District Consumer Disputes RedressalCommission ,Faridabad.
Consumer Complaint No.453/2020.
Date of Institution: 01.12.2020.
Date of Order: 13.04.2023
Indra Rani W/o Lt. Sh. Kanwar H.M. Singh R/o H. No. 13, Officers Colony, Sector 15A, Faridabad
……complainant…..
Versus
1. Metro Heart Institute with Multispeciality Sector 16 A, Faridabad (NCR) - 121002.
2. Dr. Pankaj Chhabra, Pulmonologist Metro Heart Institute with Multispeciality Sector 16 A, Faridabad (NCR) - 121002.
3. Dr. S.S. Bansal,(Formerly Employed at Metro Heart Institute with Multispeciality, Faridabad) Presently at SSB Heart and Multispeciality Hospital (Previously known as QRG Central Hospital) At Plot No. 69 Mathura Road, near Neelam Flyover, Sector 20 A, New Industrial Town, Faridabad, Haryana 121001
4. M/s Bajaj Alliance General Insurance Company Ltd. SCO-102/103, Shop No. 109A 1098 & 110, 1st floor, Sector 16, Faridabad, Haryana 121002 (Insurer of Respondent no. 1)
5. The Oriental Insurance Company Ltd. 5B/4, B.P, Neelam-Railway Station Road, New Industrial Town, Faridabad, Haryana 121001 (Insurer of Respondent no. 3).
6. ICICI Lombard General Insurance Company Ltd. (Insurer of Respondent no. 2 Vide Policy No. 4021/181562532/00/000) Regd. Office at: 414, Veer SavarkarMarg, Near Siddhivinayak Temple, Prabhadevi, Mumbai
Service to be effected at:
ICICI Lombard General Insurance Company Ltd. At: SCO-17, First Floor, Sector 16, Faridabad
7. The Oriental Insurance Company Ltd. 5B/4, B.P, Neelam-Railway Station Road, New Industrial Town, Faridabad, Haryana 121001 (Insurer of Respondent no. 2).
Complaint under section-12 of Consumer Protection Act, 1986
Now amended Section 34 of Consumer protection Act 2019.
BEFORE: AmitArora……………..President
Mukesh Sharma…………Member.
Indira Bhadana………….Member.
PRESENT: Sh. AnkurGosain, counsel for the complainant.
Sh. SatenderAdhana, counsel for opposite party No.1.
Shri Ravi Nagpal, counsel for opposite party No.2.
Sh. AtulKhatri, counsel for opposite party No.3.
Sh. R.K.Sahota, counsel for opposite party No.4.
Sh. AnujGupta, counsel for opposite parties Nos.5 & 7.
Sh. RakeshDabaas, counsel for opposite party No.6.
ORDER:
The facts in brief of the complaint are that the Complainant's Husband Lt. Sh. Kanwar H.M. Singh, was complaining of Fever and cough in the month of September 2019 so he was taken to Respondent no. 1 Hospital on 20.09.2019 for medical advice and there he was referred to Respondent no.2, for consultation in OPD. Thereafter Respondent no.2 on seeing the husband of the complainant prescribed some tests to be conducted and also advised admission in the Hospital. As per the advice of Respondent no.2. Complainant's Husband was admitted in MICU at Respondent no. 1 Hospital on 20.09.2019 itself and during the time Complainant's Husband was admitted in Respondent no. 1 Hospital Faridabad he was being treated by Respondent no.2 and was also being supervised by Respondent no. 3 who was at that time managing the affairs of respondent no. 1 hospital. During the said time of his admission some chest X-Rays and other tests of Complainant's Husband were also conducted at the Respondent no. 1 Hospital on 23.09.2020 and in the said report of X-ray of the Complainant's Husband dated 23.09.2019 it was written that "There was homogeneous opacity noted in left lung field with blunting of left costophrenic angle. Rest of the Lung Fields and Right Costophrenic angle are clear" Although the X-Ray films were not supplied by the respondents to the attendants of the patient even at the time of discharge. During the treatment of the husband of the complainant, the family members of the complainant inquired personally from the respondent no. 2 and 3 as to what is the reason of the sickness to which Respondent no.2 and 3 informed the complainant and her family members that there was nothing as such to worry about and that they had already got the required tests conducted and that the patient was recovering fast and respondent no. 2 and 3 clearly stated that possibility of the complainant's husband having Pneumonia was totally ruled out so there is no cause of worry.On 26.9.2019 the respondents told the family of the complainant that the condition of the complainant's husband is quite stable and that the respondents had decided to discharge him. Thereafter Complainant's Husband was discharged on 26.09.2019 at about 3 p.m. with the instructions to follow up after one week stating him to be in stable condition and at the time of discharge on 26.09.2019 only discharge summary was handed over to the attendants by the Hospital and other documents like X-Ray Films etc.. were deliberately withheld and concealed from Family of Lt. Sh. Kanwar H.M. Singh by the Respondents. At the time of discharge as the respondents had assured the complainant's family that the husband of the complainant has almost recovered from illness and his condition was stable, so the complainant and her family had no reason to doubt the respondents.
2. After few hours of discharge on 26.09.2019 itself Lt. Sh. Kanwar H.M. Singh again suffered breathlessness and he was again rushed to Respondent no. 1 Hospital and there Lt. Sh. Kanwar H.M. Singh was admitted in Emergency. The opposite parties nos.. 2 and 3 were informed telephonically by daughter of the Complainant and also through Whatsapp Messages that the patient is having severe breathlessness and that he was being brought in Emergency . On reaching the opposite party No..1 Hospital in emergency and again chest X-Rays were conducted upon Lt. Sh. Kanwar H.M. Singh by the junior doctors present at the hospital and the opposite parties Nos.. 2 and 3 were informed by the junior/ resident Doctors. At that time the grandson of the complainant clicked the photographs of the X-Ray films which X ray was conducted by the opposite party no.1 hospital at 11: 44 P.M. to seek second opinion. When inspite to various calls made by the daughters to the opposite parties respondent no.2 to 3, the opposite parties Nos..2 and 3 did not turn up and even stopped taking the calls so the husband of the complainant was got discharged from the Respondent no. 1 Hospital under the compelled circumstances. Again at the time of discharge at mid- night of 26.09.2019 the X- ray Films were deliberately withheld by opposite party no. 1. Now the complainant had come to know that the deliberate concealment of X-Ray films was done by the respondent as the Phneumonia was clearly visible in the same and had the same been provided to the complainant then the gross negligence on the part of the respondents would have become clear then and there. Thereafter, Complainant immediately shifted her Husband to Medanta Hospital. Gurgaon and again chest X-ray was conducted at about 2:00 A.M. and severe infection was found in left lung and Pneumonia was diagnosed and the husband of the complainant was admitted in ICU by Dr. BornaliDatta on 27.09.2019 at 02:56 A.M. The said infection of Pneumonia was caused to the complainant's Husband during the period he remained admitted in opposite party no. 1 Hospital due to the gross negligent conduct and incorrect treatment given by the treating doctors opposite parties nos. 2 and 3. After admitting Lt. Sh. Kanwar H.M. Singh in Medanta Hospital, the Doctors gave treatment but his condition did not improve as such the family of the complainant got her husband discharged from Medanta Hospital, Gurgaon and shifted him to AIIMS, New Delhi in the intervening night of 30.09.2019 and 1.10.2019 where Lt. Sh. Kanwar H.M. Singh was admitted immediately and was diagnosed with Hospital Acquired Pneumonia by the doctors of AIIMS, New Delhi after analyzing all his reports. Then Lt. Sh. Kanwar H.M. Singh was then being treated for the same at AIIMS, New Delhi but his condition did not improve and thereafter the Complainant's Husband Lt. Sh. Kanwar H.M. Singh expired on 16.10.2019 at 3:37 P.M. Also, in the death summary provided by AIIMS. New Delhi it is clearly been stated that Lt. Sh. Kanwar H.M. Singh had Hospital Acquired Pneumonia.The Complainant's Husband was a healthy man, he had no such medical history and even at the age of 75 years he was having no complains of Blood Pressure, diabetes. thyroid, kidney disorder etc. This fact was even mentioned in the In patient Assessment Record of Medanta Hospital. Further it was worth mentioning that there was history of longevity of life in the family of the husband of the complainant, the elder sister of Lt. Sh. Kanwar H.M. Singh is 78 years of age and wasalive, the mother of Lt. Sh. Kanwar H.M. Singh also died at the age of 100 years, hence death of Complainant's Husband was attributed to all the opposite parties, as Complainant's Husband acquired Pneumonia during the duration of his admission at opposite party no. 1 due to the improper treatment. carelessness. wrongful acts and gross negligence on the part of Respondents eventually resulting into his death. Lt. Sh. Kanwar H.M. Singh was discharged by opposite parties nos. 2 and 3 from the opposite party no. 1 Hospital on oral medications on 26.09.2019 stating him to be stable despite having knowledge that he was having severe infection of Pneumonia in his left lung as it was clearly visible in his X- Ray films. This was deliberately done by the opposite parties as they were well aware that the patient had acquired Pneumonia due to the gross negligence on part of Respondents and over that the opposite parties nos. 2 and 3 mislead the complainant and her family just to escape from their liability, also in order to get rid of the Patient they discharged Lt. Sh. Kanwar H.M. Singh in severe condition stating him to be stable and deliberately withheld the X-Ray Films and reports so that their negligence do not come to light. Further when the Complainant's Husband was readmitted in the emergency at opposite party no.1 just after few hours of his discharge on 26.09.2019 as his condition worsened, opposite parties nos. 2 and 3 who had been treating Lt. Sh. Kanwar H.M. Singh for last one week and were well aware about the case/history, deliberately avoided to attend Lt. Sh. Kanwar H.M. Singh and left him at the mercy of junior Doctors in Emergency. It was bounden duty of the Respondents to render a helping hand to the patient at their mercy but instead of properly treating him. correcting what has gone wrong and trying to save the patient, the opposite parties discharged the patient in such severe condition in the afternoon on 26.09.2020 and when the Complainant's Husband was re-admitted in emergency just after few hours of discharge, the opposite parties nos. 2 and 3 despite having knowledge of the serious condition of patient did not attend the patient and even stopped taking the calls of anyone from family of the complainant. Reports and X-Ray films of Complainant's Husband were deliberately concealed by the opposite party no. 1 to hide professional misconduct and gross negligence on part of the opposite parties nos. 2 and 3. There was dereliction of duty on part of the opposite partyt no. 1 Hospital and treating doctors opposite parties nos. 2 and 3 in rendering medical service to their patient Lt. Sh. Kanwar H.M. Singh. During the time Complainant's husband was admitted in opposite party no. 1 Hospital Opposite party no. 3 was having the control of management of the opposite party no. 1 Hospital and was also looking after Complainant's Husband personally as he was a senior citizen and was complaining of breathlessness, so it was considered necessary by Respondent no. 2 to consult and involve a cardiologist for treatment of complainant's Husband. Again when the complainant approached the Hospital for obtaining the reports and X-Ray Films of her husband after his death then the officials at opposite party no. 1 clearly stated that they did not have any such reports of complainant's husband in their record whereas as per the Medical Council Regulations 2002, Hospital/Medical Practitioners were required to compulsorily keep the record of their patients for a time period of 3 years from the date of commencement of treatment, that the above act of the Respondents clearly shows that they were deliberately concealing the record of X on part of Rays films complainant's Husband just to hide the negligence on opposite parties and to escape from their liability. The complainant apprehends that opposite parties had deliberately destroyed the same as they were well aware that those can establish their gross negligence and establish that complainant's husband acquired Pneumonia during the period he was admitted in opposite party no. 1 Hospital and that too due to the gross negligence of the opposite parties nos. 2 and 3. The aforesaid act of opposite parties amounts to deficiency of service and hence the complaint. The complainant has prayed for directions to the opposite parties to:
a) pay compensation and damages to the tune of Rs.98,00,000/- on account of loss of life of the husband of the complainant coupled with mental agony and financial loss suffered by the complainant, to the complainant alongwith pendentlite interest @ 18% p.a.
b) pay Rs. 1,00,,000 /-as litigation expenses.
3. Opposite party No.1 put in appearance through counsel and filed written statement wherein Opposite party No.1 refuted claim of the complainant and submitted that the patientLt. Sh. Kanwar H.M. Singh74 years Male, approached the OP Hospital on 20.09.2019 in emergency with the complaint of fever, shortness of breath and cough since 15-20 days, shivering and cough (dry) since 20 days. Accordingly, the patient was admitted for further management. As per history recorded and physical examination done at the time of arrival of the complainant, the patient was a known case of ILD (Idiopathic Pulmonary Fibrosis Type of ILD) was having the history of breathlessness since 6 months. Since last 20 days patient had increased breathlessness, fever on and off and dry cough. Accordingly, on the basis of clinical examination and considering the symptoms of the patient his provisional diagnosis was made as Pneumonia??& Known case of ILD. A consent was also signed by the attendant of the patient with provisional diagnosis of Pneumonia??.On examination patient was febrile (100.5F), chest examination revealed B/L Crepts. Patient was admitted in MICU, necessary baseline investigations were carried out and treatment was started on immediate basis as per the hospitalprotocol. Treatment of LRTI (Lower Respiratory Tract Infection) with respiratory distress with associated underlying ILD (Interstitial lung disease) was started. Patient was put on I/V antibiotics, 02 inhalation PPI's antipyretics and other supportive treatment. HRCT chest was suggestive of mild cardiomegaly with diffuse bilateral multifocal ground glass opacities with smooth interlobular septal thickening in bilateral lungs sign of interstitial lung disease (NSIP pattern) with small mediastinal lymphadenopathy and minimal left pleural effusion. His blood investigation showed Hb-9.8, TLC 13510, Platelet Count-193000, KFT (Urea-37, Creatnine-1.4, S.Na+-135.0, K+-4.8), PT/INR-12.6/11.2/1.13, LFT (S.Total Bilirubin -0.7, SGOT-34, SGPT-25), S. Alkaline Phosphatase 105, Total Protein -7.3, Albumin-3.4/globulin-3.9, A/G ratio 0.87, HbA1c-5.37%, PCT-0.70, Dengue NS1-Negative, Dengue IgG&IgM-negative. In view of deranged KFT, Nephrologist consultation was taken and advice was followed. Patient was treated with IV antibiotics, Nebulization, chest Physiotherapy, bronchodilators and other symptomatic treatment. Considering the investigation report and all other factors, the patient was shifted to ward on 21.09.2019. Treatment was continued and patient was showing signs of improvement with the given treatment. Oxygen saturation improved & was maintaining at 90% on 2L of oxygen. During the course of hospitalization Sputum for culture and sensitivity was sent which showed no growth after 24hours. Patient improvedgradually over the period of 6-7 days, and subsequently his discharge was planned on 26/09/2020. At the time of discharge patient was stable, conscious and oriented with no signs of breathlessness, his BP was 120/70 mmhg, pulse 86/min and regular, afebrile with saturation of 92% on room air (Normal for patients with underlying ILD). Patient was discharged on 26/09/2019 at approx 01:00pm. The patient again presented to emergency department on 26/09/2020 at 11:15PM with complaints of high-grade fever associated with vomiting, breathlessness and cough. Patient was admitted under Dr. P. Chhabara under the diagnosis left side Pneumonia. Initial examination revealed a febrile (101degree F), BP 140/100mmhg, pulse 94/min and spo2 of 90% on RA. Patient was admitted immediately in MICU and prompt treatment started with I/V antibiotics, Nebulization I/V antipyretics. Patient was put on BIPAP in MICU and injection Meropenem (Broad spectrum) was added to the treatment. CXR done on 27/09/2020 showed shadowing of Left Lung. Patient required further hospitalization, but attendants insisted for the discharge. Inspite of continuous effort of the doctors and hospital authority for continuation of hospitalization and treatment till the improvement is achieved; attendants were not ready to lend their ears and were demanding for immediate discharge. LAMA discharge summary was issued in favor of the patient on 27/09/2020 at around 01:00 AM. The treatment was carried out in the proper manner appropriately, as per established medical guidelines. The attendants were in unnecessary hurry and took the patient by force to be admitted in other hospital. Patient's attendants after admitting the patient at different hospital left the treatment incomplete and again shifted their patient to AIIMS Delhi. This carelessness and unnecessary urgency shown by the attendants to admit, discharge, again admit and again discharge at three different hospitals in no time led to this chaos and incomprehensive treatment which cost patient's precious life. At the time of initial admission, the patient was diagnosed as Pneumonia with a known case of ILD. The patient had the severe LRTI (Lower Respiratory Tract Infection) and the best possible treatment was given to the patient during the hospitalization at the Respondent No. 1 Hospital. During the entire treatment the Hospital and its medical team acted well, attended the patient properly and gave the proper treatment which caused that the patient was recovered and discharged on 26.09.2019 in a stable condition with certain advice of Do and Don't. It seems that the attendants and patient did not follow the advice of treating doctors which could had caused serious problem and the patient was readmitted in the Hospital. Here again the attendants did not follow the advice of doctors and forced to discharge the patient within 3 hours. At no point of time there was any negligence or deficiency in service and the patient had been given the best possible treatment as per his condition. In fact it is the attendant who did not follow the advice of treating doctors which resulted the condition of the patient worsen. Opposite party No.1 denied rest of the allegations leveled in the complaint and prayed for dismissal of the complaint.
4. Opposite party No.2 put in appearance through counsel and filed written statement wherein Opposite party No.1 refuted claim of the complainant and submitted that the patient Lt. Sh. Kanwar HM Singh, 74 years Male, approached the OP Hospital on 20.09.2019 in emergency with the complaint of fever, shortness of breath and cough since 15-20 days, shivering and cough (dry) since 20 days. Accordingly, the patient was admitted for further management. As per history recorded and physical examination done at the time of arrival of the complainant, the patient was a known case of ILD (Idiopathic Pulmonary Fibrosis Type of ILD), and was having the history of breathlessness for the last 6 months. Since last 20 days, patient had increased breathlessness, fever on and off and dry cough. On the basis of clinical examination and symptoms of the patient his provisional diagnosis was made as: Pneumonia?? and Known case of ILD. On examination patient was febrile (100.5°F), Chest examination revealed B/L Crepts. Patient was admitted in MICU, necessary baseline investigations were carried out and treatment was started immediately as per the hospital protocol. Treatment of LRTI (Lower Respiratory Tract Infection) with respiratory distress with associated underlying ILD (Interstitial lung disease) was started. Patient was put on I/V antibiotics, O2 inhalation, PPI's, antipyretics and other supportive treatment. HRCT chest was suggestive of mild cardiomegaly with diffuse bilateral multifocal ground glass opacities with smooth interlobular septal thickening in bilateral lungs sign of interstitial lung disease (NSIP pattern) with small mediastinal lymphadenopathy and minimal left pleural effusion. His blood investigation showed Hb-9.8, TLC-13510, Platelet Count-193000, KFT (Urea:37, Creatnine:1.4, S. Na:135.0, K:4.8), PT/INR:12.6/11.2/1.13, LFT (S. Total Bilirubin :0.7, SGOT-34, SGPT-25), S. Alkaline Phosphatase: 105, Total Protein:7.3, Albumin:3.4, Globulin:3.9, A/G ratio:0.87, HbA1c:5.37%, PCT:0.70, Dengue NS1:Negative, Dengue IgG&IgM:Negative. In view of deranged KFT, Nephrologist consultation was taken and advice was followed. Patient was treated with IV antibiotics, Nebulization, chest Physiotherapy, bronchodilators and other symptomatic treatment. Considering the test results and all other factors, the patient was shifted to ward on 21.09.2019. Treatment was continued and patient was showing signs of improvement with the given treatment. Oxygen saturation improved, and was maintaining at 90% on 2L of oxygen. During the course of hospitalization, Sputum for culture and sensitivity was sent which showed no growth after 24 hours. Patient improved gradually over the period of 6-7 days, and subsequently his discharge was planned on 26/09/2020. At the time of discharge patient was stable, conscious and oriented with no signs of breathlessness, his BP was 120/70 mm of Hg, pulse 86/min and regular, afebrile with saturation of 92% on room air (Normal for patients with underlying ILD). Patient was discharged on 26/09/2019 at about 1:00 pm. The patient again presented to Emergency department on 26/09/2020 at 11:15 pm with complaints of high-grade fever associated with vomiting, breathlessness and cough. Patient was admitted and diagnosed as a case of left side Pneumonia. Initial examination revealed a febrile (101° F), BP 140/100 mm of Hg, pulse 94/min and SPO2 of 90% on RA. Patient was admitted immediately in MICU and prompt treatment started with I/V antibiotics, Nebulization I/V antipyretics. Patient was put on BIPAP in MICU and injection Meropenem (Broad spectrum) was added to the treatment. CXR done on 27/09/2020 showed shadowing of Left Lung. Patient required further hospitalization,but attendants insisted for the discharge.Attendants took away the patient against medical advice in spite of the fact that doctors and hospital advised them to continue the treatment. LAMA discharge summary was issued in favor of the patient on 27/09/2020 at around 01:00 AM. The treatment was carried out in the proper manner appropriately, as per established medical guidelines. That the attendants acted negligently and were in unnecessary hurry and took away the patient against medical advice.Patient's attendants after admitting the patient at other hospital again left the treatment incomplete and again shifted their patient to AIIMS Delhi. This carelessness shown by the attendants to admit, discharge, again admit and again discharge at three different hospitals in very short interval led to incomprehensive treatment which cost patient's precious life. At the time of initial admission, the patient was diagnosed as Pneumonia with a known case of ILD. The patient had the severe LRTI (Lower Respiratory Tract Infection) and the best possible treatment was given to the patient during the hospitalization at the OP Hospital. During the entire treatment the Hospital and its medical team acted well, attended the patient properly and gave the proper treatment which caused that the patient was recovered and discharged on 26.09.2019 in a stable condition with certain advice of Do and Don't. It seems that the attendants and patient did not follow the advice of treating doctors which could have caused serious problem and the patient was readmitted in the Hospital. Here again the attendants did not follow the advice of doctors and forced to discharge the patient within 3 hours. At no point of time, there was any negligence or deficiency in service and the patient had been given the best possible treatment as per his condition. In fact, it was the attendant who did not follow the advice of treating doctors which resulted the condition of the patient worsen. In Jacob Mathew v. State of Punjab, (2005) 6 SCC1, The Hon'ble Supreme Court has observed as follows:
i. So long as it can be found that the procedure which was in fact adopted was one which was acceptable to medical science as on that date, the medical practitioner cannot be held negligent merely because he chose to follow one procedure and not another and the result was a failure. Opposite party No.2 denied rest of the allegations leveled in the complaint and prayed for dismissal of the complaint.
5. Opposite party No.3 put in appearance through counsel and filed written statement wherein Opposite party No.3 refuted claim of the complainant and submitted that the complaint was bad for misjoinder and non-joinder of necessary parties as the complainant is alleging about her husband further treatment in Medanta Hospital, Gurgaon and AIIMS, New Delhi, but had not impleded them as party to the present complaint who are otherwise a necessary party to the aforesaid proceeding. The complainant had illegally named the answering respondent No.3 as party to the present complaint as the complainant has complete knowledge about the fact that the husband of the complainant was neither admitted under the answering respondent No.3 nor treated by answering respondent No.3 at any point of time as alleged by the complainant. Moreover, answering respondent No.3 had left the respondent No.1 Hospital and retired from the company M/s Metro Specialty Hospitals Private Limited on 10.11.2020 and the same had been notified to Registrar of companies as well but the complainant in order to harass the answering respondent No.3 impleaded him in the present complaint.Dduring the period of 2019-20, answering respondent No.3 was insured under the policy named as Professional Indemnity Doctors Policy Schedule bearing number 272400/48/2020/270 w.e.f. 07.04.2019 till 06.04.2020 issued by M/s Oriental Insurance Company Limited. Without prejudice of the merits of the case, it wass submitted that in case this Hon'ble District Commission may come to the conclusion that there was error or omission on the part of respondent No.3 then in that event M/s Oriental Insurance Company Limited may be made solely liable to make the payment of the amount of damages or compensation that may be awarded in favour of the complainant as the respondent No.3 was insured with the said insurance company. The complainant was guilty of concealment of material facts to the respondents and as such not entitled for any indulgence from this Hon'ble Court. The real facts are that the Patient KanwarHarMohinder Singh 78 yrs (hereinafter called Patient) was admitted on 20th September 2019 in Metro Hospital, Faridabad under DrPankajChhabra. Answering Respondent No.3 was a heart specialist and Patient was admitted under the treatment of a respiratory consultant Dr. PankajChhabra as he was suffering from lung infection with pre-existing lung disease. Answering Respondent No.3 had neither treated nor supervised the treatment of this patient at any point of time as the patient was never ever admitted under the Answering Respondent which was a matter of record and hence the complaint is factually wrong. Patient discharge summary mentioned the diagnosis of pre-existing interstitial lung disease (ILD) with nonspecific interstitial pneumonia for which appropriate antibiotics were given to which patient's fever responded and he was discharged in stable condition. Therefore, the allegation that Dr. Pankaj Chabbra missed the diagnosis of pneumonia was also factually wrong and as antibiotics were given from day one in view of pneumonia also proves that the allegation of not treating pneumonia was also wrong. As the patient presented to respondent No.1 hospital with fever and lung infection and his first Scan showed opacity proves that patient did not acquire it from respondent No.1 hospital. Secondary superadded infection if any could have occurred later on in other hospital where patient was taken before going to AIIMS. Patient responded well to antibiotic treatment in respondent No.1 hospital and was therefore discharged in stable condition. Despite remaining afebrile for number of days in hospital on antibiotics, somehow, he again developed fever which nobody can predict and was brought to hospital under DrPankajchhabra. During his first admission his CT scan report dated 23.09.2019 had mentioned about opacities which means pneumonia which was diagnosed and treated with appropriate drugs. During 2nd episode of fever also, he was given very high antibiotics for fever but family wanted him to get discharged therefore patient was discharged under LAMA consent and family took him to Medanta, Gurgaon where he was treated for 4 days i.e. 27.09.2019 to 30.09.2019. The family decided to take him to AIIMS, New Delhi where he was treated from 30.09.2019 to 16.10.2019. It was clear from above that when patient aged 74 had serious pre-existing lung disease of ILD and presented to respondent No.1 hospital with pneumonia and was given appropriate antibiotics and died many days after going from respondent No.1 hospital despite treatment of worsening Pneumonia after initial improvement in respondent No.1 Metro hospital.
As per record, patient has died many days after treatment of pneumonia in Medanta and AIIMS and was appropriately diagnosed and treated at respondent No.1 Metro hospital Faridabad for lung infection. Thus, everything right from the admission till discharge was done following best practices and treatment best suited to the complainant. Thus, the treating doctor has performed his duty to the best of his abilities and with due care and caution with reasonable competence. The treatment given by the respondents to the complainant was standard and recommended as per medical literature. Thus, the Complaint seems to be misconceived, malicious and malafide in nature to extract money from the answering respondent. The entire allegations alleged by the complainant against the answering respondent No.3 are wrong, false and baseless which can be suffice from the fact that the respondent no.1 Hospital diagnosed the husband of the complainant with ILD/NSIP which means Interstitial Lung Disease/Non-Specific interstitial pneumonia. The same could be suffice from the X-Ray and HRCT report as well as discharge summary of respondent No.1 Hospital which says"HRCT chest was done which showed mild cardiomegaly with diffuse bilateral multifocal ground glass opacities with smooth interlobular septal thickening in bilateral lungs s/o interstitial lung disease (NISP Pattern) with small mediastinal lymphadenopathy and minimal left pleural effusion".Accordingly, he was treated with IV antibiotics, Nebulization, Chest Physiotherapy, bronchodilator and other symptomatic treatment which was a common medicine for treating Pneumonia and treated as per medical protocol. Thus, it's wrong to say that the husband of the complainant acquired pneumonia during the stay in respondent No.1 Hospital. Moreover, husband of the complainant got treated from the respondent No.1 Hospital w.e.f 20.06.2019 to 26.06.2019 and discharged under LAMA consent and thereafter moved to another hospitals i.e. Medanta Hospital w.e.f. 27.09.2019 to 30.09.2019 and AIIMS Hospital w.e.f 01.20.2019 to 16.10.2019 where he was declared dead. The allegations leveled by the complainant about acquiring of pneumonia during hospitalization in the respondent No.1 Hospital are wrong, false and unfounded as Medical Literature says that Hospital acquired infections (nosocomial infections) are acquired in healthcare setting by patients admitted for reasons unrelated to the infection or not previously infected when admitted, whereas in the present case, complainant husband was admitted with the complaint of fever, shortness of breath and cough since 15-20 days, shivering and dry cough since 20 days which were known symptoms of pneumonia in terms of medical terminology. Moreover, respondent no.1 Hospital diagnosed the husband of the complainant with ILD/NSIP which means Interstitial Lung Disease/Non-Specific interstitial pneumonia. Thus, it can't be said that husband of the complainant acquired pneumonia during stay at hospitalization. The complainant has alleged that despite non recovery from pneumonia, respondent No. 1 Hospital has discharged the husband of the complainant which was a clear negligence on the part of the respondent No.1 Hospital. The same was false and baseless allegations as after admission at respondent No.1 hospital, patient was diagnosed with serious illness of interstitial lung disease with nonspecific interstitial pneumonia for which appropriate antibiotics were given to which patient's fever responded and he was discharged in stable condition. Despite remaining afebrile for number of days in hospital on antibiotics, somehow, he again developed fever and was brought to hospital under Dr. Pankaj Chhabra i.e. respondent no. 2. Again, he was given very high antibiotics, Nebulization, antipyretics for fever but family wanted to discharge him and therefore patient was discharged under LAMA consent and family took him to Medanta, Gurgaon where he was treated for 4 days i.e. 27.09.2019 to 30.09.2019. The family decided to take him to AIIMS, New Delhi where he was treated from 30.09.2019 to 16.10.2019. It is clear from above that patient aged 74 had serious pre-existing lung disease of ILD and presented to all the hospitals with pneumonia and was given antibiotics. Moreover, admission and discharge of patient was decided by the treating Doctor and not by answering respondent No.3 in any manner. The answering doctor No.3 had not committed any medical negligence as alleged by the complainant as answering respondent No.3 had neither treated nor supervised the husband of the complainant at any point of time as alleged by the complainant. Answering respondent No.3 was a cardiologist and husband of the complainant was under the treatment of a respiratory consultant as he was suffering from lung infection with pre-existing lung disease. The allegations of acquiring pneumonia during the duration of his admission at respondent No.1 hospital were false and baseless which was suffice from the fact that even before the admission at respondent No.1 Hospital, husband of complainant was suffering from fever, shortness of breath and cough for the last 15-20 days, which were similar symptoms of pneumonia in terms of medical guidelines as well. Thus, its shows that the husband of the complainant was infected with pneumonia before his admission at respondent No.1 Hospital. Opposite party No.3 denied rest of the allegations leveled in the complaint and prayed for dismissal of the complaint.
6. Opposite party No.4 put in appearance through counsel and filed written statement wherein Opposite party No.4 refuted claim of the complainant and submitted that as per record, Metro Specialty Hospital Pvt. Ltd. Sector-16A, Faridabad (Hr.) has obtained a "Professional Indemnity Insurance Policy" bearing No.OG-19 1124-3305-00000001, valid for the period of 11.02.2019 to 10.02.2020 in respect of indemnity for INR 50,000,000 per claim and in aggregate. Extensions-Medical/ Practitioners Endorsement. Loss of documents including Computer records, viz. medical records, Breach of confidentiality viz. personal information. Dishonesty of employees viz. Fraud and dishonesty of employees. Libel and slander Defamation written or verbal defamation subject to deductible INR 200,000 for each and every claim. As a matter of fact, the insured has not furnished any medical document as wellas information with regards to providing treatment to the named patient - Kanwar H.M.Singh, so as to enabling the insurance company to defend itself. As such, it was likelythat the insured was in collusion with the complainant, so as to cause monetary loss to theinsurance company. Hence, the insurance company did not own any liability orindemnification, in the given circumstances, on behalf of the insured. As prescribed under the policy terms and conditions of the professional indemnity policy the liability of the insurance company shall arise only after the liability of the insured/Respondent No. 1 was established through the present complaint or any other legal suit decided and holding the insured/Respondent No. 1 guilty of professional misconduct and delinquency in the services provided. The relevant terms and conditions have been reproduced herein below for the reference of the Hon'ble Commission:
1. COVERAGE
1.1 Insuring Agreements
Subject to all the terms contained herein and endorsed hereon, the Company will indemnify the Insured for those sums which the Insured, as a result of conducting the insured profession, will become legally liable to pay as damages for loss caused by an incident which takes place in the coverage territory during the policy period.
This insurance applies to an incident only if a claim for damages arising there from isfirst made in writing against any Insured during the policy period.
A claim would be deemed to have been first made when written notice of such claim is received by any Insured or by the Company, whichever comes first, and in accordance with Section 3. of the policy, the Limits of Insurance in effect when such claim is first made will specify the most the Company will pay.
All claims for damages because of loss arising out of the same incident would be deemed to have been made at the time the first of those claims is made against any Insured. The Company would have the right but not the duty to defend any claim in accordance with Section 4.4 of the policy, but the amount that the Company will indemnify for damages and claims expenses is limited as described in Section 3. of the policy, and the Company may investigate any incident or claim, and settle any claim at Company's discretion.
This insurance applies only to damages for loss which are determined in a suit on the merits taking place in the country in which the named Insured's address as shown in the Schedule is located, or in a settlement to which the Company agrees; provided, however, that this insurance does not apply to any suit taking place in the United States of America, its territories or possessions, or Canada, and the Company will in no event agree to any settlement which is effected, made in contemplation of litigation taking place, or with respect to which there is litigation pending or threatened to take place, within the United States of America, its territories or possessions, or Canada.
It was further submitted that the terms and conditions of the policy as issued also explicitly mention and bars making the answering respondent or the Insurance Company a party to any proceedings in the court of law or making it a party of any suit before the court of law wherein the damages were being sought or prayed from the insured who is Respondent No. 1 in the present case. The relevant terms and conditions had been reproduced herein below for the reference of the Hon'ble Commission:
4. CONDITIONS
The due observance and fulfillment of the terms of this policy in so far as they relate toanything to be done or not to be done by the Insured, and the truth and completeness of all statements and information supplied to the Company by the Insured were conditions precedent to any liability of the Company to make any payment under this policy. 4.8 Legal Action against the Company No person or organization has a right under this policy to join the Company as a party or otherwise bring the Company into a suit asking for damages from an Insured.
In a similar case titled as "BAJAJ ALLIANZ GENERAL INSURANCE COMPANY LIMITED.....Appellant (s) Versus DEVENDER MOHAN ANAND & ANR., and THE CHAIRMAN, MANAGING COMMITTEE OF SUNDER LAL JAIN HOSPITAL", with case number "FIRST APPEAL NO. 2081 OF 2018" the Hon'ble National Consumer Disputes Redressal Commission, Delhi has specifically held that as there was no privity of contract between a third party and Insurance company and there was no dispute between the aforesaid two parties and thus making the insurance company a party to such proceedings for damages is not proper and the insurance company was not a necessary party to any such proceedings. The relevant paragraphs ofthe aforesaid judgment by the Hon'ble National Consumer Disputes RedressalCommission, Delhi, have been reproduced herein below for the reference of theHon'ble Commission:
The insurance policy is a separate and a distinctively different contractbetween the hospital and the insurance co., and is governed by its own terms andconditions.
The alleged medical negligence has as yet to be examined and adjudicated on
merit by the State Commission. At this stage, when the allegations of medical
negligence were as yet under adjudication on merit before the State Commission,cause of action re the hospital qua the insurance co. is 'future', 'contingent','assumptive', 'hypothetical'.
Impleading the hospital's insurance co. as a proper or necessary party, when there was no dispute between the insurance co. and the complainant, and when
there was but a 'future', 'contingent', 'assumptive', 'hypothetical' cause of action rethe hospital (insured) qua the insurance co. (insurer), is erroneous.It was obligatory on the part of the insured to intimate the insurance company immediately in respect of the claim and/or grievances or complaint lodged on behalf of the complainant and at the same time to provide the related medical documents regarding treatment of the deceased - Kanwar H.M. Singh to the insurance company. However, the insured - opposite party No.1 had failed to perform its part of obligation, in terms of condition No.4.4, condition No.4.5, 4.9 as well as condition No.4.10 of the Professional Indemnity Insurance Policy.
At the very threshold, the present complaint was not maintainable in the present form. It was submitted that the complaint was pre-mature, because no claim had ever been lodged with the replying opposite party in respect of the alleged cause either by the insured hospital - opposite party No.1 or the complainant. It was further submitted that since the present complaint is pre-mature & unwarranted, hence, no deficiency in-service can be attributed at the part of the insurance company.
In terms of the pleading under para No.1 read with paras No.13 & 14 of the complaint, the complainant has claimed the death of her husband viz. KanwarHarMohinder Singh. Resultantly, the present complaint was bad for non-joinder of all the legal representatives of the deceased. The complaint is also bad for mis-joinder of the parties.
In view of the pleading under the present complaint, the same was not maintainable and sustainable in the present form qua the opposite party No.1 as well as the replying opposite party No.4 - M/s. Bajaj Allianz General Insurance Company Ltd. As a matter of fact, neither any medical evidence being expert in nature has been relied upon nor supplied to the replying opposite party, in support of complaint by the complainant. Opposite party No.4 denied rest of the allegations leveled in the complaint and prayed for dismissal of the complaint.
7. Opposite party No.5 put in appearance through counsel and filed written statement wherein Opposite party No.5 refuted claim of the complainant and submitted thatThere was nothing in the form of documentary evidence to support the alleged allegations pointing medical negligence upon the respondent No.3 (Dr. S.S. Bansal) insured with the answering respondent, therefore the proceedings initiated by the complainant against the answering respondentwere nonest, null, void and without jurisdiction, hence the complaint deserve dismissal in limine with cost. The summary procedure prescribed by The Consumer Protection Act would suit only glaring cases of negligence and in complaint involving complicated issues requiring recording of the evidence of expert, the complainant could be asked to approach the civil courts, therefore the present complaint was not maintainable. It was submitted that the husband of complainant was treated by various doctors of various hospitals for number of days like AllMS, New Delhi and MedantaGurugram, so in absence of specific role, specific condition of every time treatment given by every doctor and in absence of the scientific opinion of medical board no complaint of medical negligence is maintainable. Thus, the present Complaint seems to be misconceived, malicious and malafide in nature to extract money from the answering respondent. The Complainant had no cause of action and locus standi to file the present complaint against the answering respondent, since a bare perusal of the documents filed and relied upon by the complainant reveals that the husband of complainant never remain admitted under or treated by Dr. S.S. Bansal at any point of time, so the answering respondent who had issued Professional Indemnity-Doctors Policy 272400/48/2020/270 valid from 07-04-2019 to 06-04-2020 in the name of Dr. S.S. Bansal, was not liable to pay any amount to the complainant, if any passed.It is submitted that as per documents filed the complainant, husband of complainant was admitted on 20-09-2019 in Metro Hospital,Faridabad being suffering from lung infection he was treated by Dr. PankajChhabra being respiratory consultant not by Dr. S.S. Bansal who was Cardiologist. Even otherwise answering respondent had issued Professional Indemnity-Doctors Policy this policy did not cover indemnity for any fault, ignorance or liability arising out of managing affair of hospital. The complaint was bad for misjoinder of party, since the husband of complainant never remain admitted under or treated by Dr. S.S. Bansal at any point of time, so the answering respondent who has issued Professional Indemnity Policy in the name of Dr. S.S. Bansal, was unnecessary party and its name was liable to be deleted. It was submitted that at the time of admission patient was having complaint of fever, shortness of breath and cough since 15-20 days, shivering and dry cough since 20 days which are known symptoms of pneumonia in terms of medical terminology. It was well settled medical preposition that Hospital acquired infections (nosocomial infections) were acquired in healthcare setting by patients admitted for reasons unrelated to the infection or not previously infected when admitted, whereas in the present case the patient was well known case of pneumonia, even at the time of his admission. Opposite party No.5 denied rest of the allegations leveled in the complaint and prayed for dismissal of the complaint.
8. Opposite party No.6 put in appearance through counsel and filed written statement wherein Opposite party No.6 refuted claim of the complainant and submitted that the complainant was a case of alleged negligence against the remaining opposite parties and the answering opposite party No.6 vide the policy No. 4021/A/210071964/0/000 for the period 19.11.2020 to 18.11.2021 had entered into insurance contract with the opposite party NO.2 i.e. dr. Pankaj Chhabra, Pummoologist at Metro Heat Institute with Multispecialty, sector-16A, Faridabad (NCR) – 121002 was only liable to indemnify as per the certain terms and conditions of the said contract. It was imperative to mention herein that there was no ground to implead answering opposite party NO.6 as a proper
or necessary party in the present complaint. The complainant in the present case had prayed for compensation and damages to the tune of INR 98,00,000/- on account of loss of life of the husband of the complainant coupled with mental tension, agony and financial loss suffered by the complainant. It was most humbly submitted that, without prejudice to the rights of answering opposite party NO.6 under the Policy and under the law, under Part II of the Schedule of the Policy clause 3 “exclusions”, it was stated that:
“This policy shall not indemnify the insured against any claim arising out of or in respect of:
xi) all personal injury suits for grounds such as libel, slander, false arrest, wrongful conviction, wrongful detention, defamation, etc. and mental injury, anguish or shock resulting therefrom.”
As per the terms and conditions of the policy the liability if any arises should be limited to as mentioned in Part I of the schedule i.e Rs.50,00,000/- subject to compulsory excess (each and every claim) i.e. 0.25% of the claim amount subject ot minimum of Rs.12,500. The insured/opposite party No.2 had only intimated the answering opposite party No.6 by vide the letter dated 27.01.2021, the basis of assessment of the claim shall be as only per the terms and conditions of the policy which would be valuated once the insured approaches the answering opposite party No.6 for indemnification alongwith required documents. In the present case, the liability of opposite party No.6 would be based on the contractual agreement with opposite party No.2. It was humbly submitted that unlike cases of statutory liability such as third party motor insurance, the liability of opposite party No.6 was purely contractual in nature. The policy clearly states that the oppositeparty NO.2 would be ‘Indemnified” in respect of the claims. Hence, in order for the policy to be invoked, payment by the policyholder as per the order/judgement of the Hon’ble commission was necessary and thereupon, the insurer would indemnify the insured in accordance with the terms and conditions of the policy. Opposite party No.6 denied rest of the allegations leveled in the complaint and prayed for the dismissal of the complaint.
9. Opposite party No.7 put in appearance through counsel and filed written statement wherein Opposite party No.7 refuted claim of the complainant and submitted that the present complaint was not maintainable in its present form as per the settled law of land. Since as of now there was no definite opinion of Medical Board establishing omission or negligence in professional service by respondent No.2 which was the basic and foremost mandatory requirement under the law as propounded by Hon'ble Supreme Court. Apart from that There was nothing in the form of documentary evidence to support the alleged allegations pointing medical negligence upon the respondent No.2 (Dr. PankajChhabra) insured with the answering respondent, therefore the proceedings initiated by the complainant against the answering respondent werenonest, null, void and without jurisdiction, hence the complaint deserve dismissal in limine with cost. It was submitted that the husband of complainant was treated by various doctors of various hospitals for number of days like AIIMS, New Delhi and Medanta Gurugram, so in absence of specific role, specific condition of every time treatment given by every doctor and in absence of the scientific opinion of medical board no complaint of medical negligence was maintainable. Thus, the present Complaint seems to be misconceived, malicious and malafide in nature to extract money from the answering respondent. The complainant had got no locus standi to institute the present complaint against the answering respondent, because a bare perusal of the complaint, annexed documents and Professional Indemnity Doctors Policy No. 272200/48/2019/14102 issued by the answering respondent having period of insurance from 19-11-18 to 18-11-2019 covering aggregate risk for the entire policy period of Rs. 50,00,000/- reveals that as per complaint, the husband of complainant has taken treatment from respondent No.1 (Metro Heart Institute with Multispeciality, Sector-16A, Faridabad) through consultant respondent No.2 Dr. PankajChhabra, whereas under the above captioned insurance policy the covered location was not respondent No.1 (Metro Heart Institute with Multispeciality, Sector-16A, Faridabad) It was further submitted that the answering respondent was not liable to indemnify or pay any compensation if any found payable due to violation of the conditions of the policy on the part of insured such as :
Clause 8.1.
"The insured shall give written notice to the Company as soon as reasonably practicable of any claim made against the insured (or any specific event or circumstances that may give rise to a claim being made against the insured) and which forms the subject of indemnity under this policy and shall give all such additional information as the Co. may require. Every claim, writ, summons or process and all documents relating to the event shall be forwarded to the company immediately they are received by the insured."
Clause 8.5.
"The insured shall give notice as soon as reasonably practicable of any fact, event or circumstance which materially changes the information supplied to the Company at the time when this policy was effected and the Company may amend the terms of this policy."
Since the insured Dr. PankajChhabra did not bother to intimate the answering respondentabout the present case and forward relevant documents, hence he had violated the above statedfundamental terms and condition of the insurance policy and due to non compliance of these condition, the insured had lost the right of indemnification under the present policy and no liability forindemnification or direct payment can be fastened upon the answering respondent. It was submitted that as per documents filed by the complainant, husband of complainant was admitted on 20-09-2019 in Metro Hospital, Faridabad being suffering from lung infection he was treated by Dr. Pankaj Chhabra being respiratory consultant in respondent No.1 hospital. Even otherwise answering respondent had issued Professional Indemnity-Doctors Policy this policy does not cover indemnity for any fault, ignorance or liability arising out of managing affair of hospital. It is settled law that "HOSPITAL COULD NOT CLAIM TO BE INDEMNIFIED BY THE INSURER UNDER POLICY OBTAINED BY DOCTOR." The present complaint was misconceived and deserve dismissal since as per documents filed by the complainant at the time of admission patient was having complaint of fever, shortness of breath and cough since 15-20 days, shivering and dry cough since 20 days which were known symptoms of pneumonia in terms of medical terminology. It was well settled medical preposition that Hospital acquired infections (nosocomial infections)were acquired in healthcare setting by patients admitted for reasons unrelated to the infection or not previously infected when admitted, whereas in the present case the patient was well known case of pneumonia, even at the time of his admission. Opposite party No.7 denied rest of the allegations leveled in the complaint and prayed for dismissal of the complaint.
10. The parties led evidence in support of their respective versions.
11. We have heard learned counsel for the parties and have gone through the record on the file.
12. In this case the complaint was filed by the complainant against opposite parties– Metro Heart Institute with the prayer to: a) pay compensation and damages to the tune of Rs.98,00,000/- on account of loss of life of the husband of the complainant coupled with mental agony and financial loss suffered by the complainant, to the complainant alongwith pendentlite interest @ 18% p.a. b) pay Rs. 1,00,,000 /-as litigation expenses.
To establish his case the complainant has led in his evidence, Ex.CW1/A – affidavit of Indra Rani,Ex.C1 – X-Ray Chest P.A.View, Ex.C-2 Discharge summary, Ex.C-3 – wordsapp message,, Ex.C-4 – photograph of X-Ray film, Ex.C-5 – X-ray film dated 27.09.2019, Ex.C-6(colly) – other reports. Ex.C-7 – discharge summary alongwith other reports documents, Ex.C-8 Adult In Patient Initial assessment Record, Ex.C-9 – Progress sheet, Ex.C-10 – Report of All India Institute of Medical Science,
On the other hand counsel for the opposite party No.1strongly
agitated and opposed. As per the evidence of the opposite party No.1 Ex.DW1/A – affidavit of Dr. Vishal Sharma, General Manager, Operations/authorized Signatory/Representative, Metro Heart Institute with Multispecialty, Sector-16A, Faridabad. Ex.D1 – Enquiry report,,Ex.D2 – letter No.23 dated 11.11.2020, Ex.D-3 – letter dated 07.10.2020, Ex.D4 – letter dated 03.07.2021,,, Ex.D5 – letter dated 21.12.2020, Annx.R-1/1 – Admission f
orm, Annx.R-1/1 – Discharge summary, & other documents,, Annx.R-1/2 – LAMA summary.
Opposite party No.2 has led in his evidence Ex.RW-2/A – affidavit of dr. Pankaj Chabra, Pulmonologist, metro hart Institute with Multispecialty, Sector-16A, Faridabad . Annexure 2/1 – photocopies of academic and professional qualifications and registration certificates of Dr. PankajChhabra, Annexure R-2/2 – Professional Indemnity for doctor and Medical Practioners,, Annexure R-2/3 – Declaration form, Annexue-2/4 – Discharge summary alongwith other documents.
Opposite party No.3 had led in his evidence Ex.RW2/A – affidavit of Dr. S.S.Bansal, Managing Director, M/s. SSB Heart and Multi specialty Hospital, Plot NO. 69, sector-20A, near Neelam flyover, Faridabad, Ex.r-1 – letter dated 22.12.2020, ex.R-2 – insurance policy for the period 07.04.2019 to 06.04.2020.
Opposite party No.4 has led in his evidence, affidavit of Shri Shyama Charan Vats (Legal) M/s. Bajaj Allianz General Insurance Company ltd., Block-4, 7th floor, DLF, tower-15, ShivajiMarg, New Delhi, Ex.O-4/A – Transcript of proposal for professional indemnity insurance policy, Ex.O-4/B - Professional Indemnity Insurance Policy Schedule.
Opposite parties Nos.5 & 7 have led in his evidence, affidavit of Shri Ramesh Kumar, Sr. Divn. Manager , the Oriental Insurance co. Ltd., NIT, Faridabad, Ex.R7/1 – Professional Indemnity – doctors Policy schedule, Ex.R-7/2 - Proposal form for doctors and medical practitioners.
Opposite party No.6 has led in his evidence, affidavit of Shri Deepak Bansal, Manager (Leal), M/s. ICICI Lombard General Insurance co. Ltd., 4th floor, Red Fort, Capital Parsvnath tower, Bhai Veer Singh Marg, Gole Market, New Delhi, Ex.RX – Professional Inde
mity Policy for doctor and Medical Practitioner,
13. In this case, the patient suffered from acute pneumonia as is made out from the written statement. This fact must have necessitated X ray Chest at the time of admission and a X-ray chest at the time of discharge. But no such document has been placed on record by the Metro Hospital.
The perusal of the documents i.e. the discharge summary Ex.C-2 would show that there is no mention of disease 'pneumonia' in the discharge summary. In fact the report dated 26.09.2019 suggests that the patient was being discharged in a 'stable condition'. Condition of pneumonia is too grave to be missed out by a Corporate Superspeciality Hospital either at the time of admission of the patient or at the time of his discharge.
14. It may be noted here that the Metro Hospital, Faridabad withheld the X-ray film and X-ray report of the patient at the time of his admission and at the time of his discharge. The only plausible inference would be that the patient had no pneumonia condition at the time of his admission and the X-ray showed his lungs clear.
15. The patient was discharged from the Metro Hospital, Faridabad on 26.09.2019 at 02.00 pm. As per the petitioner, his condition worsened within few hours of the discharge, which fact prompted the family members of the patient to make an attempt to contact the attending doctor and Dr. Bansal but neither of them responded to their repeated calls. The patient was immediately rushed to emergency of Metro Hospital but neither the attending doctor nor Dr. Bansal cared to visit the emergency or passed on some instructions to the duty doctor in the emergency. Resultantly, the patient was rushed to Medanta Hospital, Gurugram, where he was admitted at 02.00 am mediacity pneumonia at the on 27.09.2019. The medical record of time of admission showed acute
16. It is evident from the evidence available on record and referred to above that the patient was admitted to Medanta Hospital, Gurugram within hours of his discharge from Metro Hospital. Those X-ray films and reports are available, which clearly go to show that both the lungs of the patient had turned hazy meaning thereby the patient had been pushed into serious problem of pneumonia long ago during his stay at Metro Hospital, Faridabad. This condition developed between the time of his admission at Metro Hospital, Faridabad and before he was admitted for his treatment at Medanta Hospital, Gurugram. Since Senior Resident Doctor of All India Institute of Medical Sciences very specifically reported that it was 'hospital acquired pneumonia', it could not have been contacted by the patient within few hours at his residence after his discharge on 26.09.2019. All this evidence would leave no manner of doubt that the patient contacted the lung infection during the course of his hospitalization at Metro Hospital, Faridabad between 20.09.2019 to 26.09.2019 which ultimately caused his death in All India Institute of Medical Sciences on 16.10.2019.
17. Suffice here to say that the report of All India Institute of Medical Sciences Ex. C-10 leaves no manner of doubt that the patient had acquired hospital induced pneumonia during the course of his treatment in Metro Hospital, Faridabad between 20.09.2019 to 26.09.2019. There is overwhelming evidence available on record specially the record maintained by Metro Hospital, Faridabad and the discharge summary prepared by the attending Palmonologist of that hospital that the patient did not suffer from the disease called pneumonia at the time of his admission. The statement of the petitioner witnesses that the patient did not suffer from pneumonia at the time of his admission receives corroboration from the above records. Since the Metro Hospital, Faridabad has withheld the first X-ray film, inference shall be drawn that X-ray films, if placed on record would have favoured the case of petitioner that the film and the report did not show and mention pneumonia or acute lung infection. No other X-ray film or report taken and prepared during the course of treatment at Metro Hospital, Faridabad has been relied upon by the hospital. The petitioner had moved an application for supply of those documents but the hospital washed off its hands by reporting that such records were not available with them. Needless here to say that all these records are always maintained by the hospital even after the discharge of the patient and are never destroyed which such haste. The all important evidence was thus deliberately and clandestinely withheld by the hospital because it went against its own pleaded case and favoured the case of the claimant.
18. Much emphasis has been put by the respondent on the report of the Medical Board, which absolves it of its responsibility. There are number of reasons to reject the report outright. The report cannot rule out the findings of All India Institute of Medical Sciences, Delhi that the patient died as a result of 'hospital acquired pneumonia'. Secondly, the report does not pin-point the manner and the place where the patient may have contacted the total infection. It is not clear that as to how the Board of doctors arrived at the conclusion that there is no negligence on the part of Metro Hospital, Faridabad without pursuing the chest X-ray and the report at the time of admission and during the treatment. Moreover, such report is useful only for initiating criminal proceedings against the hospital and cannot be considered for taking into account the tortious liability. The report thus does not support the case of Metro Hospital, Faridabad in any manner, whatsoever, in the face of
Overwhelming evidence available on record that the fatal condition developed because of the infection contacted by the patient during his stay at Metro Hospital, Faridabad and no-where else.
19. In this complaint, the complaint was filed with the prayer to pay compensation and damages to the tune of Rs.98,00,000/- on account of loss of life of the husband of the complainant coupled with mental agony and financial loss suffered by the complainant, to the complainant alongwith pendentlite interest @ 18% p.a. All the parties were given the written submissions and their evidences.
20. As per the allegations of the complainant, the main crux of the case is that the death of Shri Kanwar H.M.Singh was due to infection acquired
from the hospital and thrre is negligence on the part of the treating doctor and CEO of opposite party No.3. As per the evidence the complainant has failed to establish her case qua the opposite party No.3. As per the evidence, Dr. S.S.Bansal is the CEO/M.D only of the concerned hospital. There is no negligence on the part of opposite party No.3. On the other hand, opposite party No.1 is the hospital. As per Ex.C10, doctors of All India Institutes of Medical Sciences, Delhi has given their opinion that the infection acquired from the hospital. Although the medical board has given their opinion against the complainant but they never joined the complainant as per her allegations and no notice was given to the complainant for joining the medical proceedings. As per Ex.C10, the doctor of the AIIMS mentioned and on the basis of the documents that the patient admitted in the hospital i.e opposite party No.1 (20-26.9.2019). As per the allegations of the complainant about the pneumonia part which shows the negligence of the treating doctor. As per the evidence of the complainant, the Commission is of the opinion that there is infection acquired from the hospital; i.e opposite party No.1. There is negligence of the treating doctor Shri Pankjaj Chhabra i.e. opposite party No.2. There is no negligence on the part of opposite party No.3.
21. Thus, keeping in view the above discussions and evidence on record, preponderance of probability and inferences, the Commission hold that the complainant has been able to prove her case and deficiency in service and medical negligence against opposite parties Nos. 1 & 2 and proved that due to the said negligence the patient has to suffered more hospitalization, medical expenses and ultimately his life could not be saved.
22. In this case, the report of AIIMS a National Level Medical Institute, would super cede the medical report of the medical board of the district level hospital and this summary – report of AIIMS (Annexure C-10) proved that “the outside hospital i.e. Metro Hospital acquired Pneumonia” during the treatment which ultimately resulted to cause of death of the patient.
Human life is most precious and it cannot be measured by money. It is extremely difficult to decide the quantum of the compensation in the medical negligence cases, as the quantum is highly subjective in nature. Hence, in the interest of natural justice, the complaint is allowed against opposite parties Nos.1 & 2.
23. Opposite party No.1 i.e. Metro Heart Institute with Multispecialty who was insured with opposite party No.4 is directed to pay Rs.34,75,000/- (Rs. Thirty Four
Lacs Seventy five thousand only) as compensation to the complainant. Opposite party No.2 i.e. Dr. Pankaj Chhabra, Pulmonologist who was insured with opposite party NO.6 i.e. ICICI Lombard General Insurance Company Limited is directed to pay Rs.14,75,000/- (Rs. Fourteen Lacs Seventy five thousand only) as compensation to the complainant. It is further directed to opposite parties Nos.1 & 2, jointly & severally, pay Rs.25,000/- (Rs. Twenty Five Thousand only) as compensation for causing mental agony & harassment alognwith Rs.25,000/- (Rs. Twenty Five Thousand only) as litigation expenses to the complainant. Compliance of this order be made within 30 days from the date of receipt of copy of order. Copy of this order be given to the parties concerned free of costs and file be consigned to record room.
Announced on: 13.4.2023 (Amit Arora)
President
District Consumer Disputes
Redressal Commission, Faridabad.
(Mukesh Sharma)
Member
District Consumer Disputes
Redressal Commission, Faridabad.
(Indira Bhadana)
Member
District Consumer Disputes
Redressal Commission, Faridabad.
