Sri. P. Satheesh Chandran Nair (President):

                   The complainant filed this petition u/s.12 of the C.P. Act 1986 for getting relief from the opposite parties.

                   2. The case of the complainant is as follows:  On 19.06.2013 while the complainant was waiting at the private bus stand at Pathanamthitta she felt uneasiness and fatigue, suddenly she informed the details to her daughter who is residing at Omalloor.  The daughter rushed to the spot and took the complainant to 1^st opposite party’s Medical Centre and the hospital authorities admitted the complainant in casualty department after a preliminary check up.  It is contended that the concerned doctor to the casualty told that the health condition of the complainant is so worse and she has to be admitted in ICCU for treatment.  The doctor concerned to ICCU examined the complainant and found that the complainant was affected heart disease for that a sum of rupees was also required.  On 19.06.2013 at about 6.30 p.m it is informed that the complainant’s B.P not coming to a normal stage, so that some other medicines were also required.  On 20.06.2013 at 12 p.m the health condition of the complainant was became so worse and it is inform to admit this complainant to any other hospital for further expert treatment.  According to the complainant, due to the direction of 2^nd opposite party an injection named Dobucin had been taken to this patient for 16 times and another medicine named Dopamine was also injected for 22 times.  It is further stated that all the above said administration of medicine to complainant’s body highly affected the normal health condition of the complainant and further stated that these medicines are administered without considering the health condition, reactive condition and old ageness of the complainant.  According to the complainant, all the above medicines had side effect and due to these medicines her liver and kidney functions are also affected.  This act of the opposite party 1 and 2 are against the medical ethics and for accepted more money from the complainant.  It is stated that for the treatment dated 19.06.2013 and 20.06.2013 the complainant remitted an amount of Rs.55,000/- to 1^st opposite party’s medical institution.  It is contended that as per the direction of the opposite party 1 and 2 the complainant admitted at Medical College Hospital, Kottayam and it is known that the administration of the medicines at 1^st opposite party’s hospital caused to the malfunctioning of the kidney and liver of the complainant.  These facts are informed to the complainant by the doctors who were treated the complainant at Medical College Hospital, Kottayam.  It is further contended that due to the deficiency in service and unfair trade practice of the opposite party 1 and 2, the complainant suffering a lot and even not capable to do her daily necessities.  It caused mental and financial losses to her.  The complainant filed this petition before this Forum for directing the opposite party 1 and 2 to realise the amount remit to this hospital for her treatment and further expenses incurred by her at Medical College Hospital, compensation etc.

                   3. This Forum entertained the complaint and decided to issue notice to opposite party 1 and 2 in this case.  Opposite party 1 and 2 entered appearance and they filed separate version in this case.  During the time of trial, the complainant filed an impleading petition (I.A.No.8/15) and on the strength of the order in the said I.A opposite party 3 is also impleaded as the additional opposite party 3 in this case.  Though the opposite party 3 received notice from this Forum he failed to appear before the Forum and on 25.03.2015 he was again called absent hence he was declared exparte.

                   4. Opposite party 1 and 2 are filed their version separately.  The contents of the 2 versions are stated as follows:  According to 1^st opposite party the complaint is not maintainable either in law or on facts.  It is contended that the complainant purposefully suppressing the true facts solely for the un view financial advantage of the complainant.  It is admitted that on 19.06.2013 she was admitted in the hospital with the history of chest pain.  She was timely managed and after proper diognisation medicines and injections are started.  It is diagnose that she is suffering acute coronary syndrome, acute inferior and right ventricular ST elevation, myocardial infraction, diabetes mellitus and systemic hypertension etc.  All the serious situations are informed to the daughter of the complainant and with the voluntary consent of her the complainant was admitted in ICCU.  Since the patient had hypertension the doctor concerned started on ion tropes in the form of Dobutmine along with IV fluids after stopping Streptokinase.  When B.P remain low, Dopamine infusion was also started and later on noradrenaline infusion also used to bring up B.P.  The necessary medicines are also use to prevent allergic reaction and for keeping blood sugar level and also checked to urine output.  All the above treatments are clearly explained to the bystander and when the complainant developed oxygen destruction and the same was also managed.  When the complainant went into the most dreaded complication of myocardial infraction and the same was also managed with continuous and strenuous cardiopulmonary resuscitation.  It is further stated that even after administering the above stated medicines and other management to the complainant the general position of the complainant was became so worse and the real position was informed to the complainant bystander time to time.  On 21.06.2013 the complainant became dysphonic with low oxygen saturation and also failed to respond to nebulisation and frusemide.  The patient required further intervention to improve her condition, the matter was discussed to the bystander and they preferred to continue further treatment at Medical College Hospital, Kottayam.  According to this opposite party, the medicines and other management applied from 1^st opposite party’s hospital they are absolutely necessary for stabilizing the patient from a condition of acute ST elevation, myocardial infraction with hypertension.  It is contended the 2^nd opposite party had exercised due diligence, care and expertise in the management of the patient and the life of the complainant could be saved by the timely measures taken by the 2^nd opposite party.  There is any negligence or rashness happened on the side of opposite party 1 and 2 as alleged by the complainant and the 2^nd opposite party did not advise the bystander to shift the patient to somewhere else when her condition became so deteriorated.  According to this opposite party, all the medicines are applied after evaluating the general health condition of the complainant.  According to this opposite party, the complainant is not suffering any mental agony and physical strain due to the act of this opposite party and the complainant has no right to get any kind of relief as alleged through this complainant.  Therefore, this opposite party prayed to dismiss this complaint with cost to 1^st opposite party.

                   5. In the light of complaint, versions and document before us, we framed the following issues for consideration:

1. Whether the case is maintainable?
2. Whether the opposite party 1 and 2 committed any deficiency in service or unfair trade practice as alleged by the complainant?
3. If so, regarding relief and cost?

         6. In order to prove the case of the complainant, complainant filed a proof affidavit in lieu of chief examination and marked Ext.A1 to A13.  Ext.A1 is the power of attorney executed by the complainant.  Ext.A2 is the photocopy of the application (subject to proof) dated 23.11.2013 issued by the complainant to Kerala State Human Rights Commission.  Ext.A3 series are the medical bills (14 Nos.) issued by the 1^st opposite party to the complainant.  Ext.A4 is the O.P. Registration.  Ext.A5 series are the medical bills (10 Nos.) issued by Medical College Hospital, Kottayam.  Ext.A6 is the photocopy of medical bills (10 Nos.)  issued by 1^st opposite party’s hospital to the complainant.  Ext.A7 is the ambulance Trip Sheet dated 21.06.2013 for Rs.6,000/- issued by 1^st opposite party to the complainant.  Ext.A8 series are the photocopy of lab reports (8 Nos.).  Ext.A9 is the copy of discharge summary dated 01.07.2013.  Ext.A10 is the photocopy of summary sheet (subject to proof) issued by Medical College Hospital, Kottayam.  Ext.A11 is the photocopy of the application (subject to proof).  Ext.A12 is the out-patient ticket dated 23.06.2013.  Ext.A13 is the medical bills (7 Nos.).  PW2 is the head of cardiology section of Kottayam Medical College through him Ext.A14 and A15 are also marked.  Ext.A14 series is the photocopy of case records.  Ext.A15  is the discharge summary.  PW3 is the head of Nephrology Section of Kottayam Medical College also examined in favour of the complainant.  Through this PW3 no documents were marked.  On the other hand, for and on behalf of 1^st opposite party the Deputy Medical Superintendent of Muthoot Medical Centre was examined as DW1.  No documents marked in favour of opposite party 1 and 2 in this case.  PW1 is the daughter and power of attorney holder of the complainant in this case.  She deposed more or less as per the tune of her mother’s complaint.  According to her testimony, it is deposed that the admission to ICCU at opposite party’s Medical Centre was not with her consent and the administration of medicine and management in the 1^st opposite party’s hospital was against medical ethics and the administration of the injection Dobucin and Dopamine were the reason for the acute heart failure and damage of liver and kidney.  It is deposed that these above stated failures happened due to the deficiency and negligence of administration and medical management of opposite party 1 and 2.

          7. According to PW2, as a result of the better treatment given to the patient at Medical College Hospital, Kottayam the general condition of the complainant was developed and when he started the treatment.  The blood pressure of the complainant was so low and it is also revealed that as per the records of 1^st opposite party’s hospital, the functioning of the complainant’s heart was stop for three times and it was restarted by 2^nd opposite party with the ventilation support.  It is also pointed out that the treatment for restart of heart functioning was a total success at 1^st opposite party’s hospital.  He deposed that the use of Dobucin and Dopamine was not seen excessive when considering the general health position of the complainant.  PW3 is the head of Nephrology Department of Medical College Hospital, Kottayam, he who deposed that all the medicine administered at 1^st opposite party’s hospital and the management with regard to this complaint was in order and no excessive application of medicine can be seen from the records available before him.  DW1, who deposed for and on behalf of 1^st opposite party to the effect that there is no medical negligence of any sort is happened at 1^st opposite party’s hospital and also deposed that 2^nd opposite party has treated this complainant with due diligence and without any negligence.  After the closure of evidence from both side, we heard both the counsels of the complainant, opposite party 1 and 2. 

          8. Point No.1:- Opposite party 1 and 2 in this case raised a serious contention to the effect that the case of the complainant is not sustainable before this Forum and it is not maintainable also.  It is seen that the complainant was admitted in 1^st opposite party’s hospital and 2^nd opposite party as the doctor in charge of ICCU of 1^st opposite party treated the person for two days.  It is admitted that the complainant was undergone ICCU for heart disease and some other complicated diseases.  It is also admitted that the complainant spent 2 days in 1^st opposite party’s hospital and the complainant paid an amount of Rs.55,000/- as the medical bills of 1^st opposite party’s hospital at the time of her discharge to Medical College Hospital, Kottayam.  This evidence is sufficient to see that the complainant is a consumer and the opposite party 1 and 2 are service providers.  Hence we can safely concluded that this case is maintainable before this Forum and Point No.1 find in favour of the complainant. 

          9. Point No.2 and 3:  For the sake of convenience we would like to consider Point No.2 and 3 together.  The next question to be considered is whether opposite party 1 and 2 have committed any deficiency in service for the treatment.  The case of the complainant is that admission of PW1’s mother in ICCU of 1^st opposite party’s hospital was not necessary.  PW1 deposed that only minor medical difficulties was faced by the complainant at the time of admission at 1^st opposite party’s hospital on 19.06.2013.  She deposed that the administration of Dobucin and Dopamine on excess quantity within the ICCU were the reason for the heart failure, liver functioning and failure of kidney.  She deposed that the administration of medicine and medical management of 1^st opposite party was against medical ethics and in order to extort money from the complainant.  In order to prove the case of the complainant, the complainant examined PW2 and PW3 in this case.  It is to see that PW2 and PW3 are the heads of Cardiology and Nephrology of Medical College Hospital, Kottayam.   Either the complainant or the opposite party 1 and 2 challenged the competency and credibility of this witness even at the time of examination or even at the time of hearing of this case.  According to PW2 in chief he deposed like this, “എൻറെ hospital -ലെ തുടർ ചകിത്സ വഴി രോഗിയുടെ അവസ്ഥ മെച്ചപ്പെട്ടു document പ്രകാരം improvement ഉണ്ടായ ശേഷമാണ് രോഗി discharge ആയത്..  Ext.B1 & B1(a) രേഖ നോക്കിയതിൽ രോഗിയുടെ  sugar level-ഉം, cholostrole--ഉം ഉയർന്ന നിലയിൽ ആയിരുന്നു. കൂടാതെ kidneyþഉം failure ആയിരുന്നു പെട്ടെന്നv cardiac problem ഉള്ള patient വരുമ്പോള് പരിശോധനാ റിപ്പോർട്ട് വരും വരെ കാത്തിരിക്കാതെ ചികിത്സ നടത്തേണ്ടി വരും.  Patient Kottayam Medical Collegeþ ൽ വന്ന സമയം blood preassure താഴ്ന്ന നിലയിലായിരുന്നു. രേഖകള് പ്രകാരം മനസ്സിലാകുന്നത് രോഗിയുടെ ഹൃദയം നിലശ്ചത് restart ചെയ്യിച്ചv ventilator support കൊടുത്തു എന്നാണ്. ഹൃദയ പുനരുജ്ജീവന ചികിത്സ ഫലപ്രദമായാണ് രോഗി medical collegeþൽ എത്തിയത്”.   The complainant’s counsel asked a question to PW2, “Dobucin, Dopamine എന്നീ medicine യാതൊരു മാനദണ്ഢവുമില്ലാതെ ക്രമാതീതമായി രണ്ടാം opposite party നൽകിയതിനാൽ അല്ലേ kidneyþ-ഉം liverþഉം fail ആയത് v? “അല്ല.”.  Witness adds, “Cardiac arrest ഉണ്ടായാൽ വൈദ്യുതി പായിച്ച് ചികിത്സ നടത്തിയാണ് (CPR)  Cardio Pulminary Resuscitation രോഗിയെ രക്ഷിക്കുന്നത്. ഇപ്രകാരം രക്ഷപെട്ട രോഗിയുടെ blood pressure നിലനിർത്താൻ വേണ്ടി നൽകുന്ന medicine ആണ് Dobucin, Dopamine.  രേഖകള് പ്രകാരം കൂടുതൽ അളവിൽ കൊടുത്തതായി കാണുന്നില്ല”. It is so interesting to see that though PW2 was examined for substantiating the case of the complainant, the deposition of PW1 in chief examination itself was against the complainant’s case.  The evidence of PW2 in this case is actually cut the route of complainant’s case.  When we peruse the answer of this witness for the cross-examination of opposite party 1 and 2 is also highly interesting.  Dopamine, Dobucin and Dobutamine Nuroprenaline are administrated under supervision.  As per the records it is shown that 3 times shocks were given to the patient for restarting the heart.  He again adds, “ഈ രോഗിയുടെ രോഗാവസ്ഥയിൽ രക്തസമ്മർദ്ദം ഉയർത്താൻ ഉള്ള മരുന്നുകള് ഫലപ്രദമാകാതിരിക്കുകയും രക്തസമ്മർദ്ദം താണനിലയിൽ തുടരുകയും ചെയ്താൽ ആ കാരണം കൊണ്ടുതന്നെ Renal failure ഉണ്ടാവില്ലേ? സാദ്ധ്യതയുണ്ട്.  The evidence of the expert witness PW2 is so helpful to come to a conclusion with regard to the negligence or deficiency which were alleged against opposite party 1 and 2 in this case.  The evidence of PW2 can be considered as a cogent and conclusive evidence to examine the alleged deficiency if any committed by 2^nd opposite party doctor in 1^st opposite party’s hospital.  Apart from PW2’s deposition before us, PW3 another Head of Nephrology, Medical College Hospital, Kottayam was also examined. In chief examination, he deposed as follows:- “ഈ രോഗിയുടെ മാരക രോഗാവസ്ഥയിൽ നിന്ന് രക്ഷപ്പെട്ടത് അവർക്ക് നൽകിയ നല്ല ചികിത്സ വഴിയാണ്. ഈ രോഗിക്ക് നൽകിയ മുൻ ചികിത്സ സാധാരണ ഇപ്രകാരം രോഗാവസ്ഥ ഉള്ള രോഗിക്ക് നൽകുന്നതു തന്നെയാണ്”.  As per the testimony of PW3, the finding of PW2 with regard to the alleged overdose of medicine is again corroborated even in his chief examination itself.  In cross-examination he deposed like this, Ext.B1 പ്രകാരം ഈ patientþ ന് നൽകിയ ചികിത്സയും മരുന്നുകളും മാരക രോഗാവസ്ഥയിൽ നിന്നും ഈ രോഗിയെ രക്ഷപ്പെടാൻ സഹായിച്ചു എന്ന് പറയുന്നത് ശരിയാണ്.  Dopamine, Dobucin മരുന്നുകള് ആവശ്യമായ അളവിലാണ് എന്ന് കാണുന്നു. ഇതേ മരുന്നുകള് medical ലും നൽകിയിരുന്നു. ഈ medicine ആണ് ഇതേ രോഗത്തിന് നൽകുക. When we are considering the evidence adduced by the complainant as PW1 to PW3, it reveals that the deficiency in service alleged against opposite party 1 and 2 by the complainant through her daughter and power of attorney holder PW1 was totally rebutted by the evidence adduced by PW2 and PW3 in this case.  We can easily find that the complainant’s evidence as PW1 to PW3 is contradictory and the evidence of PW2 and PW3 clearly cut the throught of PW1’s case.  PW1 is miserably failed to prove her case before this Forum.  Hence we find that the complaint is disallowable.

          10. In the result, we pass the following orders:

          The case is dismissed.  No order of cost.

         Dictated to the Confidential Assistant, transcribed and typed by her, corrected by me and pronounced in the Open Forum on this the 31^st day of May, 2016.

                                                                                      (Sd/-)

                                                                   P. Satheesh Chandran Nair,

                                                                                            (President)

Smt. K.P. Padmasree (Member – I)             :   (Sd/-)  

Smt. Sheela Jacob (Member- II)                 :   (Sd/-)  

Appendix:

Witness examined on the side of the complainant:

PW1  :  Sheela Sunil

PW2  :  Raju George

PW3  :  Dr. K.P. Jayakumar 

Exhibits marked on the side of the complainant:

A1 :  Power of attorney executed by the complainant. 

A2 :  Photocopy of the application (subject to proof) dated 23.11.2013 issued

        by the complainant to Kerala State Human Rights Commission.

A3 series : Medical bills (14 Nos.) issued by the 1^st opposite party

                to the complainant. 

A4  :  O.P. Registration. 

A5  :  Medical bills (10 Nos.) issued by Medical College Hospital, Kottayam. 

A6  :  Photocopy of medical bills (10 Nos.)  issued by 1^st opposite party’s

         Hospital to the complainant. 

A7 :  Ambulance Trip Sheet dated 21.06.2013 for Rs.6,000/- issued

        by 1^st opposite party to the complainant. 

A8 series :  Photocopy of lab reports (8 Nos.). 

A9   :  Copy of discharge summary dated 01.07.2013. 

A10 :  Photocopy of summary sheet (subject to proof) issued by

          Medical College Hospital, Kottayam. 

A11 :  Photocopy of the application (subject to proof). 

A12 :  Out-patient ticket dated 23.06.2013. 

A13 : Medical bills (7 Nos.). 

A14 series :  Photocopy of case records. 

A15  :  Discharge summary.

Witness examined on the side of the opposite parties:

DW1  :  Dr. Jerry John George

Exhibits marked on the side of the opposite parties: Nil.

                                                                                        (By Order)

Copy to:- (1) Saramma, Aaronnil Veedu, Anthyalankavu.P.O.,

                   Pathanamthitta – 689 649.

2. Manager, Muthoot Medical Centre, Ring Road,

Pathanamthitta – 689 645.

3. Dr. Thomas Mathew, Muthoot Medical Centre,

          Ring Road, Pathanamthitta – 689 645.

4.  The Oriental Insurance Co. Ltd., Kizhakkedathu Buildings.,

                     P.O. Box No.34, Main Road, Pathanamthitta.

              (5) The Stock File.