Chandigarh

DF-II

CC/1151/2019

Smt. Bego Devi - Complainant(s)

Versus

FORTIS Hospital - Opp.Party(s)

Adv. Pankaj Chandgothia & Sapna Vasudeva

16 Sep 2022

ORDER

DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION-II

U.T. CHANDIGARH

 

 

Consumer Complaint No.	:	1151 of 2019
Date of Institution	:	02.12.2019
Date of Decision	:	16.09.2022

 

            

 

1]  Smt.Bego Devi w/o Late Sh.Surat Singh,

2]  Sh.Rajinder Singh Rawat s/o Late Sh.Suraj Singh,

Both residents of House No.2093/2, Sector 40-C, Chandigarh.

                 ...  Complainants

Versus

 

1]  Fortis Hospital, M/s Fortis Healthcare Ltd., Sector 62, Phase-VIII, Mohali 160 062 through its Medical Superintendent.

 

2]  Dr. H.C. Bali, Consultant Doctor, Fortis Hospital, M/s Fortis Healthcare Ltd., Sector 62, Phase-VIII, Mohali 160 062

 

3]  Dr.T.S.Mahant, Consultant Doctor, Fortis Hospital, M/s Fortis Healthcare Ltd., Sector 62, Phase-VIII, Mohali 160 062

 

4]  Medical officer, CGHS Wellness Centre No.1, Sector 45, Chandigarh 160 047

 

5]  Additional Director, CGHS office, Kendriya Sadan, Sector 9, Chandigarh 160 009

    ….. Opposite Parties

 

 

BEFORE:  SMT.PRITI MALHOTRA        PRESIDING MEMBER 

                    SH.B.M.SHARMA                      MEMBER

                               

For Complainant : Sh.Pankaj Chandgothia, Advocate

For OPs         : Sh.Munish Kapila, Adv. for OPs No.1 to 3

   OPs No.4 & 5 exparte.

 

PER B.M.SHARMA, MEMBER

          Concisely put, late Sh.Suraj Singh, husband of complainant No.1 & father of complainant No.2, a CGHS beneficiary, feeling short of breath, on being referred by OPs No.4 & 5, examined at Fortis Hospital on 16.11.2017 (Ann.c-1).  It is stated that OPs examined the patient casually, the medical name of complaint is mentioned in the slip as “Dysnoe” instead of “Dyspnea”.  It is also stated that the OPs got done PFT Test and Stress Thallium Test but never shared the result of those tests with the complainant or the deceased.  It is further stated that the OP doctors & Hospital straightway awaked the complainant to get approval from CGHS authorities for CABG (Coronary Artery Bypass Grafting) (Ann.C-2) and after getting said approval, the patient late Sh.Suraj Singh was admitted in OP Hospital on 24.11.2017. It is submitted that after the approval of CGHS Authorities, the CGHS member is not required to pay anything and the entire treatment is supposed to be cashless and free for the concerned member.  The complainants have mentioned the meaning & details of Chronic Dyspnea, Thallium Stress, PFTs etc.

         It is submitted that the OP Hospital and its doctors did not diagnose & treat the patient as per medical norms, and proper care & caution was not exercised. It is also submitted that the OP Hospital was interested in getting the patient admitted in the hospital for one or the other surgery, just to get the monetary benefits.  It is pleaded that the OP doctors did not apply their mind rationally and did not use their expertise as required.  It is also pleaded that inspite of settled position of law, the Fortis Hospital, Mohali refused to release the body of the deceased without payment of the billed amount.  It is further pleaded that patient Surat Singh expired on 3.12.2017 in Fortis Hospital Mohali in the course of treatment and the Hospital raised a bill of Rs.2,05,067/- and alleged that out of this amount a sum of Rs.58,931/- is to be paid as patient share before release of body, whereas entire bill amount was payable by CGHS authorities under CGHS Scheme.  However, under forced circumstances, the son of the deceased patient, issued a cheque No.100733 dated 3.12.2017 for Rs.58,931/- in favour of OP Hospital and only then the body of deceased was handed over to the complainants.

         It is submitted that the patient expired in OP Hospital during the course of treatment on 3.12.2017 due to the deficiency in service and medical negligence of the OPs.  It is also submitted that perusal of Death Certificate  (Ann.C-5) would show that the immediate cause of death was not CAD Coronary Artery Disease but “Locally Disseminated Malignancy” and cause of death was mentioned as Ventricular Fibrillation, which shows that the diagnosis and treatment by the OP Hospital was wrongful and negligent. It is further submitted that OPs NO.1 to 3 even did not inform the OPs No.4 & 5 in time about their lapse and the OP Hospital sought approval of the CGHS authorities only after the death of the deceased (Ann.C-6).

         It is pleaded that the OPs No.4 & 5 also delayed the sanction of the amount of Rs.58,931/- which led to further harassment of the complainants. However, the office order sanctioning the said amount was passed only on 3.12.2018 (Ann.C-7).  It is also pleaded that the authorities of CGHS Scheme are also responsible for the wrongful actions of Forties Hospital as the CGHS authorities have failed to monitor and check the illegal and unfair practices of the Fortis Hospital.  It is further pleaded that the complainants had to give cheque for the demanded amount to get the body released from the OP Hospital. 

         It is stated that the OPs are guilty of deficiency in service and have indulged in medical negligence in medical treatment under CGHS scheme.  It is also stated that the OPs did not take any informed consent from the complainants for treatment of lung cancer or malignancy, which itself amounts to medical negligence.  It is asserted that the OPs never informed the complainants that they were administering high-end antibiotics to the deceased and the complainants came to know about this for the first time, when the OP Hospital presented the Bill for payment.  It is also asserted that the OPs have failed to correctly diagnose and to give proper & correct treatment to the deceased as a result of which patient Surat Singh died and complainants lost their dear one. 

         Hence, this complaint has been preferred alleging deficiency in service as well as medical negligence on the part of OPs.

 

2]       The Opposite Parties have filed joint reply and while admitting the factual matrix of the case, stated that patient Surat Singh had undergone Coronary Angiography on 4.11.2017 at Max Hospital, Mohali (Ann.OP-1/1A) and after having been advised surgical revascularization by the Cardiologist at Max Hospital, the patient visited Fortis Hospital where Dr.H.K.Bali, Director Cardiology at Fortis Hospital, Mohali on 16.11.2017 asked the patient to consult concerned Surgeon in Cardiovascular & Thoracic Surgery, Department at Fortis Hospital, where patient consulted Dr.T.S.Mahant, who advised him to undergo Stress Thallium to know the viability of surgical revascularization as well as to undergo PFT Test on OPD basis.  It is stated that after these test reports, the patient was advised by-pass surgery under high risk and CGHS authorities accorded permission to patient Surat Singh for undergoing CABG.  It is also stated that the reports of said test conducted on OPD basis were given to the patient only after which patient was advised CABG.  It is clarified that CGHS authorities had given permission only for By-pass procedure and the high-end antibiotics administered to the patient were not part of the ABG package, so these were separately charged.  It is pleaded that without bringing out any specific act or omission on the part of the answering OPs, the complainants are now alleging that the patient was not appropriately diagnosed and was not treated with caution.  It is also pleaded that the patient was a Cardiac patient, requiring surgery and there is nothing on record to show that this advice was not correct. 

         It is submitted that patient underwent high risk coronary artery bypass grafting (CABG) procedure on 25.11.2017 (Ann.OP-1/8), after getting due consent for the same vide Ann.OP-1/5, OP-1/6 & OP-1/7.  It is also submitted that the patient was shifted to ICU post operatively with high inotropic and mechanical ventilator support.  It is further submitted that after surgery, patient’s son Rajinder Singh was explained about the patient’s condition and intra-operative incidental findings and also that an anterior mediastinal mass was detected during surgery, which was removed and sent for biopsy according to international protocol for any incidental findings of any mass (Ann.OP-1/9). It is pleaded that post-operatively patient was in critical condition owing to his severe coronary artery disease and poor heart function; his immuno compromised state owning to low heart function and malignancy required administration of high end antibiotics.  It is also pleaded that it is known fact that immunosuppressan resulting from low heart function and prolonged mechanical ventilatory support alongside malignancy itself can leads to severe infection (Ann.OP-1/9A).  It is stated that biopsy report dated 29.11.2017 confirmed malignant tumour and immediately consultation from an Oncologist was sought and he did not advise any active treatment from his side till the time patient stabilized (Ann.OP-1/11 & OP-1/12).  Patient’s tracheal secretions on 1.12.2017 reported growth of pseudomonas aeruginosa. However, despite best care the patient expired on 3.12.2017. 

         It is asserted that the patient and his attendants were fully informed that by-pass procedure was a High Risk Procedure and a High risk Consent Form was also signed by the patient before performing CABG procedure.  It is also asserted that the patient and his attendants were well aware and stood duly informed that the procedure involved a very High Risk of Morbidity and Mortality but despite being fully aware of this fact, the complainants have now deliberately chosen to portray as if they were kept in dark. It is further stated that there was no negligence on the part of the Hospital and the treating doctors including OPs No.2 & 3.  It is submitted that no procedure, major or minor, is devoid of risks and merely because the procedure did not yield desired results can in no manner be termed as a negligent act on the part of the doctors or the Hospital.  It is also submitted that remaining amount of Rs.58,931/- which was not the part of CABG package was shown as patient share and it has also not been approved by CGHS, so the Hospital obtained a cheque for said amount which was dishonoured on presentation, as a result, criminal complaint under Section 138 of NI Act was filed against complainant No.2, who then deposited the amount with the Hospital.  It is stated that under a false complaint from complainant No.2, the CGHS authorities without any application of mind imposed a penalty of Rs.58,931/- along with Rs.50,000/- upon OP No.1 and directed that this amount shall be recovered from the pending bills of OP No.1.  Subsequently this amount of Rs.58,931/- was paid to the complainant No.2 by the CGHS Authorities.  It is also stated that the present complaint is hit by Res-judicata and Order 2 Rule 2 as the complainant has also filed similar complaint No.25 of 2019.  Denying all other allegations and pleading no deficiency in service or negligence, as alleged, the OPs have prayed for dismissal of the complaint.

 

3]       OPs No.4 & 5 did not turn up despite service of notice sent through regd. Post on 23.4.2021, hence they were proceeded exparte vide order dated 28.4.2022.

 

4]       Rejoinder has been filed by the complainant controverting the assertions of OPs as made in their reply.

 

5]       Parties led evidence in support of their contentions.

 

6]       We have heard the ld.Counsel for the parties and have gone through entire documents on record including written arguments.

 

7]       After going through all the documents and evidence on record as well as oral arguments of the parties, it is opined that Pre-anesthetic assessment is usually done by a team of doctors comprising a physician, an Anesthetist & Surgeon/interventionist himself & other experts related to the field concerned.  However the elaborate pre-operation tests and checks failed to detect the cancer which became conspicuously visible while operation was being conducted. Overnight spread of cancer from stage zero to advance is commonly uncommon & almost impossible. Complete diagnosis & related risk factors are clearly explained to the relatives on record in their native language. The question remains weather it was missed deliberately or was a by chance human error amounting to negligence?.

 

8]       The OP Hospital, a Super Speciality Hospital claiming to have the best doctors but sadly failed to detect the Cancer in the body of patient while conducting pre-operation tests & check-up.  The OPs themselves declared in their written reply that OP No.1 is a state of art tertiary care hospital which is also approved by JCI and NABH after periodic and thorough inspections.

 

9]       It is the duty of doctors/hospital to conduct all possible tests to ensure that the patient is completely medically fit for operation. Therefore, the present complaint deserves to be allowed.  Accordingly, the complaint is allowed against Opposite Parties No.1 to 3 with direction to pay a lumpsum amount of Rs.5,00,000/- to the complainants, which also includes the litigation expenses.

         This order shall be complied with by the OPs No.1 to 3 within a period of 45 days from the date of receipt of copy of this order, failing which they shall be liable to pay additional cost of Rs.15,000/- apart from the above relief.

 

10]      Further a number of times, it is seen that while a person is taking treatment for some illness with due permission of the CGHS authorities and a new or different disease is suddenly detected which needs treatment without delay as happened in the instant case then the person having CGHS cover for cashless treatment must not be put to the inconvenience or harassment to obtain additional/advance approval for treatment of such diseases as the delay in starting the treatment due to non availability of CGHS approval might prove fatal to the person undergoing treatment, therefore, CGHS authorities are directed to deliberate upon this/such situations and incorporate adequate safeguards, rules and provisions to allow the treatment for sudden and unforeseen health emergencies by the empanelled hospitals to ensure safe & smooth treatment of serving & retired Govt. employees who are beneficiaries of cashless treatment under CGHS scheme. 

         Certified copy of this order be sent to the parties, free of charge. After compliance, file be consigned to record room.

Announced                                                     

16^th September, 2022                               

                                                                        Sd/-

(PRITI MALHOTRA)

PRESIDING MEMBER

 

Sd/-

 (B. M. SHARMA)

MEMBER