BEFORE A.P STATE CONSUMER DISPUTES REDRESSAL COMMISSION AT HYDERABAD

F.A.No.527 OF 2012 AGAINST C.C.NO. 09 OF 2011 DISTRICT FORUM SANGA REDDY

Between:

Gayathri Children’s Nursing Home,
Opp.APSEB Main Road, Manjeeranagar
Sangareddy, rep. by Dr.K.Yellappa

Correct being Dr.Chakrapani
                                                        Appellant/opposite party no.1

        A N D

1.   Master Mohd Arsalan Hussain @ Asshu,
S/o Mohd. Ahmed Hussain Siddiqui
Aged 18 years Minor rep. by his father
Sri Mohd. Ahmed Hussain Siddiqui
S/o Ather Hussain Siddiqui, aged 49 years
Occ: Employee R/o Jalalbagh, Sangareddy
                                                Respondent/complainant

2.   Dr.Chakrapani 
C/o Gayathri Children’s Nursing Home

3.   Gayathri Diagnostic Centre
rep. by Dr.K.Yellappa

4.   M.A.Rahim
rep. by Dr.K.Yellappa

5.   N.Nagabhushanam
rep. by Dr.K.Yellappa

All are  C/o Gayathri Children’s Nursing Home,
Opp.APSEB Main Road, Manjeeranagar
Sangareddy,
       

Respondents/opposite parties No.2 to 5

 

Counsel for the Appellant                      M/s V.Gourisankara Rao

Counsel for the Respondents                 M/s K.S.Rahul

F.A.No.246 OF 2013 AGAINST C.C.NO. 09 OF 2011

Between:

Master Mohd Arsalan Hussain @ Asshu,
S/o Mohd. Ahmed Hussain Siddiqui
Aged 17 years Minor rep. by his father
Sri Mohd. Ahmed Hussain Siddiqui
S/o Ather Hussain Siddiqui, aged 48 years
Occ: Employee R/o Jalalbagh, Sangareddy
                                                        Appellant/complainant

        A N D

1.   Gayathri Children’s Nursing Home,
Opp.APSEB Main Road, Manjeeranagar
Sangareddy, rep. by Dr.K.Yellappa

2.   Dr.Chakrapani 
C/o Gayathri Children’s Nursing Home

3.   Gayathri Diagnostic Centre
rep. by Dr.K.Yellappa

4.   M.A.Rahim
rep. by Dr.K.Yellappa

5.   N.Nagabhushanam
rep. by Dr.K.Yellappa

All are  C/o Gayathri Children’s Nursing Home,
Opp.APSEB Main Road, Manjeeranagar
Sangareddy,
       

Respondents/opposite parties

 

Counsel for the Appellant                      M/s K.S.Rahul

Counsel for the Respondents                 M/s V.Gourisankara Rao

QUORUM:   SRI R.LAKSHMINARASIMHA RAO, HON’BLE  MEMBER

AND

SRI THOTA ASHOK KUMAR, HON’BLE MEMBER

     FRIDAY THE FOURTEENTH  DAY OF FEBRUARY  

                                TWO THOUSAND FOURTEEN

Oral Order (As per Sri R.Lakshminarasimha Rao, Hon’ble Member)

***

1.             The opposite party no.1 has filed appeal, F.A.No. 527 of 2012 whereas the complainant has filed the appeal, F.A No.246 of 2013 against the order of the District Forum.  The first opposite party has questioned the reasonableness of the order while the complainant has sought for enhancement of compensation. For the sake of convenience,  the parties are referred to as they are arrayed in the complaint.

2.             The complainant filed complaint through his father.  The factual matrix of the case is that on 29.12.2010 the complainant was suffering from fever and his father   took him for treatment to the opposite party no.2 for treatment.  The opposite party no.2 prescribed some medicines. As there was no relief, the   complainant again  approached the opposite party No. 2 on 31.12.2010.   The opposite party no.2 advised the complainant to undergo blood tests which were done at the opposite party No. 3 Diagnostic Centre.   On seeing the report of opposite party No. 3, opposite party No. 2 informed the father of the complainant that the platelets count is very low i.e. 45,000 against the normal range of 1.5 – 3.5 lakh cells/cumn.       The report also indicated the haemoglobin count at 5.6 gms % against the normal range of 14.0  – 18.0 gms %.   

3.             The complainant submitted that the opposite party No. 2 advised the father of the complainant to seek treatment at BBR hospital as the platelets count of the patient were low and that his life was in danger. The complainant and his father approached BBR hospital on the same day and the boy was admitted as in patient  and several tests were conducted by the opposite parties.    The platelet  count was 1.3 lakhs andhaemoglobin value is at 13.7 gm % and the doctors at BBR hospital informed that there was no danger to boy and he was discharged on 03.1.2011.      On account of the wrong diagnostic report issued by the opposite parties,  the entire family was disturbed and the complainant and family underwent   mental agony and distress. Hence the complainant filed the complaint before the District Forum seeking relief of compensation of      50,000/- from the opposite parties.

4.             The  opposite parties resisted the claim  contending that  the complainant approached him on 29.12.2010 with complaint of fever and cough and on examination the opposite party no.2  prescribed some medicines.  Again on 31.12.2010 the son of the complainant came with continuing fever and cough. The opposite party no.2 advised him to get his blood test and other tests done to find out the cause.  On seeing the report,  the opposite party no.2 referred the patient to a higher care Centre as the platelets count was very low and hemoglobin showed only 5.6gms%. The  result may vary from laboratory to laboratory and diagnosis is not final and one has to correlate with clinical findings.  The report of BBR hospital  dated 31.12.2010  shows platelet count at 1.3 lakhs and on the next day the platelet count is at 1.6 lakhs %. The patient was admitted and stayed at BBR hospital for three days, which  is sufficient cause to show that he needed care.   Since the platelet count was low the opposite party no.2 felt that he could not treat him at Sangareddy as  there was no facility to transfuse platelets at Sangareddy if needed.

5.             The complainant filed his affidavit and the documents, Exs.A1 to A10.  On behalf of the opposite parties, the opposite party no.2 filed his affidavit and did not chose to file any documents.

6.             The District Forum allowed the complaint on the premise that opposite parties had sought for repetition of diagnostic test as to platelet count and that there was error with the report and there was no negligence on the part of the second opposite party and the complainant suffered mental tension on account of wrong blood report issued by opposite party no.3. The District Forum awarded a sum of      10,000/- towards medical expenses against the opposite party no.1 alone.

7.             The first opposite party has filed appeal contending that there is no evidence to establish that the hematology report dated 313.12.2010 issued by BRR Hospital is correct. It is contended that the complainant had not got his blood test done by the Diagnosis Centre confirmed.  The first opposite party has contended that no harm was caused to the complainant and no fatal consequences will follow if the hemoglobin count is less than the standard count and that the complainant had not examined any medical expert to establish ExA1 is incorrect.

8.             The complainant has filed the appeal contending that the amount of compensation granted by the District Forum is inadequate and that he sought for enhancement of compensation to      50,000/-

9.             The point for consideration is whether the opposite parties have rendered deficient service either in issuing hematology report under ExA1 with the values mentioned therein or in administering treatment to the complainant?

10.              The complainant along with his father approached the first opposite party-nursing home with complaint of fever on 29.12.2010 and the second opposite party after examining the complainant, prescribed medicines   and as there was no positive response to the medicine, the complainant had again approached the second opposite party on 31.12.2010 and this time the second opposite party advised the complainant to undergo blood test.   The third opposite party conducted the tests and issued Hemogram Report and blood exam Report.

11.            The Hemogram Report had shown the value of Hemoglobin as 5.6 gms as against the normal value of 11.5 – 14.5 gs and the platelet count as 45,000. The second opposite party referred the complainant to higher Centre to take steps for control of fever and to avoid further decrease in platelet count. As to referring the complainant to higher centre, the second opposite party has made contradictory statement as under:

“ The complainant got blood test with respondent no.3 and the respondent no.3 issued Hemogram report and widal test and test for malaria that after going through the said report I advised the complainant to refer the higher care Centre as the said report platelet counts shown 45000 and similarly Hemoglobin are shown 5.6gms%.  The said reports were prepared by the respondent no.3 basing on the count made by the machines.  That I advised the complainant to take higher care Centre to control the fever and to avoid further fall of the platelet count”.

12.            Contrary to the statement that in view of uncontrollable fever and alarming decrease in platelet count of the complainant, the second opposite party proceeded to state that he did not advise the patient to go to higher Centre and it is the complainant’s father who requested him to refer the complainant to BBR hospital on the premise of his convenience and the statement reads as follows:

“ It is submitted that I have not charged Rs.700/- in all for prescriptions and as well as diagnostic charges.  I am not way caused fear and panicky to complainant and family referred complainant to BBR Hospital.  I did not advise the complainant to take higher care Centre, but the complainant’s father requested to refer the complainant to BBR Hospital as it is convenient to their family.”

13.            The statement of the second opposite party would show lack of any reason for a father to request the doctor to refer his son to BBR hospital which is far away and located in another district and it is not at all convincing for the second opposite party to state that in view of convenience the father of the complainant requested him to refer the complainant to BBR Hospital. The convenience theory does not stand to any test in the light of difficulty the complainant’s father in getting the complainant treated at  BBR hospital and he stated thus:

“My son and our entire family was disturbed on 31.12.2010 in view of acute low platelet counts and hemoglobin as per the opposite party no.3 diagnostic report.  I had incurred expenditure for shifting my son in a taxi and unnecessary expenditure at the BBR mutli specialty hospital for treatment in the hospital and as well as to stay of our family member in a nearby hotel.  I had incurred Rs.7,638/- net IP final bill of BBR Multi Special Hospital.  

14.            The inconvenience stated to have been caused to the complainant and his family members would support the statement of the complainant’s father that the second opposite party on going through the diagnostic reports, apprehended that there was danger to the complainant’s life in view of the low platelet count. The complainant’s father had stated about the apprehension entertained by the second opposite party as to the complainant’s state of health as under:

“The opposite party no.2 informed that there is danger to the life of my son in view of the low platelet counts and at any time bleeding may commence.  The opposite party no.2 caused fear and panicky to my son and our family and referred  my son to BBR hospital.  Accordingly, I approached BBR multi-specialty hospital on the same day i.e., 31.12.20109 and we admitted our son as inpatient vide inpatient No.31268.  in the BBR hospital, again blood examination particularly the platelets counts was done on 31.12.2010 at 3.49 pm and also complete urine test, x-ray test and ultra sound of abdomen was done”.

15.            Thus, the statement of the second opposite party that he did not refer the complainant to BBR Hospital is not only contrary to his statement and it is also against his version in reply dated 15.02.2011 to the notice got issued by the complainant on 13.01.2011 wherein it is stated that he advised the complainant’s father to take the complainant to higher Centre so as to avoid any complications.

16.            The complainant was admitted to BBR Multi Specialty Hospital on 31.12.2010 and on the same day he had undergone blood culture test, ultra sound abdomen, x-ray.  The blood culture test report has shown no bacterial growth and the ultrasound report revealed no abnormality.  Insofar as hematology report is concerned,  it has shown platelet count of 1.6 lakhs against normal range of 1.5 to 4.5 lakhs and hemoglobin to the extent of 13.5 gms%  against the normal range of 12-17gms%.

17.            The second opposite party has attempted to assert that report issued by the opposite party no.3 is correct.  He has stated that as per the report issued by BBR Hospital, the complainant was suffering from decreased platelet count and his treatment as inpatient in BBR Hospital for three days would show that he was suffering with illness on account of decreased platelet counts.  He has stated :

“The complainant categorically admitted that when he was admitted in the BBR Hospital and after going through the reports the BBR Hospital doctors advised the complainant that there is no danger to the lift of the complainant.  That if the version of the complainant is true, the BBR Hospital doctor would have discharged on the same day, but whereas the complainant was treated in the hospital as inpatient for another 3 days which itself is sufficient to hold that the patient is suffering with illness of platelets.” 

18.            The second opposite party has stated that the third opposite party issued report basing on count made by the machine.  He has not mentioned on which machine the blood test of the complainant was conducted.  It is pertinent to note that the third opposite party has been running the diagnostic Centre in the premises of the first opposite party hospital.  The third opposite party diagnostic Centre is not an independent entity from that of the first opposite party nursing home in as much as the second opposite party defended the third opposite party and the first opposite party nursing home as well. 

19.            The third opposite party or the second opposite party had not mentioned whether the blood test of the complainant was conducted onSismex Kx-21 and it cannot be denied that the accuracy and reproducibility of any parameter depends upon method adopted and how accurately performed.   The opposite party no.3 after conducting the test on machine, failed to repeat it by manual method particularly when the report had shown abnormal value of platelet count.  The second opposite party had not advised the complainant or instructed the opposite party no.3 to repeat the test in the light of abnormal platelet count of the complainant. 

20.            The opposite parties failed to take proper steps when it was found that there was noticeable change in value of platelet count of the complainant.  The second opposite party admitted that he did not mention in the prescription and report that the complainant was suffering from vasovagal syncopial attack on account of administering treatment to the complainant as an outpatient. 

21.            At BBR Multi Specialty Hospital, the tests conducted and investigations done revealed that the hemoglobin percentage of the complainant is 13.7 gms% and his platelet count is 1.3 lakhs and he was presented with, at the time of admission with high grade fever with chills, cough and cold as also an episode of vomiting on 31.12.2010.  He was diagnosed with viral fever with mild thrombocytopenia He was treated with antibiotics, antimalarial drugs and other supportive medication.   

22.            The treatment administered to the complainant by the opposite party no.2 without there being any finding or pathological report as to the exact cause of the problem the complainant suffered, amounts to per se negligence.  The opposite party no.2 has not exercised minimum care and due diligence while administering treatment to the complainant from 29.12.2010 till 31.12.2010. 

23.            The complainant had to suffer the agony even after he approached the opposite party no.2 again on 31.12.2010 as the opposite parties failed to proceed for subjecting the complainant to undergo for repeat blood test and particularly when the platelet count had shown abnormal value and they did not bother to correlate the value of the platelet count of the complainant by adopting the manual method substituting for the mechanical method.  The mechanical approach adopted by the opposite parties in the matter of conducting tests as also administering treatment invite application of res ipso loquitor as held by the Supreme Court in “V. Kishan Rao Vs. Nikhil Super Specialty Hospital” in  Civil Appeal No. 2641/ 2010 after considering the entire case law  and where the principles of   res ipsa loquitor  have been made applicable  in the case of medical negligence  held :

“In a case where negligence is evident, the principle of res ipsa loquitur operates and the complainant does not have to prove anything as the thing (res) proves itself. In such a case it is for the respondent to prove that he has taken care and done his duty to repel the charge of negligence.”

24.                  On application of the ratio laid in aforementioned decision to the facts of the case on hand, this Commission is of the considered view that the opposite party no.2 as also the other opposite parties have rendered deficient service in getting conducted the pathological test repeated as also in administering treatment to the complainant.   The District Forum without appreciating the evidence on record jumped to a conclusion that there was no any medical negligence on the part of the opposite parties which is unsustainable. 

25.            The District Forum failed to consider the treatment administered to the complainant on 29.12.2010 without advising for any pathological test and the District Forum brushed aside the decisions of this Commission in Dr.Shylaja vs Meena” in F.A.No.803 of 2008 and the decision of the National Commission in R.P.No.1980 of 2011 confirming the order of this Commission.   The District Forum had not been able to appreciate the entire evidence on record and consider application of the decisions relied upon by the learned counsel for the complainant.

26.            In “Smt.Savita Garg V.the Director National Hear Institute”, (2004) 8 SCC 56, the Hon’ble Supreme Court held:

“It is the common experience that when a patient goes to a private clinic, he goes by the reputation of the clinic and with the hope that proper care will be taken by the hospital authorities………..  They charge fee for the services rendered by them and they are supposed to bestow the best care.”

27.            In any view of the matter, the opposite parties no.1 to 3 are   guilty of negligence and deficient service in not taking care of the patient.   The appeal filed by the opposite party no.1 is devoid of any substance and liable to be dismissed. 

28.            The complainant has claimed for enhancement of compensation from      10,000/- to an amount of      50,000/- on the premise that his father incurred a sum of      7,638/- at BBR multi-specialty hospital and an amount of      6,000/- towards transportation charges besides the amount of      700/- collected by the opposite party no.2. 

29.            The medical expenditure, an amount of      7,638/- is supported by the bill issued by BBR Hospital.  Apart from the negligence exhibited by the opposite parties no.1 and 2 in administering treatment to the complainant, they had also subjected the complainant to mental tension by denying their referral of the complainant to BBR Hospital.  The complainant had undergone mental tension not only on account of report issued in a negligent manner followed by the treatment negligently administered in equal magnitude and also coupled with the denial of their  referring the complaint to BBR Hospital.  Taking into consideration of the totality of the circumstances, we are inclined to award an amount of      20,000/- towards compensation on all counts in favour of the complainant and confirming the costs awarded by the District Forum.

30.            In the result the appeal F.A.No.527 of 2012 is dismissed.  The appeal F.A.No.246 of 2013   is allowed modifying the order of the District Forum.  The complaint is allowed directing the opposite parties no.1 to 3   to pay to the complainant an amount Rs.20,000/- and  costs awarded by the District Forum is confirmed. The complaint is dismissed against the opposite parties no.4 and 5.   The parties shall bear their own costs in the appeal.  Time for compliance four weeks.   

                                                                          MEMBER

                                                                        MEMBER

                                                                     Dt.14.02.2014

కె.ఎం.కె.*