Tamil Nadu

South Chennai

CC/278/2016

R.Vijayakumari - Complainant(s)

Versus

M/s.Fortis Malar Hospital, - Opp.Party(s)

S.Arokiyamani Raj, Prakash

01 Aug 2022

ORDER

Date of Complaint Filed:21.06.2016

Date of Reservation     :07.07.2022

Date of Order              :01.08.2022

 

DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION,

CHENNAI (SOUTH), CHENNAI-3.

 

PRESENT:    TMT. B. JIJAA, M.L.,                                           : PRESIDENT

                       THIRU. T.R. SIVAKUMHAR, B.A., B.L.,           :  MEMBER  I 

                       THIRU. S. NANDAGOPALAN., B.Sc., MBA.,   : MEMBER II

 

CONSUMER COMPLAINT No.278/2016

MONDAY, THE 1^st DAY OF AUGUST 2022

Mrs. R. Vijayakumari,

Wife of Rajkumar,

No.9/5, Bazzar Street,

Royapuram, Chennai- 600 013.                                     …Complainant

 

-Vs-

M/s. Fortis Malar Hospital,

Rep. by its Managing Director,

52, 1^st Main Road,

Gandhi Nagar,

Adyar, Chennai – 20.                                                   …Opposite Party

 

******

Counsel for the Complainant          :M/s.S. Arokiamaniraj

Counsel for the Opposite Party       :M/s.R. Parthasarathy

 

        On perusal of records and after having treated the Written Argument of the Complainant as oral arguments and on hearing the oral arguments of the iCounsel for Opposite Party, we delivered the following:

 

ORDER

Pronounced by the President Tmt. B. Jijaa, M.L.,

1.      The Complainant has filed this complaij-Clexane, T-Deplatt. The Complainant’s husband was under ventilatory support with respiratory rate, BP, temperature and other vital signs were monitored and accordingly medicated on 07.06.2015 followed by a trial extubation as per Exs.B-30 to 35, Investigation Flow Chart (Pg.183 to 188), Ultra Sound Chest (Pg.279 – 280), Echo Cardiogram Report (Pg.281 to 282), Doppler Study of Upper Left Limb Arteries (Bedside Screening) (Pg.283). On 08.06.2015, the Doctors of Opposite Party made trial extubation with weaning protocol from controlled mode of ventilation on the same date at 10.00 am, after a thorough suctioning, the Complainant’s husband was extubated gradually and the condition of the patient was said to be improved, (Pg.61 to 63).  In the meantime, the Complainant’s husband’s X-ray was taken and it revealed that the lung fields showed normal broncho-vascular markings, both the pulmonary hila were normal in size, the costphrenic and cardiophrenic recesses and the domes of diaphragm were normal, the bones and soft tissues of the chest wall showed no abnormality. According to the Opposite Party due to the continuous efforts taken by the Opposite Party and its Doctors the Complainant’s husband showed quick and remarkable improvement from the condition that he was brought into the Opposite party’s Hospital and was comfortable and mobilized to a chair. His vitals showed normal readings i.e., Pulse; 80 p-min, BP ; 140/60 SPO2; 100%, Incentive Spirometry. The Complainant’s husband was given OC Enema stat, Ipravent, levolin, T.Lanoxin, T.Dytor, Syr.Duphalec, Sachet Econorm, Inj.Clexane, T.T-back L/A, L.Abiphyline SR. On 09.06.2015, the Complainant’s husband was conscious, afebrile under continuous cardiac monitoring and the medicines were continued as per drug charts.

On 10.06.2015, the Complainant’s husband was on continuous cardiac monitoring and it was found that his respiratory rate was low and he was reintubated on the same day electively, following difficulty in breathing and he was connected to Ventilator. Since the Complainant’s husband had a failed extubation trial considering his OSA-HS and recurrent pneumonia, he was taken up after obtaining Informed High Risk Consent for Trachestomy on 11.06.2015 and the Doctors of Opposite Party decided to perform Trachestomy as per Exs.B-16 to B-19 - Daily Nursing Flow Sheet (Pg.126-133), Peri-Operative Booklet(Multispeciality)(Pg.134-137), Theatre Record, Pre Operative Order Sheet, Recovery Records, (Pg.No.138 to 149), Nurses Notes (Pg.150-153)

The Opposite Party had obtained the Informed Consent for General Surgical Procedures (Pg.120 to 121), Informed Consent for High Risk(Pg.122-123) as per Exs.B-13 and B-14. The size of trachestomy tube is always decided by ENT Surgeon based on the size of patient’s endotracheal tube. According to the Opposite Party the ENT Surgeon inserted number 8 cuffed trachestomy tubes surgically in the Operation Theatre and the Complainant’s husband  continued in the ICU for 4 days followed by Trachestomy. The Trachestomy tube change was made by the Senior Consultant, ENT Surgeon with due Homeostatis and there was no bleeding, to endanger the Complainant’s husband’s life and proper medication was given by team of Doctors of Opposite Party Hospital.  The Complainant’s husband’s Blood Culture and Pus Culture reports were normal and his glucose was under control on 14.06.2015. Thereafter, on 15.06.2015, after stabilization of his condition the Complainant’s husband was transferred to private room with trachestomy in-situ on intermittent Bipap ventilation. On 16.06.2015, the Complainant’s husband had difficulty in breathing in his private room and the ENT Surgeon reviewed the patient in his room and diagnosed with a trachestomy tube block and it was decided to change the tube in view of persistent desaturation. It was contended that the change of tube was done in his private room as a life saving measure with all aseptic precautions, with the supervision of the ENT Surgeon and not in the general ward in front of other patients as alleged in the complaint and was shifted to ICU immediately and the Complainant’s husband was monitored closely by medical and para medical staff at the time of tube change. Bronchoscopy was done and BAL sample was sent to lab for culture. The Complainant’s husband’s sugar level was checked and he was monitored for low urine output and hence appropriate treatment was given. The patient’s TC, DC Bun, Creatine were sent to lab as found in Exs.B-20 to Ex.B-23 in house Transfer Summary (Pg.154-159), Nutritional Care Plan (Pg.160 to 162), (Pg.163-164), Intensive Care Unit Transfer out Summary (Pg.165 to 168), Medical Administration Record (Pg.113 to 116) as found in Ex.B-7.

On 17.06.2015, the Complainant’s husband was conscious oriented under mechanical ventilator and his vitals were stable,  HR – 72, SPO2-100%, his urine output was adequate, chest X-ray revealed diffused fluffy opscities in bilateral lung fields – pulmonary edema was recorded and medicated with Inj Colistin 2 mg, Inj Levolin 2.5 mg, Neb-levolin-1rbp, Inj-lasix 20 mg. The Complainant’s husband was stable and was under ventilator support. On 18.06.2015, the Complainant’s husband was conscious and responded to oral commands and he was in full support of mechanical ventilation with V/A Ventilation/Perfusion Mismatch) and his Chest X-ray revealed Pulmonary edema.  Medicines were given and he was also given oral suctioning by the Opposite Party Hospital. On 19.06.2015, the Complainant’s husband was having fluctuating consciousness and was on continuous cardiac monitor, support drugs were given as per Doctor’s advice. On 20.06.2015, the Complainant’s husband’s vitals were monitored under cardiac monitor and he did not obey to oral commands and his BP read 90/40mmhg, 76/38 mmHg. Hemodynamic monitoring of deteriorating Haemo dynamic Parameters were recorded by the Doctors. He was prescribed T.Eltroxin, Neb Flohale, Neb Mucomix, T.Bosentan, T.Lanoxin, Syp.Dvphalac, Oint T Bact, Inj Clexane, T.PanDsr, Inj Imipenem, Inj Colistin, Neb Levolin.

Whileso, the Complainant, wanted to continue the treatment in another Hospital and hence the Opposite Party had discharged the patient against medical advice on 22.06.2015 from the Intensive Care Unit. The Complainant’s husband was thereafter shifted to Kaveri Hospital, where he was treated for a few hours before his unfortunate death. The death certificate, Ex.A-2 issued by Kaveri Hospital reflects that the cause of death was due to “Septic Shock, Acute Respiratory Distress Syndrom, Community Acquired Pneumonia, Post Tracheostomy, Systemic Hypertension, Diabetes Mellitus, Hypothyrodism, Morbid Obesity, Obstructive Sleep Apnoea” and hence the allegation of the Complainant that her husband was dead due to the wrong treatment of fixing the tube is not sustained.

Even at the time of  admission into the Opposite Party’s Hospital the condition of the Complainant’s husband was critical. He was continuously monitored and treatment was given by a team of specialized doctors, and he also showed some improvement. However, as he once again developed complications due to his precarious health condition which led to deterioration of his health and was  discharged from the Opposite Party Hospital against medical advice, shifted to Kaveri Hospital where he faced his  death.

The Complainant is not an expert in respect of medical treatment given by the hospitals.  Therefore, the Complainant is not a competent person to comment on the medical procedures followed by the Opposite Party in his treatment.  In this case, the Opposite Party had given due care in giving treatment to the Complainant’s husband  through its qualified Doctor. There is no expert evidence to allege that the procedures followed by them in changing tubes was not medically sound.  The Tracheostomy tube change was made by the Senior Consultant, ENT Surgeon. Medical negligence must be established and not presumed. In the absence of expert evidence on behalf of the Complainant, no negligence or deficiency in service could be found against the Opposite Party.  Medical negligence cannot be inferred it has to be proved by the Complainant by evidence supported by medical expert evidence which is totally absent in the instant case. 

The duty of the Doctors towards his patient is a duty of care in deciding as to what treatment is to be given based on the condition of the patient and also, a duty to take care in the administration of the treatment. If there is any breach of any of his duties ,may lead to an action for negligence by the patient.  In this case, there is no deriliction of duty on the part of the Opposite Party. While giving treatment to the Complainant’s husband it is clear proper care and caution were taken by the Opposite Party Hospital in giving treatment to the Complainant’s husband according to his condition.  The Complainant had failed to prove that the Opposite Party has committed medical negligence and deficiency of service in their duty while treating her husband. Therefore, we are of the view that there is no medical negligence or deficiency in service on the part of the Opposite Party.  Accordingly, Point Nos.1 is answered.

Point No.2 and 3:-

We have discussed and decided that there is no medical negligence or deficiency in service on the part of the Opposite Party.  Hence, the Complainant is not entitled to get any relief as against the Opposite Party.   Accordingly, Point Nos.2 and 3 are answered.

In the result, the Complaint is dismissed. No Costs.

Dictated to Steno-Typist, transcribed and typed by her, corrected and pronounced by us in the Open Commission, on 1^st of August 2022.

 

S. NANDAGOPALAN               T.R. SIVAKUMHAR                   B.JIJAA

         MEMBER II                       MEMBER I                         PRESIDENT

 List of documents filed on the side of the Complainant:-

 

Ex.A1	22.06.2015	Discharge Summary
Ex.A2	22.06.2015	Death Certificate by Kauvery Hospital
Ex.A3	07.07.2015	Inpatient Bill (Summary)
Ex.A4	27.07.2015	Death Certificate

 

List of documents filed on the side of the OppositeParty :-

 

Ex.B1	31.05.2015	Admission Form
Ex.B2	31.05.2015	General consent for Admission
Ex.B3	31.05.2015	Admission History and Physical Assessment Form
Ex.B4	31.05.2015	Consent for Intensive Care Unit-by Vijayakumari
Ex.B5	31.05.2015	General consent for Treatments
Ex.B6	31.05.2015	Informed consent for Anesthesia-Tracheostomy
Ex.B7	31.05.2015	Nursing Assessment
Ex.B8	31.05.2015 22.06.2015	Physician Instructions and Notes
Ex.B9	15.06.2015 & 16.06.2015	Medical Administration Record
Ex.B10	02.06.2015	Consent for Operation/Procedure
Ex.B11	03.06.2015	Consent for Operation/Procedure- Fibrepotic Bronchoscopy
Ex.B12	10.06.2015	Consent for Operation/Procedure – Intubation & Mechanical Ventilator / Central Line Insertion
Ex.B13	10.06.2015	Informed consent for General Surgical Procedures
Ex.B14	11.06.2015	Informed consent for High Risk
Ex.B15	16.06.2015	Consent form for Intensive Care Unit – Signed by Priya
Ex.B16	15.06.2015 to 16.06.2015	Daily Nursing Flow Sheet
Ex.B17		Peri-Operative Booklet (multispeciality)
Ex.B18	10.06.2015	Theatre Record, Pre-Operative Order Sheet, Pre-Operative Check List, Recovery Record, Post Operative Orders
Ex.B19		Nurses Notes
Ex.B20	16.06.2015	In-House Transfer Summary
Ex.B21	02.06.2015 20.06.2015	Nutrition Care Plan – Oral
Ex.B22	08.06.2015 & 16.06.2015	Record Half Hourly/Hourly Vital Blood Sugar Chart
Ex.B23	31.05.2015 15.06.2015	Intensive Care Unit Transfer Summary
Ex.B24	22.06.2015	Request form for leaving against Medical Advice
Ex.B25	22.06.2015	Patient and Family Education Record
Ex.B26	31.05.2015 22.06.2015	Final Summary Sheet
Ex.B27	31.05.2015 22.06.2015	Discharge Summary
Ex.B28	21.06.2015	Acknowldgement form at the time of discharge
Ex.B29	22.06.2015	Acknowledgement for receiving personal belongings / Valuables
Ex.B30	31.05.2015- 20.06.2015	Investigation flow chart
Ex.B31	01.06.2015-20.06.2015	Lab reports
Ex.B32	31.5.2015-18.06.2015	Chest X Ray
Ex.B33	02.06.2015 04.06.2015	Ultra Sound Chest
Ex.B34	02.06.2015	Echo Cardiogram Report
Ex.B35	01.06.2015	Doppler Study of Upper Limb Veins
Ex.B36	22.06.2015	Radiometer & clearance & Modified subjective global assessment
Ex.B37		ICU CHART
Ex.B38		ICU CHART

 

 

 

 

 

S. NANDAGOPALAN               T.R. SIVAKUMHAR                   B.JIJAA

         MEMBER II                       MEMBER I                         PRESIDENT