(Passed on dated 30^th March, 2016)

Per Shri Atul D. Alsi – Hon’ble President.

              The complainant has been operated for castoscopy +TUR-Prostate grand on dt. 12/11/2014 by opposite party at hospital and the complainant was discharged by opposite party on dt. 17/11/2014. 

2.            The complainant’s son namely Iqbal s/o. Abdul Sattar Khan is employee of P. H. C. under D. M. O. at Sadak - Arjuni, Dist. Gondia and therefore the complainant is entitled to get reimbursement of medical expenses. According to office requirement application in prescribed pro-forma for reimbursement needs to be sign and seal by hospital, and stamp receipt of payment along with one revenue stamp and every bill to be attested by hospital along with seal and signature of medial prescription to claim reimbursement.

3.            The opposite party had refused to comply procedural formality by saying that the complainant had not informed him regarding reimbursement of medical expenses prior with medical treatment.

4.            The opposite party being registered medical practioner and duty bound to issue such certificate as opposite party had treated complainant by admitting him in his hospital for 7 days from dt. 11/11/2014 to dt. 17/11/2014.  The opposite party had advised complainant to do various test and as per test reports opposite party had came to conclusion that it is emergency case and hence opposite party had hospitalized complainant.   The opposite party might have treated complainant as an outdoor patient but as opposite party had found that it is an emergency case hence hospitalized for seven days and performed surgery.  The complainant had paid all fees of opposite party.

5.            After refusal to sign pro-forma certificate which is mandatory requirement, the complainant had again issued second notice to opposite party on dt. 17/06/2015.  The opposite party vide its reply dt. 01/07/2015 through counsel had refused to sign and seal the prescribed pro-forma.  The above act of opposite party amounts to deficiency in service.             

6.            The complainant has prayed to declare that the opposite party had committed deficiency in service by refusing to issue prescribed pro-forma certificate regarding medical treatment.  The opposite party may be directed to issue pro-forma certificate signed within 15 days from the date of order. The opposite party may be directed to pay compensation of Rs. 50,000/- towards mental and physical harassment and Rs. 20,000/- towards litigation charges.

7.            The complaint is registered and issued notices to opposite party.    After receiving notices the opposite party appeared before the Forum through his counsel and filed his written statement.

8.            In the written statement the opponent submitted that, the complainant had pain while passing urine (Dysuria) and burning while passing urine since last six months.  The complainant had a history of retention of urine since fifteen days for which he was catheterized elsewhere.  He was earlier operated for spine ailment also.  Thus the complainant presented with a long standing complaints suggestive of BHP at the outpatient department (OPD) on 10/11/2014 with no sign of any emergency.  The patient was admitted on 11^th Nov., 2014 at Soni Hospital by the respondent Dr. Rajesh Soni and on the next day i.e. 12^th Nov., 2014 he was operated as an elective procedure of Cystoscopy along with TURP.   

9.            It is also submitted that, this surgery i.e. TURP is a highly specialized elective surgery and is to be done by a qualified uro-surgeon.  The respondent Dr. Rajesh Soni is a qualified uro-surgeon  with M.Ch from Mumbai.  The respondent utilized his skill to the fullest and successfully performed the cystoscopy along with TURP.  Throughout the surgery and post operative period there was no complication.  As a result the patient has recovered completely after the surgery.  The complainant was discharged on 16^th Nov., 2014 in a healthy condition.  He was also advised to review after 10 days from the date of discharge.   All the required bills and the discharge card were issued and the patient who happens to be the complainant was discharged after all the hospital bills were cleared.

10.                   The BHP is one of the changes observed in the males between the age group of 50 years to 60 years, Due to this change the patient suffers from pain while passing urine (Dysuria), strain while passing urine and sometimes inability to pass the urine (Retention).  This condition i.e. the BHP is not an emergency condition but it is a slow onset process ongoing in the body.  The ailment BHP can be corrected by surgery.  TURP being one of the recent methods of surgical correction.  It is an elective surgery and hence has not found a place even in the text book on urological emergencies by Dr. Hunter Wessels (2^nd edition 2013), a standard text book on urological emergencies.

11.                   The fact is that the complainant had retention of urine few days prior to his reporting to the respondent.  The retention of urine of the complainant was treated elsewhere by catheterization as has been mentioned in the discharge card issued to the respondent at the time of discharge.  Thus it is an elective procedure. 

12.                   It is worth to understand here as to what we mean by emergency and elective surgeries.

              a)       Emergency Surgery: These are the types of surgeries which if not done urgently are likely to threaten the life of the individual or are likely to damage the body part e.g. gangrene.

              REF- www.surgeryencyclopedia.com.

              The Govt. of Maharashtra according to its G.R., as attached herewith, has issued a list of twenty seven conditions which are to be included as emergencies.  TURP and cystoscopy are not included in the list given in the G. R..

              b)      Elective surgeries:  There are the type of surgeries which are not required to be done urgently.

13.                   The complainant was discharged on 17^th Nov., 2014.    A discharge card was issued which bears the signature of the respondent.  The complainant was also issued the hospital bills and the medicine bills. The complainant during his follow-up visit had asked the respondent to sign and issue an emergency certificate in the pro-forma and also to sign the form C.

              Form C is the form which is to be filled for the patients who are to operate as an emergency surgery.  The fact is that the complainant who happens to be the patient was operated as an elective surgery – as TURP is not an emergency procedure.  The respondent being a law abiding citizen and a true doctor following all the ethics refused to oblige the complainant by signing on form C which the complainant was not eligible.

              In addition to this the complainant also demanded to the respondent by signing a pro-forma which states that the surgery was an emergency surgery.  The respondent rightly refused to heed to the wrong demand from the complainant and refused to sign on the pro-forma.  The respondent has kindly signed all the other bills, discharge cards and other papers which were just, right and within the legal framework.  The legal duty of the doctor i.e. the respondent herein is to work for the benefit of the health of the patient and also to fulfill the just and legal demands concerning the reimbursement.  The respondent has kindly signed all the other bills, discharge cards and other papers which were just and right and within the legal framework.   It is not at all true that the doctor i.e. the respondent is duty bound to issue the false papers to the patients i.e. the complainant.

14.                    The complainant was admitted as an elective patient and on whom an elective surgery was done by the respondent.   To corroborate the fact that cystoscopy and TURP surgery is not an emergency surgery it is worthwhile mentioning again that the above surgeries find no place in the standard book on emergencies in urology by Hunter and also the GR of government of Maharashtra.  Hence, the respondent prays that there has been no negligence on the part of the respondent as the treatment was perfectly justified and proper in all respects.  The respondent can’t be blamed for not fulfilling the illegal demands.  Hence, the entire complaint is denied as it is without any merit and is liable to be dismissed.

15.                   The complainant filed 11 documents as per list of documents at page no. 13 to 26 on record.

16.                   The O. Ps. have filed four documents at page no. 50 to 55 and 57 on record.

17.                   The learned counsel for complainant Mr. S. B. Rajankar argued that, the surgery performed by doctor is emergency surgery as per Govt. G.R. at item No. 15 filed on record by O.P. at page No.55.  It is formality to issue certificate by doctor as an emergency operation to file claim of reimbursement of insurance claim for the son of complainant from Govt. of Maharashtra.  Non- issuing of the requisite certificate by opposite party after payment of all medical bills and charges of operation amounts to negligency of service on the part of doctor.

18.                   The learned counsel for O. P. Mr. M. R. Sule argued that,   the complainant is 75 years old person having problems of the stoppage of urine, pain while passing urine (Dusaria) burning while passing urine since last 6 months.  The complainant was catheterized.  Emergency surgery is defined in website www.surgeryencyclopedia.com.  These are the types of surgery which of not done urgently are likely to threaten the life of the individuals or are likely to damage other part of Body e.g. gangrene.  According to G.R. the Government included as emergencies in which TURP and cystoscopy are not included in the list given in the Govt. of Maharashtra issued list of 27 conditions included as emergencies in which TURP and Cystascopy are not included in the list given in GR as elective surgery.  BHP is one of the changes observed in the males between the age group of 50 yrs. to 60 yrs. due to this changes the patient suffers from pain while passing urine (Dusuria) strain while passing urine and sometimes inability to pass the urine (Retention).  The BHP is not an emergency condition but it is a slow onset process ongoing in the body the element BHP can be corrected by surgery.  TURP being one of the recent methods of surgical correction.  It is an elective surgery and hence has not found a place even in the text book on agrological surgery emergencies.  Hence the petition is deserves to be dismissed.

19.                   After hearing and going through the complaint and reply the following points came to be consideration.

REASONING & FINDINGS

20.                   The complainant has availed the medical services of O.P. by paying all fees and charges hence the complainant is consumer within the meaning of consumer as per Sec. 21(d) of Consumer Protection Act, 1986, hence issue No.1 is decided accordingly.

21.                   As per discharge summary of Soni Hospital filed on page No. 26 by complainant and on page No. 57 filed by respondent, the complainant was admitted on 11/11/2014 and operated on 12/11/2014 as an elective procedure of cystoscopy along with TUPR and discharged on 17/11/2014.  The history of complainant as per discharge card was for retention of urine-straining-Dysurid and burning micturition.  The complainant has complaint for retention of urine from 5 days back and he was catheterized he had quite retention of urine 15 days back hence was catheterized.  He was earlier operated for spine ailments.

22.                   As per www.surgeryencyclopedia.com, there are mainly two types of surgeries (1) Emergency Surgery and (2) Elective Surgery.  In case of emergency surgery which is not done urgently it likely to threaten the life or likely to damage the body part i.e. gangrene.  In case of Elective surgery this type of surgery which is not required to be done urgently or within 6 hours.

23.                   The complainant has problem of retention of urine and passing of urine and pain from last 6 months.  The complainant was aged between 50 to 60 years.  Due to age of retention of urine and passing of urine are common problem in these group of patient.  The ailment which the complainant was suggested surgery for being Hypertrophy of prostate BHP.  Due to change in hormones there is Dysuria means pain in passing urine and some times strain because of retention of urine.  This condition of BHP is not emergency condition.  The TURP being one of the methods of surgical correction.  So, it is not emergency operation.  It is an elective surgery as per text book on “Urological Emergencies” by Dr. Hunter Wessels (2^nd Edition, 2013).

24.                   The complainant was discharged on 17/11/2014 and there is no complaint about surgery and payment of bills.  The O.P. has issued all bills and discharge card to complainant.

25.                   The O.P. has performed his services at pre and post operation services properly.  As per Mah. Govt. Resolution of M.G.1015/C.R.-45/95/health-5, Mantralaya, Mumbai, dated 4^th July, 2000.  The TURP and cystoscopy  surgery of complainant has not been included in the category of emergency operation hence the complainant’s surgery is elective surgery for that a doctor’s is legal duty bound to issue certificate showing  emergency surgery which is not emergency surgery with intention to get monetary benefit  from Government under any Govt. Scheme.  The complainant has not filed any evidence of expert doctor or any medical literature to prove its contention that the surgery performed on complainant is emergency surgery.  The burden of proof for the contention has not been proved by complainant.  Therefore, there is no deficiency on the part of O.P. by not issuing emergency certificate for the surgery performed on complainant by O. P..  Hence, the complaint is dismissed as per following order and issue No.2 is decided in negative.

                            -: ORDER :-

1.            The complainant’s case is dismissed.

2.            No order as to costs.