Tamil Nadu

StateCommission

FA/385/2013

M/s. Apollo Hospitals Enterprise Limited & anr. - Complainant(s)

Versus

M.S. Pandian - Opp.Party(s)

C. Manishankar

12 Mar 2018

ORDER

IN THE TAMILNADU STATE CONSUMER DISPUTES REDRESSAL COMMISSION CHENNAI.

 

Present:    THIRU.K. BASKARAN                                    PRESIDING JUDICIAL MEMBER  

                   THIRU.S.M. MURUGESSHAN                        MEMBER  

 

F.A.Nos.385/2013 & 268/2014

(Both appeals are arising out of the order of the learned District Forum Chennai (South) passed in C.C.No.492/2006 dated 13.08.2013)

 

 MONDAY THE 12^th DAY OF MARCH 2018.

 

 

F.A.No. 385/2013

                                       

1.   M/s. Apollo Hospitals Enterprises Ltd.

      No.21 Greams Lane   

      Off Greams Road

      Chennai – 600 006.

 

2.   Dr.S. Baskar

      Apollo Hospital Enterprises Ltd.

      21 Greams Road

      Chennai – 600 006                                                     Appellants/Opposite Parties

 

                       Vs

 

Mr.M.S. Pandian Advocate

S/o. Late. Madaswamy

No.A.P. 1722 102 Sector

14 K.K. Nagar

Chennai  - 600 078                                                             Respondent/Complainant

 

 

For Appellants/opposite parties              :    M/s. C. Mani Shanker Advocate.

For  Respondent/Complainant                :     Appeared - Party in person

 

 

 

F.A.No. 268/2014

 

Mr.M.S. Pandian Advocate

S/o. Late. Madaswamy

No.A.P. 1722 102

Sector 14 K.K. Nagar

Chennai  - 600 078                                                             Appellant/Complainant

 

           Vs

1.   M/s. Appollo Hospitals Enterprises Ltd.

      Rep. by its Managing Director

      No.21 Greams Lane

      Off Greams Road

      Chennai – 600 006.

 

2.   Dr.S. Baskar

      M/s. Appollo Hospital Enterprises Ltd.

      No. 21 Greams Lane

      Off Greams Road

      Chennai – 600 006                                                 Respondents/Opposite Parties

 

For Appellant/Complainant                :     Appeared - Party in person

For Respondents/opposite parties       :     M/s. C. Mani Shanker Advocate.

            Both the appeals coming before us for final hearing on 16.02.2018 and on hearing the arguments of both sides and on perusing the material records this Commission made the following:  

COMMON ORDER

THIRU.K. BASKARAN PRESIDING JUDICIAL MEMBER.

 

                The appeal in F.A.No.385/2013 was preferred under section 15 r/w section 17 (1) (a) (ii) of the Consumer Protection Act 1986 by the opposite parties who suffered an order at the hands of the learned District Forum at the instance of the complainant directing payment of compensation and costs holding that the opposite parties were guilty of deficiency in service arising out of medical negligence.

           The appeal in   F.A.No.268/2014 was filed by the complainant having felt aggrieved over the inadequacy of the relief granted by the learned District Forum.  

            As both these appeals arise out of a single order both the appeals are disposed of by this common order.                 

           For the sake of convenience and brevity the parties are referred to here as they stood arrayed in the District Forum.      

1.         The factual background culminating in these two appeals is as follows;-  That the complainant had filed this complaint against these opposite parries who are M/s. Apollo Hospital Enterprises Limited and its doctor one Thiru.S. Baskar alleging  inter alia  that his daughter one Mrs.P. Meera  was admitted in a private hospital namely Suriya Hospital on 23.06.2005 at 11.00 p.m. for providing treatment for acute fever  nausea vomiting and diarrhoea and she underwent treatment as in patient in the said hospital  and it came to be known to the complainant that the ailments were not brought under control and hence he got his daughter discharged from the said hospital and admitted her in the first opposite party hospital for further management on 26.06.2005 and she was admitted in the emergency ward at 10.30 p.m. and at about 11.30 p.m. his daughter was admitted in the critical care unit of the 1^st opposite party hospital for treatment;  that the opposite party did not explain the nature of the disease and condition of the patient to the complainant and his signature was obtained without apprising him anything as if the complainant gave his consent; that the opposite parties did not allow the complainant and his  relatives to see his daughter and only one person was allowed to remain in the hospital. Hence the complainant and his relatives were prevented from knowing the type of treatment being given to his daughter ; that the opposite parties along with the other team of doctors used to send the demand slip asking the complainant to pay heavy sums without even informing the reason for such payment and the health condition of the patient; that on the morning of 29.06.2005 the duty doctors of the 1^st opposite party informed the complainant that the chances of survival of his daughter came down to 50% from 75% and at about 10.30 a.m. it was informed that the chance of survival came down to 25% and that the opposite party insisted dialysis procedure alleging that there was  renal failure and left with no other option the complainant gave consent for the same and in the evening the complainant was informed that the chances of survival after it came down to 10% ; that no proper and adequate treatment was given to his daughter in spite of the fact that he had paid all the fees and charges demanded by the opposite parties ; that it was only when the complainant insisted that his daughter be discharged so that she breathed her last in her parental home  the duty doctors had informed the complaisant that his daughter had already expired and hence the opposite parties 1 and 2 deceived the complainant by keeping the dead body with the help of mechanical devices ;  that even after death of his daughter the opposite parties insisted payment of further amount of Rs.112740/- which the complainant was forced to pay ; that the opposite parties and the duty doctors were initially telling that that there was drug poisoning allergy and rashes in the skin to the patient but the death certificate issued by the opposite parties would state that  TOXIC SHOCK SYNDROME SEPSIS WITH MULTI ORGAN FAILURE  as the cause of death.  ; that the opposite parties had refused to furnish the case sheet maintained at the 1^st opposite party hospital and also in other hospital by name Suriya Hospital; that due to the medical negligence exhibited by the opposite  parties the complainants only daughter had lost her life at the young age of 31 years and but for this she would have lived for another 40 years and would have earned more  she being a graduate.  Hence the opposite parties should be directed to pay Rs.1750000/-as compensation towards medical expenditure incurred by the complainant and towards compensation for loss of life of his daughter and for mental agony suffered by the complainant.

2.          The claim of the complainant was resisted by the opposite parties by setting forth the defence as follows;-      Mrs. Meera since deceased  was a known non-diabetic normotensive known Acid Peptic Disease and had been taking treatment for joint pains  connective tissue disorder (Allopathy)  and Ayurvedic drugs – for nearly one year prior to her admission in the 1^st opposite party hospital; that she was suffering from intermittent fever for 15 days for which she took treatment in a private hospital ( Surya Hospital) ; that she had subsequently developed extensive skin rashes vomiting during her treatment in the said private hospital and she had further developed jaundice loose stools abdominal distension oedema of the feet and facial puffiness and that she was also suffering from low back pain hip pain and poly arthritis; that all these would show that the complainants daughter was admitted in the 1^st  opposite party hospital in a very critical condition and on admission at the 1^st opposite party hospital she was found to be conscious oriented and understood commands  and she had also jaundice bilateral pitting pedal oedema and she was febrile toxic with unstable vitals (? septic shock); that she was started on IV Fluids as she had extensive skin rashes peeling and also Erythemia ( Rashes) of both legs.   Based on clinical diagnosis she was suspected of suffering from (a) Sepsis (b) Drug induced and (c) ? Connected tissue disorder.  Considering these clinical findings  and lab reports she was advised for intensive care management and she was shifted to ICCU after approval and   treatment was started; that as the patient was found to be Hypoxic and Hypotension she was ventilated and started on Ionotropic supports and as a result the condition of the patient had improved; That further investigations were done for diagnosis and management and as the patient had multi organ failure multi disciplinary approach involving a team of consultants (Dermatologist Gastroenterologist  Rheumatologist Infectious Disease consultant and Hematologist Nephrologist Physician Gynecologist   Cardiologist and critical care team) was done as the patient was suspected of having

          (a)   Sepsis with multi organ failure

          (b)   SLE (Systemic Lupus Erythematosis (auto immune disorder where anti

                 bodies directed against the body)

          (c)    Leflunomide induced toxicity  

          (d)   Toxic Shock Syndrome    

When treatment was started and continued the patient was under the care of various specialists and in spite of the same the patients condition deteriorated and despite sufficient treatment given  the patients died of cardiac arrest at about 7.55 p.m. on 29.06.2005 ; that the line of treatment and condition of the patient were informed to the complainant and his relatives then and there and that it was not the procedure followed by the 1^st opposite parry hospital to issue case sheet to any patient and in this case the death summary was issued to the complainant.  As there was no medical negligence on the part of the opposite parties no deficiency in service arises and hence the complaint deserves dismissal.    

3.       Based on the pleadings of the respective parties  the learned District Forum had framed two points

          (1)  Whether there is any medical negligence and deficiency in service on the

                 part of the opposite parties?   

          (2)   To what relief the complainant is entitled?

By way of answering the points the learned District Forum had recorded findings that there was deficiency in service arising out of medical negligence on the part of the opposite parties and that the opposite parties are liable to pay Rs.199089.73 P being the amount paid by the complainant towards medical expenditure and to pay Rs.50000/- as compensation for mental agony and to pay Rs.5000/- as costs of the complaint.   

4.       Having felt aggrieved over the order of the learned District Forums holding that the opposite parties were guilty of deficiency in service both the opposite parties have come on appeal before this Commission in F.A.No.385/2013 and feeling that the relief granted by the learned District Forum is not adequate the complainant has preferred an appeal in F.A.No.268/2014. 

5.       F.A.No.385/2013 :-   The gist of the grounds of memorandum of appeal is that the learned District Forum had failed to consider any of the contentions raised by the appellants in the written version but mechanically held that there was medical negligence on the part of the appellants that there was neither any discussion nor any reasoning found in the order under challenge as to on what basis the District Forum recorded the finding of medical negligence ; that the order shows complete non-application of mind and made without any evidence;  that there was no pleading whatsoever by the complainant to show that there was medical negligence and further there was no iota of proof to establish the said negligence;  that the deceased was originally admitted in some other private hospital for treatment as to various ailments and after her condition became serious then only she was admitted in the 1^st opposite party hospital in a very critical condition ; that the learned District Forum failed to take notice that the patient had multi organ failure (skin gasatroenterology renal haemotopotic system heart – clinical and laboratory evidence)  and hence multi disciplinary approach involving a team of consultants (Dermatologist Gastroenterologist  Rheumatologist Infectious Disease consultant and Hematologist Nephrologists  Physician Gynecologist   Cardiologist and critical care team) was adopted as the patient was suspected of having (a)   Sepsis with multi organ failure

          (b)   SLE (Systemic Lupus Erythematosis ( auto immune disorder where anti

                 bodies directed against the body)

          (c)    Leflunomide induced toxicity 

          (d)   Toxic Shock Syndrome    

and that required treatment was given as elaborately recorded in the case sheet and hence the impugned order has to be set aside and the complaint to be dismissed.  

6.     F.A.No.268/2014:   The gist of the memorandum of grounds of appeal germane for the purpose of this appeal is as follows;- that the complainant had prayed for compensation of Rs.1750000/- which included Rs.199089.73 P towards medical expenditure and Rs.1000000/- as compensation for the loss of life of his daughter and Rs.570000/- as compensation for mental agony but the learned District Forum had awarded the compensation towards medical expenditures as prayed for but awarded only Rs.500000/- as compensation for mental agony which is not commensurate with the facts and circumstances of the case in as much the deceased in this case was an young women of just 31 years of age who was a graduate and was capable of earning and hence the reliefs as prayed in the complaint have to be granted.    

7.     The point for consideration in

         F.A.No.385/2013:-

         1)  Whether the order of the learned District Forum has to be set aside based on

              the grounds set out in the appeal?

          F.A.No.268/2014:-  

           1)  Whether the order of the learned District Forum has to be modified and the

                 complaint has to be allowed in toto ? 

8.       Points in both the appeals:   As already noticed the complainant had filed the complaint alleging medical negligence on the part of the opposite parties in the matter of providing treatment to his daughter one Mrs.P. Meera who was admitted in the first opposite party hospital on 26.09.2005 and as the opposite parties did not provide the proper treatment she died on the evening of 29.06.2005.  Per contra the defence of the opposite parties is that the daughter of the complainant had already been suffering from some other chronic ailments and that prior to the admission in the 1^st opposite party hospital she underwent treatment in yet another private hospital  from 23.06.2005 to 26.06.2005 for joint pain connective tissue disorder and intermittent fever for the past 15 days and that she had subsequently developed extensive skin rashes nausea and vomiting and during her stay in the other private hospital she had developed jaundice loose stools abdominal distension oededma of the feet and facial puffiness low back pain hip pain and poly arthritis and as her condition did not improve in the other private hospital the complainant had got his daughter discharged from the said hospital and admitted in the 1^st  opposite party hospital on 26.06.2005 in a critical condition and hence she was admitted in the ICCU and the complainants daughter was diagnosed of  (a)   Sepsis with multi organ failure (b) SLE (Systemic Lupus Erythematosis ( auto immune disorder where anti  bodies directed against the body) (c)    Leflunomide induced toxicity (d)   Toxic Shock Syndrome.

9.    A special team of specialists consisting of Dermatologist Gastroenterologist  Rheumatologist Infectious Disease consultant and Hematologist Nephrologists  Physician Gynecologist   Cardiologist and critical care team was formed consisting to take care of the patient and a multi disciplinary approach was followed after taking various tests on her and in spite of the best treatments provided to her her condition became critical and she suffered cardiac arrest on the evening of 26.09.2005 and died of Toxic Shock Syndrome and Sepsis with multi organ failure.    

10.     But unfortunately the learned District Forum had not dealt with various aspects involved in this case such as 

          (a)      What was the condition of the complainants daughter when she was admitted in the 1^st opposite party hospital on 26.06.2005. Whether she was in a critical condition or otherwise. 

          (b)     What are the diseases/ailments the complainants daughter was suffering from at the time of admission in the 1^st opposite party hospital on 26.06.2005.

          (c)    Whether the complainant had pleaded and proved that the line of treatment adopted by the opposite parties was not a correct one given the aliments suffered by the patient and what line of treatment ought to have been adopted by the opposite parties?   

          (d)    Whether the opposite parties had shown required care on the complainants daughter commensurate with her condition and whether proper and prompt treatment was provided to her?

          (e)         Whether the complainant or his relatives was then and there informed of the health condition of the complainants daughter and the line of treatment adopted?    

          (f)      Whether there was any deficiency in service on the part of the opposite parties in not providing the required adequate and proper medical care in this case and in not furnishing the medical records such as case history maintained at the 1^st opposite party hospital and the one issued by the previous hospital namely Surya Hospital which  was alleged to have been handed over to the 1^st opposite party hospital by the complainant at the time of admission.        

          (g)    If the opposite parties are found to have been guilty of culpable medical negligence making out deficiency in service then what could be the just fair and reasonable compensation awardable to the complainant.

11.      A perusal of the impugned order would show that there is no discussion whatsoever at all in respect of allegations made in the complaint and the defence set out in the written version except describing the documents marked on both sides.  There is no discussion on the above stated disputed facts for the purpose of arriving at a just conclusion as to whether there was any deficiency in service arising out of medical negligence on the part of the opposite parties or not.  No base or foundation has been made in the impugned order so as to conclude that there was medical negligence on the part of the opposite parties.  There is not even a reference to the ailments for which the deceased was admitted in the 1^st opposite party hospital for further management and the particulars of treatment provided to her at the 1^st opposite party.  Without resorting to such an exercise the learned District Forum had suddenly come to the conclusion and recorded a finding that there was medical negligence and deficiency in service on the part of the opposite parties.  Hence we have no hesitation to hold that the impugned order is bereft of any reasoning for arriving at the conclusion leave alone the proper and correct reasons.     

12.           The learned District Forum did not discuss at all regarding what relief the complainant was entitled to.  Under the caption point No.2 the learned District Forum had without any discussion straightaway held as follows; In the result the complaint is allowed.  The opposite parties 1 and 2 are jointly and severally directed to pay Rs.199089.73 being the amount paid by the complainant under Ex A3 series.  Further the opposite parties are directed to pay Rs.500000/- towards the compensation for mental agony and Rs.5000/- towards the cost of the compliant to the complainant……….   Hence there is no discussion and resultant conclusion which formed the basis for the learned District Forum to have awarded Rs.199089.73 as compensation to the complainant for medical expenditure and Rs.500000/- as compensation for mental agony and Rs.5000/- as costs whereas the complainant had prayed for Rs.1750000/- as compensation under those heads.  Hence the finding recorded by the learned District Forum for point No.2 is also bereft of discussion and reasoning.  

13.         At this juncture it is significant to bear in mind that it is a settled proposition of law that every appealable order should be written in such a way that it should be capable of being corrected by the Appellant Forum.  As already noticed in the impugned order there is no discussion resulting in the conclusion and as such the impugned order is incapable of being corrected by the appellant Forum i.e. this Commission and hence we are of the considered view that though the occurrence in this case took place in the year 2005 still we are left with no other option except to set aside the impugned order and to remit the matter back to the learned District Forum for fresh disposal according to law by a well-reasoned order.   

14.         In the light of the discussion held above we hold that the order of the learned District Forum has to be set aside and the matter has to be remitted back to the District Forum for fresh disposal by way of well reasoned order according to law and this point is answered accordingly.

15.       F.A.No.385/2013; 

            In the result this appeal  is allowed and the order of the District Forum Chennai (South) passed in C.C.No.492/2006 dated 13.08.2013 is set aside and the matter is remitted back to the District Forum Chennai (South) for fresh disposal by way of well reasoned order. There will be no order as to costs in this appeal

           F.A.No.268/2014 :- In the result this appeal is dismissed. No order as to costs in this appeal.    

 

 

S.M.MURUGESSHAN                                                    K. BASKARAN                                                                     

         MEMBER.                                                     PRESIDING JUDICIAL MEMBER.