Date of Institution : 22.03.2022

                                                            Date of final hearing: 13.06.2023

                                                            Date of Pronouncement: 30.06.2023

Case No. 56/2022   

IN THE MATTER OF

Gulveer Singh S/o Rustam Singh aged about 32 years CT/GD ITBP, Ministry of Home Affaairs, Govt.of India, CGO New Delhi 03 R/o Nagla Chand District Hathras

(Through: Advocate Amit Kumar)

                                                     V/s

1. Dheeraj Hospital Maternity and Heart centre Samad Road Near Center Point Aligarh through Dr. Manoj Gupta
2. Dr.Manoj Gupta, Dheeraj Hospital Maternity and Heart centre Samad Road NearCentre Point Market Aligarh.
3. Dr. Mini Gupta, Dheeraj Hospital Maternity and Heart centre Samad Road NearCentre Point Market Aligarh.                                     

(Through: Advocate Ved Prakash Sharma & Rajiv Mohan)

4. The New India Insurance Company Ltd, Address 339 Bombay Bozav Meerut Cantt.

(Through: Advocate Farrukh Saeed)

CORAM

 Present:

1. Shri Hasnain Qureshi, President
2. Shri Alok Upadhyaya, Member
3. Smt. Purnima Singh Rajpoot, Member

PRONOUNCED by Shri Hasnain Qureshi, President

JUDGMENT

1. The present complaint has been filed by the complainant before this commission for  the following reliefs-

1.  The Ops be directed to pay to the complainant the amount Rs.2300000/ with interest 12% as compensation.
2. The Ops be directed to pay Rs. 25000/ as litigation expenses.
3. Any other relief may deem fit be awarded.  

2. (a) Complainant has stated that he is in ITBP Force and is posted in Nathupur District Sonipat Harayana. OP no.2 Dr. Manoj Gupta is a doctor having  degree of MBBS, MD, Diploma in Cardiology. OP no.3 Dr. Mini Gupta is also doctor having degree of MBBS, DGO and PG diploma in ultrasonography. Both the doctors run the hospital OP no.1 in the name and style of Dheeraj Hospital Maternity and heart center. Complainant had come to his village on earned leave on 7.9.2021. He was not feeling comfortable due to severe chest pain, breathlessness and ghabrahat. So he visited on 8.9.2021 Puspanjali Hospital Agra and had undergone treatment there. His echocardiography was performed at Jay Cardio Diagnostic Center Agra same day. On 10.9.2021 the complainant had undergone teartment at K K Intensive Care Hospital, Aligarh and there again echocardiography was performed. On 15.9.2021 complainant visited Dheeraj Hospital (OP no.1). He submitted all the treatment reports in connection of his treatment at Agra and Aligarh’s Hospitals. The Complainant was admitted in Dheeraj Hospital on 15.9.2021 where he was prescribed treatment for chest pain associated with breathlessness and ghabrahat on the basis of the previous treatment papers and was discharged on 16.9.2021.He remained under treatment of the op hospital till 19.11.2021. The complainant was given artery clearance therapy treatment on different dates till 19.11.2021. Complainant remained under treatment at op hospital from 15.9.2021 to 19.11.2021 for artery clearance therapy but he could not get any relief despite  of remaining under treatment for a period more than two months at OP no.1 hospital and his health had gone deterioted. Complainant had joined his duties but he could not discharge  his job properly. The chief Medical Officer ITB Police referred him to specialist for opinion on 23.11.2021. On 16.12.2021 complainant was admitted in Safdarjung Hospital, New Delhi where coronary angiography was performed and it was found as left male artery-50% distal obstruction, left anterior descending artery- 70-90% ostioprox obstruction  mid 90% , left circumflex artery-20-30% ostial  obstruction plaque ramus 70%            and right coronary artery-99% proximal obstruction followed by 100%PDA filling with callatrels from LCA graptable. Complainant was advised for early CABG. On 20.12.2021 complainant was admitted in Metro Hospital and Heart  Institute, Noida under the treatment of Chief consultant Cardiac Surgeon Dr. Jeewan Pillai where coronary angiography and other tests were  conducted which revealed left main with triple vessel disease and he was advised CABG. There CABG *3 was performed and blood was transfused intra operatively. Complainant was discharged on 27.12.2021 in a stable condition OP hospital had started the treatment of complainant on 15.9.2021 by giving artery clearance therapy for severe chest pain and breathlessness for two months. Complainant could not revive his condition during the said period and the Ops doctor could have change the line of treatment having known the fact that there was no improvement in the health of the complainant. The OP doctors did not apply reasonable  degree of skill and knowledge in the treatment of the complainant and are liable for loss and hardhips caused to the complainant. Complainant incurred an amount of 300000/ for consultation, clinical tests, medicine, hospitalization charges, and conveyance and attendant charges. He had also undergone physical mental and economic sufferings and was deprived from enjoying his life during the said period of treatment. He could not discharge his duty and remained on E/L causing economic loss of salary. Such damages are estimated at Rs.200000/.          
3. Ops no 1,2 and 3 have  stated in WS that on 15.9.2021 complainant was admitted in OP no.1 Hospital with the complaint of chest pain and breathlessness. The treatment was started keeping in view the test reports and the report of echocardiography performed at Agra and Aligarh. The Complainant was brought to  notice the ways of treatment and specially the treatment by angioplasty/ bypass surgery. Complainant and his brother Yaga Datt emphasized on artery clearance therapy as informed by some old patient to them. OP no.2 explained in detail about the treatment and made them aware to visit the hospital repeatedly to undergo treatment. The blood pressure of the complainant attained normal condition and the breathlessness also cured under the treatment of Op no.2. On 16.9.2021 the complainant was discharged having recovered his health. The complainant had undergone artery clearance therapy for 2 months and he was given some advice in diet. Complainant and his relative were made aware about the options  and hardship in the treatment and they were ready and signed the papers. The Complainant was admitted in OP no.1 hospital with the consent of complainant and his relatives. Only the OP no.2 provided the treatment to the complainant and OP no.3 did not provide any treatment to the complainant who is a gynecologist. Complainant was discharged from the hospital having fully recovered and he was advised for regular intake of the medicine and to have diet as recommended. Complainant was not given wrong treatment and the allegations made against the doctors are after thought. In case answering Ops are held liable, the insurance company shall be liable for payment of the damages.
4. Op no.4 stated in WS that complainant has no cause of action against the OP no.4 and the complaint is not maintainable. No report of the panel constituted by the CMO was obtained. It is not proved from the record that  there was negligence on the part of the doctors.               
5.  Complainant has filed his affidavit and papers in support of his pleadings. and OP no. 1 has also filed his affidavit and papers in support of its pleadings.
6. We have perused the material available on record and heard the parties counsel.
7. The first question of consideration before us is whether the OP doctor were negligent in providing treatment to the complainant? If so its fact.
8. (a)Complainant was admitted at op no.1 hospital on 15.9.2021 with the complaint of Severe chest pain, breathlessness and ghabrahat where he was given treatment by the doctors having perused the echocardiography report performed at Agra and Aligarh Hospital. Complainant was provided artery clearance therapy and he was discharged on 16.9.2021 with the advice to follow up the prescription. Complainant could not get any relief there  despite of undergoing treatment for a period of more than 2 months. Complainant has joined duty but he could not discharge his duty properly and the CMO ITB Police referred him to the specialist on 23.11.2021 for opinion. On 16.12.2021 coronary angiography was performed at Safdarjung Hospital, New Delhi on the basis of coronary artery profile. He was advised for early CABG on 20.12.2021 complainant was admitted in Metro Hospital and Heart Institute Noida under the treatment of Chief consultant cardiac surgeon. On 21.12.2021. He was taken up for CABG and CABG*3 was performed and was discharged on 27.12.2021 in a stable condition. 

(b)It is evident that the complainant was adviced for CABG on the basis of coronary artery profile which reveals left interior descending artery 70-90% ostioprox obstruction mid 90% and right coronary artery 99% proximal obstruction followed by 100% PDA filling with collaterals from LCA graftable.The complainant was advised for CABG by the specialist cardiac surgeon. It means the complainant was required to undergo CABG at the earliest opportunity when he was admitted in OP no.1 hospital on 15.9.2021 and having undergone treatment there for more than 2 months, the severity of the aliment had increased and on 20.12.2021 the coronary artery profile was too high and he was advised for early CABG.

(c) The Ops used the artery clearance therapy for the treatment of coronary artery disease which could not be proved effective treatment and he was required to be given better treatment of the coronary artery disease on the basis of clinical test like angiogram and on the basis of coronary artery profile, he was advised for early CABG at Safadarjung Hospital, New Delhi. It shows that Op doctors did not apply reasonable degree of skill and knowledge in the treatment of disease as it is common in the field of medical science that the chest pain known as angina is diagnosed by angiogram which is a procedure to look at inside the arteries. It can show whether the plaque is blocking the arteries and how severe the blockages is. Doctors use this procedure to diagnose the heart disease after chest pain.

(d) The OP doctors ought to have taken reasonable care and exercise skill for proper diagnosis of the cause of disease and failure to do so amounts toact below the standard of medical care. So far as the question of providing artery clearance therapy to the complainant as per advice of the complainant and his relatives is concerned, the op doctors were under obligation to make aware the complainant about the consequences of the kind of treatment to cure the coronary artery disease. Complainant can not be said to be the expert in medical science and the OP doctors were the expert in the field to determine the kind of treatment to be given to the complainant considering his health condition and clinical test. Op doctors cannot be escaped from the liability on the pretext of the option of the kind of the treatment to be adopted in consultation with the complainant and his relatives. It was the negligence on the part of the op doctors to apply the kind of treatment as per choice of the complainant. The treatment given to the complainant was not of the standard of reasonable medical care and exercise of the skill by a medical expert. The alleged consent of the complainant and his relatives was purported to be given for the purpose of curing the disease and it was for the doctors to provide the best treatment to achieve the result. The approach of the op doctors in taking decision of the kind of the treatment given to the complainant was not of the standard of reasonable care and skill of an expert. In the case, the principle ofres ipsa loquitor is applicable, meaning thereby the circumstances of the case speak out the negligence on the part of the OP doctors in adopting the line of treatment given to the complainant. Under the circumstance no medical board was required to be constituted for expert opinion. We are of the view that there was negligence on the part of the op no.1 and 2 doctors who run the hospital whereby the complainant suffered not only monetary loss but also physical and mental sufferings.The Ops are jointly and severally liable to pay Rs.300000/ for economic loss and Rs.2000000/ as compensationfor physical and mental sufferings.

9.  The question formulated above is decided accordingly in favour of the complainant.
10. The law laid down in the ruling V. Kishan Rao V/s Nikhil Super Specialty Hospital decided by Hon’ble  Supreme Court on 8.3.2010 is applicable to the present case. It has been held in this ruling that one of the duties of the doctor  towards his patient is a duty of care in deciding  what treatment is to be given and also a duty to take care in the administration of treatment. A breach of  any of those duties may lead to an action for negligence by the patient. In case where negligence is evident, the principle of res ipsa loquitor operates. Ops  have referred to a ruling Smt. Anju Sharma Vs Dr. D. Sinha,2011(3) CPR 2011 (NC) in which it has been held that to hold a medical practitioner negligent, he must be found to have not brought to bear on treatment of his patient the skill and duty of care that an ordinary  physician in revalant branch of medicine would have. Thus the law lid down  in V. Kishan Rao case by Hon’ble Supreme Court is applicable.  
11. We hereby direct  Ops to pay to the complainant  Rs.300000/ for monitory loss and Rs.2000000/ as compensation  for physical and mental sufferings with pendente lite and future interest at the rate 9% per annum within a month. Ops also to pay to the complainant Rs.25000/ as litigation expenses.
12. Ops shall comply with the direction within a month failing which OPs shall be prosecuted for non-compliance in accordance with section 72 of the Act for awarding punishment against him.
13. A copy of this judgment be provided to all the parties as per rule as mandated by Consumer Protection Act, 2019. The judgment be uploaded forthwith on the website of the commission for the perusal of the parties.
14. File be consigned to record room along with a copy of this judgment.