Appeared at the time of arguments through video conferencing Neera Arya VS Batra Hospital & Medical Research Centre of Ch. Aishi Ram Batra Public Charitable Trust

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
Neera Arya and Ors. – Appellants
versus
Batra Hospital & Medical Research Centre of
Ch. Aishi Ram Batra Public Charitable Trust
and Ors. – Respondents
First Appeal No.564 of 2013
(Against the Order dated 31/05/2013 in Complaint No.71/2006 of the State Commission Delhi)
Decided on 23.11.2021

Advocates:
Counsel for the Parties:
For the Appellants:Mr. P.R. Chopra, Advocate
For the Respondent Nos.1 to 3 and 5:Mr. Bipin K. Dwivedi, Advocate
For the Respondent No.6:Dr. Sushil Kumar Gupta, Advocate
For the Respondent No.4:Nemo

Headnote:
Consumer Protection Act, 1986 – S.21 [Consumer Protection Act, 2019 – S.58] – Medical Negligence – State Commission dismissed Consumer Complaint – Appeal field against order of State Commission – Whether there was a deviation from the standard of practice amounting to medical negligence – The two expert medical board’s opinions do not support the case of Complainants.Thus, from both the opinions manifestly it is evident that ECG showed clear signs STEMI. Therefore the Complainants’ allegations about normal ECG and no heart attack are not sustainable. The patient’s brother received the medical record along with CDs.The death of the patient was due to cardiac arrest despite CPR – Therefore, there was no negligence on the part of both Doctors, who performed procedures (angiography and Angioplasty)per standards laid down in the American Heart Association and American College of Cardiology – the patient’s ECGs clearly showed myocardial infarction (MI). The treating two Cardiologists have chosen the course of treatment as per ACC / AHA guidelines and performed Angiography and Angioplasty procedures. There was no deviation from the standard of practice. [Paras19, 24]
Held, It revealeda massive heart attack affects a large portion of the heart muscle, or causes a large amount of heart damage. This can happen if the blockage in a coronary artery occurs in a large artery that supplies a large portion of the heart; completely blocks blood flow to the heart; or lasts for a long period of time. It can result in collapse, cardiac arrest and permanent heart damage/rapid death. The leading cause of sudden cardiac death is myocardial ischemia. As for uncomplicated acute myocardial infarction (AMI), international guidelines plead for early coronary angiography with, in case of culprit lesion, angioplasty and stent implantation. However after cardiac arrest (CA), shock, hypothermia and changes in antiplatelet pharmacokinetic may promote stent thrombosis (ST). [Para 20]
Although angioplasty is a less invasive way to open clogged arteries than bypass surgery is, the procedure still carries some risks. The most common angioplasty risks include re-narrowing of artery, blood clots formation within stents, bleeding where the Cather was inserted and bleeding. Few other risks involved are heart attack during the procedure; coronary artery may be torn or ruptured during the procedure; kidney problems and stroke etc. [Para 21]
It should be borne in mind that some doctors may have concerns about being sued if they don’t intervene aggressively. They may also be swayed by people’s expectations of a dramatic response to a heart attack. [Para 23]

ORDER

Dr. S.M. Kantikar, Member.—The instant Appeal has been filed by the Appellants — Complainants against the Order passed by the Delhi State Consumer Disputes Redressal Commission (hereinafter referred to as ‘the State Commission’) in Complaint Case No. 71/2006, wherein the Consumer Complaint was dismissed.

2.The brief facts of the case are that Mr. Harish Arya (hereinafter referred to as the “patient”) a wholesale pharmaceutical businessman, on 20.05.2004 at about 5:30am experienced slight chest discomfort. His brother, Dr. Ashok Arya checked him, the Blood Pressure (BP) was 140/90 mm of Hg and called his friend Dr. Chug to bring ECG machine, who immediately came at 6.05 to the residence and ECG was conducted. Dr. Chug telephoned the Cardiologist, Dr. Sanjeev Sharma (hereinafter referred to as the “Opposite Party No. 2) whoadvised to take thepatientBatra Hospital & Medical Research Centre (hereinafter referred to as “Batra Hospital – the Opposite Party No. 1”) and he will reach in short time. Accordingly, the patient’s brother Dr. Ashok Arya admitted the patient to BatraHospital at 6:30 am. Another ECG was conducted by the on duty resident doctor at 6.40 am and informed about the stable condition of patient and administered few medicines. It was alleged that the Opposite Party No. 2, without examining the patient and reports, telephonically informed the resident doctor to shift the patient to Cath Lab-A for Angiography. Accordingly, the patient got shifted to Cath Lab. A., thoughOpposite Party No. 2 did not reach the hospital. It was further alleged that Dr. R. D. Yadave (hereinafter referred to as the “Opposite Party No. 3”) without examining the patient or ECG; started the Coronary Angiography (CAG) procedure. It was solely based on the telephonic discussion with the Opposite Party No. 2.

3.It was alleged that the patient’s brother Dr. Ashok Arya was not given any prior information to about the decision to perform Angioplasty. At 7:20 am, the Opposite Party No. 2 arrived in the hospital, compared the two ECGs and joined the Opposite Party No. 3 in the Cath Lab-A. The Opposite Party No. 3 had already performed Angiography and he was about to start Angioplasty procedure. TheOpposite Parties Nos. 2 & 3 informed the patient’s brotherthat the only branch of Left coronary artery- Left Anterior Descending (LAD) was 100% blocked and needs one Stent. However, later on, it was told that Angioplasty was also conducted on the Right Coronary Artery (RCA) and one Stent was putin RCA at the Posterior Descending Artery (PDA) bifurcation and carried out Ballooning of Right Ventral branch.At about 9.20 am, the Opposite Parties Nos. 2 & 3 declared that procedure was successful and the patient was shifted to Recovery Room. However, at about 10.20 a.m., the patient was again taken to Cath Lab B for Angiography and Complainants were told to arrange for blood. It was alleged that though there was no problem with the RCA but the doctors performed Angioplasty of RCA and a Stent was put in its PDA branch which led to complete cut-off of the blood supply to the RV branch and death of the patient.At 1.00 pm, the Opposite Party No. 3 informed the patient’s brother Dr. Ashok Arya that the patient could not be saved despite proper Angioplasty.

4.The Complainants further alleged that the Hospital delayed to hand over the dead body of the patient. It raised exorbitant bill of Rs. 5 lakh which was settled for Rs. 3,17,566/-. It was further alleged that though the Opposite Parties Nos. 2 and 3 had claimed to put 5 stents, but the bill was raised for 4 stents. The Opposite Parties were requested to handover entire medical record including the CDs and death summary of the patient but there was no avail. The Opposite Parties might have been destroyed the CDs.

5.Being aggrieved by the death of patient due to the deficiency and negligence during treatment, the patient’s wife and two minors havefiledthe Complaint before the State Commission, Delhi and claimed compen

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Cases Referred (1)