Delhi

East Delhi

CC/377/2012

SOHIL SHAH - Complainant(s)

Versus

Max Balaji Hospital - Opp.Party(s)

23 Aug 2012

ORDER

 

 

                DISTRICT CONSUMER DISPUTE REDRESSAL FORUM-EAST, Govt of NCT Delhi

               CONVENIENT SHOPPING CENTRE, 1^st FLOOR, SAINI ENCLAVE, DELHI 110092                                                               

Consumer complaint 377/2012                                                                                                

In matter of

Mr Sohil Shah

R/o C104 ground Floor

Pushpanjali Colony, Karkardooma

Delhi…110092………………………………..………………..……………………….…………..…….Complainant

                                                                    Vs

1-Max BalaJi Hospital

Regd office 108 A, Indraprastha Extn.

Opp. Sanchar Appt, Patpargaunj, Delhi 110092     

 

2-Prof Mohan Nair,

Director Electrophysiology & Arrhythmia  Services,

Max BalaJi Hospital, Patpargunj, Delhi.110092

 

3-Dr Manoj Kumar

Sr. Interventional Cardiologist& Chief Cath Lab

Max BalaJi Hospital, Patpargunj, Delhi.110092

 

 

4-Dr Vikas Kataria

Consultant Cardiologist

Max BalaJi Hospital, Patpargunj, Delhi.110092..………………………………..…Respondents

 

                                                                                    Date of Institution- 22/05/2012 

                                                                                   Date of Decision  -  24/02 /2016 

Order by  Dr P N Tiwari, Member : 

The brief facts

Mr Sohil Shah had chest pain on 26^th April 2010 in evening and consulted Dr K B Bhatia who advised him to get admitted at Delhi Heart Hospital on the same date. He had such episodes in past but did not consult any doctor. After taking discharge from Delhi Heart Hospital, he got admitted at Max Balaji Hospital herein called Respondent 1. He was put under constant cardiac monitoring and medicare. The respondent 2 on examining complainant advised ECHO test on day one of admission. The report of ECHO was 35% Ejection Fraction from Left Ventricle. His ECGs were abnormal. Final ECHO done on 01^st May 2010 showed 65% EVF with early diastolic dysfunctions. The diagnosis was given as Idiopathic Ventricular Tachycardia. After stabilizing, he was discharged under stable condition on 03^rd May 2010 with medicines and proper follow up. He was advised for Holter monitoring after 2 months.  

Complainant had episodes of tachycardia even after discharge, so he visited Dr Suman Bhandari at Gupta Multispecialty Hospital who also could not diagnose the cause of repeated palpitations. Hence, he went to Dr Ajay Saxena at Escorts hospital who is an Electro Physiologist. Dr Ajay Saxena advised for Trans Telephonic ECG after seeing the records of OP hospital. But complainant did not consent and visited Dr Balbir Singh at Medanta hospital on 20/05/2010. There he underwent Cardiac MRI. Pulmonologist Dr Himanshu Garg’s opinion was taken. Dr Garg advised CECT chest which reported as “Multiple enlarged homogenously enhancing nodes in mediastinum in left hilar region of lung”. Possibility of Sarcoidosis was diagnosed. Detail investigations were done. Treatment was advised with regular follow up.

Thereafter, complainant again had palpitations and was re-admitted at Medanta hospital on 06/06/2010. As his heart beats were not coming to normal, Electrophysiological study was done to find out the cause of repeated ventricular tachycardia. Based on EP study, RF Ablation was done. Complainant was discharged on 10/06 2010 after observation.

The discharge summary shows that complainant was admitted stabilizing and management. He again developed palpitations and got re-admitted on 23/06/2010 and was discharged on 30/06/2010. On 24/06/2010, after cardiac MRI, AICD implantation was done on 28/06/2010. Due to repeated tachycardia, AICD machine was implanted to control palpitations. He was discharged on 07/07/2010 under stable condition. From July 2010, complainant doing his work normally.

 

 

Complainant alleged negligence of OP hospital for not diagnosing the cause of Palpitations. He has claimed treatment cost of 18.50 Lac with 24% interest along with Rs 55000 for litigation charges.  

Notices were served to all respondents. Written Statements submitted by all the treating doctors at OP hospital. Opponent denied all allegations raised by complainant. OP submitted that complainant was admitted for palpitations and fatigue which were existing for over two weeks and had not consulted any doctor. He came of his own from another hospital. In OP hospital, he was monitored by panel of cardiac specialists. The VT had different morphology and low ejection fraction. All other parameters were normal. Due to repeated occurrence of VT under proper cardiac medications, heart rhythm was not stable. All required tests were done but final diagnosis was not certain for repeated palpitations even after standard line of treatment for VT, hence diagnosis of Idiopathic Ventricular Tachycardia was given. Later his EVF was 65% checked by 2D ECHO tests, heart condition was stable, so was discharged with proper medicines and follow up. Further OP hospital stated that tests like CAG, EPS were advised but neither complainant consented nor reported for follow up.

ECHO is an important investigation in cardiology to find out the physiopathology of Heart and its functions, which was done at twice OP hospital. Complainant went to Medanta hospital where MRI and CT were done. Here, provisional diagnosis was made as Secondary Myocardial Sarcoidosis with normal left ventricular Systolic function.

 

 

Tachycardia/palpitations were not coming under control by even after RFA and AICD. All parameters were stable, hence, after proper medicines, he was discharged from Medanta hospital with follow up at regular period. Complainant got admitted number of times at Medanta hospital but the cause of tachycardia could not be made.

Complainant filed rejoinder with affidavit and OPs also filed their evidences on affidavit along with Honble Supreme Court citation as Martin F D’souza vs Mohd Ishfaq (2009)3SCC and related medical text on Tachycardia. Parties submitted their written submission.

Arguments heard from both the parties.

Being alleged a complex medical negligence case, complainant have not asked for expert medical opinion nor submitted any relevant medical text to prove that the treatment given by OP hospital is contrary to diagnosis and was not required.    

In ref to the diagnosis made by OP hospital and by Medanta hospital, Sarcoidosis was considered as a main cause of repeated ventricular tachycardia. The line of investigations and treatment adopted by OP in cardiac ailments has not been controverted by complainant on oath.

By going through the medical literature, it is clear that Echocardiography is used to detect myocardial involvement in many cardiac ailments. Cardiac pathology in Sarcoidosis can be detected but it may not detect mild myocardial abnormalities.

 

 

Sarcoidosis can be asymptomatic for many years and resolves itself also. Sarcoidosis may involve other vital organs in later stage of life.       

By taking the reference of Martin F D’Souza case under para C (a to d ) which says about Medical Practice and Practitioners in ref to medical negligence as -

(a)-Treatment in extremely serious situation successfully saving life although resulting in side effects, held, did not amount to negligence.

(b)- Bolam test as approved in Jacob Mathew case,(2005)6SCC1, held , medical practitioners would be liable only where his conduct fell below that of standard of a reasonably competent doctor. Harm resulting from mischance or misadventure or through an error of judgment would not necessarily attract such liability. Mere existence of a body of competent professional opinion considering the decision of the medical practitioner to professional opinion supporting his decision as reasonable in the circumstances of the case.

(c)- Standard of care has to be judged in the light of knowledge and equipment available at the relevant point of time. In performing a novel operation or prescribing a novel treatment to save the patient’s life when no other method of treatment is available, even if resulting in death or causing some serious harm, they should not be held liable.                                                                                                                                                     

(d)-Simply because a patient has not favorably responded to a treatment given by a doctor or a surgery has failed, the doctor cannot be held straightway liable for medical negligence by applying the doctrine of res ipsa loquitor.

 

In this case, the line of treatment adopted by OP treating doctors has not been proved wrong by complainant. Tachycardia having heart rate over 200/minute is a life threatening condition. As per Indoor case papers records, it was rightly managed and patient’s condition was brought under control. The complainant is performing his routine work normally.   

Hence, complainant has failed to prove his allegations against the respondents neither by medical opinion nor by any concrete evidence with related cardiac medical literature which can support his allegations of deficiency and negligence in the diagnosis and treatment in managing Tachycardia/palpitations were wrong.    

Complaint is dismissed. The copy of this order be sent to the parties as per rules.  

 

(Dr) P N Tiwari - Member                                                  Mr N A Zaidi - President