MRS. NEENA SANDHU, MEMBER

1.         This is an appeal filed by the appellant/complainant against the order, dated 24.12.2008 passed by District Consumer Disputes Redressal Forum-I, UT, Chandigarh (hereinafter to be called as District Forum only) in complaint case No. 569 of 2008 vide which, it dismissed the complaint. 

2.         Briefly stated, the facts of the case, are that on 18.12.2007 the complainant gave birth to a male child in normal delivery and, thereafter, on 23.12.2007, she was admitted in the hospital of OP No.1 due to pain in the left arm & left leg. She paid Rs.5,000/- for admission and Rs.8,000/-for tests and medicines.  It was stated that the condition of the complainant deteriorated in the absence of proper care of the doctor and even Dr. K. Sachdeva refused to attend her.  It was further stated that being specialist, OP No.1, had tied crape bandage, on the leg, and arm of the complainant, without giving proper treatment. After great efforts of her husband, OP No.1 came at 11 am and referred the complainant to a higher center and then immediately she was brought to OP No.2. On 25.12.2007, the complainant was admitted in OP No.2 in the emergency ward, and was attended by Dr.Manisha. She diagnosed that the complainant was suffering from septic shock and her condition was critical, due to venucs Dappler caused by OP No.1. She was shifted to the ward on 27.12.2007 in semi conscious condition.  It was further stated that even OP No.2 also did not give proper treatment and the condition of the complainant further deteriorated. As such, on 17.1.2008 her left leg was amputated. Thereafter on 28.1.2008 the Pathology Department found after examination for amputation above knee measuring 80 cm long and 10 cm maximum dia.  It was further stated that the complainant being a young lady of 30 years was looking after her entire family. Because of the negligence of the Ops, she lost her leg, at the prime age by way of amputation. It was further stated that due to the negligence of the OPs, the complainant had suffered a huge financial loss for incurring expenditure on medicines, transportation, rich diet and attendant. She also suffered permanant disability, pain, sufferings and mental agony. Hence, the complaint was filed.

3.         Reply was filed by OP No.1 (Dr.Sonam Sachdeva), wherein, it was stated that the District Forum had no jurisdiction to try and entertain the complaint as the complainant was a permanent resident of Village Rahra, Tehsil Assandh, District Karnal. It was further stated that on 24.10.2007, at about 12.00 PM, the complainant reached the hospital of OP No.1. She had delivered a child 6-9 days prior to 24.10.2007 at home without supervision of any qualified doctor. It was further stated that she had been admitted in a local Nursing Home at Assandh for 2 days with history of fever, pain in arm and leg. She was referred to Karnal for blood transfusion, where the complainant was given 6 bottles of IV fluid. It was further stated that when she came to the hospital of OP No.1, she was in semi conscious condition, her orientation was poor, her pulse was very weak and thready, her BP was only 70, (systolic). She was sweating profusely, her temperature was sub-normal. She was collapsing.  It was further stated that the condition of the complainant was very serious, which was explained to her relatives, and they opted that she be treated in the hospital of OP No.1 in emergency. The patient was admitted immediately and active management started without any delay after consent for treatment was received. Blood investigations were carried out at the same time immediately, her Hb was very low, she was in heart failure, her pallor was ++++, Hb was 3gm% and there was swelling in her left arm and left leg. Her uterus was 16 weeks (sub involuted) on PV examination, allowed with great difficulty Cervical Os was open, very dirty extremely foul smelling discharge was present.  A diagnosis of postpartum septicemic shock with ? DVT was made. The management was started on war footing immediately. The complainant was put up on prop up position. Nasal oxygen, fluid maintenance and blood was arranged. The shock was managed with charting of input/output with catherisation. Necessary drugs and antibiotics were started. Foot and arm support with elevation was done.  It was further stated that the complainant came out of shock partially, but her condition deteriorated again in the early morning on 25.10.2007. The complainant was referred to the PGI, Chandigarh for further management after discussion with her relatives.  It was further stated that OP No.1, had charged only Rs.2,000/-, as hospital fees, which was paid, at the time of discharge from the hospital on 25.12.2007. It was further stated that the crape bandage was used for support, which by no stretch of imagination could harm the complainant. All other allegations leveled by the complainant, in the complaint were denied. It was further stated that there was no medical negligence or deficiency, in service, on the part of OP No.1.

4.         Reply was filed by OP No.2, wherein, it took preliminary objections that the District Forum had no pecuniary jurisdiction to decide the complaint, as the complainant had claimed the total pecuniary relief more than Rs.20 lacs. It was stated that the complaint qua OP No.2 was not maintainable, rather OP No.2 saved the life of the patient after she was brought in critical condition.  It was further stated that no expert evidence was produced by the complainant alleging medical negligence, qua OP No.2.  It was further stated that the leg of the complainant was amputated to save her life, as her position was very critical. It was further stated that the complainant was in hypotension, had dehydration, suffering from severe anemia and was drowsy. The complainant was dehydrated & pale, bluish discolouration and blebs were also found on examination on her left upper and lower limb. Her pulse rate was feeble and systolic blood pressure was 100 mm Hg. It was further stated that proper treatment was given to the complainant. When her condition was not improving and her lower limb became unsalvageable, only then decision to amputate her leg was taken, in the interest of saving her life.  All other allegations, levelled by the complainant, in the complaint, were denied. It was further stated that there was no deficiency, in service, on the part of OP No.3.

5.         Reply was filed by OP No.3 (New India Assurance), wherein, it   took preliminary objections regarding maintainability of the complaint before the Forum, as the amount of compensation claimed exceeded Rs.20 lacs. It was further stated that the complainant had not mentioned, as to how compensation of Rs.20 lacs had been arrived at.  It was further stated that there was no deficiency, in service, on its part.

6.         The parties led evidence, in support of their case.

7.       The learned District Forum, dismissed the complaint, in the manner, referred to, in the opening para of this order.  

8.            Aggrieved by the order, passed by the learned District Forum, the appellant/complainant, has filed the instant appeal. 

9.         We have heard Sh.Pawan Kumar Sharma, Advocate, for the appellant/complainant, Sh.Virender Kumar, Advocate, proxy for Sh.S.K.Malhotra, Advocate for respondent No.1, Sh. Jatinder Singh, ADA on behalf of respondent No.2, Sh.B.S.Taunque, Advocate for respondent No.3  and, have perused the record, carefully

10.       The Counsel for the appellant, submitted that, no doubt, the complainant gave birth to a male child on 18.12.2007. He further submitted that she was admitted in the hospital of OP No.1 on 23.12.2007, with pain in left arm and left leg. He further submitted that on 24.12.2007 the condition of the complainant became critical, but she was not attended to by any of the doctors in the hospital of OP No.1. It was further submitted that ultimately, on 25.12.2007, she was referred to the PGI. It was further submitted that there was medical negligence on the part of OPs No.1 and 2.

11.       The Counsel for OP No.1 submitted that the complainant came to her hospital on 24.12.2007 and was immediately admitted in the emergency. He further submitted that, at that time her condition was very critical, but she was properly attended to by the doctors and the best available treatment was given to her. It was further submitted that she was referred to the PGI on 25.12.2007 for further management. It was further submitted that there was no medical negligence, on the part of OP No.1, nor she was deficient in service.

12.       The Government Pleader who appeared on behalf of OP No.2 submitted that there was no medical negligence on the part of OP No.2  because the leg of the complainant was amputated to save her life as her condition was very critical.  It was further submitted that she was in hypotension  had dehydration. She was also suffering from severe anemia and was drowsy. She was pale, bluish discolouration and blebs were also found on examination on her left upper and lower limb. Her pulse rate was feeble and systolic blood pressure was 100 mm Hg. It was further contended that the best treatment was given to the complainant. Inspite of that the general condition of the complainant was not improving and when her lower limb became unsalvageable, only then the decision was taken to amputate her leg in order to save her life.

13.       The learned Counsel for respondent No.3, (New India Assurance Co.) contended that as the learned District Forum below dismissed the complaint on the ground that there was no deficiency, in service, on the part of OPs, therefore, the Insurance Company was not liable to pay anything to the complainant.

14.            Admittedly, the complainant was admitted in the hospital of OP No.1 in a critical condition and the doctor immediately after admission, put the complainant on a nasal oxygen, fluid maintenance blood was arranged, shock was managed with charting of input/output with catherisation, vitals etc. was done. Her BP was monitored constantly, necessary drugs and antibiotics were started and investigations were done. On investigation, it was diagnosed that the patient was suffering from postpartum septicemic shock with ? DVT i.e. Deep Vein Thrombosis. As the condition of the complainant deteriorated further and the doctor was unable to treat her, she was referred to PGI, Chandigarh, where she could be treated by some specialist. Apparently from the record, it seems that OP No.1 had made best of her efforts to treat the complainant and we don’t find any medical negligence on the part of OP No.1.

15.     The allegations levelled against OP No.2 are also baseless and wrong. The complainant was admitted on 25.12.2007 in medicine emergency of GMCH, Sector 32, Chandigarh i.e. OP No.2 after having been referred from Sachdeva Hospital, Karnal with a diagnosis of septic shock with DVT. She was put on antibiotic. Thereafter, investigations were sent to Gynae and Surgery for consultation, which further substantiated the diagnosis of septic shock with DVT, as is evident from annexure R-3 and R-4.  However, doppler ultrasound R-5 was done on 27.12.2007. It did not reveal any evidence of DVT. The diagnosis therefore, was revised to Cellulitis with Septicemia and the treatment was continued, as is evident from annexure R-6. Subsequently, the patient was shifted to surgery for necessary intervention and surgical consultation was taken on 27.12.2007. The patient was advised Doppler u/s, which was duly done. Debridement under General Anesthesia was undertaken on 2.1.2008. Since the tissue necrosis was present, the complainant was duly informed regarding the high risk of operation. Accordingly, high risk consent was taken, vide annexure R-11. The complainant was suffering from necrotizing fasciitis of left lower limb, which required extensive debridement. Also debridement of left upper limb and necrotic tissue was undertaken. Thereafter, the complainant was treated but necrotic debris did not get cleared off. The general condition of the patient was not improving because of this, and also her left lower limb, had become unsalvageable. Therefore, the specialized doctors took a decision to amputate her leg and the same was duly conveyed to the attendant and his consent was taken vide annexure R-13. Operation was performed on 27.1.2008, and during operation it was found that muscles were necrozed till knee joint and inter-muscular pus was present. Therefore, above knee amputation was done. Histopathological Report dated 28.1.2008 also showed features consistent with gangrene, which means dead tissue. Therefore, the patient was discharged on 9.4.2008 in good health.

16.       From these facts and circumstances of the case, we are of the opinion that there was no medical negligence on the part of OPs No.1 and 2. The complainant also failed to prove that the treatment given by OPs No.1 and 2 was not proper. The complainant also did not place, on record, any expert opinion, from some specialist, nor produced any medical record, in support of her contention that the symptoms, as were found, in her case, could have been treated, in a different manner, for saving her leg. With these facts, we are of the considered opinion, that OPs No.1 and 2 had given the treatment with due care, skill and diligence and they are not guilty of medical negligence. In Jacob Mathew Vs. State of Punjab & Anr. 2005 CTJ 1085 (SC) (CP) = [2005  SCC 1] the Hon’ble Apex Court held as under ;

“A professional may be held liable for negligence on one of the two findings: either he was not possessed of the requisite skill which he professed to have possessed, or, he did not exercise, with reasonable competence in the given case, the skill which he did possess.  The standard to be applied for judging, whether the person charged has been negligent or not, would be that of an ordinary competent person exercising ordinary skill in that profession.  It is not possible for every professional to possess the highest level of expertise or skills in that branch which he practices.  A highly skilled professional may be possessed of better qualities, but that cannot be made the basis or the yardstick for judging the performance of the professional proceeded against on indictment of negligence.”

17.       From the record, it is established that OP No.1 and the doctors of OP No.2 had acted in accordance with a practice accepted as proper, by a responsible body of medical men, skilled in that particular art. There was no medical negligence, on their part. The order passed by the learned District Forum, being legal and valid, no interference is called for.

18.       For the reasons recorded above, the appeal filed by the complainant, is dismissed, with no order as to costs. The impugned order passed by the learned District Forum is upheld. 

19.            Copies of this order be sent to the parties, free of charge.

Pronounced.                                                                        

4^th August, 2011.