IN THE CONSUMER DISPUTES REDRESSAL FORUM, KOTTAYAM
Dated this the 31st day of May, 2018
Present: Sri. P.SatheeshChandran Nair, President (I/c)
Sri. K.N. Radhakrishnan, Member
Smt..Renu.P.Gopalan, Member
CC No. 35/2017(Filed on 08/02/17)
Between:
Beenamol.K.N
W/o Sathoshkumar
Narimattathil House,
Thrickothamangalam PO
Vakathanamvillage .
(By Adv. N. Sankar Ram) …..Complainant
And:
D.C.H. clinical & Pathological Laboratory
(District Co-Operative Hospital Society Ltd
No.K.764) Medical College Campus,
Gandhinagar, Kottayam686 008 Represented
by its Secretary.
(By Adv. R. Vikraman Nair) …..Opposite parties
O R D E R
Sri. K.N. Radhakrishnan, (Member)
The case of the complainant as follows. She was a pregnant woman and undergoing periodical consultation in the Department of Obsteritics & Gynacology, Government Medical College, Kottayam. As prescribed by the doctor, the complainant gave her urine sample at the laboratory of opposite party on 3-1-2017 as per bill No.59411 for examination including VDRL(venereal disease test). The complainant paid Rs.745/- for the entire tests. As per the result (No.58912) issued by the opposite party VDRL(card test) was ‘weakly reactive’. The remark in the result was ‘VDRL CARD test positive, please confirm with TPHA’. So both the complainant and her husband Sri. Santhoshkumar were advised to conduct TPHA test and samples were collected by opposite parties from both of them on 7-1-2017 and issued test reports on 8-1-2017. As per reports TPHA was found ‘reactive’ for the petitioner, where it was found ‘ non reactive’ for her husband. According to the doctors such a situation is possible only when the complainant is having sexual relationship with somebody, other than the husband. Doctors advised the petitioner and her husband to undergo lab examination again at the Laboratory of Medical College Hospital and urine samples of both of them were collected and examined in the medical college hospital and for both of them VDRL test was found on-reactive and TPHA found negative. In order to confirm it the complainant and her husband conducted the same test at DDRC Laboratory, Gandhinagar and the result was the same.
The wrong result, suggesting sexually transitted disease for the petitioner, who is a married woman and pregnant too, which resulted in suspicion and further laboratory test for her and her husband and repeated wrong results resulted in creating mental stress, agony etc to the complainant, her husband and the close relatives of their families. So there is deficiency of service on the part of the opposite party. Opposite party is liable to pay compensation to the complainant. Hence this complaint.
The notice was served with the opposite party. They appeared and filed their version contending as follows. The complaint is not maintainable either in law or on facts. As prescribed by the doctor the complainant gave her urine sample at the laboratory of the opposite party on 3-1-2017 for examination including VD test and as per the result issued by the opposite party VDRL result was ‘weakly reactive’ and that for confirmation the petitioner and her husband were advised to conduct TPHA test and samples were collected by the opposite party from both of them and issued test report, and as per the report TPHA was found “reactive”, for the petitioner but it was negative for her husband is not correct. The complainant has given urine sample and blood sample at the laboratory for conducting test for the urine Albumin, Urine sugar and urine puscells. Urine microscopic examination were conducted in urine sample where as the alleged TPHA and VDRL were conducted in serum only(serum is a fluid obtained after the blood clot formed). But the averment that according to the doctor’s such situation is possible only when the complainant is having sexual relationship with somebody other than the husband is not correct. Usually no doctor will make such an opinion since the doctor will aware that there are chances of biological false positive reaction in most of thee immunological test including TPHA (Try PonemaPallidumHaeme Agglutination) test. The TPHA test is only a primary conformation test when VDRL test for syphilis is positive. False positive reaction in immunological reaction can be due to physiological, or due to infections like infections mononuclieosis connective tissue damages, auto immune disease leprosy etc. It is a well established fact that when antigen enters into the body the body will react to eliminate the same. When any foreign body enters into the body our immune system begins to react against it and it will start producing antibodies against, the particular antigen. But there are certain antigen which may resembles the antigenic properties of certain other antigen. Such antigen may react with these antibodies and may produce biological false positive reactions. The result we got in this case may be due to this type of biological false positive reactions. Moreover a positive reaction in TPHA test at a lower range can be due to treponiman infection or may be due to biological false positive reaction. Biological false positive reaction in TPHA may be due to the heterphile antigens in infections mononucless, Auto immune disease etc. According to one of the authentic text ‘practical medical biology’ written by Mackie and marcartney, the TPHA test is the 1st of the specific tests suitable for routine screeing for syphilis. Hence it is only a first line specific test for screening the patient for syphilis. The above said test also says that occasional false positive hemagglutination may result from Heterophile antibody in the serum of patients with infections mononucleosis it means that there are chances of getting a positive in TPHA result in person who is not suffering from syphilis. The above text is also states that the diagnosis of syphilis never be made from the result of a single blood specimen. It clearly indicates that the positive result at lower titer in the 1st line specific test is not conclusive to diagnosis syphilis. It is a general practice that when such a result at lower titer are seen, the patient should be tested for the higher level tests or repeat the same test after a particular period so as to see whether there is rise in titer or decrease case in titer. If there is increase in titer the doctor may diagnose syphilis, is the result is clinically correlating with symptoms. The general practice of repeating the test is to exclude the biological false positive reactions. Due to the above reasons there is no possibility of making such an opinion. This type of mistakes are usually caused due to certain reasons already stated and beyond the control of the scientist. That is why the doctor is advice the patient to conduct repeated test for excluding the biological false positive reactions. There was no deficiency in service from the side of the opposite party. Hence this complaint may be dismissed with costs.
The complainant filed proof affidavit and documents which are marked as Exhibits A1 to A5. One witness from the side of the opposite party was examined as DW1. Heard both sides. Both sides filed argument notes. We have gone through the complaint, version, documents and evidence of both sides.
Points for consideration:
- Whether there is any deficiency in service from the side of the opposite party?
- Reliefs and costs?
Point No.1and 2
In the interest of justice we considered Points No.1 and 2 jointly. The case of the complainant is that the test(Venereal disease test VDRL) result obtained from the opposite party was ‘weakly reactive’ and there was a remark ‘VDRL CARD test positive, please confirm with TPHA’. Both the complainant and her husband were subjected to further tests and after testing the samples, opposite party again issued reports. As per the reports TPHA was found ‘reactive’ for the complainant and it was ‘non-reactive’ for her husband. It means the complainant is suffering from sexually transmitted disease and her husband has got no such disease. On advise from the Doctor complainant and her husband were again subjected to laboratory tests in Medical College Hospital, Laboratory VDRL test was found non-reactive and TPHA was found negative which means there is mistake in the test result issued by the opposite party.
The opposite party had taken a contention that there was possibility of biological false positive reactions and the circumstances leading to such situations were also quoted. According to the opposite party such type of mistakes are usually caused due to certain reasons beyond the control of scientists. The opposite party also rules out the possibility of causing mental stress and agony also. One witness was examined from the side of opposite party. The said witness was examined as an expert in the matter. He tried to establish that the errors such as in the present case are due to biological false positive reactions. From Exts.A2 followed by A4 results suggest that the complainant was suffering from Venereal diseases and her husband was not having any such disease. From A2 the laboratory test repot dtd 3/7/2012 issued by the opposite party there is a remark “VDRL CARD’ test positive, please confirm with THPA. Thus the 2nd test is the confirmation in this regard and can be treated as conclusive. Thus the admitted error can be treated as deficiency in service on the part of the opposite party. The specific case of the opposite party is that the result got in this case may be due to this type of biological false positive reactions. Moreover a positive reaction in TPHA test at a lower range can be due totreponiman infection or may be due to biological false positive reaction. Biological false positive reactions are reaction in TPHA may be due to the heterphile antigens in infections mononucless auto immune diseases etc. According to one of the authentic text “Practical Medical Biology” written by Mackie and Marcartney, the TPHA test is the 1st of the specific tests suitable for routine screening for syphilis. Hence it is only a 1st line specific test for screening the patient for syphilis. The above text also says that occasional false positive Hemagglutination may result from Heterophile antibody in the serum of patients with infections mononucleosis it means that there are chances of getting a positive in TPHA result in person who is not suffering from syphilis. The above text is also states that the diagonosis of syphilis never be made from the result of single blood specimen. It clearly indicates that the positive result at lower titer in the 1st line specific test is not conclusive to diagonosie syphilis. It is a general practice that when such a result at lower titer are seen, the patient should be tested for the higher level tests or repeat the same test after a particular period so as to see whether there is a rise in titer or decrease case in titer. If there is increase in titer the doctor may diagnose syphilis, as the result is clinically correlating with symptoms. The general practice of repeating the test is to exclude the biological false positive reactions. From the available documents and evidences of this case, it can be seen that the test reports from the opposite party was a mistake caused due to certain reasons already stated and beyond the control of the scientist. At this juncture it is important to see that in A2 report there is a remark “VDRL Card” test positive, please confirm with TPHA. Thus the 2nd test is the confirmation in this regard and can be treated as conclusive. Thus the admitted error can be treated as deficiency in service on the part of opposite party. We do admit that the test conducted by the complainant at opposite party’s laboratory is not a conclusive test. At the same time it is noted that the complainant tested her serum in two other laboratories medical college laboratory and another laboratory. All that laboratories found that the complainant was not having any venereal disease. Therefore it is to be attributed that negligence or latches happened while testing her serum at opposite party’s laboratory. The latches or negligence happened on the part of the opposite party’s laboratory is not justifiable and we found that opposite party committed deficiency in service against the complainant.. Hence the Point No.1 is found in favour of the complainant. The complainant had some inconveniences due to the act of the opposite party in issuing the test report. Point No.2 is also found in favour of the complainant as follows.
In the result we pass the following orders.
We direct the opposite party to pay Rs.25,000/-(Rupees Twenty five thousand) as compensation and pay Rs.5000/-(Rupees Five thousand) as cost of these proceedings to the complainant.
The Order shall be complied with within a period of one month from the date of receipt of a copy of this order. The order not complied within one month the amount shall be carried on interest @ 10% per annum from the date of order till payment.
Pronounced in the Open Forum on this the 31st day of May, 2018.
Sd/- Sri. K.N. Radhakrishnan, Member
Sri. P.SatheeshChandran Nair, President (I/c) Sd/-
Smt..Renu.P.Gopalan, Member Sd/-
Appendix
Exhibits marked on the side of the complainant
A1-Series of Out Patient Ticket dtd 20/12/16
A2- Laboratory Test Report dtd 3/1/17
A3-Series of bills dtd 7/1/17
A4-Laboratory test report dtd 8/1/17
A5-Series of Common Requisition Form dtd 12/1/17
Witness examined on the side of the opposite parties
DW1-Monu.S
Copy to:
1)Beenamol.K.N
W/o Sathoshkumar
Narimattathil House,
Thrickothamangalam PO
Vakathanamvillage
2) D.C.H. clinical & Pathological Laboratory
(District Co-Operative Hospital Society Ltd
No.K.764) Medical College Campus,
Gandhinagar, Kottayam686 008 Represented
by its Secretary
3)Stock file
By Order
Senior Superintendent
