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NATIONAL CONSUMER DISPUTES REDRESSAL COMMISSION, NEW DELHI
Dr. S.M. Kantikar, Presiding Member and
Binoy Kumar, Member
Manju Rai – Complainant
versus
Sanjay Gandhi Post Graduate
Institute of Medical Science and Ors. – Opp. Parties
Consumer Case No.409 of 2002
Decided on 1.12.2022
Consumer Protection Act, 1986 – Section 21(a)(i) – [Consumer Protection Act, 2019 – Section 58(1)(a)(i)] – Services – Medical Negligence - Hematemesis - Death of patient not due to oesophageal perforation - No nexus with surgery – Medical Negligence not attributable - Whether there was failure of duty of care or deficiency in service from the OP’s - The death of patient was due to cardio-respiratory arrest because of massive hematemesis. The medical record, progress notes were maintained with all details – held, such hematemesis was not due to injury by graft protrusion, but it was more likely to be due to peptic ulcer (use of painkillers for long tome) or oesophageal varices resulting from chronic liver disease – Thus, the protruding bone graft was not life threatening. The Hematemesis was not due to foreign body (graft) or trauma leading to perforation or rupture injury of the Oesophagus - The allegation of the complainant that the surgery was postponed because of non-arrival of the plates is not sustainable – Also, the entire set of instrumentation is very expensive and the model every company has their own set and sizes of plates and matching instruments – Also, the treating surgeon as an expert is the best judge of his choice of treatment – On facts, The death of patient was not due to oesophageal perforation and no way related to the surgery also. Patient died due to sudden unexpected and unrelated hematemesis. Thus, no negligence is attributed to the treating doctors or hospital – Therefore, it is not feasible to determine medical negligence or deficiency in service on the part of OP-1 the treating doctor – Complaint dismissed. [Paras 13 to 21].
Result: Complaint dismissed.
ORDER
Dr. S. M. Kantikar, Presiding Member—This Consumer Complaint has been filed by Ms. Manju Rai the Complainant under the Consumer Protection Act, 1986 (for short ‘the Act,1986’) for alleged death her husband due to medical negligence, carelessness and deficiency in service against Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow and Others (for short ‘SGPGI’ ‘Opposite Party’).
2. The relevant facts stated by the Complainant that her husband Mr. Rajendra Pratap Rai (since deceased hereinafter referred to as the ‘patient’) was suffering from Cervical Spondylitis and was under medical treatment for almost a year. He consulted Dr. D. K. Chhabra (for short, ‘OP-3’), Department of Neurosurgery at SGPGI and on 31.10.2001, he was successfully operated in SGPGI. After the operation, he was kept in Neurosurgery ICU for a night. On next day morning, X-ray Cervical Spine shown as normal and then he was shifted to Neurosurgery General ward. After 3 days the patient started complaining severe pain on upper back (both sides), shoulder, and up to arms & elbow. It was alleged that the doctors who increased the dosage of painkillers and he got some relief, but the pain continued. On 7.11.2001 after removal of the stitches, he was discharged and advised to take by train to Varanasi. It was alleged that throughout the journey, pain persisted and the painkillers were ineffective but, the OP doctors told nothing to worry and with the passage of time pain will reduce. On 10.11.2001, in Varanasi his family members consulted two Neurosurgeons, who advised to get X-ray of Cervical spine. Both the neurosurgeon on the basis of X ray told that the bone graft placed during spinal operation got extruded, therefore patient had terrible pain and difficulty in swallowing. They further informed that a sharp edge of extruded graft was pressing against the oesophagus, which may cause rupture and hemorrhage. They further told that during the operation for the stability of bone graft usually a metal plate shall be used to prevent further any chance of dislocation/extrusion, but the doctors at SGPGI have not applied such plate to the patient. Therefore, knowing the fact, the Complainant’s eldest daughter telephonically discussed with the doctors at SGPGI who asked to bring her father to SGPGl as soon as possible. They also expressed another surgery would be required for the repositioning of the dislocated graft and they have to do plating as well.
3. Accordingly, on the next day (12.11.2001) morning the patient got admitted to Neurosurgery-ICU at SGPGI. In the evening Dr. D.K. Chhabra and Dr. V.K. Jain visited to the patient, but Dr. D.K. Chhabra left the ICU without examining the patient and just said that “there was no emergency”. On 13.11.2001 the proposed corrective operation was not done, but the patient was shifted to the Neurosurgery General Ward. The patient in the meanwhile, developed few vigorous tremors unable to hold a glass of water. Dr. Deepu Banerjee who was supposed to perform the operation informed the attendants that the plate was not available in Lucknow and need to get it from Delhi. The SGPGI would get it by the evening on next day and the operation was scheduled for 15.11.2001.However, due to non-arrival of plate the operation was postponed. The relatives were assured about no risk in waiting till the imported plate arrival, and expected to be on 17.11.2001. Accordingly, the operation was scheduled to 20.11.2001 on the operation day of Dr. D. K. Chabra. During the course of time, the operated site at iliac crest (from where the bone grafts were taken) showed hematoma. It was confirmed by ultrasound and x-ray examination. Dr. D.K. Chhabra assured nothing to worry as it was due to simple local injury. On 19.11.2001, again the operation postponed due to alleged patient’s fever to 99-100o F. On 20.11.2001, about 150 ml of blood was drained out by the aspiration of hematoma and no signs of infection in the hematoma. On 20.11.20
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