Date of Filing      : 17.09.2018

                                                                                                                  Date of Disposal: 29.07.2022

DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION

THIRUVALLUR

 

 BEFORE  TMT. Dr.S.M. LATHA MAHESWARI, M.A.,M.L, Ph.D (Law)                 .…. PRESIDENT

                 THIRU.J.JAYASHANKAR, B.A.,B.L.,                                                            .....MEMEBR-I

                 THIRU.P.MURUGAN,B.Com.                                                                     ....MEMBER-II

CC. No.39/2018

THIS FRIDAY, THE 29th DAY OF JULY 2022

 

Mrs.G.Sivagami,

No.7/12, 8th Cross Street,

Rama Krishna Nagar, I Avenue,

Porur, Chennai -600 116.                                                                 ……Complainant.

 

                                                                     //Vs//

 

1.Dr.T.K.Shanmugaraj,

    Appollo Hospital Vanagaram,

    No.64, Off P.H.Road,

    Vanagaram to Ambattur Main Road,

    Ayyanambakkam, Chennai -600 095.

 

2.The Medical Director,

    Appollo Hospital Vanagaram,

    No.64, Off P.H.Road,

    Vanagaram to Ambattur Main Road,

    Ayyanambakkam, Chennai -600 095.                             ..........Opposite parties. 

 

Counsel for the complainant                                                :   Mr.A.R.Poovannan, Advocate.

Counsel for the opposite parties                                         :   Mr.Maimoona Badsha, Advocate. 

                         

This complaint is coming before us on various dates and finally on 12.07.2022 in the presence of Mr.A.R.Poovannan, Advocate counsel for the complainant and Mr.Maimoona Badsha, Advocate counsel for the opposite parties and upon perusing the documents and evidences of both sides, this Commission delivered the following: 

ORDER

PRONOUNCED BY TMT. Dr.S.M. LATHA MAHESWARI,   PRESIDENT.

 

This complaint has been filed by the complainant u/s 12 of the Consumer Protection Act, 1986 alleging medical negligence in the treatment against the doctors and the hospital along with a prayer to direct the opposite parties to repay a sum of Rs.74,000/- paid by the complainant towards the Hospital expenses and to pay a sum of Rs.3,00,000/- towards compensation for the mental agony, hardship and strain caused to the complainant and to pay a sum of Rs.10,000/- towards cost of the proceedings. 

Summary of facts culminating into complaint:-

 

The complainant is a retired Government Servant and was suffering from sugar and BP for more than seven years had got admitted for fever and for the treatment of E.coli (Urinary inflection and fever) during May 2018 in Shri Ramachandra Hospital.  She was suggested by one Dr. M.K.Sudhakar to take treatment under the 1st opposite party at Apollo Hospital Vanagaram and the complainant got admitted on 07.05.2018. In the morning at about 8.30 to 9.00, urine sample was collected but the same was not taken immediately to the lab test and in the mean time the complainant was put IV and was given medicines every now and then without the instructions from the doctors.  On 08.05.2018 again urine sample was taken along with blood and blood started oozing out from the point where the blood is taken.  When the complainant informed the 1st opposite party about the incident and requested him to discharge her from the hospital, he insisted her to get admitted for at least 10 days.  Though the complainant had no series illness she was made to stay in the hospital.  On the same day another nurse came and gave insulin due to which the sugar level of the complainant drop down and she felt unconscious.  After the nurses were informed they gave white sugar and after that the complainant regained consciousness.  The next day the complainant received a message from Vipul med corpo Limited that the 2nd opposite party hospital was requested to sanction Rs.50,000/- for the treatment of the complainant and that they have approved Rs.20,000/-. The opposite party hospital did not want to discharge the complainant  and this act amounted to unfair trade in the medical profession.  On 09.05.2018 the 1st opposite party went to the room of the complainant and misbehaved with her and asked her to stay for 10 more days.  The complainant shouted at him and called her husband who met the Assistant Director Dr.Dilip Kumar, Dr.Paul Dilip Kumar and they came to the room of the complainant with another Dr.Raja and ward secretary and told the complainant that they have found one committee to enquire. The complainant was taken to the Rediology room and before that they brought one medicine syrup mixed with water and when the complainant read the instructions on that bottle she came to know that it is fatal for childran, pregnant womens and elders. The complainant was much scared.  Even in the Radiology department, the staff also told that the patient may pass urine and motions continuously due to this medicine.  Finally on request of the complainant she was discharged on 10.05.2018 after paying Rs.73,848/-.  It is submitted that at no point of time the 1st opposite party never discussed about the treatment or ailment of the complainant for what she was admitted in the hospital and what is being done in the hospital though it is the bounden duty to inform the patient about her illness and treatment to be done and therefore the complainant was put to untold mental agony and hardship for the reason that she was not made aware about the illness for treatment given to her.  It is submitted that the 2nd opposite party is also hand in glove with the 1st opposite party and the 2nd opposite party hospital staffs never cared about the complainant. Thus alleging that the act of the opposite parties in not attending the complainant amounted to negligence and deficiency in service, the present complaint was filed for the relief as mentioned below;

1.Directing the opposite parties to repay a sum of Rs.74,000/- paid by the complainant towards the hospital expenses;

2.To pay a sum of Rs.3,00,000/- towards compensation for the mental agony and hardship caused to the complainant;

3.To pay a sum of Rs.10,000/- towards cost of the proceedings. 

Defence of the opposite parties:

The opposite parties jointly filed version disputing the allegations made in the complaint as wholly false, mischievous and malicious and not maintainable either in law or on facts.  It is submitted by them that it is a multi-specialty medical service provider across the spectrum of medical and healthcare services. It is submitted that the 1st opposite party is a highly repudiated doctor who had done his fellowship in the field of Diabetes at USA and has worked in various medical institutions. 

It is summarized by the opposite party the facts as follows; On 06.05.2018 the complainant was called over phone with complaints of abdominal pain, Dyspepsia and Loss of appetite and the Doctor advised her over the phone that if it was an emergency to immediately admit herself in the hospital and that the complainant agreed for the same.  On 07.05.2018 the complainant got herself admitted in the hospital.  The Doctor along with the ward nurse visited her and heard her complaints about her illness.  As it was a known case of diabetes and hypertension for 6-7 years with the ward nurse by his side the Doctor examined the with due respect  in view of her age, gender and medical status as per protocol and medical ethics. On evaluating the Patient’s illness the Doctor gave a provisional diagnosis as Acid Peptic Disorder (APD).  To rule out pancreatitis and pelvic inflammatory/infective disease, the Doctor obtained medical Gastroenterologist Dr.Muthukumars’s opinion and being a female patient, Gynecologist Dr.Survana’s opinion was sought for.  The initial set of investigations at the time of admission revealed Leukucytisis and Hyperglycemia (high blood sugar).  Patient was appropriately managed with IV fluids as she had been dehydrated due to hyperglycemia and provided injection PPI and insulin in view of high blood sugar.  The patient was given appropriate antibiotics as there was sign of infections (sepsis). On 08.05.2018 patient was adamant and refused to undergo upper GI endoscopy as per Gastroenterologist’s advice.  The patient was highly uncooperative, impatient and was insisting to get discharged from the day of her admission at the hospital.  The doctor with great difficulty performed CECT abdomen which revealed early pancreatitis. On 10.05.2018 the patient forced the medical team to discharge her from the hospital without completing the investigations and treatment.  After obtaining consent from the patient’s husband for discharge at request, the patient was discharged.  Further submitted that the urine sample of the patient collected on 07.05.2018  at 8.42 am the same was received by lab on 07.05.2018 at 9.48 am and room report was given immediately and the patient was given medicine through IV line only as per the Doctor’s instructions.  It is denied that the doctors advised her to stay in the hospital for 10 days.  The doctor suggested that the patient might need a few days of admission for diagnosis and treatment.  Doctor never specified the number of days of stay in hospital as alleged by the complainant. The allegation that after the ward nurse took blood sample on 08.05.2018, blood was oozing out from her right hand at the needle point and that the bed sheet of her bed had to be changed is false as there was no bleeding from IV line or no blood ooze from right hand at needle point.  The allegation that after the nurse injected insulin the complainant became unconscious is denied as the blood sugar of the patient never went below 54 mg/dl (as per guidelines less than 54 mg/dl is defined as hypoglycemia).  There was no record of hypoglycemia documented in the case sheet of the complainant.  The doctor who is 49 years old with 25 years of experience in the field of medicine, as doctor with years of experience understands a patient’s agony during their illness. It is submitted that the patient was agitated, aggressive in nature and uncooperative.  The doctor after advising her, did console her with compassion and utmost care by having a ward nurse and medical officer next to him. The complainant misunderstood the act of the doctor tapping her shoulder and verbally abused the entire medical team.  This was a surprise and shock for the medical team to learn from a senior citizen like the complainant to consider the act/gesture of kindness as misbehavior.  The medicine was given for doing contrast enhanced CT abdomen which is required investigation for pancreatitis and it is used universally and the allegation that the syrup-medicine is fatal for children, pregnant women and elder is baseless, frivolous and untenable.  On 21.05.2018 the complainant submitted a complaint letter to the Director of Medical Services, Apollo and an enquiry was conducted.  The doctor and the ward nurse submitted their version and enquiry was closed that the allegations against the doctor were denied and unjustifiable and the same was intimated to the complainant.  It is submitted that as per protocol for acute abdominal pain, active line of treatment was started by the opposite parties.  The patient was given inj.Neksium as she was having a component of Acid Peptic Disorder and the complainant was frustrated that her medical insurance got rejected as per IRD Rules and Regulations. It is submitted that during the admission at the hospital patient was agitated and aggressive in nature.  She was uncooperative and was not willing to follow any of the doctor’s advices.  She refused to undergo Upper GI Endoscope as advised by Medial Gastroenterologist.  With great difficulty, the 1st opposite party was able to perform CECT abdomen and she was diagnosed to have early pancreatitis substantiated with mild elevation of lipase in the blood test.  The patient was constantly monitored by the 2nd opposite party hospital’s staff with utmost care under the advice of the 1t opposite party.  Though the patient was agitated and aggressive, the doctor and the hospital staffs were courteous, polite and compassionate considering her age and her ailment.  The complainant alleges “inefficiently, deficiency in service, negligence, unethical and unfair“ on part of the opposite party without any basis and purely on her own assumption.  The complainant has based her entire case on irrelevant, incomplete documentation, false hood and alleged facts contrary to the medical records on a wrong presumption of medical fact.  There is not even a causal link between the alleged negligence and the treatment rendered by the opposite parties to the metal agony suffered by the complainant.  The complainant has filed this complaint for the sole propose of harassing these opposite parties with a view to extract money from them.  This opposite parties in fact did everything to render the best treatment to the complainant and the 1st opposite party acted in a deligent manner exercising care and skill of any other competent qualified medical professional would have done in the same situation. The claims such as the complainant’s merely to harass the dedicated and diligent professionals such as the opposite parties them through immense hardship and mental agony.  Courts have held that for such vexatious complaint parties are entitled to be compensated.  In fact for the harassment meted out to the opposite parties it is most respectfully prayed that this commission may be pleased to dismiss the complainant with exemplary cost.

On the side of complainant proof affidavit was filed and documents Ex.A1 to Ex.13 were marked.  On the side of opposite parties proof affidavit was filed and documents Ex.B1 to Ex.B19 were marked.

 Point for consideration:

Whether the allegation of medical negligence as alleged to have committed by the opposite parties resulting in deficiency in service has been successfully proved by the complainant?

  If so to what relief the complainant is entitled?

Point:1

On the side of complainant the following documents were filed for complaint allegations;

Bio Chemistry Report dated 07.05.2018 was marked as Ex.A1;

Microbiology Report dated 08.05.2018 was marked as Ex.A2;

X-Ray Report dated 08.05.2018 was marked as Ex.A3;

Ultra sound Report dated 08.05.2018 was marked as Ex.A4;

CT Scan Report dated 09.05.2018 was marked as Ex.A5;

 CT Scan Report (Oral Contrast) dated 09.05.2018 was marked as Ex.A6;

Final interim Bill dated 10.05.2018 was marked as Ex.A7;

Discharge summary issued by the opposite parties dated 10.05.2018 was marked as Ex.A8;

Certificate issued by the 1st opposite party dated 10.05.2018 was marked as Ex.A9;

Rejection of Insurance claim of the complainant dated 16.05.2018 was marked as Ex.A10;

Letter written by the complainant to the Director of Medical Service, Apollo Hospital dated 21.05.2018 was marked as Ex.A11;

Letter written by the complainant dated 25.05.2018 was marked as Ex.A12;

Reply by the 2nd opposite party to the complainant dated 29.05.2018 was marked as Ex.A13;

On the side of opposite parties the following documents were filed for their contentions;

Accreditation Certificate dated 20.12.2014 was marked as Ex.B1;

  B) Medical Registration Certificates and Curriculum Vitae of the 1st opposite party dated 10.03.1993was marked as Ex.B2;

c) Admission slip and Admission form dated 07.05.2018 was marked as Ex.B3;

d) General Consent Form was marked as Ex.B4;

e)  Medical Literature of Peptic Ulcer and Related Disorders-19th Edition- 

Harrison’s Manual of Medicine was marked as Ex.B5;

f) Opinion of Gastroenterologist Dr.Muthukumaran dated 07.05.2018 was marked as Ex.B6;

 g) Opinion of Gynecologist Dr.Survana dated 08.05.2018 was marked as Ex.B7;

h) Patient’s Investigation Chart dated 07.05.2018 was marked as Ex.B8;

i) Patient’s Diet & Drug Chart dated 07.05.2018 was marked as Ex.B9;

j) Patient’s CECT abdomen report dated 09.05.2018 was marked as Ex.B10;

k) Consent for discharge at request dated 10.05.2018 was marked as Ex.A11;

l) Discharge summary dated 10.05.2018 was marked as Ex.A12;

m) Doctor instruction sheet dated 07.05.2018 was marked as Ex.B13;

n) Urine Report dated 07.05.2018 was marked as Ex.B14;

o) Progress Report dated 07.05.2018 was marked as ExB15;

p) Medical Literature of Hypglycemia- American Diabetes Association issues Hypoglycemia Position Statement was marked as Ex.B16;

q) Patient’s Case Sheet dated 07.05.2018 was marked as Ex.B17;

r) Patient’s Diabetic Chart dated 07.05.2018 was marked as Ex.B18;

s) Medical Literature; Medical Literature of Ultravist (the contrast that is used universally for performing contrast enhanced CT abdomen) was marked as ExB19;

The written arguments was filed by both the parties and the counsel for the complainant represented that written arguments may be treated as oral arguments and as the opposite parties continuously failed to appear before this Commission for their oral arguments, hence this Commission decided to consider the written arguments filed by them as oral arguments to decide the complaint on merits.  

The crux of the written arguments filed by the counsel for the complainant is that the opposite parties admitted the complainant as inpatient for the treatment of E.coli (Urinary inflection and fever) and the complainant alleged that in total the opposite parties acted only to extract money from the complainant and had not treated the complainant as per the standard medical treatment.  The insurance claim was denied on the basis that the treatment was in active treatment and the complainant was made to pay a sum of Rs.73,848/- towards hospital bills and Rs.50,000/- towards incidental expenses from home to hospital.  Thus contending that the opposite parties committed deficiency in service on identifying the main cause of illness sought for the complaint to be allowed.  

As per the written arguments filed by the opposite parties the complaint allegations were disputed contending that the complainant who called over phone to the 1st opposite party on reference made by Dr. M.K.Sudhakar got admitted in the emergency ward as she made complaints of abdominal pain, Dyspepsia and Loss of appetite.  On evaluating the patient’s illness, the doctor gave a provisional diagnosis as Acid Peptic is order (APD) and to rule out pancreatitis and pelvic inflammatory/infective disease, the doctor obtained medical Gastroenterologist Dr.Muthukumaran’s opinion and being a female patient, Gynecologist Dr.Survana’s opinion was sought. The initial set of investigation at the time of admission revealed Leukocytosis and Hyperglycemia and the patient was managed appropriately with IV fluids. The patient was given antibiotics as there was sign of infection.  The patient was highly uncooperative impatient and was insisting to get discharged from the day of her admission at the hospital.  The doctor with great difficulty performed CECT abdomen which revealed early pancreatitis. The 1st opposite party tried to console the patient and gently gave a pat on her shoulder to make her feel better and there was a ward nurse with them, but the patient misunderstood his gesture and started shouting. On 10.05.2018 she got discharged on request.  Thus the opposite parties denied all the allegations made by the complainant.

To avoid repetition we are discussing only the essential points that are necessary to determine the real issue as to whether the opposite parties had committed medical negligence or not. It is submitted by the complainant that she was made to get admitted without any purpose to earn money by the Doctors from the hospital.  But actually it is admitted by both the parties that the complainant approached the 1st opposite party on reference by her physician Dr.M.K.Sudhakar and got admitted in the opposite party‘s hospital.  Also  it is admitted by the opposite party that she got admitted for abdominal pain, Dyspepsia and Loss of appetite.  The admission slip and the general consent form (Ex.B3 & Ex.B4) proved that the complainant got admitted on her own interest.  Further the document Ex.B6 and Ex.B7 shows that the complainant was examined by Gastroenterologist and Gynecologist for her aliment. Further, the investigation chart was also produced as Ex.B8.  The patient’s Diet& Drug chart (Ex.B9) shows that the patient has been administered medicines for her ailment.  It is seen that CT scan of whole abdomen was done and the report was filed.  further Ex.B11 shows that the husband of the complainant had given consent for discharge of the patient.  Ex.B14 and Ex.B15 also gives about the test taken by the complainant.  The patient case sheet was produced as Ex.B16. On over all perusal of all the documents produced by the both parties we could see that on admission by the complainant with the opposite party hospital necessary investigation and treatment was given to her and we are unable to find any unfair trade practice in admitting the complainant by the opposite parties and retaining her in the hospital.  The allegation of the complainant that the 1st opposite party misbehaved with her was duly disproved by the opposite party contending that on complaint given by the complainant an enquiry was conducted and it was also found that the allegation was false and the complint was closed.  Hence, we have to conclude that the opposite parties had exercised due care and skill as they are expected to exercise and that they have not deviated from the accepted practice/procedure  for the ailment of the complainant.  It is also seen that the complainant has not specified the any particular negligence against the opposite parties and the damage caused to the complainant out of negligence act by the opposite parties.  In such a situation, we could not hold out any negligence or damage caused to the complainant. Thus this Commission has no other option but to conclude that the complainant has miserably failed to prove that the opposite parties had committed medical negligence  resulting in deficiency in service.  Thus we answer the point accordingly.

Point No.2:

As we have arrived at a conclusion that no negligence and deficiency in service was proved by the complainant against the opposite parties, we answer this proing as the complainant not entitled to any relief. 

In the result the complaint is dismissed.  No order as to cost.  

Dictated by the President to the steno-typist, transcribed and computerized by him, corrected by the President and pronounced by us in the open Commission on this the 29th day of July 2022.

    -Sd-                                                    -Sd-                                                       -Sd-

MEMBER-II                                    MEMBER -I                                            PRESIDENT

 

List of document filed by the complainant:-

 

Ex.A1 07.05.2018 Bio Chemistry Report. Xerox

Ex.A2 08.05.2018 Microbology Report. Xerox

Ex.A3 08.05.2018 X-Ray Report. Xerox

Ex.A4 08.05.2018 Ultra sound Report. Xerox

Ex.A5 09.05.2018 CT Scan Report. Xerox

Ex.A6 09.05.2018 CT Scan Report (Oral Contrast). Xerox

Ex.A7 10.05.2018 Final Interim Bill. Xerox

Ex.A8 10.05.2018 Discharge Summary. Xerox

Ex.A9 10.05.2018 Certificate issued by the 1st opposite party. Xerox

Ex.A10 16.05.2018 Rejection of Insurance claim of the complainant. Xerox

Ex.A11 21.05.2018 Letter by the complainant. Xerox

Ex.A12 25.05.2018 Mail by the complainant. Xerox

Ex.A13 29.05.2018 Reply by the 2nd opposite party. Xerox

 

Document filed by the opposite parties:

 

Ex.B1 20.12.2014 JCI Accrediation Certificate. Xerox

Ex.B2 ............... Medical Registration Certificates and Curriclum Vitae of the 1st opposite party. Xerox

Ex.B3 07.05.2018 Admission slip & Admission Form. Xerox

Ex.B4 07.05.2018 General Consent Form. Xerox

Ex.B5 ............... Medical Literature of Peptic Ulcer and Related Disorders -19th Edition-Harrison’s Manual of Medicine. Xerox

Ex.B6 07.05.2018 Opinion of Gastroenterologist. Xerox

Ex.B7 08.05.2018 Opinion of Gyecologist. Xerox

Ex.B8 07.05.2018 Patient’s Investigation Chart. Xerox

Ex.B9 07.05.2018 - 09.05.18 Patient’s Diet & Drug Chart. Xerox

Ex.B10 09.05.2018 Patient’s CECT abdomen report. Xerox

Ex.B11 09.05.2018 Consent for Discharge at Request. Xerox

Ex.B12 10.05.2018 Discharge Summary. Xerox

Ex.B13 07.05.2018 – 09.05.18 Doctor Instruction Sheet. Xerox

Ex.B14 07.05.2018 Urine Report. Xerox

Ex.B15 07.05.2018 – 09.05.18 Progress Report. Xerox

Ex.B16 22.11.2016 Medical Ligerature of Hypoglycemia-Amercian Diabetes Association Issues Hypoglycemia position Statement. Xerox

Ex.B17 07.05.2018-09.05.18 Patient’s case sheet. Xerox

Ex.B18 07.05.2018-09.05.18 Patient’s Diabetic Chart. Xerox

Ex.B19 ............ Medical Literature of Ulravist Xerox

 

      -Sd-                                                       -Sd-                                                   -Sd-

MEMBER-II                                          MEMBER-I                                       PRESIDENT