BEFORE THE A.P.STATE CONSUMER DISPUTES REDRESSAL COMMISSION :HYDERABAD
F.A.No.558/2007 against C.C.No.216/2005, Dist.Forum,West Godavari: Eluru.
Between:
Sri Akkisetti Sai Kumar,
S/o.Late Venkata Ramana,
Age:50 years, Occ:Cultivation ,
R/o.26th Ward Bhagyalakshmipet,
Tadepalligudem,
West Godavari District. … Appellant
Complainant/
And
1.Dr.K.Sankara Rao, S/o.not known,
Age:Not known, Occ:Doctor,
C/o.Baby’s Civil Surgeon, Consultant,
Paediatrician, Church Road,
Tadepalligudem.
2.The Secretary , Indian Medical Association,
A.P.State Professional Protection
and Welfare Scheme. … Respondents/
Opp.parties
Counsel for the Appellant : M/s.N.V.Anantha Krishna
Counsel for the Respondent : M/s.V.Sankara Rao
CORAM: SMT. M.SHREESHA, HON’BLE MEMBER,
AND
SRI K.SATYANAND, HON’BLE MEMBER.
THURSDAY, THE FOURTH DAY FEBRUARY
TWO THOUSAND TEN.
Oral Order (Per Smt M.Shreesha, Hon’ble Member)
****
Aggrieved by the order in C.C.No.216/2005 on the file of District Forum,West Godavari, Eluru, the complainant preferred this appeal.
The brief facts as set out in the complaint are that the complainant admitted his only son in the clinic of opposite party no.1 at 4 a.m. on 2.10.2004 with a complaint of fever and vomiting and the opposite party no.1 on seeing the child directed the complainant to obtain blood test, X-ray of the boy at Srinivasa Diagnostic Centre and without even observing the reports, the opposite party directed his night attender to give Flagyi and Ci-Tri injections and diagnosed the pain as appendicitis and advised the complainant to admit the boy as inpatient. Within an hour of administering the said injection, the boy complained severe breathing problem and the same was informed to the opposite party no.1 but he did not care about it and at about 8.30 a.m. on 2.10.2004 the opposite party no.1 asked the complainant to get the scanning done to conduct the operation. When the complainant came back to the clinic with the reports, the doctor left for Tadepalligudem and at about 11 a.m. the complainant went to Area Hospital to inform about the scanning report and opposite party no.1 saw the report only at 3 p.m. and directed the complainant to take the patient to Tadepalligudem for a second opinion. When the complainant took the patient for second opinion he was informed by that doctor that the child was very serious and to take back to the earlier doctor i.e. opposite party no.1. The opposite party no.1 stated that it was not appendicitis but pancreatitis and asked the complainant to admit the boy into Abhaya Emergency Hospital, Rajahmundry. Since the boy’s condition was fast deteriorating, from the outskirts of the Tadepalligudem the complainant returned to opposite party no.1 clinic and the opposite party no.1 declared the boy as dead. The complainant submits that only because of the negligence of opposite party, the boy died and seeks direction to the opposite party no.1 to pay Rs.15 lakhs towards compensation together with interest and costs.
The opposite party no.1 filed his version stating that after examining the boy he advised the complainant to get the blood report and X ray and after examining the reports he came to the conclusion that the patient was suffering from acute pancreatitis. The opposite party stated that the boy was examined by Dr.Jayaprakash Reddy at 11.15 a.m. and at 2 a.m. the patient had vomiting and complained increased pain in the abdomen then this opposite party referred the patient to the General surgeon Dr.K.Satyanarayana after administering Buscopan 1 amp. and phenergan 1CC injectins. The said Dr.Satyananaryana after examining the patient advised the opposite party to continue the treatment and at about 3.50 p.m. the opposite party no.1 advised the complainant to shift the boy to emergency hospital for cardio respiratory support and expert line of treatment. He arranged an ambulance and his staff Mr.Vijay accompanied the patient along with oxygen and IV fluids. The patient left from his clinic at 5.15 p.m. and thereafter he was informed that the patient died during travel to Rajahmundry. The opposite party no.1 contends that after 23 days of death of the complainant’s son, the complainant sent a petition to the police and that there is no negligence on his behalf .
The opposite party no.2 filed version stating that the opposite party no.1 given the treatment on standard lines and there is no negligence on the part of the opposite party no.1 according to the enquiry report submitted by Dr.Ravi Kumar,V.V.M.S.(Genl.), Rajahmundry.
The District Forum based on the evidence adduced i.e. Exs.A1 to A16 and B1 to B23 and PW.1 to PW.5 on behalf of the complainant and RW.1 to RW.5 on behalf of the opposite party dismissed the complaint.
Aggrieved by the said order the complainant preferred this appeal.
The facts not in dispute are that the complainant approached the opposite party no.1 on 2.10.2004 at 4 a.m. for treatment of his only son, an young boy of 13 years old, studying 9th class with a complaint of fever and vomiting. It is the complainant’s case that they were made to wait for an hour and an X-ray was advised along with blood test and without waiting for the reports the doctor directed his night attender to give the Flagyi and Ci-Tri injections. The complainant submits that the opposite party no.1 doctor did not spend any time with the boy inspite of the child being admitted as an inpatient and having diagnosed the pain as appendicitis. Within an hour of administering the injections the patient complained of severe breathing problem and was gasping for breathing and at about 8.30 a.m. on 2.10.2004 the opposite party no.1 doctor advised the patient to get the scanning done and the complainant immediately got it done and came to the clinic at 10.30 a.m. to appraise the doctor, but the doctor immediately left to Tadepalligudem and returned only at 3 p.m. by which time the complainant’s condition deteriorated and he asked the complainant to take the boy to Dr.K.Satyanarayana, Tadepalligudem and this doctor opined that the boy was in serious condition and asked him to take back the patient to opposite party no.1 clinic and at that point of time the opposite party no.1 stated that it is not appendicitis but pancreatitis and advised the complainant to get the patient admitted in Abhaya Emergency Hospital, Rajahmundry. It is the complainant’s case that opposite party no.1 did not care to arrange the oxygen cylinder to the patient but by the time they reached the outskirts of Tadepallygudem in their private vehicle the patient was suffering from severe breathing problem hence the complainant immediately returned back to the opposite party no.1 where he declared dead. The learned counsel for the appellant/complainant contended that the respondent/opposite party no.1 did not spell out as to how he arrived at diagnosis of acute pancreatitis and even if the diagnosis by him is true the treatment was not done for acute pancreatitis and opposite party no.1 did not even refer the patient to Gastroenterologist and contended that expert opinion Ex.B6 of Dr.Vittal cannot be considered since he is only a pediatrician and not the gastroenterologist and further contends that the case sheet and other papers filed by the respondent/opp.party no.1 have fabricated for the purpose of this case.
Opposite party no.1 filed affidavit denying the contentions of the complainant and submits that he carried out G.I.Track examination and noted down the same in the case sheet and diagnosed the disease as acute pancreatitis and immediately advised the complainant to get the blood examination done and also plain X-ray of the abdomen and chest. The respondent/opp.party no.1 submits in his affidavit that Dr.Jayaprakash Reddy, MD. , physician examined the patient at 11.15 a.m. on the same day i.e. 2.10.2004 and at 12.10 p.m. he went through the opinion of the said physician and noted down that I.V. fluids and antibiotics were given and Oxygen inhalation ryle’s tube aspiration at 1 p.m. and the general condition was same i.e. blood urea 30 mg. Serum Creatinine 1.1 mg. and Serum Electrolytes Na 139 Cliride 102, Potassium 4.5 . It was only in the best interest of the patient the Doctor referred the patient to Dr.K.Satyanarayana, Surgeon. At 3.20 p.m. Dr.Surendra Kumar examined the patient and noted that the patient had a history of fever and that the patient is conscious and coherent with the oxygen saturation 95%, lungs clinically clear , no wheeze , no crepitation. At about 3.50 p.m the doctor advised the complainant to shift the patient to the emergency hospital. It is the case of the opposite party that an oxygen cylinder was organized in an ambulance together with compounder to assist the patient but the patient died enroute to Rajahmundry. Ex.A3 is the prescription given by the respondent/opp.party no.1 dt.2.10.2004 for injection C-TRI and injection FIAGIL. Ex.A4 is the Heamotology report showing the blood picture and Ex.A5 is the letter addressed by Dr.K.Sankara Rao who is the respondent/opp.partyno.1 to Dr.K.Satyanarayana stating that the patient is suffering from pancreatitis. Ex.A7 is the scanning report which states that appendix is not visualized and there is calculus of 6 m.m. seen in the pelvis of the right kidney . Ex.B1 is the case sheet maintained by respondent/opp.party in which it is clearly stated that the patient was suffering from fever two days prior to 2.10.2004 and there were 3 vomits and the line of treatment followed by the Doctor including administration of antibiotics from 4.20 a.m. together with I.V. fluids monitoring of B.P. and pulse rate almost every hour. Notes of consultant Dr.Jayaprakash Reddy is also very clear and the line of treatment followed was antibiotics with I.V.Fluids and the diagnosis was confirmed to be acute pancreatitis. The documentary evidence shows that a scan, X-ray and the necessary blood tests were taken. It is the contention of the complainant that without examining the reports the doctor started off the patient with Flagyi and Ci-Tri injections which deteriorated the condition of the patient. We observe from the record that the patient was admitted into respondent/opp.party no.1 clinic in the early hours on 2.10.2004 and immediately he was started off treatment with antibiotics and IV Fluids and as per the medical literature i.e. Harrison’s Principles of Internal Medicines , 14th Edition in volume no.2 page 1744 states that acute pancreatitis is a high risk disease with maximum mortality rate and the best line of treatment for pancreatitis is administration of antibiotics with IV fluids. It is not in dispute that the patient had been admitted in the respondent/opp.party no.1 clinic only in the early hours on 2.10.2004 and died on the same day in the evening hours at around 5.30. In this short duration of time the point which falls for consideration is whether the respondent/opp.party no.1 doctor had administered proper treatment and has taken all precautions as per the standards of medical parlance. Ex.B1 case sheet shows the line of treatment with notes written by Dr.Jayaprakash Reddy MD, consultant physician and also Dr.C.SurendraKumar, Chest physician who both clearly state that the diagnosis is acute pancreatitis and that the line of treatment given is antibiotics with I.V. Fluids. It is only because of the breathlessness developed by the patient that he was advised to shift to Abhaya Emergency Hospital, Rajahmundry at 3.50 p.m. for cardio respiratory support. At 5.15 p.m. in the case sheet it is written that the patient left the clinic, whereas it is the contention of the appellant/complainant that the patient had returned to the clinic and died there. There is no proof to establish the same . Ex.B2 is a medical case sheet which shows the B.P., pulse rate, oxygen saturation and other investigations taken i.e. X-ray and scanning and other reports which show that the doctor has taken all precautionary measures at that point of time for that kind of disease. Ex.B3 is the enquiry report conducted by the enquiry officer i.e. District Coordinator of Hospital Services, Rajahmundry who stated that there is no negligence on behalf of the respondent/opp.party. Ex.B6 is the export opinion of Dr.Vittal Rao, Asst. Prof. of Pediatrics who stated that pancreatitis is a dangerous disease with high mortality rate and that there is no professional negligence or otherwise on behalf of the respondent/opp.party no.1. We observe from the record that the complainant has not taken any steps to file any expert opinion in support of his case that the line of treatment by the opposite party is negligent. We rely on the decision of the Apex Court in Bolam v. Friern Hospital Management Committee, WLR at p.586 it is held as follows:
“Where you get a situation which involves the use of some special skill or competence, then the test as to whether there has been negligence or not is not the test of the man on the top of a Clapham omnibus, because he has not got this special skill. The test is the standard of the ordinary skilled man exercising and professing to have that special skill. A man need not possess the highest expert skill….It is well established law that it is sufficient if he exercises the ordinary skill of an ordinary competent man exercising that particular art”
In INDIAN MEDICAL ASSN. v. V.P.SHANTHA (1995) 6 SCC 651 the court approved a passage from Jackson and Powell on Professional Negligence and held that”
“The approach of the courts is to require that professional
men should possess a certain minimum degree of competence
and that they should exercise reasonable care in the discharge
of their duties. In general, a professional man owns to his client
a duty in tort as well as in contract to exercise reasonable care in giving advise or performing services”.
Supreme Court then opined as under:
“The skill of medical practitioner differs from doctor to doctor. The very nature of the profession is such that there may be more than one course of treatment which may be advisable for treating a patient. Courts would indeed be slow in attributing negligence on the part of a doctor if he has performed his duties to the best of his ability and with due care and caution. Medical opinion may differ with regard to the course of action to be taken by a doctor treating a patient, but as long as a doctor acts in a manner which is acceptable to the medical profession and the court finds that he has attended on the patient with due care, skill and diligence and if the patient still does not survive or suffers a permanent ailment, it would be difficult to hold the doctor to be guilty of negligence”.
The Hon’ble Supreme Court in Achut Rao Haribhau Khodwa Vs. State of Maharashtra and others (1996 CTJ 950 SC (CP) held “For establishing negligence or deficiency in service there must be sufficient evidence that a doctor or hospital has not taken reasonable care while treating the patient. Reasonable care in discharge of duties by the hospital and doctors varies from case to case, and expertise expected on the subject, which a doctor or a hospital has undertaken. Courts would be slow on attributing negligence on the part of the doctor if he has performed his duties to the best of his ability with due care and caution.”
In view of the afore mentioned judgements and the reasoning afore mentioned we are of the considered view that the complainant had failed to prove that there was any negligence in the line of treatment accorded by the respondent/opp.party no.1 and therefore this appeal fails and is accordingly dismissed.
In the result this appeal fails and is accordingly dismissed. No costs.
MEMBER
MEMBER
PM* Dt.4.2.2010
