Tamil Nadu

South Chennai

CC/152/2013

M.Samoon Rawoothar - Complainant(s)

Versus

Dr.A.L.Narayanan, - Opp.Party(s)

Party in Person

26 Nov 2021

ORDER

                                                                           

                                                                                                                                                             Date of Complaint Filed:18.03.2013

                                                                                                                                                             Date of Reservation: 09.11.2021

                                                                                                                                                             Date of Order: 26.11.2021

                                                                                                       

DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION,

CHENNAI (SOUTH)

 

Present:

 

                  Thiru. R.V.R. Deenadayalan, B.A., B.L.                                  : President

                 Thiru. T. Vinodh Kumar, B.A., B.L.                                           : Member

 

CONSUMER COMPLAINT No.152/2013

 

FRIDAY, THE 26^TH DAY OF NOVEMBER 2021

                                

 

S/o.M.Samoon Rowoothar,

S/o.Late Meeral Hussain Rawoothar,

No.1, Officer Club Road,

Kadambady,Nagapattinam.                                                                      .. Complainant.                                                              

..Versus..

 

1.Dr.A.L. Narayanan, M.D., D.M.,

   New No.24, Old No.47,

   Vaidhyanathan Street,

   Nugambakkam, Chennai – 600 034.

 

2.Dr.S.Gopal,

   Vijaya Hospital,

   New No.434, Old No.180,

   NSK Salai, Vadapalani,

   Chennai – 600 026.

 

3.Senior Manager (H.R.)

   Vijaya Hospital,

   New No.434, Old No.180, NSK Salai, Vadapalani,

   Chennai – 600 026.                                                                           ..  Opposite parties.

******

 

Counsel for the complainant                              : Mr.A.Srivastava, Advocate.

Counsel for the 1^st & 2^nd opposite parties       : M/s. Dr.B.Cheran.

Counsel for the 3^rd opposite party                   : Exparte

 

                On perusal of both side records and after having heard the oral arguments of opposite parties we delivered the following:

ORDER

Pronounced by the President Thiru. R.V.R. Deenadayalan, B.A., B.L.

            The complainant has filed this complaint under section 12 of the Consumer Protection Act, 1986 for seeking direction to repay a sum of Rs.53,639/-  towards the treatment of the complainant and to pay a sum of Rs.80,493.14/- towards medical expenses incurred at the Apollo Hospital and to pay a sum of Rs.3,00,000/- towards compensation for suffering and mental agony with interest @ 12% per annum to the complainant.

2. In order to prove the case, on the side of the complainant proof affidavit submitted as his evidence and documents Ex.A1 to Ex.A16 documents were marked and written argument filed and not adduced oral argument on his side. While so, on the side of the 1^st opposite party, the proof affidavit submitted as his evidence and Ex.B1 and Ex. B6 documents were filed and written argument filed and also adduced oral argument of 1^st and 2^nd opposite parties. The 3^rd opposite party was set ex-parte on 28.01.2014.

                3. The averments of the complaint in brief are as follows:-

            The complainant having swelling and redness in his right leg for 10 days, for which  complainant consulted the 1^st opposite party who is  Dr. A.L. Narayanan on 26.01.2012.  On examination, he advised that the complainant has to admit in the 3^rd opposite party Hospital for further management. Accordingly the complainant was also admitted in the Vijaya hospital, Chennai/3^rd opposite party on 27.01.2012. The complainant was given treatment in the hospital under guidance of the 2^nd opposite party, who is the Doctor S.Gopal and he administered IV injections and Medicines, after which the complainant suddenly developed features of blood vomiting and also bleeding through his anus. Hence the complainant was immediately discharged by the 1^st and 2^nd opposite parties on 30.01.2012 with an advice to do upper GI endoscopy, for which Dr.K.R.Palanisamy, Gastroenterologist at Apollo Hospitals, Chennai was recommended. The complainant was admitted at Apollo Hospitals on 30.01.2012 in a critical and serious condition. The complainant was found blood clot present in his stomach for which the complainant was given best treatment and cured completely and thereby his life was saved in time at the Apollo Hospital, Chennai. The complainant state that the opposite party was prescribed Inj.Dalacin 600 mg once in 8^th hourly, due to which the complainant had a sudden bout of bleeding and vomited blood but it was not stopped by the opposite parties. Hence the complainant   stated that the opposite parties had committed negligence in the diagnosis of the disease and on the basis of such faulty Diagnosis, proceeded with wrong treatment by which the opposite parties committed deficiency in service. Experts held that Inj.Dalacin of 600mg 8^th hourly should not have been prescribed, under his clinical condition worse the fact, the opposite parties did not follow the universal treatment protocol for the complainant, because Clindamycin Therapy has been associated with severe colitis, which may end fatally.  It is reported that it should not be used in patients with non-bacterial infections but it is used to treat infections. The complainant issued a legal notice dated 01.08.2012 to the opposite parties and for which the 1^st and 3^rd opposite parties sent reply notice with false averments without any specific denial for the allegations of the complainant. Hence this complaint is filed.

4. Witten Version of  1^st Opposite Party in brief:-

 

            The complainant aged about 73 years, consulted the 1^st opposite party on 26.01.2012 at his private clinic.  The complainant was having swelling redness in his right leg and discharge of fluid for 10 days and the complainant was treated at some other hospital.  As the complainant was not cured, he came for consultation to the 1^st opposite party.  The complainant is a known case of coronary artery disease for 10 years.  He is also a known diabetic for 10 years.  He is a chronic smoker for 40 years and was treated for pulmonary tuberculosis for 6 months.  He is a chronic alcoholic.  As the complainant was suffering from all the above problems in addition to swelling and discharge from right leg, he was advised to get admitted into 3^rd opposite party Hospital. After investigation they have diagnosis that the complainant had Cellulitis on his right leg. The complainant got admitted into the 3^rd opposite party hospital on 27.01.2012 and the admitting Doctor requested Dr.S.Gopal, consultant physician and diabetologist to see the patient and he had confirmed the diagnosis and had suggested necessary investigations which were carried out.  The complainant was having a huge swelling, compression of any underlying blood vessel and deep vein thrombosis has to be ruled out.  The complainant was seen by Dr.Shankar, Vascular surgeon. Doppler study of right leg venous system was normal.  The diagnosis of cellulitis was not disputed but accepted at a later hospital also namely Apollo Hospital. With the background history of chronic diabetes and chronic alcoholism, the complainant was started on Inj.Clindamycin.  Clindamycin is the accepted drug for cellulitis in such a clinical setup of skin and soft tissue infections.  The likely causative organisms like streptococcl and anaerobes are covered by clindamycin.  It is submitted that there is no evidence in medical literature documenting significant haematemesis and malene secondary to clindamycin use.  Hence presence of haematemesis and malena are not due to clindamycin usage.  Endoscopy performed at Apollo Hospital revealed Gastric ulcer with visible vessels at base.  Also it is impartment to note that there is no medical evidence from literature that use of clindamycin causes Gastric Ulcer.  Neither there is any evidence for significant Gastro intestinal bleed following clindamycin.  The only possible cause for Gastric Ulcer and Gastro intestinal bleed could only be chronic alcoholison. The complainant was given extraordinary care when he developed gastro intestinal bleed.  He was transfused with 3 units of packed red blood cells.  His hypotension improved with intravenous fluids and blood transfusion.  Medical gastroenterologist opinion was taken as per suggestion proton pump inhibitors and somatostatin analogues were added.  The treatment was continued on the lines suggested by medical gastroenterologist. Their informed consent was obtained.  Appointment with Apollo Hospital was fixed and the complainant was safely transferred on 30.01.2012.  The complainant became alright and was discharged from Apollo Hospitals after three days on 03.02.2012. Hence the 1^st opposite party has not committed any omission or commission.  The alleged loss and damage is not due to any negligence, deficiency or action of 1^st opposite party. Hence it is requested this complaint may be dismissed.

 

5. Witten Version of  2^nd Opposite Party in brief:-

 

            The 2^nd opposite party is working as an internal medicine consultant in Vijaya Hospital.  He has MD qualification in general medicine.  He take care of diabetic patients in the hospital and there is no cause of action as against him.  The 2^nd opposite party has not committed any omission or commission.  The alleged loss and damage is not due to any negligence, deficiency or action or 2^nd opposite party.  Hence it is requested that this complaint may be dismissed.

            6.The points for consideration are:-

            1) Whether there is any medical negligence on the part of the opposite parties?

            2) Whether there is any deficiency in service on the part of the opposite parties?

            3) Whether the complainant is entitled to get reliefs as claimed in the complaint?

            4) To what relief, the complainant is entitled?

7. Point Nos.1&2:-

 

            The complainant has raised the following allegations as against the opposite parties are:

 

1. The 1st opposite party ought not have been admitted the complainant in the hospital.
2.  The opposite parties are wrongly diagnosised as if the complainant has suffered from cellulitis
3. The opposite parties shall consult a dermatologist, once diagnosised as cellulitis and
4. The opposite parties wrongly prescribed Inj.Dalacin 600mg once in 8^th hour and which leads to blood vomiting and also bleeding through anus of the complainant.

 

 

8. The complainant has stated as per discharge summary of the Vijaya hospital the complainant was admitted on 27.01.2012 for Mild erythema/induration no active discharge, foot swelling. As per IDSA Practical Guidelines for SSTIs, Outpatient therapy is recommended for patients who do not have SIRS, altered mental status, or hemodynamic instability. Hospitalization is recommended if there is concern for a deeper or necrotizing infection, for patients with poor adherence to therapy, for infection in a severely immune compromised patient, or if outpatient treatment is failing. For that the 1^st opposite party shall referred to give oral medication for skin infection and he cannot advised the complainant to admit in the 3^rd opposite party hospital. The opposite party with no clue of the nature of cellulitis hospitalized the complainant, which lacks the reasonable care and duty of the 1^st opposite party.

 

9. It is submitted by the 1^st opposite party as that the complainant came for consultation to the 1^st opposite party’s private clinic to clear swelling redness in his right leg and discharge of fluid for 10 days and the complainant was treated at some other hospital and as the problem was not cured and that the complainant was aged about 73 years. The complainant is a known case of coronary artery disease for 10 years, diabetic for 10 years, chronic smoker for 40 years and also treated for pulmonary tuberculosis for six months and he is a chronic alcoholic. Therefore the 1^st opposite party advised the complainant to admit in Vijaya Hospital considering the old age and having complicated issues as stated above and for welfare of the complainant advised him to admit in the 3^rd opposite party hospital.  If the complainant is not willing for admission in the 3^rd opposite party he can very well approach to some other doctors. But the complainant himself voulantary accept the advice of the doctor and he himself admitted in the hospital. Having accepted and followed the advice of the 1^st opposite party now he cannot go beyond his desire and the same is after thought with an intention to file this complaint. Therefore the 1^st allegation is untenable one.

 

10. The complainant was admitted in the hospital on 27-01-2012 and then all kind of test were taken. After examination of the test reports the opposite parties diagnoses that the complainant had cellulitis on his right leg. As per the discharge summary of the 3^rd opposite party they diagnosis as:

 UPPER GI BLEED K 92.2,

 RIGHT LEG CELLULITIS L03.1,

DIABETES MELLITUS E14.5,

CORONARY ARTERY DISEASE I 25.1.

 

                 Cellulitis is a common and potentially serious bacterial skin infection. It is an admitted fact that the complainant was suffered for 10 days on his right leg swelling redness with discharge. Even without taking any test on oral examination itself any qualified doctor can be diagnosis as a inflammatory and infectious skin disease. Therefore the diagnosis of the opposite parties as that the complainant has RIGHT LEG CELLULITIS is correct. Further there is no evidence to prove that the diagnosis of the opposite parties are wrong.  Hence we found that the 2^nd allegation of the complainant is also not correct.

            11. There is no hard and fast rule, if any patient was diagnosis, having skin disease, he shall be consulted only by a dermatologist. It is an admitted fact that the 1^st opposite party has M.D. qualification in general medicine and also qualified Cardiologist with D.M.Degree. The 2^nd opposite party has M.D. qualification in general medicine. They are qualified doctors to treat a patient who suffered skin disease. Therefore the 3^rd allegation is also not correct.

            12. Dalacin is otherwise called Clindamycin. The complainant submitted the above drug cannot be prescribed or administered by the opposite party for his suffering.   Glindamycin has been shown to be effective in the treatment of skin and soft tissue infection including Cellulitis. The opposite party submitted  medical literature, ‘’ Practice Guidelines for the Diagnosis and Management of Skin and soft Tissue Infections:2014 update by the Infectious Diseases Society of America ‘’ and it read as follows on the topic of management SSTIs- NONPRULENT necrotizing infection/Cellulitis /Erysipleas in moderate condition intravenous Clindamicin can be administered. Further on the topic of ‘’Recommendation for Erysiplas and Cellulitis’’ it is stated as “Therapy for typical cases of cellulitis should include an antibiotic active against streptococci (Table2).  A large percentage of patients can receive oral medications from the start for typical Cellulitis (56), and suitable antibiotics for most patients include penicillin, amoxicillin, amoxicillin-clauvlanate, dicloxacillin, cephalexin, or clindamycin.

            13. Further there is no proof that, because of administered Inj.Dalacin 600mg 8^th hourly to the complainant suddenly complainant developed features of blood vomiting and also bleeding through is anus.  Unfortunately the complainant has not submitted the discharge of the Apollo hospital. Therefore it is presumes that the discharge summary of Apollo Hospital has not made any adverse remarks as against the opposite parties.

            Considering of the facts submitted by both parties before this commission we found that there is no medical negligence or deficiency in service on their part of the opposite party.  Accordingly point Nos.1 and 2 are answered.

            14.Point Nos.3 & 4:-

            We have discussed and decided that there is no medical negligence on the part of the opposite parties and there is no deficiency in service on their part.  Therefore the complainant is not entitled to get any reliefs as against the opposite parties as claimed in this complaint. 

            In the result, this complaint is dismissed.  No costs.

            Dictated to steno-typist, transcribed and typed by him, corrected and pronounced by us in the open commission, on this the 26^th day of November 2021.

 

VINODH KUMAR                                                                                                           R.V.R.DEENADAYALAN

         MEMBER                                                                                                                           PRESIDENT

 

                List of documents filed by the complainant:-

 

Ex.A1	26.01.2012	Echo Cardiogram Report from IDHAYA, Nungambakkam, Chennai	Original
Ex.A2	26.01.2012	Reference letter from the 1st opposite party.	Original
Ex.A3	27.01.2012	Doppler study report of the complainant taken from Vijaya Diagnostic and Research Centre.	Original
Ex.A4	28.01.2012	Ultra sound study of Abdomen and pelvis of the complainant obtained from the Vaibava Scans.	Original
Ex.A5	30.01.2012	Discharge summary of the complainant issued by the 3rd opposite party.	Original
Ex.A6	30.01.2012	Reference letter to the Apollo hospital, Chennai issued by the 1st opposite party.	Original
Ex.A7	30.01.2012	Final bill issued by the 3rd opposite party to the complainant.	Original
Ex.A8	30.01.2012	Gastroscopy clip and sclerotherapy report of the complainant obtained from the Apollo hospital Chennai.	Original
Ex.A9	31.01.2012	Ultrasound whole Abdomen of the complainant taken by the Apollo Hospital Chennai.	Original
Ex.A10	01.02.2012	Ultra sound whole Abdomen Bed side of the complainant taken by the Apollo Hospital Chennai.	Original
Ex.A11	03.02.2012	In patient bill issued by the Apollo hospital enterprise limited, Chennai to the complainant.	Original
Ex.A12	01.08.2012	Legal notice issued to the opposite party by the counsel for the complainant.	Original
Ex.A13	11.08.2012	Acknowledgement card from the 1st opposite party	Original
Ex.A14	29.08.2012	Acknowledgement card from the 2nd opposite party	Original
Ex.A15	29.08.2012	Acknowledgement card from the 3rd opposite party.	Original
Ex.A16	03.09.2012	Reply notice issued by the 3rd opposite party in which the reply notice of 1st and 2nd opposite party was enclosed.	Original

 

            List of documents filed by the 1^st & 2^nd opposite parties:-

Ex.B1	27.01.2012	Copy of case sheet & Discharge summary	Xerox
Ex.B2		Copy of the information brochure	Xerox
Ex.B3		Copy of Cleveland clinic journal of medicine.	Xerox
Ex.B4		Copy of infectious disease society of America.	Xerox
Ex.B5		Copy of john Hopkins text book of “Diagnosis and treatment of infectious diseases”	Xerox
Ex.B6		Copy of Mandell’s Basic principles in the Diagnosis and Management of Infectious Diseases.	Xerox

 

 

VINODH KUMAR                                                                                                               R.V.R.DEENADAYALAN

         MEMBER                                                                                                                              PRESIDENT