Judicial Analysis Court Copy Headnote Facts Arguments Court observation

NATIONAL CONSUMER DISPUTES REDRESSAL COMMISSION, NEW DELHI
R.K. Agrawal, President and Dr. S.M. Kantikar, Member
Appeared at the time of arguments through Video Conferencing
Smt. Devarakonda Surya Sesha Mani – Complainant
versus
Care Hospitals Institute of Medical
Sciences and Ors. – Opp. Parties
Consumer Case No.339 of 2014
Decided on 24.3.2021

Counsel for the Parties:
For the Complainant:Mr. Aburi Srinivasa Rao, Advocate
For the Opp. Parties:Mr. M. Srinivas R. Rao and Mr. Abid Ali Beeran, Advocates

IMPORTANT POINT
“Since doctors made all efforts to resuscitate the patient from the cardiac arrest but could not revive the patient and since treating doctors performed their duty with reasonable standard of care, therefore care of medical negligence ruled out.”

Headnote:
Consumer Protection Act, 1986 – Sections 21 and 2(1)(g) : Consumer Protection Act, 2019 – Sections 58 and 2(11) – Medical Negligence – Death by Cardiogonic shock – Claim for – Scope – Deceased was husband of complainant – On Vomiting and breathlessness he was admitted in opposite party Hospital – Plea that patient was not admitted in ICU till arrival of cardiologist or that oxygen was not given and there was delay in the treatment of the patient not accepted in view of materials on record – ECG revealed clear findings of myocardial infraction – Patient got admitted in serious condition in the Hospital – There was past medical history of diabetes and ECGs were confirmatory of acute MI, (STEMT) – Doctors made all efforts to resuscitate the patient from the cardiac arrest but could not revive the patient – They performed their duty with reasonable standard of care – No deficiency in service found on part of Hospital or treating doctors – Claim for Medical Negligence ruled out.
Held: As per medical record, Raja Ram Mohan was about 47 years of age with weight 45 kg and known Diabetic (DM Type-2) since 20 years. He was alcoholic and tobacco chewer / snuffer. The senior Cardiologist examined the patient at 10.20 p.m. and injection Tenecteplese 40 mg IV Bolous was given which is used to prevent death from heart attack. It is an expensive medicine worth Rs. 40,000/-. The record revealed that the Cardiology resident doctor (Opposite Party No. 3) was present on duty and regularly briefing the relatives of the patient about the health status of the patient. We do not accept that the patient was not admitted in ICU till arrival of the Cardiologist or that Oxygen was not given and there was delay in the treatment of the patient.
It is pertinent to note that the ECG done at 10.15 p.m. revealed clear findings of myocardial infarction i.e. ST Elevation in V1 to V6 and aVL leads and ST depression in II, III and aVF. The 2D Echo reveals moderate LV dysfunction. Dr. G.S.R. Murthy diagnosed it as acute extensive anterolateral STEMI and very bad prognosis. The patient suffered cardiac arrest and the CPR was started as per ACLS guidelines. The record revealed that after thrombolysis, the patient suffered recurrent ventricular fibrillation. Therefore, injection Cordarone bolus was given and Adrenaline infusion was started; however, the patient could not survive.
The next question is whether the ground of impersonation taken by the Opposite Parties is valid. According to the Opposite Parties, there was an ample doubt that the person who went for the medical check-up at Hyderabad diagnostic centre before going to Kuwait and the person who actually went to Kuwait are not same. The Annexure C2 is an employment letter dated 10.09.2013, whereas Annexure C5 is medical report issued by Hyderabad Diagnostic Centre dated 04.11.2013. We have carefully perused photographs in Annexure C2 and C5 which showed marginal difference in appearance but not convinced that both are different person. However, in the instant case, it is irrelevant and we are not concerned and inclined to discuss on this issue.
It should be borne in mind that we are dealing with a case of alleged medical negligence and thus need to analyze whether the treating doctors or hospital failed in their reasonable duty of care. The medical record of the Care Hospital is a vital document to prove the medical negligence, if any. It is apparent from the record that the Annexure C5 - the medical report, issued on 04.11.2013 is a normal report. We note after nine months of that report the patient got admitted in serious condition in Care Hospital. There was past medical history of diabetes and the ECGs were confirmatory of acute MI (STEMI). Therefore, we cannot rule out the possibility that the patient developed cardiac problems during the nine months. We note that the doctors made all efforts to resuscitate the patient from the cardiac arrest but could not revive the patient. In our view, they performed their duty with reasonable standard of care. We do not find any deficiency either from the hospital or the treating doctors.
It should be borne in mind that simply proving the suffering of ailment by the patient does not amount to medical negligence. The Hon’ble Supreme Court has recently held in the case S. K. Jhunjhunwala Vs. Dhanwati Kaur and Anr., (2019) 2 SCC 28 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. The only assurance that such a professional can give or can be understood to have given by implication is that he possessed the requisite skill in that branch of the profession which they are practising and while undertaking the performance of the task entrusted to them, they would be exercising their skill with reasonable competence, court added.
In other case Achutrao Harbhau Khodwa Vs. State of Maharashtra, (1996) 2 SCC 634 the Hon’ble Supreme Court has held:
“The skill of medical practitioner differs from doctor to doctor. The nature of the profession is such that there may be more than one course of treatment which may be advisable for treating a patient. Courts would indeed be slow in attributing negligence on the part of a doctor if he has performed his duties to the best of his ability and with due care and caution. Medical opinion may differ with regard to the course of action to be taken by a doctor treating a patient, but as long as a doctor acts in a manner which is acceptable to the medical profession, and the court finds that he has attended on the patient with due care skill and diligence and if the patient still does not survive or suffers a permanent ailment, it would be difficult to hold the doctor to be guilty of negligence.”
In the instant case, the medical negligence is not conclusively established against the Opposite Parties. (Paras 7 to 13)
Result:Complaint Dismissed.

ORDER

Dr. S.M. Kantikar, Member.—The instant Complaint was filed under Section 21(a)(i) of the Consumer Protection Act 1986 by Smt. Devarakonda Surya Sesha Mani for the alleged medical negligence and deficiency in service against the Opposite Parties during treatment of her husband – Mr. Raja Ram Mohan (hereinafter referred to as the ‘patient’), who lost his life. Her husband was working as an Instrumentation Engineer in Kuwait and was earning KD 1200 per month. On 12.06.2014, he came to his home town at Vishakhapatnam for 10 days to spend time with the family and he was supposed to return on 20.06.2014. His health was good. On 18.06.2014 at 9.45 p.m., he had vomiting and was taken to Care Hospital (hereinafter referred to as the Opposite Party No. 1). The patient walked from the main gate to the casualty of the hospital. The General Physician - Dr. D. Swaroop (hereinafter referred to as the ‘Opposite Party No. 3’) examined the patient in the casualty and kept him there for three hours. The hospital authorities collected Rs. 5,000/- at the time of admission. In the casualty, the patient again vomited and for the first time complained about breathlessness. The patient and his wife requested for Oxygen mask but the Opposite Party No. 3 did not pay heed to the request. The Opposite Party No. 3 roughly told the Complainant and the attendants to stay away from casualty ward and also instructed the hospital staff to close the doors of casualty. Therefore, they were observing the patient through glass window from outside. The Opposite Party No. 3 gave one injection to the patient upon which the patient immediately developed convulsions and cramps and he became unconscious. The Complainant and relatives shouted and cried to save the life of the patient. It was alleged that at 10.20 p.m., one assisting doctor came outside the casualty and informed that due to 70% of blockage of arteries of heart, the patient became unconscious. It was further alleged that the Opposite Party No. 3 demanded medicines worth Rs. 40,000/- and the Complainant paid the same on the spot. The Complainant repeatedly requested the hospital staff to call the Cardiologist, Dr. G.S.R. Murthy (the Opposite Party No. 2), but no avail. At 12’ O clock midnight, the Opposite Party No. 2 attended the patient and patient was shifted to ICU, however, the patient expired at 1.06 a.m. on 19.06.2014. On inquiry, the Opposite Party No. 2 did not give proper explanation for cause of death of her husband and simply walked away. The Complainant alleged that the precious time was wasted in casualty for non-administration of initial injection, non-supply of the oxygen mask and not shifting the patient to the ICU. It was further alleged that despite requests for entire medical record, the hospital supplied only three documents. The Complainant also requested to provide CCTV Camera recording for 19.06.2014 but it was not provided. The Opposite Parties treated the patient casually. Being aggrieved, the Complainant filed the Complaint for alleged medical negligence and deficiency in service during treatment of the patient by the Opposite Parties. As her husband was drawing salary of KD1200 per month i.e. equivalent to

Rs. 2,61,000/-, she prayed for compensation of Rs. 7 crores with 18% interest and Rs. 3 crores for mental agony from the Opposite Parties.

2. The Opposite Parties filed their written version through Dr. Thotamohan, the whole time Director of the Care Hospital and denied all the allegations of medical negligence. He submitted that the Consumer Complaint has to be dismissed as it was frivolous. The Complaint is defective for misjoinder of parties because there is no doctor by name Dr. D. Swaroop working in the hospital. The patient and his wife at the time of admission suppressed that the deceased was suffering from diabetes for the last 20 years. He further submitted that the patient was brought to the Opposite Party No. 1 hospital on 18.06.2014 to the casualty at 9.45 p.m.

Click Here to Read the rest of this document

IMPORTANT POINT“Since doctors made all efforts to resuscitate the patient from the cardiac arrest but could not revive the patient and since treating doctors performed their duty with reasonable standard of care, therefore care of medical negligence ruled out.”

Cases Referred (1)

IMPORTANT POINT
“Since doctors made all efforts to resuscitate the patient from the cardiac arrest but could not revive the patient and since treating doctors performed their duty with reasonable standard of care, therefore care of medical negligence ruled out.”