F I N A L   O R D E R

The complainant has filed this case U/S 12 of Consumer Protection Act, 1986 with the prayer directing the O.Ps. to pay compensation of Rs.5,00,000/- for mental pain and agony and petitioner and her family members, Rs.50,000/- as expenses and Rs.10,000/- as litigation cost.

In short the case of the complainant is that, the son of the complainant namely Pintu Nandi is a cardiac patient since 10 - 12 years and for last two years the patient became serious as such he was/is under treatment of Rabindra Nath Tagore International Institute of Cardiac Sciences, Kolkata. Doctor of that hospital, who detected that INR level of the patient is too low, as a result the blood became clotted and doctor suggested for taking Warfarin 0.5 tablet to control the blood clot and prescribed other medicines for better health of patient. Generally normal range of INR status is 2 to 3. On 20.07.2014 the complainant along with her son Pintu Nandi attended for check up the INR status to the pathological laboratory of O.P. No.2 and O.P. No.1, who is the consultant pathologist of O.P. No.2. O.P. No.2 took the sample of blood from the body of Pintu Nandi and after pathological test report supplied to the patient party prepared by O.P. No.1 and in that report shown that the patient INR status was 8.61 which is excessively high. The complainant asked the O.P. No.1 to take blood again and test further but the O.P. No.1 denied, rather he is in the pathological field for 25 years as such his report is correct one. The complainant then contacted with the doctor of R. N. Tagore and intimated the report of blood, the doctor advised to stop Warfarin tablet and come immediate to their Institution for treatment. But due to non-availability of communication for early period the patient could not reach in time but patient reached at R. N. Tagore on 23.07.2014, where his blood was tested and report shows that INR status became normal, thereafter for further confident the blood was further tested at Super Speciality Hospital, Kolkata, where also report shown that INR status was normal. The doctor of R. N. Tagore comments the blood report of O.P. No.1 was not correct report and prepared a wrong report, the patient as well as the family members were suffered mental tension, harassment and also suffered financial loss as such the complainant appeared before this Forum.

O.P. No.1 and 2 contested this case by filing joint W.V., denying the allegations of the complainant while stating inter alia that their blood report was correct, that on taking Warfarin continuously patient and INR may be raised to this level, after stopping of medicine for 2/3 days (Warfarin) may results rapid reduction of INR level, the doctor of this O.P. rightly performed the blood test (INR Status) of the patient and as per report INR level of the patient was 8.61 at that time on that day and the O.Ps. prayed for dismissal of the complaint.

To prove her case the complainant has submitted memo of evidence supported by an affidavit, oral evidence, authorize letter and photo copies of blood report and prescriptions etc.

To establish their defence case the O.Ps. have submitted joint W.V. but they did not adduce any evidence.

DECISIONS WITH REASONS

We carefully perused the complaint, W.V., evidences and documents and argument advanced by the parties.

On perusal of complaint and documents it appears that the son of the complainant, Pintu Nandi was/ is a cardiac patient since 10 – 12 years but last two years he has been suffering from low level of INR problem which results that blood became clotted, for that heart will not function properly rather danger may arise to a human being. For keeping the normal level of INR the doctor always advised the patient to take Warfarin tablet in a certain dose, which controlled the blood clotting and heart will function properly with taking other medicines. From the medical documents i.e. prescriptions and pathological report it shows that about two years the patient Pintu Nandi, son of the complainant was/ is treated by International Institute of Cardiac Sciences and Similar institution of Kolkata, who are specially famous for cardic patient treatment.

Such type of low level of INR patients are always advised by the doctor for periodical test of INR level for proper functioning of heart. On 20.07.2014 the patient Pintu Nandi went to the pathological clinic of O.P. No.2 where O.P. No.1 being a pathological doctor of that laboratory after testing the blood, prepared report which shows that INR level of the patient was 8.61 i.e. excessive high and it is admitted by the O.Ps. though the complainant requested the O.P. No.1 to take further blood test as it seems doubtfull but the O.P. No.1 stated that he is an experienced pathologist and his report is correct one and no need to further test. After getting delivery of blood report from O.P. No.2 the patient and the family members become puzzled and were mentally upset and the patient became ill for the consequence of such high level INR. Finding no way the complainant immediately contacted with the doctor of R. N. Tagore, Kolkata and intimated the INR status of blood test report as 8.61 and on hearing the INR level the said doctor advised the patient to stop taking Warfarin tablet and asked to attend their hospital immediately for emergency treatment but on trying various level the family members could not collect train ticket for such long distance journey with the patient. However the family members along with the patient, Pintu Nandi by a hired ambulance reached R. N. Tagore Hospital on 23.07.2014 where doctor tested the blood of the patient on that day at 10:52 hrs. find report showing that INR level was 2.49 and on the same day again collected blood from said patient by Medica Super Speciality Hospital, Kolkata at 18:47 hrs, where test report shows the INR level was 2.43. Be it mentioned here that on 23.07.2014 the patient and his family members to gather more confidence arrange further testing of blood as a whole and after getting report it was found there was no abnormality detected from any of the report of blood.

On the date of hearing of argument from the side of the complainant submitted Net Searching of U.K. Medical information/ medicines information Warfarin and the O.Ps. have also submitted copy Harrisons Internal Medicine regarding description of Warfarin medicine use and INR laboratory test etc.

We find from the U.K. Medical information where it mentioned that "Warfarin is a drug that can be given if there is a risk of blood clot forming or a clot has developed and treatment is needed to prevent further clots". there are also mentioned side effects of Warfarin too much use of Warfarin, haemorrhage (severe bleeding) is the major side effect of Warfarin. Seek urgent medical attention, a high INR 5 effect heavily bleeding gums, heavy periods, bruises for no reason, nosebleeds that last longer 10 minutes or frequent none bleeds, blood in the urine, coffee ground, vomit or passes of black faces" and in the too little Warfarin also some side effects.

Harison’s Internal Medicine described the methodology of pathological test of INR level that “The Prothrombin time is most commonly measured using blood plasma. Blood is drawn in to a test tube containing Sodium Citrate, which acts as an anticoagulant by binding calcium in a sample. The blood is mixed, then contifuged to separate blood cells from plasma. For an accurate measurement, the prothrombim of blood to citrate needs to be fixed, many laboratories will not perform the assay if the tube is underfiled and contains a relatively high concentration of citrate. If the tube is underfiled or overfilled with blood, the standardized dilution of 1 part anticoagulant to 9 parts whole blood is no longer valid. For the prothrombin time test, the appropriate Sample is Sodium citrate tube, which is a liquid anticoagulant.”

In view of the discussions above we find that INR test report of O.P. No.1 was 8.61, too much high and in the high range of INR what are the side effects as medical science described above O.P. No.1 should know being a pathological doctor. So, the question may arise how the O.P. No.1 is overconfident of his report without asking any question of the side effects of high INR level. Comparing the two subsequent INR status report prepared by R. N. Tagore hospital and Medical Super Speciality hospital, Kolkata with INR report of O.P. No.1 it is apparently showing that the report of O.P. No.1 is a wrong report. If the report of O.P. No.1 was correct, then as per medical sciences a high INR 5 would cause side effect of heavy bleeding gums, nosebleeds that last longer 10 minutes or frequent nosebleeds, blood in urine, haemorrhage etc. But such symptoms were absent on the patient’s body. So the INR status report prepared by O.P. No.1 can easily be said is a wrong report. At the time of argument on behalf of complainant it was stated that the O.P. No.1 is a medical practitioner and as a pathological doctor of State Government Hospital, Uttar Dinajpur District. From the medical guide lines referred above it can be assumed that O.P. No.1 did not follow the methodology of laboratory test as per medical science.

It is common prudent that such type of wrong report of INR status of a heart patient must have caused great mental and physical tension, anxiety, which cause harmful effect and endanger of a human life and also have to suffer the same by the family members of the patient.

In view of the discussions hereinbefore, we are of opinion that the O.P. No.1 was negligent, careless and deficient in service as such the complainant is entitled to get an award of compensation, expenses and also litigation cost.

Fees paid is correct.

Hence, it is

ORDERED,

That the complaint case being No. CC - 98/2014 is allowed in part on contest against O.P. No.1 & 2.

That the complainant do get an award directing the O.P. No.1 to pay Rs.50,000/- as compensation for harassment, mental pain and agony and Rs.15,000/- as expenses incurred for journey by ambulance, hired vehicles and train fair etc. and Rs.2,000/- as litigation cost to the complainant within one month from the date of this order till full realization, failing which the complainant is at liberty to place this award in execution according to law.