Medical practitioners and hospitals must maintain an appropriate standard of care in treatment; negligence must be clearly established, not merely inferred from adverse outcomes.

ORDER

1. The present complaint has been instituted by the parents and the elder sister of the deceased, Manasi Tilak, who have complained of negligence in management, diagnosis and treatment of the deceased at the OP-1 Hospital under the OP-2 to 4. The allegations are that the OPs-1 to 4, particularly, the OP-2 Dr. Dharma Choudhary did not take prompt care to analyse and diagnose the requisite treatment with the right dosage of medicine at the appropriate time, as a result whereof the deceased developed Graft versus Host Disease (GvHD). The contention is that had the deceased been administered the correct medicine and the right dose at the appropriate time, the sufferance of the disease would not have advanced from Grade-I/II to Grade –IV which happened at the Hospital of OP-1 where the treatment was being given by the OP-2 and his team of doctors.

2. The case has a chequered history as there are events that have occurred during the pendency of the complaint as an outcome of the orders passed from time to time and which need to be chronologically referred to.

3. At the outset, it may be pointed out that the deceased child was diagnosed for Acute Lymphoblastic Leukemia (ALL) Pre-V on 16.01.2010 at Sir Ganga Ram Hospital, New Delhi. At that time, she was an eight year old girl and upon diagnosis, she was put on chemotherapy and other tests including Bone Marrow Test was awaited. The said treatment plan of Sir Ganga Ram Hospital is on record, which also indicates that she was also advised and administered Prednisolone 40 mg daily for 28 days and then to be halved every three days to taper over 9 days. She was discharged from Sir Ganga Ram Hospital on 19.01.2010, where-after her Leukemia re-lapsed and she was admitted at Indra Prastha Apollo Hospital, New Delhi in 2012. She was discharged on 18.08.2012 after 5 days in the hospital after undertaking chemotherapy and was discharged in a stable condition. She was advised to be re-admitted on 27.08.2012 and then again admitted on 28.08.2012 and discharged on 12.09.2012. During this period her chemotherapy continued. She was again admitted for chemotherapy at Appollo Hospital and was there from 20.09.2012 to 05.10.2012.

4. Thereafter, she was planned to visit the Christian Medical College, Vellore for Bone Marrow Transplant (BMT). She was admitted on 20.11.2012 at Christian Medical College, Vellore, where her Bone Marrow Transplant was carried out on 29.11.2012 and was discharged on 24.12.2012. The discharge summary of the hospital advised for local follow up with Dr. Dharma Choudhary in B.L. Kapur Hospital- OP-1 & 2 herein.

5. She arrived and met the OP-2, who clinically investigated her on 09.02.2013 and advised her the medicines and also advised investigations as well. She was called on after 10 days to visit again on 20.02.2013. On 20.02.2013, tests were carried out and further pathological tests were advised. The prescription dated 20.02.2012, does prescribe Necrol-25 mg (a Cyclosporin drug) B.D. Her pathological tests are on record dated 20.02.2013 relating to her blood data, Kidney Function, Liver Function etc.

6. The complainants have come forwarded contending that on 05.03.2013, Cyclosporine, which had been prescribed, to have to be administered in a tapering way by the Christina Medical College, Vellore, was stopped by the OP-2. This according to the complainants was done without carrying out any tests or examining the requirement of the patient but the OP-2 casually asked the complainants to come after 10 days after stopping Cyclosporine. According to the complainants neither any monitoring or suggestions or any tests were carried out by the OP-2, which was not a prudent act on his part, which resulted in the complications in the GvHD getting aggravated, which had already set-in.

7. On the patient exper