THE A.P.STATE CONSUMER DISPUTES REDRESSAL COMMISSION:HYDERABAD

C.D.NO.31 OF 2004

Between:

1.   Smt Deepashree Chincholi W/o late Dr.Rajeev Chincholi
Age 28 years, Housewife

2.   Master Nikhil Chincholi S/o late Rajeev Chincholi
Age 3 ½ years, Minor rep. by mother and guardian
complainant no.1
R/o H.No.4-6-384, Esamia Bazar,Hyderabad

1.   Mediciti Hospital rep. by its
Managing Director/Chief Executive
Officer Sri B.Narayanaswamy

2.   Dr.Sriramachandra Damaraju
Aged about 40 years, Neurologist

3.   Dr.Laxmareddy Anesthetist

4.   Dr.Satyanarayana
Aged about 50 years
Physician
No.1 to 4 C/o Mediciti Hospital, Secretariat Road
Hyderabad

Counsel for the Complainants   Counsel for the opposite parties

QUORUM:  

SMT M.SHREESHA, LADY MEMBER
                            

   ***

a)         

b)    The doctors on duty did not give antibiotics to the patient from the date of admission.

c)     Even though the patient developed high fever; Physician ( Internal medicine spcecialist0 was not consulted.

d)    Even till the moment of death, the patient was not given milk feeding or other liquids through nasogastrict tube (Ryles’ Tube ( Enteral feeding)

e)    ECG, 2D Echo, and Ultra Sound of abdomen and LFT were not done and Cardiologist consultation and physician consultation was not taken

f)      Elastic Stockings (TED Stockings) to the lower limbs of the patient were not put for prevention of Pulmonary embolism

g)    Even till 10.00 p.m. on 28.3.2004 no physician was called to help the patient even though the patient was running high temperature of 102 degrees and no Cardiologist was called even though the heart rate was 180 per minute.

h)   As already submitted Dr.Sriramachandra Damaraju, Neurosurgeon who was in charge of the patient, left for Bidar without entrusting the patient to a competent physician or surgeon.    Dr.Satyuanaryana who was o duty was enjoying TV in his room .  HE continued to see the TV and talk on phone.

i)      Opposite party no.3 did not treat the patient from 6 p.m. on 27.3.2004 to 11 p.m. on 28.3.2004 in spite of repeated requests and opposite party no.3 represented that if it is necessary his anesthetic technician boy might be contacted. th   

The complainant submits that the opposite parties did not register the case as medico legal one and insisted that the complainant take away the dead body at 1.35 p.m. and though the police were informed no body turned up and the complainant shifted the dead body at 5 a.m. to Gulbarga.        

Opposite party no.2 filed counter which was adopted by opposite parties 1, 3 and 4.  Opposite partyno.2 waited in anticipation of grievously ill patient coming for admission that day and cancelled his appointments but however there was no admission on that day.            It is absolutely imperative that during the treatment of any patient with injuries, severe dehydration should be avoided.      

Opposite party no.2 submitted that the patient was admitted in Mediciti Hospital on 25.3.2004 at 4.23 p.m.   

a)    This 32 years old male was known to consume alcohol regularly.  

b)   According to the relatives he consumed alcohol and went on a motorcycle and had an accident with a bicycle and sustained a severe head injury.

c)    The said patient fell on the left side of the head and had an injury in the region of the ear.  

d)   IT was also noticed that the said patient had clear fluid discharging from the left ear.     

e)    The patient was also very restless at the time fo admission to the hospital.        

f)      The arterial blood gas study showed the patient had hypoxia.    

g)    The CT scan showed a thin right fronto-temporal acute subdural haemotoma; this is a blood clot which collects between the dura mater which is a covering of the brain, and the brain itself.           

h)   Since the acute subdural haematoma was giving rise to a midline shift by about 2-3 mm only, it was decided not to operate on the patient, but to treat him with medications only.            

Opposite party no.2 denied that in spite of knowing fully well that the patient was in critical condition, he visited the patient only once in 24 hours     It is further submitted that Heparin is usually given to patients who are unconscious to prevent DVT.     On the morning of 26.3.2004 the patient was found to have low grade temperature and opposite party no.2 advised him to start the patient on tepid sponging.            

Opposite party no.2 further submitted with regard to DVT that stagnation of blood in the legs leads to clotting of blood in the legs.          There was no shift of the midline.        

Opposite party no.2 further submitted that on the morning of 28.3.2004, the patient was found to be not moving the left side.            Since the patient was moving his head to command, the oedema was localized and that there was no immediate threat to his life due to the intracranial clot oedema.           

Opposite party no.2 further submitted that it is wrong to say that no physician was contacted by Dr.Lakshma Reddy since the patient had pulmonary embolism which is known to cause high temperature and an increased heart rate.                 

The complainant filed affidavit evidence reiterating the facts in the complaint and filed Exs.A1 to A8 by way of evidence.  

The brief point for consideration is whether there is any medical negligence on behalf of the opposite parties in treating the husband of the complainant no.1.

We heard both sides and both sides also filed written arguments.

Ex.A1 is the legal notice dated 25.4.2004 got issued by the complainant to the opposite parties calling upon them to handover the Xerox copies of the case sheet, investigation reports and death summary.        

Ex.B1 is the progress note in which treatment rendered to the patient by the hospital.      

On perusal of the material on record we observe that the facts not in dispute are that the patient is an Assistant Professor in Periodontology, Dental College Hospital in Gulbarga and the first complainant is his wife.  while riding a motor cycle at about 11 p.m. the first complainant’s husband fell down and sustained head injuries and was immediately shifted to Basaveshwar Hospital at Gulbarga and was treated in that hospital on that night and on the next day and thereafter he was brought to Mediciti Hospital i.e., opposite party no.1 and was admitted in the hospital at about 4 p.m. on 25.3.2004 under the care of opposite party no.2.    postmortem was conducted and that the death was not recorded as a medico legal case and the body was handed over          

 Opposite party no.2 admitted that he reviewed the patient and found no change in neurological status and advised to continue the same treatment.    The contention of the complainant that had the patient been given TED stockings the DVT would not have occurred in the legs,nd 

It is also an admitted fact that on 28.3.2004 opposite party no.2 had gone to Bidar.   .    .     Opposite party no.2 in his cross examination stated that the case sheet was written after the entire treatment was over and the patient had died. seen by K.Laxma Reddy’

We note that when the patient was in an emergency situation care ought to have been taken to see that a neuro surgeon and his team were present in SICU.   With reference to duties of the doctors to the patient, the National Commission in

“The duties which a doctor owes to his patient are clear.     

In.the court approved a passage from Jackson and Powell on Professional Negligence and held that”

men should possess a certain minimum degree of competence

         In Jacob Mathew v. State of Punjab reported in III (2005) CPJ 9 (SC), the Apex Court has concluded in para 48(3) as follows:

“ .

“ Where you get a situation which involves the use of some special skill or competence, then the test as to whether there has been negligence or not is not the test of the man on the top of Clapham omnibus, because he has not got this special skill.  

         In the instant case for the aforementioned reasons we are of the considered view that this duty in tort or reasonable care as per standard medical parlance was not exercised. 

It is also an admitted fact that no physician was contacted by Dr.Laxma Reddy and that patient had Pulmonary Embolism which is known to cause high temperature and an increased heart beat.       

There is also no evidence on record to state that postmortem was  In regard to the choice of the multiplicand the

“98.   

Further as to the multiplier, Halsbury states:

“However, the multiplier is a figure considerably less than the number of years taken as the duration of the expectancy. 

The Hon’ble Supreme Court in the case of 

Again it held that multiplier method involves ascertainment of the laws of dependency of multiplicand having with regard to the circumstances of the case and capitalizing multiplicand by appropriate multiplier.  

Apex Court while observing that much of the calculation necessarily remains in the realm of hypothesis “in every case it is the overall picture that matters” the Court must try to assess as best as it can the loss suffered, specifically observed that “the chances that deceased might have got better employment or might have lost his employment or income altogether”, needs to be taken into account.

The complainant has filed salary certificate which shows that the deceased was drawing a salary of Rs.15,000/- per month minus professional tax of Rs.200/- and the total amount comes to Rs.14,800/-.    

In the result this complaint is allowed in part directing the opposite parties to pay Rs.21,60,000/- together with medical expenses of Rs.28,500/- along with costs of Rs.5,000/-. 

KMK*                                                                                

APPENDIX OF EVIDENCE

WITNESSES EXAMINED

For complainant

PW1            PW2            PW3           

For opposite parties

RW1           RW2          

For complainants

Ex.A1    

For opposite parties

Ex.B1