BEFORE THE A.P STATE CONSUMER DISPUTES REDRESSAL COMMISSION AT HYDERABAD.
F.A.No.11/2009 against C.C.No.12/2005, District Forum, Khammam.
Between:
1. Dr.V.Venkateswarlu,
Govt. Hospital, Sathupally,
C/o.Dr.Lalitha Kumari, M.D.,
Near Bus Stand,
Sathupalli, Khammam District. Appellant/
Opp.party No.3
And
1. Adapa Kumaraiah, S/o.Venkata Narasaiah,
2. Adapa Rajamma, W/o.Adapa Kumaraiah.
Both are residents of Mandalapalli (V)
Dammapet (M), Khammam Dist., Respondents/
Complainants
3. Dr.K.Sambasiva Rao,
Present address:Prinary Health Centre,
Burghampadu.
4. Dr.Raju, Govt. Hospital,
Guduru, Chittoor Dist.,
5. Dr.Srinivasa Rao,
Govt. Head Quarters Hopsital, Khammam.
6. Sup[erintendent of Govt. Hospital, Khammam.
7. District Collector, Khammam.
Respondents/
Opp.parties 1, 2, 4 to 6.
Counsel for the Appellant: Mr.M.Hari Babu.
Counsel for the Respondents: Mr.P.Narasimha Rao
R1 appeared in person.
QUORUM: THE HON’BLE SRI JUSTICE D.APPA RAO, PRESIDENT AND
SMT.M.SHREESHA, MEMBER
.
FRIDAY, THE THIRTIETH DAY OF JULY,
TWO THOUSAND TEN
(Typed to the dictation of Smt.M.Shreesha, Hon’ble Member.)
***
Aggrieved by the order in C.D.No.12/2005 on the file of District Forum, Khammam, opposite party No.3 preferred this appeal.
The brief facts as set out in the complaint are that the complainant’s son was taken to Primary Health Care Centre of opposite party No.1 on 28-8-2003 since the complainant’s son was suffering from fever. Opposite parties 1 and 2 examined the patient and prescribed some medicines but thereafter the patient suffered from throat pain and stomach pain and was again was taken to opposite party No.1 hospital. Opposite party No.1 advised the complainant to take their son to Government Hospital, Sattupalli as they are having some urgent work in Bhadrachalam. The complainant submits that without examining the patient, they had advised him to take his son to opposite party No.3 hospital who was working there on contract basis. Opposite party no.3 examined the patient at his wife’s clinic and advised the complainants to take the patient to Government Hospital, Khammam. On the same day, the complainants brought the patient to Government hospital, Khammam and got him admitted there. The complainant submit that they repeatedly requested opposite party No.4 to treat the patient but opposite party no.4 bluntly refused stating that he cannot treat free of cost and only because timely treatment was not provided to the patient, he collapsed in the hospital itself on 30-8-2003 and the complainant narrated this incident to the District Collector who ordered suspension of opposite party no.4 doctor and directed the police to register a complaint against opposite party No.4. The complainants contend that it is only because of the negligence of opposite parties 1 to 4, that they lost their only son and bread earner. Hence the complaint seeking direction to the opposite parties to pay Rs.5,00,000/- which includes medical expenses, compensation and costs.
Opposite parties 1 and 2 filed their written version contending that on 29-8-2003 at 10.00 A.M. the complainants brought their son to PHC with high fever and pain in the throat and abdomen. Opposite parties 1 and 2 examined the patient and gave him IV lifeline with ringer lactate, Cifron IV, Paracitimol injection Diclofenace, Tab.Domstal, Inj. Ecodran and Inj. Ranidine. As his condition was deteriorating and there were no equipment and investigation facilities in PHC, Dammapet, they advised the complainant to take the patient to Government hospital Sattupalli and submit that there is no negligence on their behalf.
Opposite party No.3 filed counter stating that the patient was suffering from infective polyneurotis which is called Gullian Bary Syndrome and he required ventilatory support and since such facility is not available, opposite party No.3 advised the complainants to take their son to Government Hospital, khammam and even gave first aid, preliminary treatment and also a referral letter and even arranged an ambulance and sent them to Government Hospital, Khammam. He submits that he attended the patient and administered IV fluid oxygenation and there is no negligence on his behalf.
Opposite party no.4 submits that the patient was brought to Government Hospital, Khammam on a reference from opposite party No.3 on 29-8-2003 at 7.45 p.m. and that his condition was poor and he was in a semi conscious state. He was admitted by Dr.Rafia, the Causality Medical Officer, who gave antibiotics and IV fluids and shifted the patient to acute Medical Care Ward and also informed the physician, Dr.Chandra Prakash, who attended to the patient at 8.20 P.M. Opposite party no.4 made rounds at 8.20 p.m. 9.00 p.m 10.20 p.m 12.00 might and 8.00 a.m. On 30-8-2003, he had attended the entire 9 wards in the hospital and also the special rooms and he was relieved at 9.00 a.m. and he gave charge to Dr.Usha. He strictly followed the instructions of the physician as he is only a duty medical officer and took all care and precaution and there is no deficiency in service on his behalf.
Opposite parties 5 and 6 did not choose to file any counter.
The District Forum based on the evidence adduced, i.e. the depositions of P.W.1, R.W.1 and R.W.2 and exhibits A1 to A5 and B1 to B5, allowed the complaint directing opposite parties 1 to 6 to pay an amount of Rs.4,00,000/- with interest at 9% p.a. from the date of filing of the complaint till the date of realization together with costs of Rs.10,000/-.
Aggrieved by the said order, opposite party No.3 preferred this appeal.
Heard the counsel for the appellant and also the party in person representing R1 and R2.
It is the complainant’s case that his son, Ramakrishna, who was studying 5th class was suffering from fever and he took him to opposite party No.1 PHC where opposite parties 1 and 2 were working as doctors and gave the patient three types of medicines. But the patient’s condition did not improve and he suffered with severe throat pain and stomach pain. Again on 29-8-2003 they took the patient to the same hospital but opposite parties 1 and 2 recklessly prescribed some medicines and thereafter advised them to take the patient to Government hospital, Sattupalli since there were going on a trip to Bhadrachalam. The complainants brought the patient to opposite party No.3 at Sattupalli who examined the patient at his wife’s clinic and advised them to take the patient to Government hospital, Khammam and arranged an ambulance and also gave them a referral letter. It is the case of the complainants that opposite party No.3 being a Government doctor has neglected to discharge his duties in the hospital and instead was doing private practice at his wife’s clinic. They reached Khammam hospital at 7.30 p.m. on the same day i.e. 29-8-2003 but no treatment was given except for giving the patient oxygen.
Opposite party No.4 filed his chief affidavit as R.W.1 and in his deposition submitted that as per the post mortem report, the patient died due to acute Broncho Pneumonia and to know the said disease blood culture is necessary. He further admits the blood culture of the patient was not prescribed since they have to wait for 48-72 hours to get the report. He only followed the treatment prescribed by Dr.Chandra Prakash who suspected Gullian Bary Syndrome, i.e. infection to all the nerves and R.W.1 i.e. opposite party No.4 also deposed that he advised the patient’s mother to take him to Osmania General Hospital for better treatment. He denied that though the patient was critical, he treated him in a very casual manner and he submits that he only followed the instructions of the physician, who was examined as R.W.2. R.W.2 i.e. Dr.Chandra Prakash deposed that the patient was suffering from Gullian Bary Syndrome and he was in a serious condition and that he advised the complainants to shift the patient to Osmania General Hospital or to MGM hospital, Warangal. He also admits that at the time when the patient died in the hospital, the District Collector was presiding over a meeting and he visited the hospital and found the dead body of the patient and ordered suspension of the duty doctor. R.W.2 admits that patient of this nature is generally treated by a Neurophysician.
A perusal of Ex.A2, post mortem report, evidences that the patient Ramakrishna died due to acute encephalitis and acute Bronco Pneumonia. Ex.A4 is the letter of Superintendent addressed to the police enclosing enquiry report as per the direction of the District Collector and as per Ex.B4 which is the actual enquiry report wherein the Enquiry officers concluded that ventilator support was not given though it is available in acute medical care unit and the input and output charts were not maintained. Based on this report, it is clear that the patient required ventilator support because of which opposite party No.3 had referred him and even organized an ambulance and sent him to opposite party No.4, opposite party No.4 hospital authorities did not take proper precautions by putting the patient on the ventilator. The conclusions of Ex.B4 is evidenced as under:
1. Patient Mr.A.Rama Krishna, S/o.Komariah, R/o.Mandalapalli was brought to the hospital in a critical condition and he was kept in AMC and treated to their capacity.
2. Only certain investigations like Widal test, TC, DC, ESR, HB
3. Other investigations like Blood Urea, Serum Creatinin, X-ray chest, blood for malarial parasites were not done though they have written in the case sheet.
4. Ventilatory support was not given though it is available in this AMC.
5. Input and Output chart was not maintained, CBD (Continous Bladder Drainage) was not done.
6. They have not instructed any attendant to shift the patient to any private hospital but instructed to shift the case to Osmania General Hospital, Hyderabad/MGM Warangal for better management.
7. They have not demanded money from the patient or attendants.
Though they have opined that there is no gross negligence on the part of the doctors and the staff, the committee has observed that they are certain minor lacunae, especially a trained staff and qualified nurse not being present to operate the ventilator.
It is pertinent to note that in the entire enquiry report, appellant/opposite party No.3 does not figure in the proceedings nor did the complainant establish that the line of treatment followed by appellant/opposite party no.3 is wrong or not according to standards of medical parlance. We find force in the contention of the learned counsel for the appellant/opposite party no.3 wherein he stated that the duty hours of opposite party No.3 at Government hospital, Sattupalli are from 8 to 12 and evening 4 to 8 and that he treated the patient with care and caution and seeing the seriousness of the disease advised the complainants to take the patient to Government hospital, Khammam for better management. The contention of the respondent/complainant that the treatment rendered by appellant/opposite party No.3 is negligent, is unsustainable firstly since the patient was hardly present at the hospital for a few hours and secondly since it is an admitted fact that the appellant/opposite party No.3 himself organized an ambulance and also gave the referral letter and correctly advised the patient to go to Government hospital, Khammam for better management. Even in the enquiry report in which the appellant does not figure, the committee concluded that the patient required ventilatory support which was not available in the appellant’s hospital because of which he advised them to go to Government hospital, Khammam where ventilatory support was available. The cause of death as mentioned in the post mortem report, Ex.A2 is Broncho Pneumonia for which the experts have concluded that ventilatory support is absolutely necessary. In Bolam v. Friern Hospital Management Committee, WLR at p.586 it is held 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 a Clapham omnibus, because he has not got this special skill. The test is the standard of the ordinary skilled man exercising and professing to have that special skill. A man need not possess the highest expert skill….It is well established law that it is sufficient if he exercises the ordinary skill of an ordinary competent man exercising that particular art”
Keeping in view the aforementioned reasons that the opposite party No.3 acted as per standards of normal medical practice and taken proper care and caution in treating the patient, and the judgement of the apex court, we conclude that there is no negligence on behalf of appellant/opposite party no.3.
In the result this appeal is allowed and the order of the District Forum is set aside with respect to appellant/opposite party No.3 only and the rest of the order of the District Forum stands confirmed. Time for compliance four weeks.
Sd/-PRESIDENT.
Sd/-MEMBER.
JM Dt.30-7-2010
