PRESENT:      Sh.Amit Jaiswal, Adv. for complainant

Ms.Ritu Jain, Govt. Pleader for OP.

                              ---

PER LAKSHMAN SHARMA, PRESIDENT

          Ms.Upasana and Mrs.Rishpal Saini have filed this complaint under section 12 of the Consumer Protection Act, 1986 praying therein that OP be directed  to :-

i)              To pay Rs.6,00,000/- as cost of treatment, medicines, transportation, attendant and stay in Chandigarh.

ii)         To pay a sum of Rs.5,00,000/- as compensation for mental and physical harassment.

iii)    To pay a sum of Rs.8,00,000/- for loss of dependency.

2.        In brief, the case of the complainants is that Sh.Paramjit Singh who was practicing advocate at Haldwani was suffering from appetite loss and also used to vomit sometimes after taking food. He took treatment at Haldwani but did not get any relief. So on the advice of his close relatives, he visited Chandigarh to get himself checked up.  He was taken to OP-Hospital in month of June, 2006. As per the clinical diagnoses, he was found to be suffering from Cholelithiasis (i.e. stone in gall bladder). Sh.Paramjit Singh was admitted in the hospital and was advised to get himself operated on 03.07.06. According to the complainants, on the advice of OP, Sh.Paramjit Singh was operated on 03.07.06 and gall bladder was removed. After removal of the gall bladder, it was sent to pathology laboratory for report. According to the complainants, they were kept in dark about the report of pathology for many days. Later on, it came to light that no stone was recovered from the gall bladder. According to the complainants, the diagnosis was absolutely wrong and there was no necessity for operating Sh.Paramjit Singh as he was not having any stone in gall bladder. It has further been averred that the procedure recognized and adopted by the doctors all over the world was not followed by the OP which resulted in wrong diagnosis of the disease and resulted into unnecessary operation. It has further been pleaded that the operation was performed on the ill advice as the patient was suffering from severe liver dysfunction. The gall bladder is the organ which is attached to the liver and both the organs work in tandem.  As the patient was already suffering from liver dysfunction, the removal of gall bladder only worsened the condition.

          It has further been pleaded that after operation, Sh.Paramjit Singh was moved to general ward where his condition started deteriorating due to pipes which were inserted into the body of the patient and the same started oozing out fluids in large quantity despite the fact that attention  of the attending doctors was brought towards the condition of the patient but they did not bother. On 14.07.2006, Sh.Paramjit Singh was removed to emergency unit of the Hospital. However, it was too late. The infection had spread to the whole body of the patient which finally resulted into multiple organs failure. Keeping in view the condition of Sh.Paramjit Singh, he was shifted to ICU on 24.07.2006 but his life could not be saved and ultimately he died on 30.08.2006.

          According to the complainants, the death of Sh.Paramjit Singh occurred due to sheer negligence and deficiency in service on the part of OP. The diagnosis were not proper and were not based on procedure recognized and adopted by the doctors all over the world. So because of the wrong diagnosis, Sh.Paramjit Singh was operated without there being any necessity and even in the post operative treatment, OP had been negligent which resulted in spreading of infection all over the body of Sh.Paramjit Singh and ultimately resulted into his death. In these circumstances, the present complaint was filed seeking the reliefs mentioned above.

3.        In the reply filed by OP, it has been pleaded that Sh.Paramjit Singh was suffering from appetite loss and off and on vomiting and used to consume alcohol daily for the last 20 years.  It has further been pleaded that Sh.Paramjit Singh produced the ultrasound report dated 03.06.06 from Haldwani which clearly showed that the patient had Cholelithiasis(stone in gall bladder). The ultrasound was done by qualified radiologist Dr.Pankaj Mahesh, MD (Radiodiagnosis) who was formerly consultant at St.Stephens Hospital, New Delhi.  So the provisional diagnosis of gall bladder disease was made and Sh.Paramjit Singh was advised certain tests i.e. Hemoglobin, TLC, DLC, ESR, X-Ray Chest, Liver Function tests, S.Alkaline Phosphatase to confirm the said disease. 

          It has further been pleaded that two pre-operative ultrasounds (Annexure V and VI) one brought by patient himself from Haldwani and done by qualified radiologist and former consultant St.Stephens Hospital, New Delhi and other from GMCH, Sector 32, Chandigarh showed cholelithiasis, cholecystitis, polyposis, choleterosis, all pointing towards that the gall bladder was pathological, that is diseased. According to OP, Sh.Paramjit Singh again visited on 24.06.06 and prenaesthetic check up was advised to get fitness for surgery. After going through the history, physical examination, systemic examination and various investigations including liver function tests, the patient was admitted on 01.07.2006 for cholecystectomy.  It has further been averred that day before surgery i.e. 02.07.06, the patient had ultrasound in view of raised serum alkaline phosphatase which pointed towards common bile duct stone. The ultrasound report further showed gall bladder with oedematous wall thickening with echogenic foci with polyps with cholesterosis with acute acholecystitis with biliary sludge which further enforces the diagnosis for gall bladder disease.  According to OP, the patient had preoperative liver function tests on 01.07.06 which showed normal serum bilirubin and normal serum proteins with slightly raised serum alkaline phosphatase on 414.70 u/I (Normal 80-306 u/I) and this could be raised only when there is stone in the common bile duct so it was decided to do preoperative cholangiogram. SGOT/SGPT were slightly raised preoperatively which could  be due to chronic liver disease or gallbladder disease (patient was chronic alcoholic for last 20 years as per history and PAC chart).

          It has further been pleaded that operation of cholecystectomy was performed and gall bladder was removed from liver bed. It is removed when it is pathological and it is a very commonly performed operation. It is also a routine to cut open the specimen and to see for any growth or tumour inside the gall bladder so that lesion could be marked. During this, the gall stones remained in the tray which is filled with liquid normal saline and the gall bladder is sent for histopathological diagnosis which showed chronic cholecystitis, which means long standing inflammation of the gall bladder which is a strong indication of cholecystectomy.  It has further been pleaded that the complainants were not kept in  dark as the histopathology report was reported on 08.07.06 which clearly showed chronic cholecystitis meaning thereby that the gall bladder was diseased. Furthermore, the histopathology is done to rule out any cancerous condition since it came out to be chronic cholecystitis and no change in treatment plan anticipated so stress not laid during regular discussion with family.  It has further been pleaded that the patient’s condition got stabilized and therefore, he was shifted to general ward and the drain pipe was put in the abdomen so that any collected fluid comes out of the abdominal cavity and the treating doctors were well aware of the daily drain output which is clearly mentioned in the daily input and output chart (Annexure R-VII). According to OP, as the patient has cirrhotic liver because of liver disease, so more drain output was anticipated as the fluid seeps through the surface of liver in cirrhotic liver and through peritoneal surfaces and gastroenterologist of the hospital was contacted personally who advised to transfer the case to the medicine side for further management. So the patient was shifted to medical emergency on 14.07.06

          It has been denied that it was late to transfer to the medical emergency as regular medical consultation was taken on 10.07.06, 12.07.06, 13.07.06 and 14.07.06 when Prof. & Head, Medicine and Gastroenterologist advised to transfer the patient to the Department of Medicine for further management.  It has further been pleaded that blood cultures of the patient was done on 25.07.06,27.07.06, 31.07.06, 03.08.06 and 24.08.06 which clearly showed that no organism growth was seen after 72 hours and total leucocyte count on date 17.07.06 was 8500/cumm which is in normal range.

          According to the OP, there is no negligence on the part of treating doctors and all reasonable care was taken while treating the patient and the case was dealt sympathetically as patient made poor free by HOD, Department of Surgery on 25.07.06, the day after patient was shifted to ICU on request of complainant No.2 who pleaded that she could not afford the expenditure of ICU.  In these circumstances, according to OP, there is no deficiency in service on its part and the complaint deserves dismissal.

4.        We have heard the learned counsel for the parties and have gone through the entire record including documents, Annexures, affidavits etc. 

5.        The case of the complainants is that diagnosis of the disease suffered by Sh.Paramjit Singh was not proper and the OP had not followed the procedure recognized and adopted by the doctors all over the world.  It has not been mentioned as to what was the procedure recognized and adopted by the doctors all over the world for diagnosis of the said disease nor it been mentioned that what steps of such recognized procedure were not followed. Neither any report of any expert has been placed on record to prove this fact nor any extract from medical textbook has been placed on record to prove this fact.

6.        On the other hand, the case of OP is that the clinical diagnosis as well as the report of ultrasound report dated 03.06.06 done by qualified doctor and produced by the complainant himself showed that Sh.Paramjit Singh had Cholelithiasis (i.e. stone in gall bladder). So the patient(Sh.Paramjit Singh) was advised certain tests i.e. Hemoglobin, TLC, DLC, ESR, X-Ray Chest, Liver Function tests, S.Alkaline Phosphatase to confirm the said disease.  Even day before surgery i.e. 02.07.06, the patient had ultrasound in view of raised serum alkaline phosphatase which showed common bile duct stone. The ultrasound report further showed gall bladder with oedematous wall thickening with echogenic foci with polyps with cholesterosis with acute acholecystitis with biliary sludge, which further enforces the diagnosis for gall bladder disease. Even both the ultrasound reports (Annexure V & VI) confirms that the complainant was suffering from Cholelithiasis.  So report relied upon by the complainants himself confirmed that Sh.Paramjit Singh was suffering from Cholelithiasis and operation was the only remedy to save the life of the patient.  Thus according to OP, all the necessary tests and all the procedures recognized by medical science to diagnose the disease of Sh.Paramjit Singh were followed and there is no deficiency in service on the part of treating doctors on this score.

7.        It has further been argued that Sh.Paramjit Singh, patient was also suffering from cirrohitic liver because of alcoholic liver disease which resulted into deterioration of his health. It has also been argued that there was no post operative negligence on the part of OP. After operation when the condition of Sh.Paramjit Singh improved, he was shifted to General ward. Sh.Paramjit Singh remained in the general   ward till his condition was good. However, when his condition started deteriorating, he was shifted to emergency ward and later on he was shifted to ICU for better management under the supervision of Prof and Head of Medicine and Gastroneterologist.

          As mentioned above, there is no report of any medical expert nor is there any extract from authentic medical literature to prove that the procedure adopted by the treating doctors was not in accordance with the procedure recognized and adopted by the doctors all over the world.

8.        On the other hand, from the evidence in the shape of medical record placed on record, it is proved that all the necessary tests for diagnosis of the disease suffered by Sh.Paramjit Singh were conducted and it was found that the operation was the only remedy to save the life of Sh.Paramjit Singh. Mere fact that the operation was not successful does not prove the negligence/deficiency in service on the part of OP.

9.        In these circumstances, from the evidence on record, it is proved that there was no medical negligence or deficiency in service on the part of the OP. Therefore, the complaint deserves dismissal. Hence, this complaint is dismissed leaving the parties to bear their own costs.

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

Announced                                        

22.01.2010