BEFORE THE A.P.STATE CONSUMER DISPUTES REDRESSAL COMMISSION:HYDERABADF .A.No.1617/2005 against C.D.No.113/2004 , Dist.Forum, Prakasam Dist. at Ongole.
Between
Mr.Pattipati Rama Murthy,
S/o. Late Chalamaiah, aged 43 years,
Hindu , Advocate, H.No.8-3-9,
Kothapet, Ongole. …Appellant/
Complainant
And
Dr.Kancharla Hanumantha Rao,
S/o.Kancharla Kondaiah, Hindu,.
Hindu, aged about 40 years, Doctor,
Sri Karthikeya Cardiac Centre,
Anjaiah road, Ongole, Prakasam Dist. …Respondent/
Opp.party.
Counsel for the appellant : Party in person
Counsel for the respondent : M/s. V.Gowrisankar Rao
CORAM :THE HON’BLE JUSTICE SRI D.APPA RAO , PRESIDENT,
AND
SRI G.BHOOPATHI REDDY , HON’BLE MEMBER.
MONDAY, THE EIGHTH DAY OF SEPTEMBER,
TWO THOUSAND EIGHT.
Oral Order : (Per Sri G.Bhoopathi Reddy, Hon’ble Member)
******
This is an appeal filed by the appellant/complainant under Section 15 of the Consumer Protection Act,1986 to set aside the dismissal order passed by the District Forum, Prakasam Dist. at Ongole in C.D.No.113/2004 dt. 2.9.2005 .
The appellant herein is the complainant before the District Forum. He filed complaint to direct the opp.party to Rs.5 lakhs with interest from the date of the death and costs to the complainant and family of the patient.
The case of the complainant is as follows:
The father of the complainant was admitted in the opp.party’s hospital with a complaint of chest pain on 17.4.2002 at around 5 p.m. The opp.party informed that the condition of the patient was serious and Urokinase injection which costs high was to be given to the patient as first aid and when the complainant said no problem for money the opp.party started treatment. When the complainant expressed his idea of shifting of the patient either to Apollo Hospital , Chennai or Vijayawada or NIMs , Hyderabad for further treatment, the opp.party told that what type of treatment available in the said hospitals is available in his hospital and also told that journey risk was there. When the complainant felt uneasiness in respiration at around 9 p.m. on 17.4.2002 , the complainant requested the staff of the hospital to call the opp.party doctor , they have informed that no other doctor is available in the hospital and the opp.party will come only on the next day morning and further they informed that the uneasiness in respiration is common as heavy dose of drugs was given. Surprisingly the opposite party advised the complainant to take the patient immediately either to City Cardiac Centre or to Saumya Apollo Hospital , Vijayawada for further treatment at around 10.30 a.m . on 18.4.2002 . The complainant taken the patient in an ambulance of Pushpa Clinic , Onogle to Vijayawada for treatment . No qualified person was there in the opp.party’s hospital to accompany the patient. The ambulance attendant named Anjaneyulu RMP was accompanied the patient. As the patient felt severe suffocation and was unable to inhale oxygen and as the ambulance did not cross even the town limits of Ongole, the complainant got back the patient to the opp.party’s hospital. The opp.party enquired the ambulance attendant and advised to take away the patient as he was already. After few days i.e. on 6.5.2002 the complainant approached the opp.party for the certificates, bills and for knowing whether the death of the patient was reported to the Registrar of Births and Deaths, Ongole. The opp.party advised the complainant to come on 8.5.2002 and again on 8.5.2002 asked to bring case sheet , rough bills given at the time of discharging the patient.. The complainant approached with the said documents on 9.5.2002 at around 1.30 p.m., the opp.party kept the complainant awaited till 5 p.m. . Thought he opp.party got prepared the certificates bills etc. and obtained acknowledgement of the complainant having received the same did not deliver the same. The opp.party tampered the case sheet deliberately according to his convenience with an intention to screen away from the clutches of law . Hence the complainant approached the District Forum to direct the opp.party to pay Rs.5 lakhs with interest from the date of the death and costs to the complainant and family of the patient.
The opp.party filed counter contending that the complaint is barred by limitation and the complaint is not maintainable . The complainant wanted the opp.party to give false certificates and when refused filed the complaint. The opp.party examined the patient and immediately took ECG . and also examined oxygen saturation and conducted ECHO and other important tests and felt that the patient had massive heart attack and also explained the seriousness of the patient to the complainant and his relatives . On 18.4.2002 the opposite party took ECG which showed improvement . In view of fresh problem of chest pain and Dysnea ( Fresh Heart Attack ) the opposite party explained to the attendants of the patient about the seriousness and risk to life despite the best drugs which have already administered . The opp.party kept the patient under his constant observation in view of development of hypotension the need for IABP emergency CAG and Revascularization has been explained for better clinical out come of the patient and at the same time the journey risk in that clinical situation has been explained in detail. The opp.party did not tamper the case sheet from the complainant. The opp.party prayed to dismiss the complaint .
Exs.A1 to A13 documents are filed on behalf of the complainant. Exs.B1 to B9 documents filed on behalf of the opp.party . The District Forum based on the evidence adduced and pleadings held that the complainant failed to establish that there is deficiency in service on the part of the opp.party and dismissed the complaint.
Aggrieved by the dismissal order of the District Forum the complainant preferred this appeal contending that the District Forum has not properly appreciated the evidence on record and given finding that there was no medical negligence on the part of the opp.party the said finding is not sustainable. The District Forum failed to note that the proceedings are of civil nature mere preponderance of probability is sufficient and the opp.party is not entitled to the benefit of every doubt and failed to apply the rule Res Ipsa Loquitur , by inferring he negligence of the opp.party drawn from the facts . The District Forum has not properly discussed the medical literature filed by the complainant and as per the medical literature primary angioplasty is better treatment than the application of the streptokinase , urokinase etc. , to the heart patient without lingering for expert’s oral evidence to corroborate the Article (Expert Opinion) published in “The Hindu” India’s National News Paper. The District Forum failed to observe that the literature filed by the opp.party Ex.B7 to B9 speaks against him. The District Forum has not considered the answers to the interrogatories filed by the opp.party , belatedly and come to a conclusion that the opp.party did not answer many interrogatories. The District Forum failed to verify Ex.A 10 and failed to conclude that the patient died due to excessive usage of the drugs particularly when the patient was not fit for the treatment Thrombolytic therapy. The District Forum failed to note the contradictory statements of the opp.party i.e. post thrombolysis , ECG showed marked improvement in the form of decrease in the height of the ST segment in leads V4 , V6 which is contra to the answers to the question no. 22 of interrogatories . The appellant prayed to set aside the order passed by the District Forum and allow the appeal .
There is no dispute that the father of the complainant was admitted in the opp.party hospital with a complaint of chest pain on 17.4.2002. After seeing the seriousness of the patient the opp.party has administered urokinase injection. As the condition of the complainant’s father was not improved , the opp.party suggested the complainant to shift the patient either to Apollo Hospital Chennai or NIMS , Hyderabad and while shifting the patient in an ambulance, on the way he died on 18.4.2002. . The appellant contended that the opp.party has not given proper treatment to his father and his father died on account of excessive usage of drugs and that the proper treatment for heart patients is Angioplasty . The respondent resisted the plea that on seeing the condition of the patient after conducting all the tests only, the treatment was commenced by him and the treatment given by him is thrombolytic treatment and Urokinase injection was also given to the patient which is proper treatment. PW.1 in his evidence affidavit stated that the opp.party informed Urokinase injection was to be given as first aid to the patient, that when his father complained about uneasiness in breathing he requested the staff of the hospital to inform the doctor , but they said that no other doctor is available in the hospital and the opp.party would not come till the next day morning . He has also stated that on 18.4.2002 when his father’s condition was serious, the opp.party informed to take the patient either to City Cardiac Centre or Saumya Apollo Hospital, Vijayawada for treatment and while shifting his father in an ambulance he died. Apart from the evidence of complainant , other witness Bollineni Srihari Rao was examined as PW.2. He has stated that on 17.4.2002 he went to the hospital of opp.party to see complainant’s father and he was suffering with heart ailment He did not depose with regard to the medical negligence aspect . He is only a friend of PW.1. The complainant has not examined any expert witness to prove that on account of the treatment given by the opp.party doctor the complainant’s father died. The appellant contended that the District Forum has not properly appreciated the documentary evidence. The submission made by the appellant is concerned we have gone through the documentary evidence filed by the complainant . Ex.A1 is the complaint given by the complainant to the police. In the said complaint itself it is alleged that while his father is suffering heart attack he was taken to the opp.party hospital on 17.4. 2002 , thereafter the doctor has confirmed that he was suffering heart attack and he assured that he will treat him and on the next day i.e. on 18.4.2002 the doctor advised him to shift to the Cardiac Centre or Saumya Apollo hospital, for further treatment as the condition of the patient is serious and while shifting his father died. Ex.A4 is the certificate issued by Pushpa Clinic & Nursing Home stating that the father of the complainant died on the way to Vijayawada near outskirts of Ongole due to heart attack on 18.4.2002. . Ex.A5 is the death certificate . Ex.A6 is office copy of the legal notice. Ex.A9 is the copy of ECG report and Ex.10 is the copy of information brochure for usage of drug Urokinase. The appellant submits that the case sheet and other relevant documents are in the custody of opposite party and he has not produced the said record and an adverse inference can be drawn against the opp.party that on account of the medical negligence on the part of the opp.party his father died . The complainant has not taken steps to summon the case sheet and other relevant documents from the opp.party. The complainant has cross examined the opp.party . In the cross examination also there was no suggestion put to the opp.party with regard to the documentary evidence is concerned . The complainant has filed interrogatories and for that interrogatories the opp.party filed answers . We have also gone through the answers submitted by the opp.party to the interrogatories of the complainant .The opp.party has clarified in the cross examination that the death of the deceased was not occurred in their hospital and the death was occurred on the way in shifting to other hospital.
The appellant submits that the District Forum has not taken into consideration the medical literature filed by him . We have gone through all the medical literature filed by the complainant as well as the opp.party . Ex.A13 is the news item published in The Hindu news paper dt.10.12.2002 wherein it was mentioned that Angioplasty is the right answer for acute heart attacks according to expert. The appellant further submits that the District Forum has failed to observe the literature filed by the opp.party Ex.B7 to B9. We have gone through the documentary evidence Exs. B7 to B9. In Ex.B7 it is stated that large randomized clinical trials have demonstrated that thrombolytic therapy reduces mortality in patient with ST elevation treated within the first 6 to 12 hours of Acute infarction. The evidence of opp.party discloses that the patient was brought to the hospital after 6 hours . Ex. B8 is the therapy and prevention with regard Coronary Thrombolysis . In Ex.B9 it is stated that “ Although thrombolytic therapy trials excluded elderly patients . Even in these large trials of thrombolytic therapy the benefit of treating patients aged more than 75 years was only marginal . The District Forum has elaborately discussed all this medical literature filed by the opp.party and given finding . The appellant further submits that instead of going for angioplasty the opp.party selected the treatment of application of the Streptokinase , Urokinase and on account of that death occurred. The appellant did not lead any expert evidence except filing the medical literature . Even the medical literature also not supported by any oral evidence of the complainant nor the case sheet and other documentary evidence The appellant submits that the opp.party did not follow the No.5 Cautions Item Adverse Reactions and administered heavy dose of drug 15 lakhs IU when the patient’s blood pressure ws low pulse disorder (low rate ) dyspnea , vomiting etc. The appellant is only relied on the medical literature and the medical literature filed by the appellant is not supported by any oral evidence or documentary evidence. We are of the opinion that the evidence without pleadings is only an after thought even though it is true and correct it should be proved by medical expert examining witnesses. Even the appellant has not lead any evidence that Urokinase injection was administered by the opp.party when the patient’s blood pressure was low , pulse in disorder and he is suffering with dyspnea and vomiting etc. The appellant submits that as per Ex.A8 the deceased patient was not fit for thrombolytic therapy . The submission made by the appellant is not supported by oral evidence or other documentary evidence . .. As per the medical literature the appellant failed to establish that there was negligence on the part of the opp.party . There was no oral or other documentary evidence to support the medical literature. District Forum has considered the said medical literature and given finding that there was no medical negligence on the part of the opp.party . The appellant has relied on a judgement reported in AIR 1966 ALL page 570 and 2004 I CPJ 21 SC where in it is held that in the absence of expert opinion , literature filed by the parties can be taken into consideration. The medical literature filed by the complainant discloses that the best choice of treatment for emergency acute heart attacks is primary angioplasty because of very high success rate with least complication rate. In our present case is concerned the complainant’s father was suffering with heart attack in serious condition in those circumstances the opp.party has given treatment by giving Urokinase injection . The appellant has not lead any evidence to show that on account of administration of Urokinase injection his father died . On the other hand evidence of RW.1 and RW2 discloses that Urokinase injection was administered by the opp.party when the patient’s blood pressure was low pulse and he suffered with vomtings etc. . The burden of proof to prove the medical negligence aspect lies on the appellant. The appellant has failed to prove the medical negligence aspect. . . There was no documentary evidence filed to prove that there was medical negligence on the part of the opp.party. The respondent contended that there are two types of treatments and they can choose any kind of treatment in order to save the patient and the complainant’s father did not die on account of administering injection by him. The complainant failed to prove that on account of the negligence on the part of the opp.parties , his father died. The District Forum has elaborately discussed and given finding. We do not see any merits.
In the result appeal is dismissed . In the circumstances without costs.
.
PRESIDENT LADY MEMBER MALE MEMBER
Pm* Dt.8.9.2008
