Chandigarh

DF-I

CC/631/2018

Col. Mohan Singh (Retd.), Advocate - Complainant(s)

Versus

Fortis Hospital - Opp.Party(s)

Pankaj Chandgothia

11 Jan 2022

ORDER

DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION-I,

U.T. CHANDIGARH

 

                    

Consumer Complaint No.	:	CC/631/2018
Date of Institution	:	06/12/2018
Date of Decision	:	11/01/2022

 

Col.Mohan Singh (Retd.), Advocate, House No.2039, Sector 64, Mohali.

… Complainant

V E R S U S

1. Fortis Hospital (Through its MD) Sector 62, Phase VIII Mohali-160062.
2. Dr.G.S.Kalra Director Cardiology c/o Fortis Hospital Sector 62, Phase VIII Mohali-160062.
3. Managing Director Central Org, ECHS Maude Lines Delhi Cantt-110010.
4. ECHS Regional Centre Chandigarh, ECHS Wellness Centre, C/o ECHS Polyclinic/Dispensary, Chandigarh, Near Govt. High School, Sector 47-A Chandigarh (UT).

… Opposite Parties

CORAM :	RAJAN DEWAN	PRESIDENT
	SURESH KUMAR SARDANA	MEMBER

                                                

 

ARGUED BY	:	Sh.Pankaj Chandgothia, Counsel for complainant.
	:	Sh.Munish Kapila, Counsel for OP No.1 & 2.
	:	OP No.3 & 4 ex-parte.

 

Per Suresh Kumar Sardana, Member

1.      The long and short of the allegations are that the complainant is a retired Army personnel. He is a beneficiary of the ECHS Scheme and became a member of ECHS as per memo dated 13.08.2003, by paying the prescribed amount of Rs.18,000/-. Copy of the said memo is annexed as Annexure C-1. The aim of scheme is to provide quality healthcare to Ex-servicemen pensioners and their dependents. As per complaint, the complainant felt breathlessness and weakness and therefore, went to ECHS Clinic, Sector 29, Chandigarh. The office of ECHS referred the complainant to Fortis Hospital, Mohali, for further investigation and treatment. Copy of the said reference which is annexed as Annexure C-2. The Fortis Hospital is one of the empanelled hospitals under the ECHS Scheme. The Complainant was admitted in the OP Hospital and after relevant tests, the OP No.1 & 2 diagnosed that the complainant cardiac output is deficient and there is problem in cardiac impulse formation and the complainant is suffering from conduction disorders. They advised for implant of a permanent pacemaker to correct the problem in the complainant heart. The complainant had no reason or apprehension to doubt the senior doctor’s word to get operated under the supervision of OP No.2 in Fortis Hospital, where he was referred by OP No.4.

         As per complainant, on the next day i.e. on 02.11.2016, permanent pacemaker implantation was done and the complainant was advised to follow up in OPD. It was given the specification summary of the pacemaker which was implanted in him. The complainant’s was shocked that the pacemaker which was implanted in his body was not MRI compatible and was not the one which was agreed to be implanted, the copy of the brochure detailing the pacemaker and specification which is annexed as Annexure C-5. However, this claim has no sanctity because the pacemaker model mentioned in the bill is apparently different from this literature. Moreover, the doctors should have provided the original sticker of the model, which only can ensure that the said model has been implanted. The complainant had asked for an MRI compatible implant, which the OPs have conveniently ignored. As per complaint, the OP discharged the complainant and asked him to clear the outstanding dues of the treatment and the operation carried out on the complainant. The complainant was surprised, because being covered under the ECHS Scheme; it was entitled to free and cashless medical services. It was billed to the tune of Rs.1,84,683/-/. The Hospital showed only an amount of Rs.1,12,883/- as ECHS contribution/deduction and the patient share was shown as Rs.71,800/- an amount which was demanded from the complainant. Copy of discharge summary is annexed as Annexure C-6. The complainant reasoned with the OPs that he being an ECHS member should not be charged any medical expense as his complete medical treatment should be free and cashless, but the OP hospital and doctor refused to listen to the genuine request of the complainant. The complainant had to pay the demanded bill amount to get him discharged from the OP hospital. A copy of the bill which is annexed as Annexure C-7. The complainant got served upon the Opposite Party a legal notice on 03.10.2018 which is annexed as Annexure C-8 and postal receipts are annexed as Annexure C-9, but no reply to the said legal notice was received. The Complainant has filed the instant Consumer Complaint, alleging that the aforesaid act amount to deficiency in service and unfair trade practice on the part of the Opposite Party.   

2.     Opposite Party No.1 & 2 contested the consumer complaint. As per Section 24-A of the Consumer Protection Act, a complaint could have been instituted within a period of 2 years from the date when cause of action arose. The perusal of the present complaint reveals that it is dated 06.12.2018 which is beyond 2 years as prescribed under the Consumer Protection Act. This Hon’ble Commission does not have the territorial jurisdiction to hear and decided the present complaint. The Fortis Hospital, Mohali is located in Mohali. No cause of action has accrued at Chandigarh. The contents of paragraph No.5 are not admitted, as nothing to this effect was made on the prescription form Annexure C-2. In pursuance to the direction of the ECHS, DDDR Pacemaker was implanted in the case of the complainant. The Opposite Party No.1 & 2 has denied having issued detailed cost of the different implants vide Annexure C-4 and maintained that the same has not been prepared by Opposite Party No.2 and the signatures of Opposite Party No.2 are forged. The OP No.1 & 2 have alleged that the complainant has fabricated this document with ulterior motive. The complainant was clearly told by the hospital authorities that the permanent pacemaker implant which has been approved by the ECHS authorities shall be used in his case. The complainant is falsely alleging that he was shocked to know after his procedure that MRI compatible pacemaker was not implanted in his case. As per complaint, Annexure C-5 that SENSIA SEDR01 pacemaker has been implanted in the case of the complainant and the same is also mentioned in the bill at page No.37 of the complaint. In view of the same complainant has without any basis alleged that model of the Pacemaker mentioned in the bill and the one mentioned in Annexure C-5 are not one and the same. As far as the original stickers of the pacemaker are concerned that the original sticker has been provided to the ECHS.

        Opposite Party No.1 stated that prior to implantation of DDDR Pacemaker, complainant was explained about the make and quality of the pacemaker and the SENSIA SEDR01 DDDR Pacemaker available at Fortis Hospital, Mohali and that it is priced at Rs.1,55,000/-. He was informed that ECHS shall bear a sum of Rs.82,300/- and in case the complainant agrees for implanting the same, complainant shall have to pay the differential amount over and above Rs.82,300/-. Complainant agreed for the same and in pursuance to the undertaking given by the complainant’s attendant SENSIA SEDR01 pacemaker was implanted. The copy of the undertaking given by the complainant’s attendant is annexed as Annexure OP-1/2. The Opposite Party No.1 also stated that the ECHS has fixed an amount for DDDR Pacemaker. The amount so fixed is borne by the ECHS authorities and any amount over and above it is has to be borne by the patient. In the present case ECHS authorities fixed an amount of Rs.83,200/-. Thus the remaining amount was to be paid by the complainant. Complainant agreed for the same and the complainant’s attendant gave an undertaking to the said effect. This fact was brought to the notice of the complainant and his attendant before the procedure. The Opposite Party No.1 also stated that both MRI compatible Pacemaker and non-MRI compatible pacemaker have the same function. Merely using a non-MRI compatible pacemaker does not hampers the quality of complainant’s life. An MRI can be performed in both non-MRI compatible pacemaker and in a MRI compatible pacemaker. Thus, there is no deficiency of service or unfair trade practice on the part of answering Opposite Party No.1 & 2. On these lines, the case is sought to be defended.

3.     Notice of the complaint was sent to Opposite Parties No.3 & 4 seeking their version of the case. However, nobody appeared on behalf of Opposite Parties No.3 & 4 despite service, therefore, they were proceeded ex-parte on 31.01.2019.
4.     Rejoinder was filed and averments made in the consumer complaint were reiterated.
5.     Parties led evidence by way of affidavits and documents.
6.     We have heard the learned counsel for the parties and gone through the record of the case. After perusal of record, our findings are as under:-
7.     We have perused the documents annexed by the Opposite Party No.1 & 2 that is Annexure OP-1/1, of Central Organization, ECHS Adjutant General’s Branch Integrated Headquarters Ministry of Defence (Army) Maude Lines Delhi Cantt-110010, letter No.B/49773/AG/ECHS/Rates/Policy dated 25 August, 2015, which is advisory for empanelled hospitals choice of costlier IOL/Coronary Stent/ any other authorized Implant/Device/Equipment for ECHS beneficiaries. Para 2 of the said letter is reproduced here below:-

         “2. As per the letter under reference ECHS beneficiaries are permitted to get costlier IOL/Coronary Stents/ any other authorized Implant/Device/Equipment after paying for the difference in cost over and above the laid down ceiling rates. A certificate to this effect duly signed by the ECHS beneficiary will be attached with the medical claim.”

8.     We have also gone through the documents annexed by the Opposite Party No.2 that is Annexure OP-1/2 which is a certificate by the complainant. Vide para No.2, of the said certificate he has given an express and unconditional consent that he was willingly agreeing for the installation of pacemaker of higher value and vide para No.3 of the same certificate by the complainant, he has undertaken to make the payment of the difference in the amount between the high value of Rs.71,800/- and the ceiling rate of the same which is approved by ECHS.
9.     Hence, we are of the concerted view that the complainant was very well aware of the cost of the pacemaker which was being installed and he himself as agreed to pay the difference of an amount of Rs.71,800/-  being the difference in the amount between the high value and the ceiling rate. Hence we are of the concerted view that he has failed to prove his case.
10.     In view of the aforesaid discussion and the reasons recorded hereinbefore, we do not find any deficiency in service or unfair trade practice on the part of the Opposite Parties. Accordingly, the consumer complaint, being meritless, is hereby dismissed, leaving the parties to bear their own costs. 
11.     Certified copies of this order be sent to the parties free of charge. The file be consigned. 

	Sd/-	Sd/-
11/01/2022	[Suresh Kumar Sardana]	[Rajan Dewan]
Ls	Member	President