IMPORTANT POINT
Bile - The doctors/staff on duty at Apollo Hospital failed to insert drainage tube, which could have accumulated the bile.

ORDER

Dr. S. M. Kantikar, Presiding Member—The instant appeal is a challenge against the impugned Order dated 25.06.2012 passed by Jharkhand State Consumer Disputes Redressal Commission Ranchi (for short ‘the State Commission’) in CC No. 13 of 2003 whereby the State Commission held the Opposite Parties Nos. 1 to 5 (Appellants herein) liable for medical negligence. The State Commission dismissed the complaint against the Apollo Hospital, the OP No. 6 (Respondent No. 4 herein).

2. Brief facts that, on 02.07.2001 the Complainant’s wife Smt. Sudha Ekka, aged 45 years (since deceased hereinafter referred to be the ‘patient’) was operated by Dr. P.K. Agrawal for laparoscopic cholecystectomy (removal of gall bladder)in the ISPAT Hospital (OP-1). During hospital stay on 09.07.2001, the bile discharge found to be abnormally high. Therefore on the next day she was referred to Andur Razzaque Ansari Memorial Weavers’ Hospital (OP-6), (for short ‘Apollo Hospital’). There ERCP was performed but it remained incomplete as the doctor was unable to cannulate the Common Bile Duct (CBD). Finally, Hepaticojejunostomy operation was performed, but her condition deteriorated from 22.07.2001 and she expired on 24.07.2001. The cause of death was mentioned as ‘Biliary Peritonitis’, internal bleeding leading to cardio respiratory failure.

3. Being aggrieved, the Complainants (the husband and two sons) have filed the Consumer Complainant before State Commission. For the convenience all the Complainants are collectively further referred as a Complainant.

4. All the OPs filed their replies. M/s ISPAT Hospital (OP-1) and the doctors have denied any deficiency and medical negligence. Dr. P.K. Agrawal during the proceedings expired therefore his name was deleted from the array of parties. Dr. S.K. Mishra and Dr. Sreeniwasulu have filed their replies, denied any negligence during operation and post-operative care. The allegation of Complainant was vague. The treating doctors have chosen appropriate method based on the condition of the patient. The laparoscopic procedure is a least invasive and safe method for the instant patient as she was diabetic and obese. It was further submitted that as entire preparations were ready, the procedure cannot be changed abruptly with short notice. Therefore allegation of Consent was taken for open surgery and it was changed to the laparoscopic, which was not sustainable. It was denied that due to negligence the CBD was injured and caused biliary leakage. The Apollo Hospital (OP-6) denied about the removal of the drainage tube on 11.07.2001. It was submitted that the drainage tube came out on its own. It was denied that the open surgery was delayed till 17.07.2001. The operation was not possible because of fluctuating blood sugar levels of the patient. Thus there was no deficiency or negligence.

5. After hearing both sides and considering the entire material on record & evidence, the State Commission partly allowed the Complainant and held the OP-1 to 5 (Appellants herein) liable to pay Rs. 25 lacs along with interest @9% and Rs.1 lac towards litigation charges to the Complainants. The State Commission dismissed the complaint qua the Apollo Hospital (OP No. 6).

6. Being aggrieved the OP-1 to 5 have filed the instant Appeal.

7. Heard the arguments from the parties.

8. The learned counsel for Complainants argued that the doctors at ISPAT Hospital during laparoscopic cholecystectomy had cut the CBD instead of cystic duct and wrongly clipped the lower trunk of CBD leaving upper part of duct un-clipped. It resulted in uncontrolled biliary leak in the peritoneal cavity and biliary peritonitis. However, the doctors were not serious. They just waited till 10.07.2001 and then referred for ERCP at Apollo Hospital (OP-6) to shift their liability on OP-6. Moreover, the doctors in OP-6 were also careless and performed ERCP negligently.