NATIONAL CONSUMER DISPUTES REDRESSAL COMMISSION, NEW DELHI
Dr. S.M. Kantikar, Presiding Member and
Binoy Kumar, Member
Director, Sanjay Gandhi
Post Graduate Institute of
Medical Sciences – Appellant
versus
G.K. Raghuvanshi – Respondent
First Appeal No.364 of 2020
(Against the Order dated 30/12/2019 in Complaint No. 7/2015 of the State Commission Uttar Pradesh)
Decided on 6.4.2023
Consumer Protection Act, 1986 – Section 19 [Consumer Protection Act, 2019 – Section 51] – Appeal - Services – Medical Negligence – The written and video graphic informed consent - Transplant done after detailed counselling - Medical Negligence Not attributable - On careful perusal of record, admittedly the patient was known diabetic since 7 years and on Insulin therapy for 4 years. He was hypertensive also. The chronology of treatment, clearly shows that since June, 2007 to December, 2013, the Complainant had underwent several surgical procedures like coronary angiography, angioplasty, coronary artery bypass grafting (CABG) and haemodialysis. He underwent Renal transplant on 25.07.2011, from a kidney donated by his wife. The renal transplant was done after detailed family counselling for high risks. The written and video graphic informed consent was taken from the donor and recipient. He was discharged on 30.10.2011. At the time of discharge, his blood urea was 36.7 mg% and serum creatinine 1.05 mg% (normal). Subsequently the patient was managed by Department of Urology, however he developed diabetic nephropathy. It is known that about 50% of the diabetic patients would develop gangrene with associated peripheral vascular disease - The diabetic patients are prone to develop diabetic foot because of compromised blood supply to the periphery and also infections because of immune compromised state. As the patient was on immunosuppressive agents for his new transplanted kidney. Therefore, the department of Nephrology has no role in the treatment of gangrene. Thus, any specific treatment for the diabetic foot lesions was not advised by the department of Nephrology as it has neither the knowledge nor the expertise to deal with such problem, thus he was referred to the concerned endocrine surgery department. The patient was kept under follow up with Nephrology for transplanted kidney - No doubt, every patient expects complete cure, but in certain cases complete cure depends upon several inherent factors. Moreover, no cure is not negligence – On merits, no doctor will gain any thing by doing something wrong. The doctors will not be able to serve the patients with their dedication if the halter is on their neck, the instant case was filed based on just surmises and presumptions with lack of medical acumen. The State Commission erred in holding the OP was liable for the gangrene and amputation of toes due to medical negligence. The Order of State Commission is not sustainable, same is set aside. The Complainant failed to prove negligence of the doctors working at SGPGIMS – Appeal Allowed. [Paras 10 to 24].
Result: Appeal allowed.
ORDER
Dr. S. M. Kantikar, Presiding Member—Patients’ expectations are defined as a set of beliefs an individual holds in regard to the treatment and its outcomes with an anticipation that a given event is likely to happen as a consequence of an intervention. Those in health care continue to increase and need to be managed adequately in order to improve outcomes and decrease liability. The days of absolute trust and blind obedience to doctors are over.
The Appellant-Sanjay Gandhi Post Graduate Institute of Medical Sciences (SGPGIMS), Lucknow through his Director Mr. Uttam Singh has filed the instant Appeal under section 19 of the Consumer Protection Act, 1986 (in short “the Act”), against the Judgment dated 30.12.2019 passed by the State Consumer Disputes Redressal Commission, U.P. (hereinafter referred to as the “State Commission”) in C.C. no. 07/2015, whereby the State Commission allowed the complaint.
2. The facts in brief are that the Complainant G. K. Raghuvanshi (for short ‘the Patient’) since June 2007 was suffering from multiple health problems like diabetes, cardiac and kidney. Till December 2012 end on several occasions he was hospitalized and underwent few procedures like angioplasty, CABG ,hemodialysis. On 25.07.2011 he underwent renal transplant in SGPGIMS, the kidney was donated by his wife and he was put on immunosuppressive drugs. He alleged that there was urinary leakage for three months after renal transplant. On 31.10.2011 he got himself discharged from the OP hospital and got admitted in Fortis Hospital on 02.11.2011. As Fortis he underwent ‘Graft kidney with closure of celestial fistula and removal of PCN tube under GA’ and the urinary leak was stopped, he was discharged on 09.11.2011. The patient suffered ‘gangrene’ of toes in Rt. Foot and on 26.12.2012 consulted Dr. Amit Gupta, Professor of Nephrology at SGPGIMS. He further referred the patient to Department of ‘Endocrine Surgery’ OPD for advice. Again he was referred back to the ‘Nephrology’ Department with advice to clean daily the gangrenous wounds of the Rt. foot and use Betadine ointment. It was alleged that, at the initial stage of gangrene both the departments did not take proper care . On 20.02.2013 he approached department of ‘CVTS’ but the doctors there also took it casually and prescribed medicines only. Also he took hyperbaric oxygen session at Fortis but gangrene was not healed due to alleged delay in treatment of SGPGI. Consequently, on 20.03.2013 amputation of toes was done and discharged on 30.03.2013. Thereafter, on 03.04.2013 he was admitted to OP hospital in the Endocrine Surgery department. His lumbar sympathectomy was done on 12.04.2013 for the relief from pain. It was alleged that Endocrine department did not adopt ‘Balloon Dilation Therapy’ available in the institute. The patient was discharged on 17.04.2013.
3. The allegation of the Complainant was that not providing Endovascular Intervention Therapy, his Right 3rd and 4th toe was amputated on 31.05.2013. On 04.12.2013 the Complainant requested Chief Secretary who was Chairman of OP to make available ‘Balloon Dilation Therapy’. Thereafter he was admitted on 16.12.2013 for ‘Endovascular Intervention Therapy’ but doctors were unable to save his left great toe. He further alleged that his wife donated kidney for him , became a patient of Chronic Kidney Disease (CKD) and type-2 DM. Due to unbearable hardship, she got her treatment at Shekhar Hospital, Lucknow.
4. Being aggrieved due to alleged medical negligence and deficiency in service from the SGPGIMA, the Complainant filed Consumer Complaint No. 07/2015 before State Consumer Dispute Redressal Commission, U.P. (for short, the ‘State Commission’) to claim compensation of Rs.99,98,800/-.
5. The Opposite Party did not file written statement, therefore proceeded against ex-parte.
6. The State Commission decided the Complaint after obtaining an expert report from King George Medical University (KGMU), Lucknow. It relied upon the decision
(1) Diabetic patient – The diabetic patients are prone to develop diabetic foot because of compromised blood supply to the periphery and also infections because of immune compromised state.(2) Surmis....
No negligence is established in medical treatment unless proven with cogent evidence; treatment variations do not imply negligence.
Medical Negligence – 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....
Organ transplant - The complainant suffered these complications which are expected and are potential risks of transplant surgery. Kidney transplantation is a major surgical procedure that has risks b....
Organ transplant - The complainant suffered these complications which are expected and are potential risks of transplant surgery. Kidney transplantation is a major surgical procedure that has risks b....
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Death of Patient - Thus by any stretch of imagination was no co-relation between the tuberculosis, renal transplant and septicemia. The death was neither due to Tuberculosis nor by renal transplantat....
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