Haryana

Sonipat

03/2015

Dharambir Singh S/o Bhagwan Singh - Complainant(s)

Versus

Dr. Ramesh Batra - Opp.Party(s)

REJESH DULL

11 Apr 2016

ORDER

BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM,

SONEPAT.

             

                             Complaint No.03 of 2015

                             Instituted on:02.01.2015

                             Date of order:11.04.2016

 

 

Dharambir Singh son of Bhagwan Singh (retired Field Man from the office of Asstt. Plant Protection Officer Sonepat) resident of village Pritampura, sub tehsil Rai, Distt. Sonepat.

 

…Complainant.       

Versus

 

1.Dr Ramesh Batra, Batra Nursing Home and Heart Care Centre, Old DC road, Sonepat.

2.Assistant Plant Protection Officer, Mini Sectt. Sonepat.

3.Insurance Company Ltd. the particulars will be supplied as and when disclosed by the respondents no.1 and 2.

                                                …Respondents.

 

COMPLAINT UNDER SECTION 12 OF

THE CONSUMER PROTECTION ACT,1986

 

Argued by: Sh. Rajesh Dhull, Advocate for complainant.   

          Sh.  RD Sharma & Sh. Ajay Garg, Advocates

for respondent no.1.

          Sh.  Ravinder Dahiya ADO. for respondent no.2.

         

Before-  Nagender Singh-President.

Prabha Wati-Member.

 

O R D E R

 

          Complainant has filed the present complaint against the respondents alleging therein that his wife Parmeshwari Devi was feeling ill and she was taken to the hospital of respondent no.1 on 14.10.2014 vide indoor no.155 dated 14.7.2014 and was admitted in ICCU and was discharged on 17.10.2014 after inserting a stent. The respondent no.1 charged Rs.1,57,150/- from the complainant.   The respondent no.1 assured the complainant that he also issued a emergency certificate for medical reimbursement and the amount will be reimbursed to him.   The complainant on 27.10.2014 submitted all the documents well within time with the respondent no.2 for reimbursement of the amount of Rs.157150/-, who forwarded the case to Civil Surgeon, Sonepat for issuing emergency certificate of the treatment of complainant’s wife, but the Civil Surgeon Sonepat did not issue emergency certificate as there is no emergency for inserting any stent in the heart of complainant’s wife and thus, respondent no.2 issued a letter no.812 dated 27.11.2014 to the complainant in this regard.  It is further submitted that non-reimbursement of the bill and due to negligence on the part of the respondent no.1, the complainant has suffered huge financial loss and he has also suffered unnecessary mental agony and harassment. So, he has come to this Forum and has filed the present complaint.

2.        The respondents no.1 and 2 appeared through their respective counsel and filed their separate written statement.

          The respondent no.1 in its written statement has submitted that the complainant is a Govt. servant and the Govt. authorities refused to issue him the emergency certificate and his claim was declined by the Govt. authorities and his claim is with regard to medical reimbursement and thus, this dispute does not come within the definition of service.  The dispute is between the complainant and his employer. The complainant is not a consumer of the respondent no.1.  The respondent no.1 did his duty with sufficient care and skill with the purpose to save the lift of complainant’s wife who came in a very critical condition.    The complainant’s wife had already undergone angioplasty in the year 2010. Angiography was done by Dr RR Mantri and as per report, there was 90% obstruction of the mid-right coronary artery.  The complainant was advised placement of the stent to relive the obstruction.  With the consent of the complainant and his relatives, successful PTCA/Stent (Yukon Choice PC 2.75x32mm to RCA) was done as per standard guidelines. The hospital bill of Rs.92150/- and the stent bill of Rs.68250/- was raised and the complainant has cleared the same.  The respondent no.1 has denied the fact that there was no emergency in inserting any stent in the heart of the complainant’s wife.  There is no negligence on the part of the respondent no.1. If the employer of the complainant denied to reimburse him on the ground that there was no emergency in the case of his wife, that opinion is not binding on the respondent no.1.  The complainant is not entitled for any claim from the respondent no.1 and thus, prayed for the dismissal of the present complaint.

          The respondent no.2 in his reply has submitted that the medical reimbursement does not come under the definition of service as envisaged in Section 2(1)(o) of Consumer Protection Act.  In case of the complainant, the requisite emergency certificate had been denied by the Civil Surgeon Sonepat with the remarks that the patient not took treatment in emergency. Accordingly vide letter no.812 dated 27.11.2014 the complainant was informed about the same. Thus, it cannot be said that there was any kind of deficiency in service on the part of the respondent no.2 and thus, prayed for the dismissal of the present complaint.

3.        We have heard the arguments  advanced by the learned counsel for both the parties at length.  All the documents have been perused very carefully and minutely.  We very carefully and minutely also perused the written arguments submitted on behalf of the complainant and respondent no.1 as well.

          The complainant in his written arguments has mentioned the pleadings of the complaint.  It is also submitted that without emergency certificate, the amount incurred by the complainant cannot be reimbursed to the complainant by his department.  If the complainant had got treated his wife in Govt. Hospital or Haryana Govt. Panel Hospitals, then he had not to pay any amount for the treatment of his wife.  Non-reimbursement of the bill and due to the negligence on the part of the respondent no.1, the complainant has suffered mental agony, harassment and huge financial loss. Dr. HR Singhal, CMO (Retired) did not find any emergency treatment which was given by respondent no.1 to the wife of the complainant and without any emergency, the respondent no.1 has charged Rs.1,57,150/- from the complainant and due to this, CMO Sonepat did not issue any emergency certificate and the complainant has suffered a loss of Rs.157150/- at the hands of the respondent no.1.

          In the present case, on the application filed on 9.7.2015 by the ld. Counsel for the complainant, Dr HR Singhal from Civil Hospital Sonepat was summoned as a witness for his cross-examination, who appeared before this Forum on 24.12.2015 for his cross-examination by Dr RR Mantri, MBBS MD DM (Cardiology)  DNB (Cardiology), FACC, FSCA Sir Ganga Ram Hospital New Delhi for Dr Ramesh Batra respondent.

          Ld. Counsel for the complainant has argued that the Civil Surgeon Sonepat did not issue emergency certificate to the complainant’s wife as there is no emergency in inserting any stent in the heart of complainant’s wife.  The respondent no.2 issued a letter no.812 dated 27.11.2014 to the complainant with the remarks that the patient was not in emergency condition and there was no need to insert stent and due to this, the amount incurred by the complainant could not reimbursed to him and this all has happened due to the negligence of the respondent no.1, who knowing well that there is no need to insert any stent, inserted the stent in the heart of the complainant’s wife through Dr RR Mantri working in Sir Ganga Ram Hospital, New Delhi.  So, the respondent no.1 is liable to refund the amount of Rs.1,57,150/- to the complainant alongwith interest and compensation.

          Ld. Counsel for the respondent no.1 has submitted that the complainant is a Govt. servant and the Govt. authorities refused to issue him the emergency certificate and his claim was declined by the Govt. authorities and his claim is with regard to medical reimbursement and thus, this dispute does not come within the definition of service.  The dispute is between the complainant and his employer. The complainant is not a consumer of the respondent no.1.  The respondent no.1 did his duty with sufficient care and skill with the purpose to save the lift of complainant’s wife who came in a very critical condition.    The complainant’s wife had already undergone angioplasty in the year 2010. Angiography was done by Dr RR Mantri and as per report, there was 90% obstruction of the mid-right coronary artery.  The complainant was advised placement of the stent to relive the obstruction.  With the consent of the complainant and his relatives, successful PTCA/Stent (Yukon Choice PC 2.75x32mm to RCA) was done as per standard guidelines. The hospital bill of Rs.92150/- and the stent bill of Rs.68250/- was raised and the complainant has cleared the same.  The respondent no.1 has denied the fact that there was no emergency in inserting any stent in the heart of the complainant’s wife.  There is no negligence on the part of the respondent no.1. If the employer of the complainant denied to reimburse him on the ground that there was no emergency in the case of his wife, that opinion is not binding on the respondent no.1.  The complainant is not entitled for any claim from the respondent no.1.

          Dr. Mukesh Joon, Doctor of Joon’s Superspeciality Heart and Diabetes Clinic, Sonepat has issued a certificate mentioning therein that unstable angina is a condition which is characterized by pain chest occurring on rest.  It is possible that ECG is normal in ustable angine.  It is a medical emergency.  There is significant morbidity and mortality in this disease.  It increases manifold if patient is already having coronary artery disease. Coronary angiography decides the final plan of treatment.  If there is a critical lesion in one artery PTCA and Stent is the treatment of choice. If lesions in coronary artery are not suitable for PTCA and Stent, CABG may also be required.

          Similarly, Dr RR Mantri, Doctor of Sir Ganga Ram Hospital, New Delhi has issued the certificate that Parmeshwari Devi, who was known case of coronary artery disease with previous PTCA and stent in LAD in 2010 presented with 15 days history of progressively increasing chest pain (angina) which was occurring at rest also in last 24 hours prior to admission despite ongoing medicines.  Her coronery angiography revealed 90% critical disease in RCA.  This was unstable angina with critical blockage in one of the major artery and is a medical emergency.  Her immediate angioplasty with stenting was necessary to save any complication due to underlying disease  which could have been harmful and even fatal to her life.

          It is also pertinent to mention here that during the cross-examination of Dr. HR Singhal, Dr. RR Mantri has put a question to Dr HR Singhal :-

          “Why following facts are totally ignored in the statement submitted?

1.    Patient already is known cardiac patient. Stent in one artery.
2. Patient having chest pain on activity which is gradually increasing for last 15 days and pain at rest associated with sweating and Ghabarhat (very serious signs).
3. Angiogram done shows critical life threatening  (90% blockage in right coronary artery.
4. Treatment given in form of Ecosprin, Plagril, Dilzem, Cristor and injection.

These facts are totally overlooked by Dr HR Singhal and they are the most vital facts.

Ans     It is correct that I have not mentioned these things in my affidavit Ex.CW2/A.”

Q:        Is unstable angina not a cardiac emergency?

Ans.      Yes. It is correct that unstable angina is medical emergency.

 

          In the cross-examination, Dr HR Singhal deposed that I have not acquired any medical degree specifically for any heart disease.  I have not seen the patient.  So, I cannot tell the critical condition of the patient at that time.

 

          Now the main question arises for consideration before this Forum is whether the complainant by way of present complaint is entitled for any relief or not?

 

          In the present case, Dr HR Singhal was cross-examined by Dr RR Mantri and it is gathered from the cross-examination of Dr HR Singhal (who has tendered his affidavit Ex.CW2/A) that the patient i.e. wife of the complainant was in emergency and the treatment given by the respondent no.1 doctor was legal, perfectly justified and as per medical procedure only to save the life of the complainant’s wife.  The affidavit and cross examination of Dr HR Singhal reveals that he is not a cardiologist.  He had not taken into consideration the history of chest pain even at rest.  He had not taken into consideration the fact that the patient was already having compromised heart with stenting done in 2010 making her more vulnerable for mortality and morbidity if her angina was not treated promptly and properly. He had not taken into consideration the findings of the angiography which had revealed 90% blockage in RCA.  The incorrect opinion of Dr HR Singhal is rebutted by expert opinion of Dr RR Mantri and Dr Mukesh Joon.  The complainant has not come forward to rebut the evidence led by the respondent no.1 in support of his case and that’s why, the same has gone unrebutted and unchallenged.  This Forum is also unable to ignore the evidence led by the respondent no.1 since it is not rebutted or challenged by the complainant. In our view, the respondent no.1 had given a proper and correct treatment as was expected from a doctor under the circumstances.  If he had not advised emergency admission and not provided prompt & proper treatment, that would have amounted to medical negligence. So, the complainant is not entitled for any relief and compensation from the respondent no.1 doctor and no directions to refund any amount by the respondent no.1 to the complainant can be given in any manner thus, we hereby dismiss the present complaint as it has no merit against the respondent no.1 doctor.

          However, since it has been proved that the wife of the complainant was in emergency and the respondent no.1 had given a proper and correct treatment, thus, in the interest of justice, we hereby direct the respondent no.2 to consider the reimbursement bill of the complainant sympathetically and to forward the same to the higher authorities as per rules because it is proved in the present case that the wife of the complainant was in emergency and the respondent no.1 had given a proper and correct treatment to her.  The complainant shall complete all the formalities in this regard. 

          The parties are left to bear their own costs.

          With these observations, findings and directions, the present complaint qua respondent no.1 doctor stands dismissed.

          However, the respondent no.2 has been given some directions in the preceding para, thus, we hereby dispose off the present complaint qua respondent no.2.

          Certified copy of this order be provided to both the parties free of cost.

File be consigned to the record-room.

 

 

 

(Prabha Wati)                   (Nagender Singh-President)

Member DCDRF                                DCDRF, Sonepat.

 

Announced: 11.04.2016