1.      Heard Mr. Nikhil Jain, Advocate, for the appellants and Mr. Ram Sewak Tripathi, Advocate, for the respondents. 

2.      Shakun Maternity Home and Dr. Nilimam Singh have filed above appeal against the order of Uttar Pradesh State Consumer Disputes Redressal Commission, Lucknow dated 23.03.2023 passed in CC/02/2015 whereby four Members Bench of the State Commission by a 3/4 majority judgment partly allowed the complaint and directed appellant-1 (OP-1) to pay Rs.25/- lacs to the complainants (respondents 1 to 5 herein) with interest @ 12% from 12.01.2013 within 45 days failing which the interest would be payable @ 15% from 12.01.2013 till the date of actual payment.  

3.      Respondents 1 to 5 filed consumer complaint 02/2015 for directing the appellants and Dr. Arvind Kumar Awasthi, Dr. Rakesh Kumar, Neera Nurshing Home and Dr. Ram Manohar LOhiya Hospital to pay (1) Rs.9912512/- with interest @ 18% p.a.; and (2) any other relief as deemed fit in the facts and circumstances of the case.

5.      The complainant stated that OPs-1 & 5 are registered nursing homes and OPs-2, 3 & 4 are doctors associated with them. OP-6 is an insurance company. Complainants-1 & 5 are son and mother respectively and complainants-2 to 4 are daughters of complainant-1. The case of the complainants is that late Mrs. Aarti Shilpker, wife of complainant-1 (hereinafter referred to as ‘the patient’) was pregnant and he has his wife for routine check-ups to Shakun Maternity Home on 27.08.2012, 13.09.2012 23.10.2012, 05.12.2012, 24.12.2012, 26.12.2012, 27.12.2012, 07.01.2013, 08.01.2013, 09.01.2013 and 12.01.2013. Certain pathological tests were also done as and when advised by the gynaecologist. On 24.12.2012, the patient complained of stomach pain and she was immediately taken to OP-1 nursing home who admitted the patient where she delivered a child. During admission of the patient, OP-2 advised certain medical tests like haemoglobin, P.C.V., bleeding time, coagulation which were conducted by Priya Pathology, Mahanagar, Lucknow. Obstetric ultra sound was also conducted at Sarkar Diagnostic. The complainants also arranged one unit blood. On 27.12.2012, on the advice of OP-2 the patient was discharged. On 07.01.2013 at about 5 pm the patient suffered labout pain and she was immediately taken to OP-1. Dr. Neelima Singh attended the patient and told that it was not a labour pain there is nothing to worry. Then the complainant came out of the nursing home to park his vehicle in the proper parking. When he came back in the nursing home, his family members that the patient has been taken for operation as an emergency case, where she was operated without the consent of the complainants.  It was informed that a female baby was born at 6.10 pm. A cardiologist was called who informed that the patient was under seizures and cardiac arrest for which treatment is going on. It was also informed that the condition of the patient is serious and they are taking her to Neera Nursing Home for better treatment and ventilator support. The complainants requested Dr. Neelima Singh to refer the patient either to King George Medical College, (KGMC) Lucknow or Sanjay Gandhi Post Graduate Institute, (SGPGI) Lucknow but the request of the complainants was turned down and on same day the patient was shifted to Neera Nursing Home. There is tie up and collusion between Shakun Maternity Home and Neera Nursing Home to shield each other and cover up the mistakes of each other, therefore, the patient was shifted to Neera Nursing Home. The complainants paid Rs.3/- lacs from 07.01.2013 to 10.01.2013 to OPs 1 & 5 for which no proper receipt was issued by them. However, payment receipts for lesser amount were issued. The complainants were wrongly informed that the condition of the patient is improving and in fact her condition was deteriorating. On 10.01.2013, the doctors of Neera Nursing Home advised the complainants to shift the patient either to KGMC or SGPGI or somewhere else. Complainant-1 enquired in the KGMC and SGPGI for admission of his wife but he was informed that there was waiting of ventilator beds for 10 to 15 days. Then the complainants were advised to shift the patient to Ram Manohar Lohia Hospital or any other hospital in Lucknow and Neera Nursing Home was not agree to keep the patient anymore. ON 10.01.2013 at about 3.55 pm under the compelling circumstances the complainants took the patient to Ram Manohar Lohia Hospital, Gomti Nagar, Lucknow where ventilator bed was available but unfortunately the patient died on 12.01.2013 at 7.24 am. The doctors at Ram Manohar Lohia Hospital informed that the root cause of the death of the patient was negligence and lack of pre-operative care before surgery. Pre mature surgery of the patient was conducted by Dr. Neellima Singh with lack of pre anaesthetical check up resulting in seizures and cardiac arrest. Ultrasound report dated 24.12.2012 showed ‘single live foetus corresponding to 32 weeks 6 days + 1 week of gestation.’ On the basis of ultrasound reports dated 13.09.2012 and 24.12.2012 as well as Dr. Neelima Singh opined that the due date of delivery was 26.02.2013 but OP-2 conducted the surgery much before the due date of delivery without pre anaesthetical check up, which amounts to medical negligence. Anaesthesia was not given by a qualified anaesthetic but by the surgeon and an approximate/estimated dose was given which adversely affected the veins and mind, resulting in seizures and cardiac arrest. No free and valid consent was taken by the complainants and OP-2 took signatures of complainant-1 on blank papers and blank printed forms. The complainants were not informed about the possible risks, side effects and complicates of the surgery. No cardiologist was available in the operation theatre at the time of surgery. Medical report dated 08.01.2013 of Neera Nursing Home shows that when the patient had suffered seizures and cardiac arrest, artificial respiration (CPR) was given. Eclampsia is an acute and life threatening complication of pregnancy characterized by appearance of tonic clonic seizure. Since no pre operative measures were taken by OP-2 seizures and cardiac arrest occurred in the operation theatre, which ultimately resulted in development of eclampsia. The opposite parties did not supply the complete medical records relating to the treatment of the patient despite repeated requests and letters by complainant-1. Alleging medical negligence on the part of the opposite parties, the complainants filed above complaint before the State Commission.  

6.      The appellants filed their joint written reply stating that on 27.08.2012 the patient came as a case of 16 weeks pregnancy. She was a patient of hypothyroidism anaemia with the history of and two caesarean deliveries. Earlier two deliveries were also conducted at OP-1 nursing home by OP-2 doctor.  She was informed about all complications third caesarean delivery, obesity, age, hypothyroidism keeping in view the history of diabetes and blood pressure in her family. The patient did not adhere to the advice of OP-2 which is clear from the prescriptions dated 27.08.2012, 23.10.2012 and 05/06/2012 filed by the complainants. On 05.12.2012, OP-2 advised the patient to bring previous medical records and also prescribed certain tests but neither the patient nor the complainants cooperated with OP-2. On 24.12.2012 she was admitted with pre mature labour pain with slight leaking. The opposite parties have done appropriate management for improvement of anaemia. During previous visits, she has mild high blood pressure for which appropriate medicine was given. After stabilisation of the patient as per standard medical protocol she was discharged on 27.12.2012 with the advice to report after four days but she failed to come after four days for check up. Thereafter, on 07.01.2013 she was brought to the nursing home as an emergency case with labour pain. At that time, the only option with OP-2 was to conduct immediate surgery. As per hospital records, informed consent was taken before surgery. The patient was attended by OP-2 with the team of qualified doctors and paramedical staff. Anaesthesia was administered by well qualified anaesthetist Dr. Arvind Kumar Awasthi. Pre operative management was also done by the opposite parties, however, the patient developed seizures sending the patient into a shock resulting in cardiac arrest. The patient could revive with the help of the treating doctors in the presence of super specialist cardiologist Dr. Rakesh Kumar, MD (Medicine), Dip Card and Dr. Ashutosh Vashisth, MBBS, Dip Card who attended the patient on an immediate call. As the patient could not revive completely due to unforeseen complications which occurred because of fluctuating blood pressure, pulse rate and weakly pupillary (eye) reaction the team of doctors including the cardiologist decided to shift the patient to the ICU for management of post-shock sequel, therefore, the patient was shifted to the nearest medical centre i.e. Neera Hospital. Occurrence of medical complications cannot be attributed to the opposite parties. Even on the day of surgery, the opposite parties have taken all pre-operative measures and arranged one bottle of blood in advance. The allegation that seizures and cardiac arrest occurred in the operation theatre, which ultimately resulted in development of eclampsia, is self-explanatory and not correct. The patient had moderate hybrid pressure for which she was prescribed antihypertensive treatment. The situation was not even preeclamptic let alone eclampsia. The patient developed fits and cardiovascular collapse midway during surgery. The cardiologist was called and the doctors could restore the breathing and other heart activity of the patient. There is no deficiency in service on the part of the opposite parties and the complaint is liable to be dismissed.  

7.      Opposite party-3 filed its separate written reply stating that he is a highly qualified and experienced anaesthetist. At the time of procedure, he was present with OP-2 and made detailed noting in the hospital records with reference to administering the anaesthesia. He admitted the written statement filed by OPs-1 & 2.

8.      Opposite party-4 filed his separate written version stating that he was informed on phone by OP-2 that the patient had started fits and she had a cardiac arrest although they had revived her but she is still serious, therefore, help of OP-4 was required. On reaching the nursing home he examined the patient and found that the patient was having continuous seizures and her blood pressure was very low, as such she was required ventilator support. Her husband was called explained the seriousness and requirement of ventilator support. He was given option to take the patient to the hospital where ventilator support was available i.e. SGPGI, Vivekanand Hospital or Neera Hospital. With the consent of complainant-1, the patient was shifted to Neera Nursing Home on 07.01.2013. On 08.01.2013, OP-4 referred the patient to SGPGI but seeing the progress in the condition of the patient, the complainants did not shift the patient for two days and on 10.01.2013, complainant-1 has taken her to Ram Manohar Lohia Hospital, Gomti Nagar, Lucknow. There is no medical negligence on the part of OP-4.

9.      Opposite party-5 also filed its separate written version stating that it is a multi speciality hospital and equipped with all the facilities which were required for treatment of the patient. The patient was admitted in OP-5 hospital on 07.01.2013 at about 8.30 pm as a case of post operative seizure and cardiac arrest. As the patient was having regular seizures in a very short time and her condition was serious, she was kept on ventilator support. OP-5 had tried its best but unfortunately the patient could not be saved. There is no deficiency in service at all on the part of OP-5.

7.      State Commission, after hearing the parties, vide impugned judgment held that there was deficiency in service on the part of OP-1 and directed it to pay Rs.25/- lacs to the complainants with interest @ 12% from 12.01.2013. Aggrieved by the impugned judgment, OPs-1 & 2 have filed the above appeal.

8.      We have considered the arguments of the parties and examined the record.

ORDER

In view of aforesaid discussions, the appeal is allowed. The order of Telangana State Consumer Disputes Redressal Commission, Hyderabad dated 24.06.2022 passed in CC/143/2017 is set aside. The appellant is directed to issue fresh demand of balance amount as per agreement within one month from the date of this judgment. The appellant shall charge interest @9% per annum on balance amount from 01.02.2016 till the issue of the demand. After receiving the demand, the respondent shall deposit balance amount within a period of one month and complete formalities of execution of conveyance deed. On making payment of balance amount and completing other formalities, the appellant will execute conveyance deed and handover possession with copy of occupation certificate, if not handed over earlier, without any further delay.