BEFORE THE A.P.STATE CONSUMER DISPUTES REDRESSAL COMMISSION: AT HYDERABAD.
F.A.No. 1594
Between
Dr.Ch.Raghuram S/o Ch.Appala Swamy
Aged about 32 years, Civil Assistant Surgeon
Community Health Centre, Paderu
Vishakapatnam Dist.
1. Kasuladev Anusha father and natural guardian Kasuladev Rama Rao
S/o K.Suryanarayana, aged about 48 yrs
Occ: Driver, APSRTC,HaripuramVillage
Mandasa Mandal, Srikakulam District
Respondent/complainant
2. Dr.A.V.Ramakrishna
Savitri Nursing Home
Main Road, Sompeta-532284
Srikakulam Dist.
3. Dr.Balaga Venkat Rao
Medical officer
Community Health Centre
Sompeta-532284, Srikakulam Dist.
Respondents/opposite parties No.1 and 2
Counsel for the Appellant
Counsel for the Respondents No.1 Counsel for the Respondents No.2&3
QUORUM:SRI SYED ABDULLAH, HON’BLE MEMBER
&
Oral Order ( As per R.Lakshminarsimha Rao, Member)
The opposite party no.3 is the appellant.
The complainant being a minor has filed the complaint through her father, Rama Rao who, on 25-08-2002 took her to the opposite party no.3 for treatment of bulging of her throat.
After SevenHillsHospital thyroid gland thyroid direction to the opposite parties to pay Rs.10 lakhs compensation together with interest and costs.
The opposite party no.1 resisted the case contending that on request of the opposite party no.3 on telephone, the opposite party no.1 provided operation theatre in his
Govt.Hospital
The points for consideration are
1.
2. Whether there was any negligence or deficiency in service on the part of the opposite parties no.1 to 3 in the treatment of the complainant?
3. To what relief?
This opposite party also submit that at the time of admitted (sic-admission)
It is pertinent to note that the opposite party no.1 has stated that the complainant has not paid any fees for having utilized the operation theatre in his nursing home.
In Smt.savita garg vs
“It is the common experience that when a patient goes to a Private clinic, he goes by the reputation of the clinic and with the hope that proper care will be taken by the Hospital Autho rities .It is not possible for the patient to know that which, doctor, will treat him. When a patient is admitted to a
The opposite party no.1 has stated that he had provided the operation theatre and nursing home to the opposite parties no.2 and 3 and except that he had not participated in the operation or had collected any amount from the complainant.
The opposite party no.2 adopting the course of defence taken by the opposite parties no.1 and 3 stated that he had not received any amount from the complainant for performing the operation. CommunityHospital, Somapeta.
POINT NO.2 DattasaiHospital We would consider the circumstances and the condition of the complainant at the time she was admitted to the nursing home of the opposite partyno.1 a little later and insofar as the defence of the opposite party no.3 that he had not treated the complainant is concerned, we have already held in the aforementioned paragraphs that the complainant and her father approached the opposite party no.3 on 15.8.2002 consulted the opposite party no.3 in the government hospital at Haripuram and on the advice of the opposite party no.3 the complainant was admitted in his private nursing home, Dattasai Nursing Home at Haripuram.
From the time of admission of the complainant in Dattasai Nursing of the opposite party no.3, the allegations and imputations would come into picture where the opposite party no.3 bluntly denied that he had not performed the operation as against the statement of the father of the complainant that the opposite parties no.2 and 3 performed the operation on 16.8.2002 in the nursing home of the opposite party no.3.
Complications developed immediately after the opposite party no.3 conducted surgery on the complainant.
The opposite party no.3 had contended by filing the appeal that it is the opposite parties no.1 and 2 who were negligent in treating the complainant. As such the responsibility of the
Originally, the complainant was admitted to the nursing home of the opposite party no.3 with the problem of bulging of her neck. It is not known what happened in the nursing home of the opposite party no.3 as also the nature of the operation performed by the opposite party no.3. reopened the operative portion and at that time a cyst was ruptured that cyst may be a lymphnode or thyroglossal without thyroid”. ”.
The opposite party no.2 has stated that the opposite party no.1 had issued the certificate under wrong notion that the opposite parties no.2 and 3 conducted operation for thyroglossal cyst.
The opposite party no.1 has issued the letter to the effect that the complainant had undergone thyroglossal cyst operation whereas the opposite party no.2 contends that the opposite party no.1 was not in the operation theatre at the time the operation was conducted and according to him he has not conducted thyroglossal cyst operation . He has stated
The complainant after the operation and discharge from the nursing home of the opposite party no.1, the complainant has stated that she had developed complications such as, nervousness, sweating of the body and behavioral change whereon she consulted the opposite party no.3 who informed her that it would take few months for her to restore normalcy and asked her not to consult him any further in future. Visakhapatnam
“1.
The impression given by the consultant was that the features and findings mentioned in the scan commensurate with post-thyroidectomy status. Therefore, at theSevenHillsHospital
In “Jacob Mathew Vs the State ofPunjab” reported in 2005 CPJ 9 (SC) the Supreme Court held that a doctor should not experiment unless necessary and even then he should originarily get a written consent from the patient.
The consistent version of the complainant and her father that they had been kept in dark and were not informed of the operation procedure and the complications thereof on both the occasions, at the nursing home of the opposite party no.3 and thereafter while the surgery was conducted on the complainant in summarized the principles relating to consent as follows :
(i) A doctor has to seek and secure the consent of the patient before commencing a 'treatment' (the term 'treatment' includes surgery also). The consent so obtained should be real and valid, which means that : the patient should have the capacity and competence to consent; his consent should be voluntary; and his consent should be on the basis of adequate information concerning the nature of the treatment procedure, so that he knows what is consenting to.
(ii) The 'adequate information' to be furnished by the doctor (or a member of his team) who treats the patient, should enable the patient to make a balanced judgment as to whether he should submit himself to the particular treatment as to whether he should submit himself to the particular treatment or not. This means that the Doctor should disclose (a) nature and procedure of the treatment and its purpose, benefits and effect; (b) alternatives if any available; (c) an outline of the substantial risks; and (d) adverse consequences of refusing treatment. But there is no need to explain remote or theoretical risks involved, which may frighten or confuse a patient and result in refusal of consent for the necessary treatment. Similarly, there is no need to explain the remote or theoretical risks of refusal to take treatment which may persuade a patient to undergo a fanciful or unnecessary treatment. A balance should be achieved between the need for disclosing necessary and adequate information and at the same time avoid the possibility of the patient being deterred from agreeing to a necessary treatment or offering to undergo an unnecessary treatment.
(iii) Consent given only for a diagnostic procedure, cannot be considered as consent for therapeutic treatment. Consent given for a specific treatment procedure will not be valid for conducting some other treatment procedure. The fact that the unauthorized additional surgery is beneficial to the patient, or that it would save considerable time and expense to the patient, or would relieve the patient from pain and suffering in future, are not grounds of defence in an action in tort for negligence or assault and battery. The only exception to this rule is where the additional procedure though unauthorized, is necessary in order to save the life or preserve the health of the patient and it would be unreasonable to delay such unauthorized procedure until patient regains consciousness and takes a decision.
The opposite party no.3 had gone to the extent of disowning the treatment rendered by him to the complainant at his private nursing and at the nursing home of the opposite party no.1.
The Hon’ble Supreme Court in Martin F.D’Souza V. Mohd. Ishfaq held:
Although this decision has laid down that it is the duty of a doctor to attend to a patient who is brought to him in an emergency, it does not state what penalty will be imposed on a doctor who refuses to attend the said patient. India India
The question arises as to the quantum of compensation to be awarded against the opposite parties no.1 to 3.
Insofar as the proportionate liability of the opposite parties is concerned, the opposite party no.3 in no manner of doubt had caused enormous loss not only by the negligent treatment rendered by him but also by his blunt denial and disowning of the very treatment he had rendered subjecting the complainant to the helpless condition. Compared to the negligence exhibited by the opposite party no.3, the opposite parties no.1 and 2 can be said to have contributed to a lesser extent in exposing the complainant to the disaster of deprivation of the tyroid gland.
In the result the appeal is partly allowed modifying the order dated 14.9.2007 passed by the District Forum.
Kmk*
