BEFORE THE A.P.STATE CONSUMER DISPUTES REDRESSAL COMMISSION:HYDERABAD
F.A.No.1824/2005 AGAINST C.D.No.559/2003, DISTRICT CONSUMER FORUM-II, HYDERABAD.
Between:
1. Mythri Multi Speciality Hospital,
Rep. by its Managing Director, Dr.Prakash
B.Vegunta, Plot No.4, Mythri Vihar, Behind
Mythrivanam Bldg., Ameerpet, Hyderabad.
2. Dr.Prakash B.Vegunta, S/o.late V.V.N.Prasad,
Aged about 44 years, Occ:Doctor,
C/o.Mythri Multi Speciality Hosptial, Plot No.4,
Mythri Vihar, Behind Mythrivanam Bldg.,
Ameerpet, Hyderabad. ..Appellants/
Opp.parties
And
A.Anil Kumar, S/o.A.Shiva Ramakrishna Rao,
Aged about 29 years, Hindu, Occ:Private Service,
R/o.Flat No.102, Vijaya Apartments, Dharam Karam
Road, Ameerpet, Hyderabad-500 016. Respondent/
complainant
Counsel for the Appellants: Mr.G.Dhananjai
Counsel for the Respondent : Mr.N.Jaya Surya
QUORUM: THE HON’BLE MR.JUSTICE D.APPA RAO, PRESIDENT.
SMT.M.SHREESHA, MEMBER.
AND
SRI G.BHOOPATHI REDDY , MEMBER.
FRIDAY, THE TWELFTH DAY OF SEPTEMBER,
TWO THOUSAND EIGHT.
ORAL ORDER: (Per Smt.M.Shreesha, Hon’ble Member)
***
Aggrieved by the order in C.D.No.559/2003 on the file of District Forum-II, Hyderabad, opposite parties preferred this appeal.
The brief facts as set out in the complaint are that on 10-5-2003 as the complainant was suffering from severe pain on the right side of his stomach went to opposite party No. 1 hospital and opposite party No.2 attended on him. Opposite party No.2 administered pain killer injection and also gave tablets to reduce the pain. Opposite party No.2 advised the complainant to undergo several tests and the complainant had undergone the said tests but opposite party No.2 did not diagnose his pain. All the tests were conducted in the laboratory of opposite party No.1 except a C.T. scan which was taken outside opposite party No.1 hospital. Even after receipt of C.T. scan report also, opposite party No.2 did not diagnose the cause for severe pain the stomach on the right side of stomach. The complainant submitted that due to negligent attitude of opposite party No.2 in treating him, his health became worse day by day and therefore his parents and family members pressurized opposite party No.2 about the bad condition of complainant’s severe pain, and he advised immediate operation without exactly diagnosing the disease. Under those circumstances he was shifted to Vivekananda Hospital situated at Begumpet and even the discharge summary was not issued and after pressure it was issued without signature of the concerned official. At Vivekanand hospital, the complainant was attended by Dr.Nageshwar Reddy, who after conducting tests diagnosed his case as Appendicitis and the complainant underwent operation for Appendicitis on 15-5-2003 and was discharged on 31-5-2003. The complainant further stated that before operation 5 litres of pus was removed from his abdomen due to bursting of Appendicitis, which is purely due to negligence of opposite party No.2 in not diagnosing in proper time due to which the complainant had to spend heavily and also suffered mental agony. He sent a legal notice to opposite parties 1 and 2 demanding a sum of Rs.4,31,262/- for which there was no response from the opposite parties. Hence the complaint for a direction to the opposite parties 1 and 2 to pay a sum of Rs.31,262/- towards the charges paid by him towards diagnosis, medical bills and other expenses both at Mythri Multi Speciality Hospital and Vivekananda Hospital and to pay a sum of Rs.4,00,000/- for the loss of health, mental agony, injury suffered by him and his family members together with costs.
Opposite parties filed counter denying the allegations made by the complainant. Opposite party No.2 stated that he is the Managing Director of opposite party No.1 hospital and that he is a qualified surgeon and specialized in Gastro Enterology and Laparoscopic surgery. He admitted that the complainant approached him in opposite party No.1 hospital with a complaint of severe pain in upper abdomen and to determine the treatment, he was asked to undergone some tests. Though there were clinical symptoms of Appendicitis, the investigations did not support the said clinical symptoms and in order to confirm the diagnosis, C.T.Scan of the abdomen was taken. Opposite party No.2 had discussions with other doctors but to his surprise, the complainant left the hospital without informing and without settling the bills. C.T.scan done on 13-5-2003 showed suspicion of acute appendicitis and the patient was advised Laparoscopy with a view to proceed appendectomy if necessary. Opposite party No.2 submitted that he is qualified surgeon in Gastroenterology with 15 years experience both in India and U.K. and that he did not issue any discharge summary or certificate and that it has been fabricated. He submitted that he has given treatment as per the norms and standards and prayed for dismissal of the complaint
Based on the evidence adduced i.e. Exs.A1 to A94 and the pleadings put forward, the District Forum allowed the complaint in part directing opposite parties 1 and 2 to jointly and severally pay a sum of Rs.14,292/- towards medical expenses spent by the complainant in opposite party No.1 hospital and also medicines purchased by him on the advice of opposite party No.2 doctor. Opposite parties 1 and 2 were further directed to pay compensation of Rs.50,000/- for the mental agony and torture suffered by the complainant from 10-5-2003 till the morning of 14-5-2003 together with costs of Rs.1,000/-.
Aggrieved by the said order, opposite parties 1 and 2 preferred this appeal.
The learned counsel for the appellants submitted that the District Forum erred in giving a finding that opposite party No.2 did not diagnose the case and sought for setting aside that finding in view of the documents filed by the complainant himself and submitted that they have taken proper care and advised some tests and in all the tests the reports were normal. He submitted that when the liver function test was conducted, it was found that Bilrubin was above normal and on the basis of the said report, the appellants came to a conclusion that the complainant had mild hepatitis and none of the investigations or observations disclosed any evidence of acute infection. He also submitted that the District Forum failed to consider as to what are the essential symptoms for the appendicitis and failed to examine the said issue and erroneously came to a wrong conclusion. The medical treatment given was according to the procedure and symptoms of the patient. In the instant case there is no increase of white cells in the complainant’s blood test and no fever to the patient and heart beat increases if the patient suffers from appendicitis but no such symptoms were present and hence the question of negligence does not arise. The appellants submitted that the District Forum failed to appreciate the documents filed by the complainant after admission and submitted that the complainant abruptly left the hospital without informing the appellants and even without settling the bills, and after one month the complainant paid the bill, which is marked as Ex.A90 which itself shows the attitude of the patient and therefore the appellants should not be penalized. The learned counsel further submitted that the doctor who treated in Vivekananda Hospital failed to perform the operation on the same day i.e. on 14-5-2003 and therefore the complainant had to incur heavy expenditure and cannot blame the appellants. He also submitted that the District Forum failed to appreciate the judgement rendered in AIR 1969 SC P.128 and wrongly interpreted their case. He further submitted that the District Forum failed to consider the main issue regarding taking expert’s opinion in this case and that the complainant failed to produce any expert opinion with regard to negligence of the doctor in performing his duties and failed to consider the judgements relied by them and prayed to allow the appeal.
We have perused the material on record. It is not in dispute that the complainant approached opposite parties on 10-5-2003 with a complaint of severe pain in the upper abdomen. It is the case of the complainant that opposite party No.2 administered pain killer injections and tablets to reduce the pain and subsequently advised for several diagnostic tests like Amylase, CBP, Abdomen (whole) liver function test, ECG etc., including HIV I & II test to detect the cause of pain and all these tests were conducted in opposite party No.1 laboratory except for CT scan which was done outside. It is the case of the complainant that even after 4 days i.e. on 13-5-2003 no treatment was started by opposite party No.2 and as the complainant’s health started deteriorating and when they confronted to opposite party No.2, he advised the patient to be shifted to Vivekananda Hospital. At that hospital, the complainant was diagnosed to be having appendicitis and the necessary operation was done on 15-5-2003 and since there were lot of complications because of the delayed diagnosis, he was discharged on 31-5-2003. The complainant submitted that his condition was critical and his chances of survival were only 25% at the time of operation on 15-5-2005. It is the appellants’ case that though the clinical symptoms were suspicious of appendicitis, the investigations done did not support the diagnosis. They submitted in their counter affidavit that a Medical Gastroenterologist opinion was sought and after receiving the C.T.scan report, the complainant was advised to undergo Laprotomy but to their surprise the patient left the hospital without informing them and also did not settle the bill.
We have perused the C.T. scan report of the abdomen which is dated 13-5-2003 wherein evidence of Hypodense fluid filled vescus is seen in right iliac fossa (Scans 70-73)-? Appendicitis, Gall bladder is decompressed. In view of this report the contention of the appellants that they could not diagnose it to be appendicitis in the absence of any definite investigation is unsustainable. The discharge summary issued by both Nageswara Reddy, Consultant Gastroenterologist and Dr.G.V.Rao, Consultant Surgeon of Asian Institute, wherein the complainant underwent Appendicitis operation on 15-5-2003 clearly state that there was Appendicular Perforation with General Peritonitis and that the patient underwent Laporotomy + Peritoneal Lavage and Appendicectomy. This record clearly states that the patient was indeed suffering from appendicitis which was not diagnosed in opposite party hospital though the patient stayed there for 4 days from 10-5-2003 to 13-5-2003 which had aggravated the patient’s condition. The contention of the appellants that had the patient waited till 14-5-2003, they themselves would have conducted Laporotomy is not substantiated by any documentary evidence or stated in their discharge summary/discharge bill that the patient was advised Laporotomy and was being discharged against their advice. There is no case sheet or hospital record with respect to the treatment rendered at appellants’ hospital which was filed before the District Forum or before this Commission to state that they had advised the patient to undergo Laporotomy and that he has been discharged against their advise.
We rely on the decision of Dr.Laxman Balkrishna Joshi v. Dr.Trimbak Bapu Godbole and Anr. reported in (1969) I SCR 2006 in which the Apex Court had clearly discussed the duty of care which
a) A duty of care in deciding whether to undertake the case
b) A duty of care in deciding what treatment to be given
c) A duty of care in the administration of that treatment
the doctors have to render to their patients. Taking into consideration the aforementioned observations, we are of the considered opinion that the appellants did not take proper care of the patient with respect to diagnosis which necessitated the complainant to shift to another hospital and undergo emergency operation there. Therefore, we see no reason to interfere with the well considered order of the District Forum.
In the result this appeal fails and it is accordingly dismissed. Time for compliance four weeks.
PRESIDENT. LADY MEMBER. MALE MEMBER.
JM DATED 12th September, 2008.
