BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, SIRSA.
Consumer Complaint no. 19 of 2017
Date of Institution : 27.1.2017
Date of Decision : 28.08.2019
1 Mastana Singh aged about 25 years son of Shri Mangal Singh resident of village Nakhatia, Tehsil and District Fatehabad.
2 Darshan Singh aged about 58 years son of Sh. Saudagar Singh resident of village Sikanderpur, Tehsil and District Sirsa.
……Complainants.
Versus.
1. Jyani Maternity & Children Hospital, Opposite Surkhab Tourist Complex, Hisar Road, Sirsa, through its owner.
2. Dr. Aruna Jyani, Jyani Maternity & Children Hospital, Opposite Surkhab Tourist Complex, Hisar Road, Sirsa.
3. Oriental Insurance Company Ltd., 4E/14 Azad Bhawan Jhandewala Ext, New Delhi thorough Branch manager at Branch Office, Janta Bhawan Road, Sirsa, (Professional Indemnity policy no.272200/48/2017/9866 valid from 12.8.2016 to 11.8.2017)
...…Opposite parties.
4. Sukhwinder Kaur wife of Sh. Darshan Singh, 5. Rajvinder Singh son of Sh. Darshan Singh, 6. Jodhvir Singh son of Sh. Dharshan Singh, 7. Harmeet Kaur daughter of Sh. Darshan Singh, All residents of village Sikanderpur, Tehsil and District Sirsa.
…..Proforma opposite parties.
Complaint under Section 12 of the Consumer Protection Act,1986.
Before: SHRI R.L. AHUJA……………….. PRESIDENT.
SHRI ISSAM SINGH SAGWAL……MEMBER.
SMT. SUKHDEEP KAUR……… MEMBER
Present: Sh. Parveen Ahmad, Advocate for complainant.
Sh. J.D. Garg, Advocate for opposite parties no.1&2.
Sh. Ravinder Goyal, Advocate for opposite party no.3.
Sh. Vikas Jain, Advocate for proforma opposite parties no.4 to 7.
ORDER
In brief, the case of complainants is that the complainant no.1 is husband of deceased Harpreet Kaur and is serving in Punjab Police as constable , complainant no.2 is father, proforma-op no.4 is mother, proforma ops no.5&6 are brother and proforma op no.7 is married sister of deceased Harpreet Kaur. The present complaint is being filed by complainants and proforma-ops no.4 to 7 seeking the claim of medicine bills, expenses for the treatment of deceased Harpreet Kaur and compensation for the death of Harpreet Kaur and un-born child(as deceased Harpreet Kaur was having pregnancy of 8 months), on account of negligent and deficient act on the part of op/doctor in attending and treating the deceased.
2. It is further averred that deceased Harpreet Kaur was married with complainant no.1 on 14.12.2015 and after the pregnancy got herself checked from op-doctor time to time from February, 2016 and was under regular treatment of op/doctor who is running the hospital known as Jyani Maternity & Children Hospital, Opposite Surkhab Tourist Complex, Hisar Road, Sirsa. During the period of regular check-up Harpreet Kaur took all the medicines and precautions as prescribed by the op/doctor. All of sudden on 26.8.2016, when there was vomiting, burning epigastria, pain abdomen, back pain, swelling over foot, loss of appetite, then deceased Harpreet Kaur was admitted in the hospital by the doctor/op no.2. During this period of treatment, she was advised to undergo various tests including ultra sound, even referred on 4.8.2016 to Dr. Amit Narang consultant Neuropsychiatric, on the pretext that Harpreet Kaur was not having the bodily problem, rather has wrong prescription about her ill-health in her mind and due to this, she is not keeping good health. Except few test of ultra sound, the entire path test were got conducted by op-doctor in her hospital or in some lab of another hospital known to op-doctor. It is further averred that since the day of start of treatment, condition of deceased Harpreet Kaur was not well as T.L.C was increasing and Hb was decreasing, but as complainants were illiterate regarding medical terminology, thus were fully dependent on op-doctor and were always ready to pay for the test and medicines so prescribed by the op/doctor, but as condition became worst day by day, the op/doctor instead of referring her to higher institute kept the lust of money and kept under her treatment and when her condition was deteriorated, only then op doctor discharged her by mentioning the words “discharge on request”. She was discharged on request by way of pressure by complainants and other village members and Harpreet Kaur was taken to AMC Hisar, but as the condition of Harpreet Kaur was severe and she was having Jaundice and Septicemia HE, thus deceased Harpreet Kaur though was got admitted explaining risk to patient life and gastroenterologist opinion was sought as patient was drowsy, but after admission of one day, Harpreet Kaur was advised to be taken to higher institute (after receipt of reports of various test) considering the condition of Harpreet Kaur. All the reports of test were notified by the doctor pathologist. Thereafter, she was taken to Fortis Hospital, Mohali on 2.9.2016. All efforts were made there at Hospital at Mohali, but Harpreet Kaur died on 5.9.2016 at 9:10 A.M. It is further averred that cause of death noticed by doctor of Fortis Hospital Mohali is Refractory shock, multi orgam failure, acute fulminate liver failure. This multi organ failure was/is the result of not taking care by op-doctor at initial stage by not giving the appropriate treatment which would have been given. The op no.2/ doctor is referring and mentioning herself to be the expert of maternity and women problem but she is simply MBBS and ops are misleading the persons like complainants. Thus when op doctor is not a specialized doctor in the field of treating the pregnant lady like the deceased Harpreet Kaur, then this is also one of the factor contributing in not proper diagnose and treatment of deceased. It is further averred that had the doctor Aruna Jyani been really a specialist in treating the women and maternity delivery treatment, she could have very well advised and treated the deceased timely after coming to know about increase in TLC and decrease in Hb and other relevant test ought to have been got conducted by her from the competent pathologist as got conducted by AMC Hospital, Hisar and Fortis Hospital, Mohali. It is further averred that despite repeated requests for making a call for visit of expert doctor of the relevant field or to discharge her, the op doctor for the lust of money did not permit the complainants to take her to higher institute, rather stated that she is well and she is in drowsing condition because of effects of medicine, thus complainants were misguided and no reasonable care in treating and attending Harpreet Kaur was taken by the op doctor. It was expected from the op doctor to call for an expert doctor at the cost payable by the complainants, but she avoided the same having an apprehension that complainants will take her from her hospital and the op doctor kept the her admitted despite unable to manage and control her. It is further averred that another glaring example of deficient and negligent act on the part of op doctor is that her hospital has no pathologist and no test reports were conducted by a pathologist rather same were conducted by a simple lab technician with a sole object of making money from the patients like complainants. Each and every test is got conducted through an unauthorized, unapproved path lab and the reports are delivered under the signature of lab technician only, rather than after due observation of sample by the competent pathologist, so the test reports which were obtained by op doctor from their own lab seems to be not correct, genuine and authenticated one, resultantly no proper and effective prescriptions was given by the doctor who otherwise was also not competent to handle the condition of deceased who has been reported to be affected with severe jaundice, having high level blood urea and high level SGOT, SGPT, ALK Phosphates, S. Bilirubin total, S.Bilirubin direct, S.Bilirubin indirect. It is further averred that complainants in total paid Rs.26,000/- to the ops. The ops failed in discharging their duties with the due diligence with reasonable degree of care and skill, rather were/are after the money and due to the deficient and negligent act on the part of ops, condition of deceased Harpreet Kaur became deteriorated to the extent of un-controllable/non-controllable, even by the multi specialty hospital namely AMC Hisar and Fortis Mohali and due to this deficient and negligent act, complainants were forced to pay Rs.32,000/- at AMC Hospital Hisar and incurred Rs.34,000/- on medicines and report at AMC Hospital Hisar and also spent Rs.6,19,945/- at Fortis Hospital Mohali, but despite spending the huge amount, complainant were not able to save Harpreet Kaur, even fetus/child in the womb also died due to the problem faced by deceased Harpreet Kaur, for which whole responsibility is on the part of ops due to their deficient and negligent act, as they were not qualified in holding the deceased Harpreet Kaur and were not able to treat her being not specialized in the field, but kept her under their own treatment deliberately and malafidely in order to mint/fetch the money from the complainants. Though the complainants and proforma ops are entitled to compensation of more than Rs.twenty lacs, but are claiming refund of amount of Rs.71,9,945/- spent on treatment, lump sum amount of Rs.12 lacs as compensation for the death of deceased Harpreet Kaur as they have lost love and affection of Harpreet Kaur and also her valuable services being rendered by her towards her above said family members. They are also entitled to further amount of Rs.50,000/- as compensation for harassment and Rs.30,000/- as litigation expenses. It is further averred that complainants visited the ops several times for handing over the entire record of treatment and they also made request to the higher authorities but to no effect. That due to the act and conduct and deficiency in service on the part of ops, they undergone much mental tension, harassment. Hence, this complaint.
3. On notice, opposite parties appeared. Opposite party no.1 and 2 filed written statement taking certain preliminary objections that complainant is wholly misconceived, groundless, frivolous, vexatious and scurrilous which is unsustainable in the eyes of law, complainants have failed to explain the cause of action against ops no.1 and 2, the ops no.1 and 2 have not committed any negligence in this case while providing the treatment and that complaint is bad for non arraignment and mis arraignment of parties. It is submitted that Dr. Aruna Jyani was duly insured with “The Oriental India Insurance Company Ltd.”, 4E/14 Azad Bhawan Jhandewalan Ext, New Delhi-110055, vide Professional Indemnity bearing Insurance Policy No.272200/48/2017/9866, effective from 12.8.2016 to 11.8.2017. It is further submitted that op no.2 is well qualified, Government Medical College Bikaner MBBS and one year rotating housemanship internship trained and now a reputed and respected doctor. She was a physician and gynecologist in Maternity & Welfare centre(SDMH) Happy Nursing Home, Jaipur RMO fulltime resident surgeon from April 1988 to May 1991, Government RPSC confirmed Jr. Specialist posted at Government Hospital Jaitaran, Pali Jodhpur and Nohar Sri Ganganagar Hospitals from June 1991 to October 1992 i.e, Ex-RCMS (Rajasthan Government Medical Service), and S.M.O at Janta Maternity and General Multispecialty more than 100 bedded S.S. Hospital registered welfare trust Sirsa as a women doctor specialist since November 1992 to October 26, 1997 continuously for five years. She remained as a trained obstetrician and Gynecologist under Dr. V.N Mathur MS retd. Director G of Health Services Haryana and performed tubectomies, L.S. caesarian operations and GynaeHysterectomy operations and MTPs. Now she is running her own hospital as authorized owner and full time resident doctor residing in the same campus premises on first floor home of Jyani MC Hospital since 26 October 1997 till date. It is further submitted that she attended many CMEs, Refresher courses and many FOGSI annual medical conferences and symposiums. It is further submitted that now she is a life member of FOGS IMUMBAI and Haryana association of Infertile society(I.S.A.R.). It is further submitted that patient Smt. Harpreet Kaur aged 24 years married in December 2015. The literate patient and wife of a Punjab Police constable in service first came in OPD on 25.2.2016 with pregnancy of two months for routine checkup. Later the patient visted on 9.6.2016, 4.8.2016, 26.8.2016 and 27.8.2016 late evening in OPD chamber. Patient was investigated and treatment given but revisited on 27th night, got admitted for short stay of about 80 hours in total in the hospital between 27.8.2016 night to 31.8.2016 morning. At the time of admission, the patient had complaints of pregnancy of about eight months, with a short one to two day history of fever, vomiting and mild swelling of both lower limbs, pain in abdomen and back with burning in epigastrium, and loss of appetite. It is further submitted that she and her attendants relatives were very well informed and explained by Dr. Mrs Aruna of the type, nature and possible progress and outcome may be serious for her and foetal well being due to jaundice and swelling feet and body. Even after giving the best treatment in hospital, the prognosis is never good and may be bad and dangerous for both in future. The patient was advised Bed and mental rest and a high carbohydrate juices and Glocose but a low fatty and low protein diet. She was advised blood and urine tests and given IV fluids, multi vitamins, antacids, anti emetic and Antibiotics with Metronidazole infusions and supportive symptomatic treatment. Diagnosis of pregnancy with jaundice with mild hypertension. (Slightly in above range) of late pregnancy was made. Tests of Urine bile salts (BS) and bile pigments(BP) were positive and a mild significant increase in serum bilirubin level and raised SGOT and SGOT levels and increased TLC infection marker. But her blood tests of MP, Widal test, Blood sugar levels and Prothrombin time were well in normal range. It is further submitted that already tested for blood group B positive and normal VDRL, HIV, Hepatitis B and C virus were already performed in routine OPD checkup before hand in antenatal care checkup. As well as the patient was with them, the fetus was well and shown moving and alive foetal cardiac rate pulsations were normal USG scan report on a radiologist centre scan Sirsa sonography. There was no IUD till the patient was under the care of the op no.1&2. On 3rd day of admission her blood hemoglobin level were slightly lower 10 to 9.6 gram % and a serum bilirubin level for jaundice increased from 5.5 mg to 6,7 mg% but the TLC level improved from 17600 to 14000 level and slight presence of one point 1+ albumin and a normal Blood Urea of 34 mg%. Normal platelet count of 220000 normal and bleeding and clotting time. Since the patient was having a eighth month pregnancy with jaundice and hypertension with increased TLC and Serum bilirubin and rising fever and headache and irritable behavior with body aches but normal foetal condition, the attendants were requested to consult for a physician or gynecologist for a second opinion and expert views for further management and may take the patient to a higher medical centre. The attendants asked for a discharge of the patient on request. They were well advised and got the patient relieved and discharged with continued IV fluids line and the patient was also referred to the higher medical centre institute esp for PGI, Chandigarh on 30.8.2016 night but the attendants requested ops to keep her till early morning and continue the treatment or so and left the hospital in mobile condition walking and accompanied by their female nursing staff of her native village for and into the car outside their hospital verandah. Even after referral to higher medical centre institute, (PGI, Chandigarh) the patient consulted many doctors in Sirsa and got admitted for few days in Hisar city AMC hospital instead of visiting PGI, Chandigarh. This is the sole negligence of the patient party. It is further submitted that later after a period of four days in Mohali Fortis hospital, the patient and her fetus died of natural death due to advanced stage of pregnancy jaundice with multiorgan failure. It is further submitted that pregnancy with jaundice is a serious combination with high mortality. Pregnancy with jaundice was found to be the most common cause of mortality in pregnancy (68.5% of the total). Jaundice and pregnancy are a deadly combination resulting in a very high prenatal as well as maternal morbidity and mortality. Everything the op no.1&2 have done was done diligently, prudently, with utmost due care and caution in treating the said patient. It is also submitted that Proforma ops are not the consumer of the op no.1 and 2. Remaining contents of the complaint are also denied and prayer for dismissal of complaint made
4. On being impleaded, the Oriental Insurance Company Limited as op no.3 and on notice, appeared and filed written statement taking certain preliminary objections. It is submitted that answering op has come to know the filing of present complaint before this forum, only in the month of April, 2017, when the answering op received the summons from this forum, hence for delay in reporting any case against insured, answering op should not be burdened with any liability on account of interest for the pre-appearance period, if any is ordered to be paid by this forum and op no.2 should be burdened with the same as per terms and conditions of the policy. It is further submitted that op no.2 failed to abide by the terms and conditions of the policy and due to this deliberate and willful breach of term and conditions of the policy, answering op should not be burdened with any liability. It is further submitted that op no.2/doctor was insured with the maximum indemnification from 12.8.2016 to 11.8.2017 for the sum of Rs.500,000/- only subject to compliance of term and conditions of the policy. Remaining contents qua op no.3 are also denied and prayer for dismissal of complaint made.
5. The parties then led their respective evidence.
6. The complainants have tendered their affidavits Ex.CW1/A, Ex.CW1/B and copies of documents Ex.C1 to Ex.C51. On the other hand, ops no 1 and 2 produced affidavit of op no.2 as Ex.R1 and copies of documents Ex.R2 to Ex.R28. Op no.3 produced affidavit of Sh. Sushil Kumar, Senior Divisional Manager Ex.R29 and copy of policy schedule Ex.R30.
7. We have heard learned counsel for the parties.
8. Learned counsel for complainant filed written submission in which it has been submitted that patient deceased Harpreet Kaur was brought in the hospital of ops to be attended by op no.2 during her pregnancy checkup from time to time from February, 2016 and was under regular treatment of op no.2. On 26.8.2016, Harpreet Kaur was having vomiting, burning, epigastria, pain abdomen, back pain, swelling over foot, loss of appetite as mentioned in Ex.R12. The doctor op no.2 treated the patient on the basis of reports got prepared by herself from some Lab technician on her printed hospital proforma. Doctor is not pathologist. Report has not been prepared by a Pathologist or by competent person as held by Hon’ble Supreme Court, so the treatment given by making such reports as basis, is an act of negligent, deficiency, willful and deliberate violation of law and to play with the life of patient. Ex.C9 to Ex.C12 are proforma of reports. These reports and treatment thereof of the ops’ hospital are incorrect and wrong as patient Harpreet Kaur was diagnosed with having S.G.O.T 135, S.G.P.T 99 as per Ex.C2. It has been further submitted that on 31.8.2016 when deceased was taken after diagnose on request by the family as condition was becoming worsened and the record of hospital Ex.C38 and Ex.C39 reflect jaundice and septicemia and condition was poor and severe. This reflects that on 31.8.2016 she suffered with the jaundice and infection, which was due to in-expertise in treating such patient by getting relevant proper test conducted and same became septicemia. It has further been submitted that Ex.C23 reflects caution taken by the AMC hospital authorities that they referred the patient at their own considering her condition to be critical having pregnancy, jaundice, septicemia on the very next day i.e. on 1.9.2016 after going through the reports and consultancy with the gastroenterologist. The opinion of gastroenterologist was sought vide Ex.C39. It has been further submitted that op doctor never got conducted the test of PT for taking proper action after the receipt of result of same, as was got conducted at Hisar vide Ex.C32, which has a reference “P.T. is a non specific indicator of the extrinsic blood coagulation mechanism. Deficiency of P.T and factor V, VII & X give rise to a prolonged time as well as the presence of heparin in the blood and hypo fibringenemia. Some of the common causes of a prolonged P.T. are Coumarine therapy (warfarin), obstructive jaundice, liver disease, heparin therapy, malabsorbtion states (vitamin K deficiency) and TLC reports is Ex.C31 and SGPT was 1370, SGOT was 160, S.Bilirubin total was 15.22 mg, ALK. Phosphates was 930, S.Bilirubin direct was 12.79 mg S. Bilirubin indirect was 2.43 mg on 31.8.2016 itself as per Ex.C26 (after discharge from the hospital of doctor), whereas as per Ex.C12 no SGOT, SGPT were tested and S.Bilirubin total was 9.4 mg and TLC were 21000 and as per Ex.C11 there was no test of SGPT, SGOT, S. Bilirubin got tested by op doctor on 30.8.2016 and even no test of SGOT, SGPT on 29.8.2016 as per Ex.C10 and TLC was 21000 on 31.8.2016 as per Ex.C12 of Dr. Jyani Hospital, whereas as per TLC report Ex.C29 of Pathologist Hisar, TLC were 44200. The op doctor never called, consulted the expert doctor, physician, gastroenterologist. After the hospital of op no.2, patient was taken to Jindal Institute, Hisar, but they referred the patient vide Ex.C24.
9. It has further been submitted that op no.2 attended the patient Harpreet Kaur carelessly and did not properly diagnose the disease and did not give proper treatment of jaundice during her pregnancy of more than eight months. The health condition of Harpreet Kaur was being deteriorated day after day but however, op doctor did not refer the patient to any higher medical institution knowing well about the deteriorated condition of the patient and continued to retain her in her hospital despite the fact that she was not having any well equipped laboratory with a qualified pathologist nor she was having any properly equipped hospital with specialists doctors. She is only a MBBS doctor and is not specialist in any field of gynecology or pathology which clearly amounts to unfair trade practice and negligence on the part of ops no.1 and 2. Learned counsel for complainant has relied upon judgments of the Hon’ble Supreme Court in cases titled as V. Kishan Rao vs. Nikhil Super Speciality Hospital & anr. 2010 (4) JT 630 and North Gujarat Unit of Association of Self employed owners of private pathology laboratories of Gujarat vs. North Gujarat Pathologists Associations & Ors, SLP No. 28529 of 2010 decided on 12.12.2017 and also decision of the Hon’ble High Court of Gujarat at Ahmedabad in case titled as Association of Pathologist of Bhavnagar Versus Secretary Health Department, Special Civil Application No.7999 of 1998 and others decided on 17.9.2010.
10. On the other hand, learned counsel for ops no.1 and 2 has strongly contended that complainants have badly failed to prove any allegations against the ops as the complaint of the complainants is wholly misconceived, groundless, frivolous and vexatious. They have failed to prove the negligence on the part of ops no.1 and 2 and no cause of action has arisen to them to file the present complaint. The ops have not committed any act of negligence on their part. The op no.2 is a well qualified from Government Medical College, Bikaner and one year rotating housemanship internship trained and now a reputed and respected doctor. She was a physician and gynecologist in Maternity & Welfare centre (SDMH) happy nursing home Jaipur RMO fulltime resident surgeon from April 1988 to May, 1991, Govt. RPSC confirmed Jr. Specialist posted as Govt. hospital Jaitaran, Pali Jodhpur and Nohar Sri Ganganagar hospitals from June 1991 to October 1992 and SMO at Janta Maternity and General Multispecialty more than 100 bedded SS Hospital registered welfare trust Sirsa as a women doctor specialist since November 1992 to October 26, 1997 continuously for five years. A trained obstetrician and Gynecologist under Dr. V.N. Mathur, MS Retired Director G of Health Services Haryana and performed tubectomies, L.S caesarian operations and GynaeHysterectomy operations and MTPs and now running her own hospital. The patient only came to the hospital on 25.2.2016 with pregnancy of two months and thereafter she came in the hospital on 9.6.2016, 4.8.2016, 26.8.2016 and 27.8.2016. Patient was investigated and treatment given but revisited on 27th night, got admitted for short say of about 80 hours in total in the hospital between 27.08.2016 night to 31.08.2016 morning. At the time of admission, the patient with pregnancy of about eight months had complaints of with a short one to two day history of fever, vomiting and mild swelling of both lower limbs, pain in abdomen and back with burning in epigastrium and loss of appetite. She and her attendants relatives were very well informed and explained by Dr. Mrs. Aruna of the type, nature and possible progress and outcome, may be serious for her and foetal well being due to jaundice and swelling feet and body. She was given proper treatment which is standard prescribed treatment for fever and jaundice. There is no negligence on the part of op doctor in treating the patient. Learned counsel for ops no.1 and 2 has relied upon judgment of Hon’ble National Commission in case titled as K. Muniasamy and anr. vs. Harley Ram Nursing Home and ors. 2008 (1) CPJ 293.
11. Learned counsel for op no.3 has strongly contended that present complaint is not maintainable against op no.3. Intimation regarding claim has been received by op no.3 at later stage when it was impleaded as a party. The op no.2 doctor was insured for the period 12.8.2016 to 11.8.2017 with maximum indemnification of Rs.5,00,000/- only subject to compliance of term and conditions of the policy where the Forum gives a finding that doctor committed medical negligence. The op no.2 failed to abide by terms and conditions of the policy and due to this willful and deliberate breach of term and conditions of the policy, op no.3 should not be burdened with any liability.
12. We have considered the rival contentions of the parties and have gone through the written submissions of the complainants and judgments relied upon by learned counsel for the parties and have gone through the record carefully.
13. Undisputedly, deceased Harpreet Kaur wife of complainant no.1 and daughter of complainant no.2 had approached the opposite party no.2 doctor for her treatment for the first time on 25.2.2016 with pregnancy of two months. After test of pregnancy, she got herself checked from op no.2 and she was under regular treatment of op no.2 from time to time. As per contention of complainants, all of sudden on 26.8.2016, when there was vomiting, burning epigastria, pain abdomen, back pain, swelling over foot, loss of appetite, then Harpreet Kaur was admitted in the hospital by op no.2. During the period of treatment, she was advised to undergo various tests including ultrasound and other pathology tests. Even on 4.8.2016 she was taken to Dr. Amit Narang Consultant Neuropsychiatric on the pretext that deceased Harpreet Kaur was not having the bodily problem rather has wrong prescription about her ill health in her mind and due to this she is not keeping good health. Except few test of ultrasound, the entire path tests were got conducted by op doctor in her hospital or in some laboratory of another hospital known to op doctor. Since the day of start of treatment, the condition of Harpreet Kaur was not that well as TLC was increasing and Hb was decreasing, but as complainants were illiterate regarding medical terminology, thus were fully dependent on the prescription of op doctor. The doctor instead of referring her to higher medical institution, kept her as indoor patient in her hospital for lust of money and kept under her treatment and when the condition of deceased Harpreet Kaur was deteriorated, only than doctor discharged her by mentioning the words “discharge on request”. Then deceased Harpreet Kaur was taken to AMC hospital, Hisar but her condition was severe and she was having jaundice and septicemia and thereafter she was referred to Fortis Hospital, Mohali where she was treated for jaundice and septicemia but ultimately she died on 5.9.2016 at Fortis Hospital. As per contention of complainants, the cause of death noticed by doctor of Fortis Hospital, Mohali was refractory shock, multi organ failure, acute fulminate liver failure and this multi organ failure is result of not taking care by op doctor at initial stage and not giving adequate treatment as would have been given.
14. On the other hand, there is specific plea of ops no.1 and 2 that Dr. Aruna Jyani is a qualified doctor having experience of number of years by serving different reputed health institutions. There is no negligence on the part of op doctor as treatment was given as per medical protocol.
15. It is an admitted fact on record that deceased Harpreet Kaur had been visited at the hospital of ops no.1 and 2 from time to time since February to August, 2016 and had been getting regular treatment during her pregnancy. It is further admitted fact on record that she visited twice or thrice in the month of August, 2016 and lastly on 27.8.2018 night she was admitted in the hospital with pregnancy of eight months and she was complaining/ having history of fever from one or two days, vomiting and mild swelling of both lower limbs, pain in abdomen and back with burning in epigastrium and loss of appetite and remained admitted till 31.8.2016. It is also admitted fact on record that she was discharged on the request of relatives of deceased Harpreet Kaur. During the course of her stay in the hospital, she was given treatment after diagnosing her disease by op no.2 in her hospital op no.1. As per contention of op no.2 she had given treatment as per medical protocol but on the other hand, there is specific plea of complainants that op doctor did not diagnose properly and was not serious about the gravity of the disease which was being aggravated day by day. The perusal of Ex.C7 report of op no.1’s hospital reveals that on 4.8.2016, Hb was 9.0 gram and TLC were 8100. As per Ex.C8, on 20.8.2016, TLC were 11200. As per Ex.C9, on 27.8.2016, TLC were 17600 and Bilirubin was 5.5 mg and the report Ex.C10 dated 29.8.2016 proves Hb was 9.6 gram and TLC at 14800, bilirubin was 6.7 mg and as per report Ex.C11 dated 30.8.2016, blood urea was 34 mg and as per report Ex.C12 dated 31.8.2016, Hb was 9.5 grams and TLC were 21000 whereas normal rate is 4000-10000, bilirubin was 9.4 mg. So, it appears from these reports that TLC and bilirubin were increasing rapidly day after day and Hb was going low which proves that condition of the patient was being deteriorated day after day but perusal of treatment chart reveals that op no.2 did not give any serious thought towards the increase in the TLC and bilirubin and lowering of Hb. It also speaks that pathology tests were being got conducted by op no.2 in her own laboratory which is being managed by lab technician and not by a specialist post graduate pathologist as prescribed by Hon’ble Supreme Court in its judgment in the case of North Gujarat Unit of Association (supra) in which it has been held that “stand of the Medical Council of India that Laboratory Report can be counter signed only by a registered medical practitioner with a post graduate qualification in pathology is correct.” These reports further reveal that same have not been counter signed by any specialist having qualification of post graduate in pathology. The treating doctor knowing well about deteriorated condition of the patient did not refer the patient to any higher institution having fully equipped facility and laboratory in order to tackle the disease of such like patient. The discharge summary reveals that lastly patient was discharged on the request of relatives of the patient, but doctor did not refer the patient due to reason best known to her rather she delayed the reference only with a intention to retain the patient in her own hospital. Discharge summary Ex.R22 also reveals that condition of the patient at the time of discharge mentioned as fully conscious except mild uncomfortable b/c fever and headache (Temp 100* F) BP 130/90, good movements, good volume whereas the report of Pathology laboratory speaks high in the condition of the patient qua increase in her TLC and bilirubin.
16. The patient was taken to AMC Hospital, Hisar on 31.8.2016 and they further referred her to Fortis Hospital, Mohali. The death summary Ex.C13 written by Fortis Hospital is reproduced as under :-
Patient was brought with complaints of fever, jaundice for 3-4 days, restlessness and sleepiness for 2-3 days, patient was recently admitted for NVD/ cesarean section at AMC Hospital where she was intubated in v/o airway protection. She was detected to have low platelet count. She had also been detected to have high blood pressure record for last 5-6 days prior to admission to the current hospital. Family was told about intrauterine death. She was shifted to Fortis Mohali in a critical state for further evaluation and management. Further in the death summary course in the hospital has been mentioned that Patient was received intubated, E1V1M3, BP-100/60. She was admitted in MICU. O/E GC was critical, on nor The cause of death has been mentioned in the death summary as Refractory shock, multi organ failure and acute fulminant liver failure. In the prescription slip of AMC Hospital, Hisar dated 1.9.2016 Ex.C23, the diagnosis is recorded as Pregnancy with jaundice with septicemia. The patient was admitted in that hospital on 31.8.2016 and was discharged on 1.9.2016 and patient was on ventilator and she was referred to higher centre i.e. Fortis Hospital Mohali as mentioned in Ex.C23. and was discharged on 1.9.2016. From the record of AMC Hospital as well as death summary recorded by Fortis Hospital, Mohali, it is apparently clear that patient Harpreet Kaur was having pregnancy of more than eight months and she was suffering from jaundice which is not so evident from copy of pathology reports and jaundice was increasing day after day, but however, ops no.1 and 2 continued to retain the patient in their own hospital knowing well that they are not having any proper equipments in their hospital to tackle the situation and further, the ops were not having any pathology lab with a specialist doctor of post graduate qualification, but however continued to get the tests conducted in their hospital from lab technician who is not competent to give any report and his report is not counter signed by specialist pathologist. So, it proves from the evidence on record that tests of deceased Harpreet Kaur were not got conducted properly from a qualified specialist pathologist and as a result of which the treating doctor could not form her opinion properly in diagnosing the disease of the deceased Harpreet Kaur timely and could not give proper treatment well in time as a result of which her condition was deteriorated and when she was referred to the higher institution, she was already suffering from jaundice and septicemia which led to failure of multi organs and she lost her life. The delay in diagnosing the disease as well as referring the patient who was already in a critical condition to some higher institute clearly amounts to deficiency in service, negligence and unfair trade practice on the part of treating doctor. Though, learned counsel for ops during course of arguments has strongly contended that complainant has not examined any expert witness in order to prove allegations against attending doctor but we find force from the judgment of the Hon’ble Supreme Court in the case of V. Kishan Rao vs. Nikhil Super Speciality Hospital (supra) in which it was laid down that “Claim of petitioners cannot be rejected only on the ground that expert witness was not examined to prove negligence of doctor. It is not required to have expert evidence in all cases of medical negligence.” As in the present case it is apparently clear from the record that treating doctor was deficient and negligent in diagnosing and treating the patient and did not refer the patient well in time to some higher institution knowing well that she has no arrangement to treat the high rate of jaundice as well as septicemia in her hospital and moreover she is not having well equipped path lab. in her hospital with a specialist pathologist, so no expert opinion is required in the present case. The judgment relied upon by learned counsel for ops are not applicable to the facts and circumstances of the present case as facts of that case are quite different and distinguishable from the facts of present case.
17. So from the evidence of complainants, it is proved that complainants have succeeded in proving negligence and unfair trade practice against ops no.1 and 2 beyond all reasonable doubts and the ops no.1 and 2 appears to be liable to compensate the complainant on account of death of deceased Harpreet Kaur and her fetus and on account of medical expenses. Definitely the complainant no.1 has lost the love and affection of his wife Harpreet Kaur and parents of Harpreet Kaur also have lost their love and affection due to untimely death of deceased Harpreet Kaur, but however, complainant no.2 and proforma ops no.4 to 7 do not appear to be entitled for the compensation as prayed for as they are not legal heirs of deceased Harpreet Kaur being a married daughter/ sister and only complainant no.1 appears to be entitled to claim compensation prayed for.
18. Though, during the course of arguments, learned counsel for complainants has strongly contended and claimed Rs.7,19,945/- on account of treatment charges spent by complainants in getting treatment of deceased Harpreet Kaur in different hospitals as detailed in the complaint and have also claimed Rs.12,00,000/- on account of death of deceased Harpreet Kaur, but learned counsel for ops no.1 and 2 has strongly opposed the contention of learned counsel for complainants on the ground that complainants had paid only a very meager amount to the ops no.1 and 2 on account of treatment charges and ops no.1 and 2 are not liable to pay any such huge amount on account of treatment charges. He has further contended that cause of death is not due to negligence of ops no.1 and 2. Op no.3 has also opposed the contention of learned counsel for complainants on the ground that op no.3 is not liable to pay any amount of compensation since there is violation of terms and conditions of insurance policy by ops no.1 and 2 and their liability at the most is to the extent of Rs.5,00,000/- subject to compliance of terms and conditions of the policy.
19. We have considered this aspect of learned counsel for parties and gone through the record. No doubt, as per contention of complainants they have spent more than Rs.7,00,000/- on treatment of Harpreet Kaur and have placed on record certain bills of hospital charges as well medicines charges, but it cannot be presumed that death of deceased was solely due to utmost negligence of ops no.1 and 2. The cause of death as ascertained in the death summary of deceased Harpreet Kaur recorded by the doctors of Fortis Hospital, Mohali shows that death was due to Refractory shock, multi organ failure and acute fulminant liver failure. No doubt, we have observed in preceding paras that ops no.1 and 2 committed act of medical negligence while keeping the patient Harpreet Kaur in their hospital knowing well that deceased Harpreet Kaur was having pregnancy of eight months with severe problem of jaundice and her TLC and bilirubin were increasing rapidly and the Doctor had been getting pathology tests from her own laboratory though she was not having any specialist pathologist having a requisite qualification of post graduate and did not act timely in discharging and referring the patient to some higher medical centre which clearly amounts to deficiency in service and unfair trade practice on the part of ops no.1 and 2 but at the same time it cannot be presumed that this all led to deterioration of the condition of the patient and ops no.1 and 2 are liable proportionately to compensate the loss to the extent of their negligence in treating the deceased Harpreet Kaur.
20. In view of our above discussion, we hereby allow this complaint and direct the opposite parties no.1 and 2 to pay a sum of Rs.4,00,000/- as compensation to complainant no.1 on account of death of deceased Harpreet Kaur with her fetus and also on account of treatment expenses and further direct the ops no.1 and 2 to pay a sum of Rs.50,000/- to complainant no.1 on account of loss of love and affection and we further direct ops no.1 and 2 to make refund of Rs.26,000/- on account of treatment charges received from complainant no.1 and also direct the ops no.1 and 2 to pay Rs.20,000/- to complainant no.1 on account of litigation expenses. The ops are liable to comply with this order within a period of 45 days from the date of receipt of copy of this order, failing which ops no.1 and 2 shall be liable to pay interest @7% per annum from the date of order till its realization. Since, op no.2 had purchased a policy bearing No.272200/48/2017/9866 from op no.3 and was duly insured with op no.3, it is legal obligation of op no.3 to reimburse/ indemnify the claim in case op doctor is found to be negligent in treating the patient and since as per above discussion, ops no.1 and 2 have been held as negligent in giving treatment to deceased Harpreet Kaur, as such op no.3 is directed to indemnify/ pay the awarded amount to the ops no.1 and 2 as per terms and conditions of the policy. However, this awarded amount will be paid only to complainant no.1 and complainant no.2 as well as proforma ops no.4 to 7 shall not be entitled to any amount. A copy of this order be supplied to the parties free of costs. File be consigned to the record room.
Announced in open Forum. President,
Dated:28.08.2019. Member Member District Consumer Disputes
Redressal Forum, Sirsa.
