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NATIONAL CONSUMER DISPUTES REDRESSAL COMMISSION, NEW DELHI
R.K. Agrawal, President, Dr. S.M. Kantikar, Member and Binoy Kumar, Member
Pooja Prashar and Ors. – – Complainant
versus
Director Indraprastha Appollo
Hospital and Ors. – Opp. Parties
Consumer Case No.212 of 2006
Decided on 24.1.2023
Counsel for the Parties:
For the Complainants: Ms. Pooja Prashar, in-person, Mr. Tushar Prashar, in-person
For the Opp. Party No.1:Mr. Lalit Bhasin, Advocate, Ms. Nina Gupta, Advocate, Ms. Rimjhim Naudiyal, Advocate
For the Opp. Parties Nos.2 and 3: Ex-parte
For the Opp. Party No.4:Mr. Praveen Khattar, Advocate
IMPORTANT POINTS
(1) Medical practitioner - A medical practitioner is not to be held liable simply because things went wrong from mischance or misadventure or through an error of judgment in choosing one reasonable course of treatment in preference to another.
(2) Practice of medicine - In the practice of medicine, there could be varying approaches of treatment
Headnote:
Consumer Protection Act, 1986 – S.21(1)(a)(i)[Consumer Protection Act, 2019 – S.58(1)(a)(i)] - Services – Mediacal Negligence - cases of metastasis - Blood Transfusion - medical negligence – not attributed - the medical negligence cannot be attributed conclusively upon the OPs. In the instant case, admittedly, it was SOL with metastasis and it was unresectable tumour as due to chemo embolization the tumour size was reduced from 10 cm to 8 cm. Therefore, in the interest of patient, the decision to operate the patient as taken with due informed consent - The OPs promptly transfused the blood and blood products including FFP, PRP and Chryopecipitate. It is known from the medical literature that HCC are highly vascular and highly metastasis. The survival in the cases of metastasis is very short. The Opposite Party No. 2, the senior liver specialist performed his duty in the interest of the patient and we do not find any ill intention or unfairness – thus, a medical practitioner is not to be held liable simply because things went wrong from mischance or misadventure or through an error of judgment in choosing one reasonable course of treatment in preference to another. In the practice of medicine, there could be varying approaches of treatment - Complainant failed to prove medical negligence of the Opposite Parties - Complaint is dismissed. [Paras 21 to 24].
Result: Complaint dismissed.
ORDER
Dr. S. M. Kantikar, Member—This Complaint has been filed by legal heirs of late Col. (Rtd.) Ashok Prashar under Section 21(a)(1) of the Consumer Protection Act, 1986 against the Director, Indraprastha Apollo Hospital, New Delhi/Opposite Party No. 1 and Dr. MR Rajasekhar of Dept of HPB Surgery and Organ Transplant/Opposite Party No. 2.
2. On 21.01.2004, Col. Ashok Prashar (since deceased for short, the ‘patient’) consulted the Senior Surgeon Dr. C. J. Desai at Appollo Hospital, Ahmedabad. He was diagnosed as Space Occupying lesion (SOL) in the right lobe of liver and advised treatment by Chemotherapy instead of the major surgery. The patient responded Chemotherapy and the size of SOL reduced from 10 cm to 8 cm within two months. Dr. Desai opined that surgery was out of question for liver SOL, until patient’s platelet and WBC counts become normal. On 23.08.2004, the patient approached Dr. A. K. Sethi in Army Hospital and R & R at Delhi (for short, the AHRR), who advised Chemotherapy for 30 days. Thereafter, on 23.11.2004 in the same hospital, patient consulted Dr. Kannan and found that the SOL was static, 8 cm in diametre. He also opined that resection of SOL was risky. Thereafter, for further management, on 07.12.2004 the Patient consulted Dr. M. R. Rajasekhar (Opposite Party No. 2) the senior surgeon in HPB Surgery and Organ Transplant at Indraprastha Apollo Hospital, New Delhi (Opposite Party No. 1). The patient showed prescriptions of three previous consultants, but Opposite Party No. 2 took it casually. The Opposite Party No. 2 advised resection of SOL without proper examination and investigations. He further told that it was a minor operation, and patient will be cured in a couple of days. It was alleged that from the very beginning the Opposite Party No. 2 misled the patient. The patient’s wife (Complainant No. 1) was willing not for the operation, but Opposite Party No. 2 managed to brainwash the patient with false promises. On 11.12.2004, CT Scan of whole body was done , it showed SOL of right lobe of liver with adherent gall bladder. The other abdominal organs, chest and pelvis were normal. The Complainant stated that, on 17.12.2004, the patient directly from his office went to Opposite Party No. 1 hospital and got admitted for surgery, without taking any family members. It was alleged that on the same day, he was taken to operation theatre (OT) and without informed consent, the surgery was started at about 6.30 pm and after 8 hours, patient was brought out of OT at 2.30 am, the total duration for the operation was 8 hours. It was alleged that, whole process of resection of SOL was done in surreptitious manner and it was not possible to remove only gall bladder without resection of SOL. It was alleged that Opposite Party No. 2 resected the SOL with gall bladder, but the OT notes (record) were manipulated /forged to create impression as SOL was not resected. The Complainants further alleged that patient bled heavily during operation, therefore, 40 units of blood, plasma, cryoprecipitate and platelets were transfused within span of 24 hrs. After the operation, due to deteriorating condition of patient at 7:00p.m. the patient was put on ventilator by Dr. S. Chawla, Sr. Consultant in Anesthesia. Further, on 19.12.2004 at 5.20 am, the patient suffered heart attack, he was resuscitated. In the morning at 7.40 a.m., Dr. Vipul Rai examined the patient and advised urgent Echocardiograpgy (ECHO), but it was done in the evening at 7.30 p.m. Also, at 6.30 a.m dialysis was advised to correct renal failure, but actually patient was put on dialysis at 6.20 p.m., thus, there was delay of 12 hours to conduct Dialysis and ECHO. As per nurses daily assessment note, the dialysis machine became dysfunctional from 21.12.2004, but dialysis machine became non-functional but the hospital management did not rectify CRRT machine. Unfortunately, the patient died on 22.12.2004 in the Opposite Party No. 1 hospital. It was alleged that the com
