BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, SIRSA.
Consumer Complaint no. 228 of 2013.
Date of Institution : 24.12.2013
Date of Decision : 14.12.2016.
1. Gayatri Nandan (aged about 52 years) son of Sh. Jagdish Sumitar, resident of Begu Road, Grewal Basti, Gali No.1, Sirsa, District Sirsa.
2. Rohit Kumar (aged about 19 years) son of Sh. Gayatri Nandan,
3. Mohit Kumar (aged about 18 years) son of Sh. Gayatri Nandan, all residents of Begu Road, Grewal Basti, Gali No.1, Sirsa, District Sirsa.
……Complainants.
Versus.
1. Dr. Yogesh Sangwan, Prop. of Sangwan Hospital, Sirsa.
2. Dr. Arjun Tungaria (M.Ch), Sangwan Hospital, Sirsa, C/o Astha Neuro Care and Multispecialty Hospital, Dabwali Road, Sirsa.
3. United India Assurance Company Limited, Office No.7, GF, 150 BBC Complex, Kilokri Ring Road, Opp. Maharani Bagh, New Delhi- through its Manager insurer of the professional indemnity of respondent no.2 vide policy No.041281/46/12/35/00001188 w.e.f. 06.02.2013 to 05.02.2014.
...…Opposite parties.
Complaint under Section 12 of the Consumer Protection Act,1986.
Before: SH.S.B.LOHIA………………. ……PRESIDENT.
SHRI RANBIR SINGH PANGHAL ……… MEMBER.
Present: Sh. Manminder Singh, Advocate for the complainant.
Sh. Ravinder Monga, Advocate for opposite party no.1.
Sh.A.K.Gupta, Advocate for opposite party no.2.
Sh. R.K. Chaudhary, Advocate for opposite party no.3.
ORDER
The present complaint has been filed by complainants seeking compensation of Rs.10,00,000/- from the opposite parties on account of death of Smt. Raj Rani wife of complainant no.1 and mother of complainants No.2 & 3.
2. In brief, the case of the complainants is that Smt. Raj Rani was enjoying good health till 1.7.2013 when she suffered from a slight temperature and on 3.7.2013 she felt slight headache, so complainant no.1 took her to Dr. Chetal in Janta Hospital, Sirsa. After examination, Dr. Chetal referred her to Sarsa Imaging Centre for CECT head. Dr. A.R. Godara, M.D. (Radio diagnosis) conducted CECT head and as per his report, CECT head finding is well defined lesion in the right frontal region with mass effect as described in the report Meningeal enhancement. Possibility are evolving abscess (Tuberculoma) with meningitis? Neoplastic Lesion. Dr. A.R. Godara also advised CSF examination and contrast MRI and the report was given to Dr. Chetal who examined the report and referred Raj Rani to Sangwan Hospital, Sirsa on 3.7.2013 for further treatment where she was admitted at about 2.30 p.m. on the same day. Dr. Yogesh Sangwan is the proprietor of said hospital and Dr. Arun Tungaria employed in the said hospital claimed himself to be Neuro Surgeon. At that time, Smt. Raj Rani aged about 45 years had a slight headache and was fully conscious and there was no danger of any type to her life. The opposite parties No.1 & 2 told to the complainant no.1 and Lovedeep Sharma and Ankur Sharma that her life is in danger and she required immediate operation of brain as there is tumor in brain, otherwise she will die within no time. The complainant and others did not agree to the suggestions of ops and requested them that as per CECT dated 3.7.2013, there is only abscess (tuberculoma) and there is no tumor and also told that Dr. A.R. Godara advised for MRI in order to confirm that whether there is tumor or not? They also requested to the ops that tuberculoma can be drained out without operation and can be treated with the help of medicines, but ops did not take into consideration the advise of Dr. A.R. Godara and without consent of complainant’s side and without information, operation was conducted on the head of Smt. Raj Rani without diagnosing the tumor with the help of MRI and obtained the signatures on two papers regarding consent for operation of brain tumor without telling the contents of same to them. They only came to know regarding said consent for operation after death of Raj Rani. She died on 14.7.2013 in Sangwan Hospital, Sirsa. The ops no.1 & 2 has caused her death by medical negligence under the greed only. In the treatment record, it is mentioned that she had “Rt frontal tumor and tuberculoma” and it has been further mentioned that she has been operated for right frontal temporal crannotomy for tumor. It is further pleaded that after operation, ops sent specimen part of brain to Dr. Lal Path Lab, New Delhi in order to know whether there is any intra cranial tumor frontal or not. After diagnosis, Dr. Lal Path Lab. submitted its report and mentioned that there was no abnormal cells seen. Thus, the ops no.1 & 2 intentionally and in a negligent manner under greed conducted operation of Raj Rani for tumor but in fact there was no tumor at all. As alleged, the ops had no facility for brain tumor operation in the said hospital and op no.2 is not qualified for the operation of brain tumor. The act of op no.2 is of grave negligence which took the life of a young wife of complainant no.1 and mother of two minor children. The death of Raj Rani was unnatural and same was the result of rash and negligent act of ops, hence the complainant party lodged FIR No.527 dated 15.7.2013 under Section 304-A IPC in Police Station City Sirsa. The post mortem was conducted in G.H. Sirsa on 15.7.2013. At the instance of op no.1, the complainant no.1 deposited Rs.40,000/- with Sanjay Bagri clerk of hospital but he did not issue any receipt for the same. The complainant also paid Rs.10,000/- on 3.7.2013 for the medicines to the medicine shop situated within the premises of hospital and complainants do not know whether medicines have been used for treatment of Raj Rani because after operation, she remained unconscious and ops occasionally allowed the complainant and family members to visit her. It is further alleged that op no.2 operated the head of Raj Rani on 3.7.2013 and after operation said doctor left hospital for Jaipur at 2.00 p.m. on 4.7.2013 and did not depute any competent doctor to look after Raj Rani in his absence. This was the grave negligence on the part of op no.2. After the operation, Raj Rani was unable to speak anything and in the absence of op no.2, her condition deteriorated day by day. It is further alleged that Bala Ji CT Scan centre is situated at a distance of 100 yards from the hospital and the helper/ employee of hospital took Raj Rani on a stretcher to said centre for CT scan. At that time her condition was very serious and there was no movement in the body. The complainant no.1 paid Rs.one lac to the doctor as fee till the death of Raj Rani and also paid Rs.80,000/- as expenses of medicines. In the PMR report, it has been mentioned that cause of death in this case will be given after Histo-pathology report from PGIMS Rohtak, all the findings are ante-mortem in nature, viscera was also preserved for sending the same to PGIMS Rohtak. The pathology report from PGIMS, Rohtak dated 31.8.2013 was received by the police and same is signed by Ashmia Batra, Resident PGIMS, Rohtak. It has been mentioned in the said report “No opinion is possible.” It is pertinent to mention here that the doctor concerned did not send specimen of brain matter in order to know whether there was brain tumor or tumorcoluma. Raj Rani never suffered from any heart disease during her life time and she never suffered even a slight pain in heart throughout her life. The doctors of General Hospital, Sirsa gave their opinion about the cause of death of Smt. Raj Rani under the influence of op no.1. Hence, this complaint seeking the reliefs as detailed in prayer clause of this complaint.
3. On notice, opposite parties appeared and contested the complaint by filing their written version. The op no.1 took the preliminary objections stating that it is not a case of deficiency in service as defined in Section 2 (i) (g) of the Act. Beside it, op no.1 took the plea that the dispute like present one raised by complainants require submissions of detailed reply, adducing of evidence by both the parties, examination and cross-examination of witnesses and also in depth scrutiny of the record and other relevant documents and the matter is referable to the Civil Court for proper adjudication of the present case. It is further replied by op no.1 that entire complaint filed by the complainants with self contradictory pleas and admission and treatment of the patient in the op hospital is a matter of record. Remaining allegations of the complaint have also been denied.
4. Op no.2 who is treating doctor filed his reply that patient Smt. Raj Rani came to him on 3.7.2013 with complaint of headache, vomiting and altered consciousness. She had history of treatment from Janta Hospital, Sirsa where from Dr. Chetal had referred for x-ray and some blood tests and also referred her for NECT head and it was diagnosed as a mass occupying lesion in the right frontal region with mass effect and there was an increase Intra cranial pressure which was a life threatening condition and for that an immediate surgery was required and accordingly after explaining all the poor prognosis and risks of the surgery, the patient was operated on 3.7.2013 and total excision of tumor which intra operation looked like tubercuoma of the brain. Before surgery all the requisite tests were got conducted and pre-anesthesiatic check up was done by the anesthesiatic. However, post operatively the patient developed septicemia and chest infection which was duly taken care of by ventilator support and IV antibiotics. The patient did not improve and ultimately expired on 14.7.2013 despite all efforts throughout the stay. The patient had been given all necessary ICV care and treatment under the answering op and physician Dr. Suresh Budhnia as well as Dr. Yogesh Sangwan, surgeon of the hospital. The treatment to the patient admitted in the hospital are given by team of doctors including the answering op and not by an individual doctor and the patient had been constantly monitored by several doctors and all appropriate steps in the matter of treatment and appropriate medicines were given to the patient Raj Rani. There was no deficiency or negligence in conducting the operation or in treating the patient post operatively. The answering op is highly qualified and is M.Ch (neurology) and is experienced surgeon who had conducted thousands of brain surgeries successfully. But the prognosis in such patient is always guarded one.
5. Op no.3 submitted that the professional indemnity insurance policy has been issued in favour of Dr. Arun Tungaria and answering op is liable to indemnify the insured only as per terms and conditions of the policy. This op also denied the remaining allegations of complaint for want of knowledge.
6. By way of evidence, complainants produced affidavit of one Sunil Kumar Ex.PW1/A, affidavit of complainant Gayatri Nandan Ex.PW2/A, affidavit of one Manish Sarswat Ex.PW3/A, affidavit of Dr. Atma Ram Godara Ex.PW3/A, copies of adhar cards of complainants and Smt. Raj Rani Ex.P1 to Ex.P4, copy of CECT head report Ex.P5, copy of pathology report Ex.P6, copy of post mortem report Ex.P7, copy of FIR Ex.P8, treatment record of Smt. Raj Rani Ex.P9, copy of fluid balance chart Ex.P10, copy of lab. report Ex.P11, copy of lab. reports Ex.P12 to Ex.P28, copy of death certificate Ex.P29, copy of lab. report Ex.P30, copy of CECT head report Ex.P31. Whereas, the ops produced affidavit of op no.1 Ex.R1, affidavit of op no.2 Ex.R2, copy of certificate Ex.R3, affidavit of op no.3 Ex.R4.
7. We have heard learned counsel for the parties and have gone through the case file carefully.
8. The grievances of the complainants in this case are that opposite parties No.1 & 2 wrongly guided the complainants on the pretext that life of Smt. Raj Rani is in danger and required immediate operation of brain regarding tumor, otherwise she will die within no time. The complainants requested the ops that as per the opinion of doctor A.R. Godara, M.D. Consultant Radiologist to confirm that whether there is tumor or not, MRI of the patient is necessary. The complainants also requested the ops that tuberculoma abscess can be drained out without operation and it can also be treated with the help of medicines but ops took no pain even to hear the complainants and to accept the advise of Dr. A.R. Godara for MRI and without the consent of the complainants only in greed to take the huge charges of operation conducted surgery on the head of Smt. Raj Rani without diagnoses or any test which resulted the death of Smt. Raj Rani. On the other hand, as per the versions of ops No.1 & 2, Smt. Raj Rani was got admitted on 3.7.2013 with the complaint of headache, vomiting and altered consciousness. From the NECT head, it was diagnosed as a mass occupying lesion in the right frontal region with mass effect and there was an increase Intra cranial pressure which was a life threatening condition and for that an immediate surgery was required and accordingly after explaining all the poor prognosis and risks of the surgery the patient was operated on 3.7.2013 and total excision of tumor which intra operative looked like tuborculoma of the brain. Before surgery, all the requisite tests were got conducted and pre-anesthesiatic check up was done by the anesthesiatic. However, post operatively the patient developed septicemia and chest infection which was duly taken care of by ventilator support and IV antibiotics. The patient did not improve and ultimately expired on 14.7.2013 despite all efforts. Now, we come to the question whether the opposite party no.2 conducted the surgery without any need as alleged by the complainants. Further the question to be determined is whether ops conducted the operation in negligent and careless manner or not? To answer both these questions, we carefully gone through the available record on the case file. From the perusal of CECT Head report Ex.P5, it is clear that there was peripheral enhancing hypodense area of size 50x40 mm in right frontal region with mild perilesional edema. There is mass effect as evidenced by midline shift of 18 mm towards left side and effacement of right lateral ventricle and possibility were evolving abscess (tuberculoma) with meningitis, Neoplastic lesion. From post mortem report Ex.P7, it is clear that the cause of death was kept pending for want of Histo-pathology report from PGIMS Rohtak. Later on, the doctors of General Hospital, Sirsa on the request of police which is on file as mark A declared that “after taking consideration of Histo-pathology reports of department of Pathology, Pt. B.D. Sharma, PGIMS Rohtak, we are of the opinion that the cause of death in this case is chronic heart disease and its complications, which is sufficient to cause death in ordinary course of nature.” Beside it, complainants produced number of laboratory reports and treatment chart etc. on the record. From the perusal of series of documents produced by the complainants in order to prove their case, no negligence or carelessness on the part of ops while conducting the operation of deceased Smt. Raj Rani can be established. The averment of the complainants that op doctor conducted the operation of Smt. Raj Rani without the consent of attendants also cannot be believed as complainants failed to prove that their consent for conducting the operation was taken by the ops by keeping them in dark. Coming to the necessity of the operation of Smt. Raj Rani as alleged by the ops, we gone through the literature produced by both the parties defining the ‘Midline Shift’ and it reveals that in such type cases immediate surgery may be indicated when there is a midline shift of over 5 mm. The sign can be caused by conditions including traumatic brain injury, stroke, hematoma, or birth deformity that leads to a raised intracranial pressure. From the CECT Head report Ex.P5, it is proved that there was mass effect as evidenced by midline shift of 18 mm towards left side and effacement of right lateral ventricle. As such, in order to save the life of Smt. Raj Rani, immediate operation was required. From certificate Ex.R3, it is clear that opposite party no.2 i.e. Dr. Arun Tungaria has worked in Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow as a M.Ch. student in the department of Neurosurgery for a period from 25.7.2008 to 30.6.2011 and passed his final M.Ch. (Neurosurgery) examination in first attempt. Therefore, it cannot be said that op doctor has no knowledge of neurosurgery as alleged by the complainants. The complainants have failed to prove all the allegations of complaint.
9. Keeping in view of our above discussion, we are of the opinion that there is no merit in the present complaint and as such, the complaint is hereby dismissed with no order as to cost. A copy of this order be supplied to the parties as per rules. File be consigned to record room after due compliance.
Announced in open Forum. President,
Dated: 14.12.2016. Member. District Consumer Disputes
Redressal Forum, Sirsa.
