BEFORE THE CONSUMER DISPUTES REDRESSAL FORUM, ERNAKULAM.

Dated this the 22^nd day of October 2018

                                       Filed on: 06.04.2015

          PRESENT:

 Shri. Cherian K. Kuriakose                          President

 Smt. Beena Kumari V.K.                    Member.

                                               C.C.No.229/2015

                                   Between

O R D E R

Beena Kumari V.K., Member

The complainant is a diabetic patient and she went for a medical checkup at the 1^st opposite party – Ernakulam Medical Centre and she was referred to the 4^th opposite party- Dr.Sony Joseph.   She was admitted to the EMC hospital on the advice of Dr.Sony Joseph but after a few hours she was taken to the ICU and was put on ventilator. The moment when the complainant was taken to the ICU,  her  husband

insisted the doctors of the 1^st opposite party – Hospital to discharge her so that she can be taken to the Medical Trust Hospital for better care and treatment. But the 1^st opposite party Hospital authorities did not allow discharge from ICU for 22 days and the complainant was put in sedation without proper treatment for diabetes and by the time the complainant was completely paralyzed and was unable to move any of her body parts.  It was only on pressure exerted by the husband of the complainant, she was discharged on 22.11.2014 and the 1^st opposite party – Hospital charged an amount of Rs.562,012/- towards price of medicines, lab charges, rent of ICU, room rent, nursing charges, bedside procedures, injection charges, physiotherapy charges, equipment charges, O T Pharmacy, Nephrology procedures, professional fees, consumables and other services.  It is submitted by the complainant that owing to the continuance in ICU, the complainant developed ventilator associated pneumonia and cardio vascular collapse.  She also developed renal problems, stroke with dense hemiplegia on the left side and critical care illness neuropathy on the right extremity.  She also got associated ischemic cardio myopathy and LV dysfunction and she also developed pressure sores on the back and gluteal region. It is submitted that she was given due medical care and treatment at the Medical Trust Hospital and after that she could return to normal life.  The complainant spent an amount of Rs.785,014-53 towards treatment expenses.  The complainant’s husband had to sell 4 cents of landed property to meet the medical expenses charged by the 1^st opposite party Hospital and the 5^th opposite party – Medical Trust hospital.  It is further submitted that the complainant has to undergo continuous medication and daily physiotherapy to set right the paralysis of her right hand and left leg.  To prove the deficiency in service on the part of the opposite party – EMC Hospital the complainant has produced the medical bills, discharge summary etc and sought for the directions of this Forum to the opposite parties to pay Rs.19,47,026/- towards compensation for the loss, injury, mental agony and monetary loss suffered by the complainant along with costs of Rs.10,000/-.

2)       Notices were issued to the opposite parties from this Forum and the opposite parties filed their versions.

3)       Versions of the 1^st, 2^nd and 3^rd opposite parties

          It is submitted that the above complaint is liable to be dismissed for mis-joinder of parties.  The 1^st opposite party has altogether 6 directors in its board and the 2^nd and 3^rd opposite parties are two of the directors of the Company. The 2^nd and 3^rd opposite parties being two of the directors in the Board of Directors cannot have any personal liability.  It is not known as to why the 2^nd and 3^rd opposite parties have been brought in the party array, that the 2^nd and 3^rd opposite parties are not at all necessary parties to the complaint. The complainant was admitted in the 1^st opposite party hospital on 31.10.2014 with generalized weakness, tiredness and acidotic breathing.  She was known case of Type II Diabetes Mellitus and Hypothyroidism for which she was on treatment elsewhere.  On the time of admission the complainant’s blood sugar was very high in the glucometer and a manual check revealed 416 mg/dl with electrolyte imbalance.  Her urine acetone was 4 + and an ABG revealed severe metabolic acidosis.  Since her oxygen saturation levels were dropping, she was intubated and ventilated and insulin infusion and fluid therapy to correct her electrolyte imbalance was started after informing her husband, sister and sister’s Husband.  The Cardiologist Dr.Sujith Kumar had examined the patient on 31.10.2014.  Investigations done on his advice and treatment given for Depressed Left ventricular function and for other symptoms Anesthetists Dr.Mathew Varghese and Dr.Deepak Nair had taken over the ventilator care of the patient.  A Neurology consultation by Dr.Dinesh Kammath was done on the same day and a Nephrologist had initiated appropriate treatment.  On the basis of the collective assessment the following diagnosis was made:

1. Severe diabetic ketoacidosis due to hyperglycemia.
2. Multi organ dysfunction  
3. Hypotension and associated ischemic cardiomyopathy with severe left ventricular dysfunction.
4. Sub-acute cerebral infarct.

The complainant was treated with fluid replacement therapy, electrolyte imbalance correction, IV antibiotics, Insulin infusion etc.  A tracheostomy was done on 05.11.2014 and the patient was tried to be weaned off the ventilator.  Protein imbalance and nutritional deficiencies were corrected with albumin infusion and parenteral feeds.  Anaemia was corrected with blood transfusions.  Due to her worsening renal parameters, repeated hemodialysis was done.  X-rays taken on 11.11.2014 showed bilateral basal infiltrates suggestive of Pneumonia for which antibiotics according to culture reports were initiated.  A Pulmonology consultation by Dr.Sukumaran Nair and Dr.Shalini Vinod was done.  Repeated weaning of attempts from the ventilator was tried out by the anesthetist.  But the patient was unable to sustain Oxygen saturation without ventilator support due to underlying critical illness neuropathy/renal failure.  During the entire period of stay in 1^st opposite party hospital, patient’s condition and prognosis was well explained to her relatives.  In spite of repeated attempts to wean off the ventilator, patient was ventilator dependent.  Patient’s bystanders requested for a discharge on 22.11.2014 and the patient was discharged at request, on the same day.  On discharge, patient was on ventilator, C-Pap mode, conscious, responding to verbal stimuli and ABG showed PH 7.40 mm Hg, PCO2 42 mm Hg, PO2 55 mm Hg, HCO3 23 mm, SO2 88% with a minimal left hemiparesis.  Her sugar was well controlled with insulin infusion, chest infection controlled with IV antibiotics and other supportive measures.  Vital were stable and renal functions were improving at the time of discharge.  The various allegations raised in the above complaint are without any basis.  The 1^st opposite party hospital is a multi-speciality Hospital and has more than 60 consultant doctors working in various specialties.  It deals with all medical emergencies and many diabetic patients and their diabetic complications are being treated by the hospital. All the averments and allegations in paragraph 2 of the complaint are not fully correct.  On 31.10.2014, complainant was presented in the Casualty of the 1^st opposite party hospital with complaints of breathing difficulty, generalized weakness and high blood sugar.  She was directly admitted to the intensive care unit for critical care management.  Her blood sugar being very high (Random blood sugar:416/mg/dl) and ABG revealing severe metabolic acidosis.  HbAIC done on admission was 13.37% shows that her diabetes control prior to admission was very poor.  It is submitted that since the complainant had severe diabetic Ketoacidosis and multi organ involvement, she was kept in the intensive care unit and after getting informed consent fluid replacement therapy, insulin infusion and ventilator support were initiated to save the life of the patient.  The further allegation that on discharge the patient was completely paralyzed and unable to move any of her body parts and that if complainant remained in the 1^st opposite party hospital, she would not have been alive to file the consumer complaint are all against facts and denied.  The patient developed multi organ dysfunction due to diabetic ketoacidosis.  The allegations of the complainant that no proper medication or treatment or proper medical care was provided by the 1^st opposite party hospital to the complainant are totally against facts.  She was not charged unethically.  There was no negligence or deficiency of service from the side of the opposite parties or any of the staff of the 1^st opposite party hospital.  The further allegation that the treatment in the ICU caused the patient ventilator associated pneumonia, cardiovascular collapse, renal problems, stroke with dense hemiplegia in the left side and critical care illness neuropathy on the right extremity and that she had suffered associated ischemic cardiomyopathy and LV dysfunction and sores on the back and gluteal region are false and hence denied.  The patient was actually saved from the morbid complications of diabetic ketoacidosis.  The treatment in Medical Trust Hospital, Ernakulam is only a continuation of the treatment given to the patient in the 1^st opposite party – Hospital.  The further contention of the complainant in paragraph 7 of the complaint that an amount of Rs.5,39,947.53/- had been incurred at Medical Trust Hospital, Ernakulam due to the improper medical service on the part of the 1^st opposite party is absolutely false.  At the time of discharge from the 1^st opposite party hospital the patient did not have any paralysis of her right hand or left leg.  At the time of discharge patient had only left side hemiparesis and no hemiplegia.  It is submitted that the complainant was treated as per established and accepted medical procedures and test books.  There is no negligence or deficiency in service from the side of the opposite parties or their staff.  The compensation sought for is wishful and has no legal basis.  At any rate, the opposite parties are not liable to pay any compensation to the complainant.  The complaint is liable to be dismissed with costs to the opposite parties.

4)       Version of the 4^th opposite party

          It is contended that the consumer complaint is not maintainable either in law or on facts of the case against the 4^th opposite party.    The consumer complaint is frivolous, vexatious and devoid of truth or bonafides.  There is no negligence or deficiency in service on the part of the 4^th opposite party as alleged by the complainant in the consumer complaint.  The complainant is not entitled to get any relief as prayed for in the consumer complaint from the 4^th opposite party.  It is submitted that the 4^th opposite party is the senior consultant Physician in the 1^st opposite party hospital with MD in General Medicine.  The patient was a known case of Type II Diabetes Mellitus and Hypothyroidism for which she was on treatment elsewhere.  History from Smt.K.Radha, sister of the patient revealed that the complainant was being very irregular with her medications and had missed insulin and diabetic treatment for past few days due to her family problems.  On admission patient’s blood sugar was very high in the glucometer and a manual check revealed 416 mg/dl with electrolyte imbalance.  Her urine acetone was 4 + and an ABG revealed severe metabolic acidosis.  Since her oxygen saturation levels were dropping, she was intubated and ventilated and insulin infusion and fluid therapy to correct her electrolyte imbalance was started.  The Cardiology consultation was done and the Cardiologist Dr.Sujith Kumar had examined the patient on 31.10.2014.  Echo cardiogram revealed Left Ventricular dysfunction (LVIDd51.6 mm), Global decrease in left ventricular contractility. Whole intra ventricular septum, whole anterior wall and apex severely hypokinetic.  Depressed left ventricular function (LVEF less than 15%).  Good Right Ventricular function and appropriate treatment were instituted.  Anesthetists Dr.Mathew Varghese and Dr.Deepak Nair had taken over the ventilator care of the patient.  A Neurology consultation by Dr.Dinesh Kammath was done on the same day and a CT scan done revealed hypo density involving right high parietal region and centum semi ovale suggestive of subacute infarct right.  Due to patient’s worsened renal parameters, a Nephrology consultation by Dr.Abdul Rasheed was done on the same day and the Nephrologist had initiated appropriate treatment.  A consultation was given to the Endocrinologist Dr.Tom Babu on 31.10.2014 and he advised continuance of insulin infusion and the fluid management.  The patient was attended by the aforesaid eminent doctors for the evaluation and treatment of the critical care of the patient in the medical ICU.  On the basis of the collective assessment the following diagnosis was made.

1. Severe diabetic ketoacidosis due to hyperglycemia.
2. Multi organ dysfunction due to diabetic ketoacidosis
3. Hypotension and associated ischemic cardiomyopathy with severe left ventricular dysfunction.
4. Sub-acute cerebral infarct

Patient was treated by the aforesaid team of doctors with fluid replacement therapy, electrolyte imbalance correction, IV antibiotics (Inj.Pipercillin + Tazobactu 2.25 mg IV 8^th hourly and Inj. Meropenam 500 mg IV BD, Inj. Ornidazole 500 mg), Insulin infusion, Novorapid insulin, Thyronorm, Inj.Low molecular weight heparin 40 mg subcutaneously and probiotic therapies.  A tracheostomy was done on 05.11.2014 and protein imbalance and nutritional deficiencies were corrected with albumine infusions and parenteral feeds.  Anaemia was corrected with blood transfusions.  Due to her worsening renal parameters, repeated hemodialysis was done.  X-rays taken on 11.11.2014 showed bilateral basal infiltrates suggestive of Pneumonia for which antibiotics according to culture reports were initiated.  A Pulmonology consultation by Dr.Sukumaran Nair and Dr.Shalini Vinod was done.  Repeated weaning of attempts from the ventilator was tried out by the anesthetist.  But patient was unable to sustain Oxygen saturation without ventilator support due to underlying critical illness neuropathy/renal failure.  In spite of repeated attempts to wean off the ventilator, patient was ventilator dependent.  Patient’s bystanders requested for a discharge on 22.11.2014 and the patient was discharged at request on the same day.  On discharge, patient is on ventilator, C-Pap mode, conscious, responding to verbal stimuli and ABG shoed PH 7.40 mm Hg, PCO2 42 mm Hg, PO2 55 mm Hg, HCO3 26 mm, SO2 88% with a minimal left hemiparesis.  Her sugar was well controlled with insulin infusion, chest infection controlled with IV antibiotics and other supportive measures.  Vitals were stable and renal functions were improving at the time of discharge.  This being the true account of the treatment given to the complainant the entire contrary allegations of medical negligence and deficiency in service alleged against the opposite parties are absolutely false and stoutly denied by the 4^th opposite party.  The 1^st opposite party hospital has the infrastructure to deal with all medical emergencies.  On 31.10.2014, the patient was presented in the Casualty of Ernakulam Medical Centre with complaints of breathing difficulty, generalized weakness and high blood sugar.  Patient was directly admitted to the intensive care unit for critical care management.  Her blood sugars being very high (Random blood sugar: 416 mg/dl) and ABG revealing severe metabolic acidosis.  HbA1 C done on admission was 13.37% shows that her diabetes control prior to admission was very poor.  The patient was kept in the intensive care unit and fluid replacement therapy, insulin infusion and ventilator support were initiated to save the life of the patient.  A well informed consent signed by patient’s sister, Mrs.K Radha was taken and patient’s condition and prognosis and the necessity of ventilation were well explained to the patient’s husband and her sister.  At no point of time the bystanders had asked for a discharge of the patient or the transfer of the patient to another hospital, which is evident from the self-written informed consent. It is submitted that due to the critical nature of severe diabetic ketoacidosis and multi organ involvement, patient was kept in the medical ICU.  Insulin infusions and proper management of diabetic ketoacidosis and other ailments were initiated from day one of admission itself.  On discharge on 22.11.2014 patient is on ventilator, C-Pap mode, conscious, responding to verbal stimuli and ABG showed PH 7.40 mm Hg, PCO2 42 mm Hg, PO2 55 mm Hg, HCO3 26 mm, SO2 88% with a minimal left hemiparesis.  Her sugar was well controlled with insulin infusion, chest infection controlled with IV antibiotics and other supportive measures.  Vitals were stable and renal functions were improving at the time of discharge. It is submitted that due to elevated blood sugar and diabetic ketoacidosis, patient developed multi organ dysfunction such as acute renal failure, acute left ventricular dysfunction, acute cerebral infarct and bilateral basal pneumonitis, which was appropriately treated with insulin infusion, IV antibiotics, fluid management, repeated hemodialysis and appropriate electrolyte imbalance correction.  The allegation that no proper medication or treatment or proper medical care for diabetics was provided by the hospital to the complainant and it is evidenced by the huge amount that the complainant expended are absolutely false and hence denied.  The further allegation that the treatment in the ICU caused the patient ventilator associated pneumonia, cardiovascular collapse, renal problems, stroke with dense hemiplegia in the left side and critical care illness neuropathy on the right extremity and that she had suffered associated ischemic cardiomyopathy and LV dysfunction and sores on the back and gluteal region are false and hence denied by the 4^th opposite party.  It is submitted that all these complications are as per se complications of diabetic ketoacidosis leading to multi organ failure.   If the patient continued in the first opposite party hospital, she would have the same recovery.  The treatment in Medical Trust Hospital, Ernakulam is the continuation of the treatment given to the patient in the 1^st opposite party hospital.  It is submitted that it is due to the timely assessment and critical care management by a team of specialist doctors Anesthetists Dr.Mathew Varghese and Dr.Deepak Nair, Neurologist Dr.Dinesh Kammath, Nephrologist Dr.Abdul Rasheed, Endocrinologist Dr.Tom Babu, Physicians 4^th opposite party, Dr.Smitha and Dr.Sandhya and Cardiologist Dr.Sujith Kumar that the patient was saved from the morbid complications of diabetic ketoacidosis.  The allegation that an amount of Rs.5,39,947.53/- had been incurred by the complainant at Medical Trust Hospital, Ernakulam due to the improper medical service on the part of the 1^st opposite party is absolutely false and stoutly denied by the 4^th opposite party.  The total compensation of Rs.19,47,026.53/- claimed by the complainant shown in paragraph 8 of the consumer complaint has no merit or basis and 4^th opposite party is no way liable to pay the aforesaid compensation or any reduced sum as compensation.  None of the difficulties or inconvenience caused to the complainant was not due to any negligence or deficiency in service on the part of the opposite parties.  Hence the complainant is not entitled to get any compensation from the opposite parties either in law or on facts of the case. The complainant has no cause of action against the 4^th opposite party.  It is submitted that the complaint is bereft of any bonafides and liable to be dismissed with the cost of 4^th opposite party. 

Version of the 5^th opposite party

It is submitted that the 5^th opposite party is an unnecessary party to the proceedings and complaint is bad for misjoinder of parties since there is no cause of action against the 5^th opposite party the complaint is not maintainable.  The complainant has not alleged any deficiency in service, negligence, latches or failure to comply with any statutory obligation by the 5^th opposite party, on the other hand commended the services rendered by the 5^th opposite party in saving the life of the complainant. The complaint relates to charges levied by the opposite parties which according to the complainant was not leviable.  The dispute raised in the complaint being a pricing policy this Forum has no jurisdiction to adjudicate upon the same.  The complainant was brought to the Medical Trust Hospital on 22.11.2014 on account of the difficulty in weaning from the ventilator on discharge from the 1^st opposite party hospital.  The history of the patient/complainant revealed that she was admitted to the 1^st opposite party hospital with diabetic keto acidosis and developed severe cardiovascular pollapse and severe ventricular dysfunction which needed ventilator therapy and supportive measures.  During the course of treatment at the 1^st opposite party hospital in the ICU, the patient developed acute renal failure necessitating renal replacement therapy.  The patient also suffered from cerebrovascular accident and developed a dense hemeoplegia on the left side.  The patient/complainant was on prolonged ventilatory care requiring tracheotomy care and developed bilateral pneumonitis.  She had also developed severe weakness in the right extremities due to critical illness neuropathy and pressure sores in the dependent parts.  At the 5^th opposite party hospital, the complainant was diagnosed as suffering from ventilator associated pneumonia, acute renal failure, cerebrovascular accident, critical care illness neuropathy with history of ischemic cardiomyopathy, hyper tension and diabetic keto acidosis.  The complainant was immediately admitted to the Intensive Care Unit.  At that time, admission of the complainant, was drowsy but conscious and responding to commands and calls.  The complainant was in renal failure, hypoalbumine, hyperglycemic and was being ventilated through tracheostomy.  The complainant was started with antibiotic for ventilated associated pneumonitis and was initiated on external feeding with good nutrition and intravenous albumin supplements, chest physiotherapy, thrombophysasis and VAP bundle care were initiated.  Echo Cardio Gram showed improved myocardial functions.  Renal functions and urine output improved and the patient was managed with diuretic and albumin infusion without recourse to hemodialysis.  The patient slowly started on weaning and intensive physiotherapy was conducted for the extremities.  The pressure sores were treated by the plastic surgeon.  On the basis of the culture test that grew multi drug resistant Acinetobacter and Pseudomonas and the patient was treated with colistum and tigacillum. Over a period of weeks the patient was weaned off from the ventilator and decannulated.  The patient’s renal functions became normal and ulcers heeled.  There was improvements in her muscle functions and the extremities were beginning to move and improvements made steadily with physiotherapy. The patient/ complainant was discharged on 07.02.2015 with advise to continue dressing of pressure sores and active physiotherapy at home.  The patient was advised to continue antihypertensive, thyroid and diabetic medications and nutritional supplements.  The patient had fully recovered.  The best treatment was meted out to the complainant.    All care, caution and skill were taken during the treatment.  Moreover, the treatment was carried out in the best environment that can be provided and there had been no letups or hindrance whatsoever.  There has been no deficiency in service whatsoever on the part of the 5^th opposite party hospital or the treating doctors or the staff of the hospital.  There has been no negligence, fault or imperfection in the manner of treatment to be rendered to the complainant.  The complainant has absolutely no cause of action for the complaint.  The claim for compensation made by the complainant is unfounded and baseless and the opposite parties are not in any way liable or responsible for payment of the same.  The complainant has not suffered any pain or mental agony nor damages and hence is not entitled to seek compensation from the 5^th opposite party.  The allegation of mental agony, shock, embarrassment etc stated in the complaint as suffered by the complainant are baseless, in so far it relates to 5the opposite party. Hence it is prayed that this Forum may dismiss the complaint with costs to the 5^th opposite party.

6)       The issues to be considered in this case are as follows:

1. Whether this complainant has proved deficiency in service on the part of the opposite parties?
2. Whether the complainant is entitled to get refund of the medical charges/expenses incurred at the 1^st and the 5^th opposite party hospitals?
3. Whether the opposite parties are liable to pay compensation to the complainant along with costs?

7)       The evidence in this case consisted of the oral evidence adduced by the complainant as PW1 and through her husband as PW2 and the documentary evidences furnished by the complainant which were marked as Exbt.A1 to A4, Exbt.A1 and A3 are in series.  Exbt. A1 series are the copies of the bills.  Exbt.A3 series are the bills for Rs.245,067/-.  Exbt.A4 is the discharge summary issued by the 5^th respondent.  The medical records were marked as X1.  The opposite parties adduced oral evidence through 4^th opposite party – Dr.Sony Joseph Vadakel, as DW1.

8)       Issue No. (i)

          The complainant was admitted to the 1^st opposite party – Ernakulam Medical centre on 31.10.2014 and she was taken to the ICU after few hours and was in the ICU for 22 days.  By the time she became paralyzed and was unable to move any of her body part.  The complainant contended that the worsened condition was due to the negligent and careless treatment given by the 1^st opposite party – EMC Hospital. Due to the pressure exerted by her husband she was discharged on 22.11.2014 and continued treatment at the 5^th opposite party – Medical Trust Hospital and through this complaint, the complainant seeks for the orders of this Forum to the 1^st opposite party – hospital to refund of the medical expenses incurred of rs.562,012/- and the medical expenses incurred at the 5^th opposite party – hospital of Rs.7,85,014/- totaling to Rs.13,47,026/- along with compensation amount for the future physiotherapy.  The total claim of the complainant amounted to Rs.19,47,025.53/-.  She had claimed Rs.10,000/- towards costs.  The complainant approached the 1^st opposite party – Ernakulam Medical Centre on 31.10.2014 at 6 am.  The complainant during cross examination deposed as PW1 before the Forum that she had severe discomfort throughout the night on the previous day.  The complainant was examined at the casualty on 31.10.2014 and after 15 minutes she was fainted as deposed before this Forum.  The medical records reveal that she was admitted to the ICU.  The complainant deposed that she had regained her senses after 2 or 3 days and that she is now aware that it was due to the high sugar level it all happened and she was put to ventilation due to the decreased level of oxygen in her blood.  The 1^st opposite party stated that the complainant was given insulin therapy to make good the electrolyte imbalance and also given fluid therapy when she was in an unconscious stage.  The complainant as PW1 deposed before this Forum that she had no knowledge about the treatment given by the 1^st opposite party – Hospital that she returned to the normal condition after the treatment, at the 5^th opposite party – Medical Trust Hospital, for 76 days.  The 4^th opposite party, the treating doctor deposed before this Forum that the blood oxygen level was only 25% when the complainant was examined at the casualty and page 99 of the X1 also proves the above fact.  The blood oxygen level was between 80% and 100% as revealed by pages 331 to 344 of the medical records.  In this case the complainant was ventilated by inserting endotracheal tube after putting the mask to stabilize the oxygen by the anesthesia doctors and the doctors intubated the patient at 8.45 am as revealed by page 173 of the Exbt.X1 and the doctor diagnosed that the complainant was suffering from metabolic acidosis, diabetic keto acidosis with low level oxygen and high level sugar in the blood.  The above facts show that at the time of admission to the 1^st opposite party – Hospital the medical condition of the complainant was very serious and critical and she regained her consciousness after 2 or 3 days. The complainant patient immediately admitted to the ICU at 6.03 A.M. as revealed by page 205 of Exbt.X1and at 7.15 am the complainant –patient was admitted to coma ICU (CICU) and thereafter she was transferred to medical ICU at 7.20 am as revealed from page 206 of Exbt.X1 Vol. I.  The 4^th opposite party – treating doctor deposed before this Forum that by standers were informed of                  the fact that the kidney, brain, Heart are much affected and that from date of arrival/admission and to the date of discharge the 4^th opposite party –treating doctor had regularly informed the by standers of the complainant/patient about the condition of the complainant.  It is also deposed before this Forum the services of a team of doctors anesthetist, cardiologist, Nephrologist, Endocrinologist, physician were made available to the complainant and the 4^th opposite party – treating doctor deposed before after the treatment for 23 days in the ICU the complainant/patient was discharged and at the time of discharge the patient was conscious, was responding to the verbal stimuli, blood oxygen saturation was 88%,PCO2-42, PO2-55, Sugar level was in a controlled stage, that bed sore condition was noted in the Nurses record. Thus the complainant has no case that wrong medicines given to her during the treatment at the 1^st opposite party- Hospital.  The complainant also has not produced any expert opinion to show that the treatment given at the 1^st and 5^th opposite parties hospitals was not according to the accepted medical practices.  The 4^th opposite party also deposed that the onset of pneumonia can be occurred within a day.  Thus we find that all the medical care was given to the patient at the 1^st opposite party- Hospital and there is a pleading that the 5^th opposite party – Hospital had given the complainant-patient due care and medical treatment.  From the facts stated above, the complainant –patient failed to prove any deficiency in service on the part of the opposite parties.  Therefore the 1^st issue is decided against the complainant.

9)       Issue No. (ii) and (iii)

          Having found the issue No. (i) against the complainant, we are not inclined to consider and decide issue No. (ii) and (iii).

10)     In the result, the complaint is found liable to be dismissed and accordingly dismissed.

          Pronounced in the open Forum on this the 22^nd day of October 2018.

Sd/-Beena Kumari, V.K., Member

                                                                    Sd/-Cherian K. Kuriakose, President

                                                                                Forwarded by Order

                                                                                Senior Superintendent

APPENDIX

Complainants Exhibits

X1      :         Medical records

Opposite parties Exhibits :         Nil

Depositions  ::

                   PW1  ::        Rema Babu

                   PW2  ::        Ramesh Babu

                   DW1  ::        Sony Joseph Vadakel  

Date of Despatch   :

          By Hand      ::

          By Post       ::

................