cannot assure that the outcome of any surgery would be beneficial. The Court held that a professional might be held liable for negligence either if they do not possess the requisite skills that they claimed to have, or they don’t exercise the skill which they have. While referring to the judgements, the Court said that the human body is like a highly complex machine and a doctor could not assure full recovery of a patient.
Based on the foregoing discussion, in the given facts and relying upon the precedents from the Hon’ble Supreme Court and the entire Evidence adduced before us, it is not feasible to attribute negligence / deficiency on the Opposite Party hospital and doctors; it is difficult to conclusively establish medical negligence / deficiency on the Opposite Party hospital and doctors. (Paras 8 to 13)
Result: Complaint Dismissed.
ORDER
Dr. S.M. Kantikar, Member.—The instant Consumer Complaint has been filed by Vinod Kumar Dhanda, the Complainant under Section 21(a)(i) of the Consumer Protection Act, 1986 for alleged medical negligence causing death of his mother during treatment at Batra Hospital and Medical Research Centre, New Delhi (hereinafter referred to as the “Batra Hospital – the Opposite Party No. 1”) and the treating doctor – Dr. Vipul Sud, Surgeon (hereinafter referred to as the Opposite Party No. 2), who was the Medical Director of the Opposite Party No. 1 Hospital and Senior Consultant Plastic Surgeon. (In the Memo of Parties, the Complainant has made Dr. Vipul Sud as Opposite Parties Nos. 2 and 3 for different addresses. However, for convenience we refer Dr. Vipul Sud as the Opposite Party No. 2.)
2. The brief facts are that the Complainant’s mother Smt. Balwant Rani Dhanda (hereinafter referred to as the “patient”) developed a Sacral bedsore and consulted Dr. Vipul Sud, the Opposite Party No. 2 at the Opposite Party No. 1 Hospital, who advised debridement surgery. He assured that the surgery would be in single setup and the patient would be discharged within five days. The patient got admitted in the Opposite Party No. 1 Hospital on 24.11.2012 and on the same day and again on 27.11.2012 got operated by the Opposite Party No. 2. Unfortunately, on 28.11.2012 in the early morning, the patient passed away. It was alleged that the Opposite Party No. 2 treated the patient casually and failed to provide standard care in the Hospital. The Cardiologist clearance was not taken before both the surgeries. According to the Complainant, at the time of admission, the patient disclosed that she was allergic to Ofloxacin, but from the date of admission, Ofloxacin was administered in the hospital on multiple occasions. The patient also disclosed her past history of Atrial Fibrillation (hereinafter referred to as the “AF”) and thromboembolism, for the same she was taking drug Dilezem 120 mg and Acitrom 1mg (blood thinner) once a day as prescribed by her Cardiologist. It was alleged that the dose of Dilazim was reduced to 30 mg twice daily, therefore, AF worsened during both the successive surgeries. The patient became unstable and her pulse rate was 150 / min, but the treating doctor did not give medicine Cordarone 100mg to reduce the pulse rate below 100 / min. It was further alleged that after the 2nd surgery on 27.11.2012 anticoagulant Acitrom 1 mg was not administered and PT/INR was not checked regularly, therefore the patient developed bluish discoloration of toes. Despite knowing that it was a sign of thromboembolism, the Opposite Party No. 2 failed to seek an opinion from the Vascular Specialist but called the Cardiac Surgeon, who prescribed Tab. Pletoz 100 mg. It was alleged that though Dr. R. K. Himthani, the Gastroenterologist prescribed injection Lesuride 25 mg three times a day from 26.11.2012, the same was not given. It was further alleged that during 2nd surgery the Ryle’s tube was inserted without consent and the position of Ryle’s tube, whether it was in stomach or lung, was not confirmed either by aspiration of gastric contents or by X-ray examination. After insertion of Ryle’s tube, the patient became unresponsive and it was conveyed to the duty nurse, but the doctor came after 20 minutes. By that time, the patient was already cyanosed and CPR was started. There was no monitoring equipment in the room. The patient was declared dead at 3.15 a.m. due to cardio-respiratory arrest on 28.11.2012, but Complainant alleged that the patient might have died much earlier. It was further alleged that the Opposite Party No. 2 assured that it was a simple debridement procedure under sedation and guaranteed the complete healing of the sacral bedsore, but in contrary, the patient died due to gross deficiency in service and medical negligence of the Opposite Parties. Being aggrieved, the Complainant filed the Consumer Complaint and prayed compensation for
