BEFORE THE DISTRICT CONSUMER DISPUTES

REDRESSAL FORUM, JALANDHAR.

Complaint No.240 of 2014

Date of Instt. 22.07.2014

Date of Decision :12.06.2015

1. Neeraj Piplani, aged about 33 years son of Late Sh.P.P.Piplani;

2. Leena Piplani aged about 35 years D/o Late Sh.P.P.Piplani;

Both residents of House No.30, Ravinder Nagar, Near Urban Estate, Phase-II, Jalandhar.

..........Complainants Versus

1. Dr.VP Sharma, Cardiologist, ShriRam Cardiac Centre, Joshi Hospital Building, Kapurthala Chowk, Jalandhar.

2. National Insurance Company Limited, NN-8, Patel Chowk, Jalandhar through its Branch Manager.

.........Opposite parties

Complaint Under Section 12 of the Consumer Protection Act,1986.

Before: S. Jaspal Singh Bhatia (President)

Ms. Jyotsna Thatai (Member)

Sh.Parminder Sharma (Member)

Present: Sh.Anand Pandit Adv., counsel for complainants.

Sh.Umesh Dhingra Adv., counsel for OP No.1.

Sh.Jaswant Singh Adv., counsel for OP No.2.

Order

J.S.Bhatia (President)

1. The complainants have filed the present complaint under section 12 of the Consumer Protection Act, against the opposite parties on the averments that the complainants are only legal heirs of Late Sh.P.P.Piplani son of Chander Bhan resident of House No.30, Ravinder Nagar, Jalandhar who died on 2.5.2014. The wife of the Late Sh.P.P.Piplani had already expired few years back. The opposite party claims to be Super Specialist in Cardiology, and claims to run a fully equipped and modern techniques of cardiac care centre at the address given above in the head note of the present complaint. On 28.4.2014, the Late Sh.P.P.Piplani had suffered pain in left side of chest and left arm and breathlessness. He was brought by the complainant to ShriRam Cardiac Centre, which is run by the opposite party as stated above, where he was admitted indoor by the opposite party saying that Sh.P.P.Piplani had suffered a heart attack. After admission, opposite party conducted a series of diagnostic tests on the patient, and ultimately decided to conduct Coronary Angiography on him in order to determine the extent of blockage in the coronary arteries of the patient. Opposite party performed Coronary Angiography on Sh.P.P.Piplani in the Cath Lab of his centre on 28.4.2014 and came out declaring 85% blockage in two main coronary arteries and 100% blockage in the small artery of the patient but he did not advice or perform any procedure on the pateint to treat blockage in his arteries. It is further mentioned that the patient was under the complete charge and treatment of opposite party and he as a super specialist cardiologist, should have had advised the procedure there and then to treat the 100% blockage in the coronary arteries. Opposite party neither performed any angioplasty nor performed/advised coronary arteries Bye Pass grafting surgery, though either of the two procedures were the line of the treatment required on the patient. It is further mentioned that the stenting can be done by the cardiologist but the same has to be done in the presence of the Cardiac Surgeon, so that if there arises any complications while stenting, then the Cardiac Surgeon can handle the situation and perform the bye pass immediately upon the patient concerned. The complainant came to know few days back that the cardiac surgeon was not available in the hospital of the opposite party since last many days from the day Sh.P.P.Piplani was admitted by the opposite party in the hospital, as such, the opposite party was in no condition to do any treatment/stenting/bye pass on Sh.P.P.Piplani to cure the blockage in the arteries. The opposite party did not bring this fact of absence of cardiac surgeon in the knowledge of the complainants at any point of time which ultimately resulted in the death of the patient, as such, the opposite party acted with negligence on this score. Besides, and in addition to the above glaring negligence, dye testing before performing angiography on the patient was either not done at all or it was not done correctly. Because within 20 minutes of angiography, the patient developed anaphylastic shock which included cardiogenic shock. His condition started deteriorating and his vital parameters like blood pressure, heart rate, breathing, sweating, coldness/numbness went out of normal range. It appears that patient had developed severe allergy reaction to the dye/medicine/procedure because his treatment chart at that particular time showed administering of AVIL injection to him, which indicates severe allergy reactions. The opposite party however, did not disclose or discuss this condition of the patient, with the complainants. This constitutes another act of negligence and professional deficiency on the part of the opposite party. It is further mentioned that during the above said crisis condition of the patient, he also developed kidney failure/complications and did not pass the urine at all for five hours after performing of angiography upon him by the opposite party. This very serious and life threatening complication also arose due to the inefficient performing of angiography by the opposite party and anaphylactic shock. Temporary shock renal failure and cardiogenic shock are a part of anaphylactic. Sh.P.P.Piplani, never recovered from the above stated complications and his condition kept on deteriorating, and ultimately he expired at about 4.20 Am on 2.5.2014 in the cardiac centre of the opposite party. After the onset of the crisis after angiography and till his death, the patient was being put on ventilator and then taken off. However, during his particular period, the opposite party did not adopt any type of cardiac intervention or procedure, even when the parameters of the patient were stable on 29.4.2014 and 30.4.2014. Due to non-availability/non-providing of the appropriate treatment, the vital parameters of the patient had kept on deteriorating, and he was never stabilized, even after the genuine request of the complainants to do stenting on the patient. The main reason of not performing the stenting/bye pass on the patient was that the opposite party was incapable of performing the same, as the same could have only be done by the cardiac surgeon and not by the cardiologist which fact was not disclosed by the opposite party to the complainants. Had the opposite party disclosed this fact to the complainants, the complainants could have taken the patient to some hospital where the surgery could have been performed and they could have saved the life of the patient, but the opposite party never performed his part of official duty towards the patient to save his life, which clearly proves the fact that the negligence of the opposite party resulted in the death of the patient Sh.P.P.Piplani. After the death of Sh.P.P.Piplani, the complainants contacted the opposite party No.1 telephonically to provide the complete record of the patient, but the opposite party No.1 did not accede to the genuine requests of the complainants and kept on lingering the matter for the reasons best known to the opposite party. The complainants even personally contacted the opposite party No.1 to provide the documents related to Sh.P.P.Piplani, as they are the legal heirs of the deceased and have complete right to have the record of the entire medical file of the patient from the day he was admitted in the hospital of the opposite party No.1 till the time of his death, but the opposite party No.1 behaved very rudely with the complainants and stated that he will not provide any document to the complainants and they can do whatever they want to do. The complainants were left with no other option, but to give the application in writing for providing the documents. The copy of the same is attached herewith for kind perusal of this Forum. Furthermore, it is further mentioned that in the medical bills the complainants have not been charged with the ECHO charges, which are alleged to have been performed on the patient Sh.P.P.Piplani by the opposite party. The complainants requested the opposite party to supply the report of ECHO if the same has been performed upon the patient, but the opposite party remained reluctant not to give any document even the report of ECHO which is alleged to have been performed upon the patient. As such, from the above facts, it can be safely gathered that either the ECHO was never performed upon Sh.P.P.Piplani or if the same was performed, the opposite party is aware of the fact that if the copy of the same is supplied to the complainants, then the negligence of the opposite party would come in light the same moment. On such like averments, the complainant has prayed for Rs.15 Lacs as damages/compensation and further Rs.33,000/- on account of litigation expenses.

2. Upon notice, opposite parties appeared and filed their written replies. In its written reply, opposite party No.1 pleaded that patient Sh.P.P.Piplani, age 67 years, male was brought to the hospital of opposite party with the complaint of chest pain left side radiating to left arm previous night with breathlessness on exertion. It is further mentioned that the complainant has not disclosed the true and rather concealed the fact, that before bringing the patient to the hospital of opposite party, he was taken to S.G.L Charitable Hospital where he was diagnosed after preliminary investigation to be suffering from heart attack for which he was advised admission but the same was refused by the son/complainant and as such was prescribed medicines by the attending doctor. As per the record of SGL Hospital the patient was also advised to consult Nephrologist and Orthopedician. Thereafter,on 28.4.2014 when the patient came to the hospital of opposite party, he was diagnosed and CAG (Coronary Angiography) was done and which was over by 5.00 PM. The patient developed chest pain, sweating with fall in blood pressure at 7.00 PM, after two hours which was because of heart decease which the patient was suffering at the time of presentation to the hospital of opposite party. However, the patient was managed according to given circumstances in best possible manner through drugs/IABP support device/ventilator to give him life support. It is further mentioned that the patient had suffered heart attack more than 24 hours ago, to open artery which was 100 % blocked and also a relatively small size vessel, it was of no benefit. The patient has also blockages in the other arteries of the heart. In the case of the patient where all his 3 arteries are having severe blockages, heart attacks, in recent days, the prognosis is very poor inspite of the best treatment. All these facts about the condition of the patient was explained to the attending relatives and the risk of doing the procedure in the form of PTCA/CABG was well explained to them to which the attendants/relatives Neeraj Piplani and Shivani were not willing and ready. It is further mentioned that the CABG is not a treatment of choice for such patient in the presence of acute heart attack because the mortality and risk are very high. Moreover, if CABG has to be done then the same is to be conducted after few days of stabilization of the patient only and hospital of opposite party which is Renowned Cardiac Centre is doing routinely in such circumstances. It is further mentioned that the presence of cardiac surgeon in such circumstances is not required now a days as alleged by the complainant, only a ready cardiac OT is required and the surgeon is on standby for which arrangement the hospital of opposite party already have permanent surgeon and in the event of their non-presence the availability of standby surgeons are there. The hospital of opposite party has full cardiac surgery team of two surgeons, five anaesthesists, two perfusionists, seven OT technicians and there scrub nurses alongwith other trained para-medical staff. The hospital of opposite party have performed many such procedures during period 27.4.2014 to 2.5.2014 which is not related to the presence or absence of cardiac surgeons on side. All other facts regarding performing other methods of treatment are not correct. It is further mentioned that when the patient was a hight risk case, due to high blood pressure, he was put to life support system of ventilator and IBP. At that stage the attendants of the patient were not wiling to give consent to take high risk as there is every possibility of death on table. Therefore, the attendants/relatives did not give their consent for any such procedure. Therefore the opposite party gave the required treatment to the patient for making the patient stable so that the procedure can be done at low risk. It is wrong that the cardiac surgeon was not available in the hospital of opposite party and that the opposite party was in no condition to do any treatment as alleged. It is further mentioned that no dye testing is done before coronary angiography at any place in the world. Even if the patient give the history of dye reaction, the procedure can be still performed. The allegation that within 20 minutes of angiography, patient developed anaphylactic shock or cardiogenic shock is incorrect. In fact, for a period of 2 hours there was no complication to the patient. It is wrong that the condition of patient started deteriorating and his vital parameters like blood pressure, heart rate, breathing, sweating, coldness, numbness went out of normal range. It is wrong that the patient had developed severe allergy reaction to the dye/medicine/procedure because of administering Avil Injection to him or that indicates severe allergy reaction. In fact, the avail is given routinely before all Cath Lab procedure as a precautionary measure to all the patients before starting coronary angiography. In fact, the serious condition of patient was regularly conveyed to the attending relatives and their permission to continue the treatment was regularly sought. Patient developed kidney failure due to cardiogenic shock which was the result of his long heart disease and not because of any dye-reaction. It is again submitted here that before the patient was brought to hospital of opposite party, the patient was advised previously to consult Nephrologist and Orthopedician by the attending doctor of SGL Charitable Hospital due to the history of Nephrectomy which fact was concealed and not disclosed by complainant. The fact of the kidney failure (No Urine) was a transient failure which lasted for four hours and as the blood pressure was stable the urine also started coming. Thereafter, there was good urine flow. It is further mentioned that the urine flow is very sensitive index of heart condition and it drop immediately once the heart condition deteriorates and it improves as the heart condition, as in the presence case. The patient condition improve over initiation of required measures and he was taken off some drugs(Non epinephrine) and ventilator on 30.4.2014 at 1.10 PM. All these facts contradict the allegation of complainant as alleged in the complaint. The patient had sudden fall in blood pressure with cardiac arrest at 3.00 PM from which the patient did not recover due to cardiac rupture as shown in Echo done at bed side which demonstrated large blood collection around the heart in pericardium. In fact, the condition of patient was serious because of acute heart attack which occur to the patient few days back and the patient did not get proper treatment for the same. Moreover, due to several blockages in all three arteries of patient made his condition serious and critical. The patient had cardiogenic shock i.e fall in blood pressure due to his condition of heart and due to the kidney failure of the patient indicating a severe disease. Therefore, the patient was kept in IABP and ventilator support. It is again mentioned that in such kind of patients they have poor prognosis with 80% in hospital mortality inspite of the best efforts of giving treatment. The said mortality can be improved by doing PTCA/CSBG but to only 50% meaning thereby such patient still die upto 50% inspite of all the efforts. The attendants/relatives of the patient were completely explained the risks at every point of time and they were not ready to take risk and rather preferred to wait for more stability of the patient and did not give specific consent for the same. It is further mentioned that the cardiac centre of opposite party is known for the capability, credibility, honesty and is a ethical centre having been most capable of treating cardiac patient in this area and region. The opposite party who is having maximum year of standing as a cardiologist of treating such kind of patient and is committed to high degree of competence and in performing high risk procedure but with the consent of patient relatives. The patient expired because of cardiac rupture due to his critical condition as explained above which would have occurred after PTCA of other vessel. Cardiac rupture is known complication of any heart attack and the same is cause of sudden death. All the records were handed over and taken by the complainant. It denied other material averments of the complainants.

3. In its written reply opposite party No.2 insurance company pleaded that the opposite party No.2 has insured the opposite party No.1 vide policy No.401110/46/13/8700000023 for the period 6.7.2013 to 5.7.2014 under the professional indemnity insurance policy for indemnifying the insured in the claims arising out of bodily injury and/or death of any patient caused by or alleged to have been caused by error, omission, or negligence in professional service rendered or which should had been rendered by the insured. In the present case, there is neither any error nor any omission or negligence on the part of opposite party No.1 as such there is no liability of opposite party No.2 and the complaint is liable to be dismissed. It denied other material averments of the complainants.

4. In support of their complaint, learned counsel for the complainants has tendered into evidence affidavit Ex.CW1/A alongwith copies of documents Ex.C1 to Ex.C8 and evidence of complainant was closed by order.

5. On the other hand, learned counsel for opposite party No.1 has tendered affidavit Ex.OP/A alongwith copies of documents Ex.OP1 and closed evidence. Further learned counsel for opposite party No.2 has tendered affidavit Ex.OP2/A alongwith copies of documents Ex.OP2/1 and Ex.OP2/2 and closed evidence.

6. We have carefully gone through the record and also heard the learned counsels for the parties.

7. Counsel for the complainant contended that on 28.4.2014 patient namely Sh.P.P.Piplani suffered pain in left side of chest and left arm and further breathlessness and was taken to ShriRam Cardiac Centre of opposite party No.1, wherein angiography was performed and as per report of angiography there was blockage of 85% in two main coronary arteries and 100% blockage in the small artery of the patient but opposite party No.1 did not advice or perform any procedure to treat blockage in the arteries of the patient. He further contended that opposite party No.1 should have performed angioplasty or Bye Pass grafting surgery but no such procedure was performed even during the period when the condition of the patient was stable. He further contended that the above said procedures were not conducted by the opposite party No.1 as cardiac surgeon was not present in the hospital at the relevant time. He further contended that within 20 minutes of angiography, the patient developed anaphylastic shock and his condition started deteriorating and it appears that severe allergy reaction due to the dye/medicine/procedure developed because the treatment chart shows that AVIL injections were given to him which indicates severe allergy reactions. He further contended that due to above said shock renal failure also occurred and patient did not pass the urine for five hours after performing of angiography. He further contended that in fact the death of the patient occurred due to medical negligence of opposite party No.1. In support of his above contentions, the complainant has relied upon Satyanarayan Aggarwala Vs. Dr.Alaka Goswami, 2014(1) CLT 94, V.Krishan Rao Vs. Nikhil Super Specialist Hospital and another (2010) 5 Supreme Court Cases 513, Modern Hospital and others Vs Nasib Kaur and another 2010(2) CLT 492.

8. On the other hand, it has been contended by learned counsel for opposite party No.1 that opposite party No.1 is super specialist in cardiology having a degree of MD., DM Cardiology with experience of about 25 years in this field and has treated thousands of patient in said field. He further contended that Sh.PP Piplani aged 67 years was brought to the hospital with the complaint of chest pain on left side radiating to left arm previous night with breathlessness on exertion. He further contended that complainants have not disclosed the true facts that before bringing the patient to the hospital of opposite party No.1, he was taken to S.G.L Charitable Hospital and was diagnosed to be suffering from heart attack for which he was advised admission but the same was refused by the son/complainant. He further contended that above said hospital has advised the patient to consult Nephrologist and Orthopedician. He further contended that angiography was performed on the patient which was over by 5.00 PM but he developed chest pain, sweating with fall in blood pressure at 7.00 PM i.e after two hours because of heart decease and he was managed according to given circumstances in best possible manner through drugs/IABP support device/ventilator to provide him life support. He further contended that the prognosis of the patient was very poor and condition of the patient was explained to the attending relatives and the risk of doing the procedure in the form of PTCA/CABG but they were not ready. He further contended that the CABG is not a treatment of choice for such patient in the presence of acute heart attack and if CABG has to be done then the same is to be conducted after few days of stabilization of the patient. He further contended that patient never became stable for sufficient time to perform any procedure upon him. He further contended that hospital of opposite party No.1 have full cardiac surgery team of two surgeons, five anaesthesists, two perfusionists, seven OT technicians and there scrub nurses alongwith other trained para-medical staff and the Cardiac Centre of opposite party No.1 has performed many such procedure previously. He further contended that patient never developed any reaction or shock and Avil Injection is given precautionary measures as in his case before performing the angiography or before performing all Cath Lab procedure. He further contended that if the patient unfortunately could not survive, the opposite party No.1 can not be blamed and there was no medical negligence on his part. We have carefully considered the contentions advanced by learned counsel for both the parties.

9. The above authorities relied upon by learned counsel for the complainants are on its own facts. It depends upon the facts and circumstances of each case whether the complainant has been able to prove medical negligence or not. The law regarding medical negligence is well established. In KUSUM SHARMA & ORS VS BATRA HOSPITAL & MEDICAL RESEARCH CENTER & ORS 1(2010) CPC 29 (SC), the Hon'ble Supreme Court has held as under:-

" This Court in a landmark judgment in Jacob Mathew v. state of Punjab & Another, III (2005) CCR 9 (SC)=VI (2005) SLT 1=122(2005) DLT 83 (SC)=III (2005) CPJ 9 (SC)=(2005) 6SCC. 1 while dealing with the case of negligence by professionals also gave illustration of legal profession. The Court observed as under:

"In the law of negligence, professionals such as lawyers, doctors, architects and others are included in the category of persons professing some special skill or skilled persons generally. Any task which is required to be performed with a special skill would generally be admitted or undertaken to be performed only if the person possesses the requisite skill for performing that task. Any reasonable man entering into a profession which requires a particular level of learning to be called a professional of that branch, impliedly assures the person dealing with him that the skill which he professes to possess shall be exercised and exercised with reasonable degree of care and caution. He does not assure his client of the result. A lawyer does not tell his client that the client shall win the case in all circumstances.

A’ physician would not assure the patient of full recovery in every case. A surgeon cannot and does not guarantee that the result of surgery would invariably be beneficial, much less to the extent of 100% for the person operated on. The only assurance which such a professional can give or can be understood to have given by implication is that he is possessed of the requisite skill in that branch of profession which he is practicing and while undertaking the performance of the task entrusted to him he would be exercising his skill with reasonable competence. This is all what the person approaching the professional can expect. Judged by this standard, a professional may be held liable for negligence on one of 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 necessary for every professional to possess the highest level of expertise in that branch which he practices. In Michael Hyde and Associates v. J.D. Williams & Co. Ltd., [2001] P.N.L.R. 233, CA, Sedley L.J. said that where a profession embraces a range of views as to what is an acceptable standard of conduct, the competence of the defendant is to be. judged by the lowest standard that would be regarded as acceptable.”

It is a matter of common knowledge that after happening of unfortunate event, there is a marked tendency to look for a human factor to blame for an untoward event, a tendency which is closely linked with the desire to punish. Things have gone wrong and, therefore, somebody must be found to answer for it. A professional deserves total protection. The Indian Penal Code has taken care to ensure that people who act in good faith should not be punished. Sections 88, 92 and 370 of the Indian Penal Code give adequate protection to the professional and particularly medial professionals."

Literature of para No.1 to 11

Negligence is the breech of a duty exercised by omission to do something which a reasonable man, guided by those considerations which ordinarily regulate the conduct of human affairs, would do, or doing something which a prudent and reasonable man would not do. Negligence is an essential ingredient of the offence. The negligence to be established by the prosecution must be culpable or gross and not the negligence merely based upon an error of judgment. The medical professional is expected to bring a reasonable degree of skill and knowledge and must exercise a reasonable degree of care. Neither the very highest nor a very low degree of care and competence judged in the light of the particular circumstances of each case is what the law requires. A medical practitioner would be liable only where his conduct fell below that of the standards of a reasonably competent practitioner in his field. In the realm of diagnosis and treatment there is scope for genuine difference of opinion and one professional doctor is clearly not negligent merely because his conclusion differs from that of other professional doctor. The medical professional is often called upon to adopt a procedure which involves higher element of risk, but which he honestly believes as providing greater chances of success for the patient rather than a procedure involving lesser risk but higher chances of failure. Just because a professional looking to the gravity of illness has taken higher element of risk to redeem the patient out of his/her suffering which did not yield the desired result may not amount to negligence. Negligence cannot be attributed to a doctor so long as he performs his duties with reasonable skill and competence Merely because the doctor chooses one course of action in preference to the other one available, he would not be liable if the course of action chosen by him was acceptable to the medical profession. It would not be conducive to the efficiency of the medical profession if no Doctor could administer medicine without a halter round his neck. It is our bounden duty and obligation of the civil society to ensure that the medical professionals are not unnecessary harassed or humiliated so that they can perform their professional duties without fear and apprehension. The medical practitioners at times also have to be saved from such a class of complainants who use criminal process as a tool for pressurizing the medical professionals/hospitals particularly private hospitals or clinics for extracting uncalled for compensation. Such malicious proceedings deserve to be discarded against the medical practitioners. The medical professionals are entitled to get protection so long as they perform their duties with reasonable skill and competence and in the interest of the patient. The interest and welfare of the patients have to be paramount for the medical professionals".

10. In the present case opposite party No.1 is DM Cardiology. This fact is in there in his affidavit Ex.OP/A. So he was competent doctor to treat the patient in question. Ex.OP1 is treatment file of the patient. He was admitted in the hospital of opposite party No.1 on 28.4.2014. Admittedly angiography was done on the patient on the same day and the patient was having blockage 85% in two main coronary arteries and 100% blockage in the small artery. The grievance of the complainant is that the opposite party No.1 did not perform angioplasty and stenting or open heart surgery to save the patient and according to him, the same was not done as no cardiac surgeon was present. The opposite party No.1 has denied these facts. According to opposite party No.1, the condition of the patient never became stable for sufficient long period to perform any procedure upon him without risk. From the perusal of the treatment chart it is evident that on 28.4.2014 at 7.00 PM i.e after angiography the blood pressure of the patient was 70/40 mmHg and heart rate was 46 per minute. So at 7.00 Pm on 28.4.2014, the blood pressure and heart rate of the patient was low. In treatment charge it is mentioned that bad prognosis explained to the relative. This fact is recorded in the medical note given at 7.40 PM on the same date and at that time also blood pressure was low i.e 90/40. At 8.00 PM his blood pressure was 80/40. In medical notes written at 8.00 PM it is again specifically mentioned that bad prognosis fully explained to the relatives. In the medical note written at 8.20 AM it is mentioned that the patient was put on IABP support. In the medical note mentioned on 28.4.2014 at 10.40 PM it is mentioned that general condition of the patient is sick and patient was put on ventilator support. It is also mentioned that condition fully explained to the attendants. Again in medical note of 29.4.2014 made at 9.40 AM it is mentioned that general condition of the patient is sick and still on ventilator support. Again in medical note made on 29.4.2014 at 7.00 PM it is mentioned that general condition sick and poor prognosis explained to the relatives. In medical note of 30.4.2014 of 7.30 AM it is also mentioned that general condition of the patient is also sick and serious and patient still put on ventilator support. As per medical notice, the patient was successfully removed from ventilator support at 12.45 PM on 30.4.2014. On 30.4.2014 at 4.00 PM the patient complaint of pain over left shoulder. No doubt in medical note written at 6.25 PM on 30.4.2014 it is mentioned that patient general condition is better than before. On 1.5.2014 at 9.30 Am general condition of the patient is mentioned as better than before but in medical note made on 1.5.2014 at 11.45 AM it is mentioned that sudden complaint of chest pain alongwith sweating and at that time his blood pressure was recorded as 50/30. So condition of the patient again deteriorated. He complained of chest pain alongwith sweating and his blood pressure was also low at that time. In medical note made at 1.5.2014 at 2.00 PM it is mentioned that patient poor prognosis fully explained. However, as per medical note on 1.5.2014 at 8.00 PM general condition of the patient was better than before but was still on IABP support. In the medical note written on 1.5.2014 at 3.00 AM during night (i.e 2.5.2014), it is mentioned that his BP suddenly falls and had cardic arrest. In the medical note it is also mentioned that ECG shows straight line and finally declared dead at 4.20 Am and dead body handed over to the relatives. So from the medical notes given in the treatment file it appears that condition of the patient never became stable for sufficient period to perform any surgery or procedure upon him. So in the above circumstances, if the patient could not survive unfortunately, the opposite party No.1 can not be blamed and held liable for medical negligence. Before coming to the hospital of opposite party No. 1, patient had also gone to SGL Charitable Hospital which is super specialisty hospital and its OPD slip is on record. He was also advised to consult Nephrologist and Orthopedician. He went to that hospital on 28.4.2014 before coming to the hospital of opposite party No.1. So he was already having heart problem and kidney problem. The opposite party No.1 is a qualified doctor i.e DM Cardiology. It is for attending doctor to adopt the line of treatment, keeping in view the condition of the patient. Simply on the ground that angioplasty and stenting or open heart surgery was not done, it can not be concluded that opposite party No.1 was guilty of medical negligence in not doing so. Since condition of the patient never became stable for sufficient period and as such either of the above said procedure was not performed. Opposite party No.1 was not to gain anything by not performing angioplasty and stenting or open heart surgery, if the condition of the patient permitted to do so. The complainant has not led any cogent and reliable evidence to prove that the death of Sh.P.P.Piplani was due to any medical negligence on part of opposite party No.1.

11. In view of above discussion, we hold that there is no merit in the complaint and same is hereby dismissed with no order as to cost. Copies of the order be sent to the parties free of costs under rules. File be consigned to the record room.

Dated Parminder Sharma Jyotsna Thatai Jaspal Singh Bhatia

12.06.2015 Member Member President