DISTRICT CONSUMER DISPUTES REDRESSAL FORUM PALAKKAD
Dated this the 28th day of April 2017
Present : Smt.Shiny.P.R. President
: Smt.Suma.K.P. Member Date of filing: 09/10/2015
: Sri.V.P.Anantha Narayanan, Member
(C.C.No.140/2015)
T.A.Ayoob,
S/o.Abdul Rahiman,
Theruvathakath House,
Arafa Nagar, Palappuram,
P.O.Ottapalam,
Palakkad – 679 103 - Complainant
(By Adv.K.Dhananjayan)
V/s
1.P.K.Das Institute of Medical Sciences,
Vaniyamkulam,
Ottapalam – 679 522
2.Manager / Authorised Signatory
P.K.Das Institute of Medical Sciences,
Vaniyamkulam,
Ottapalam – 679 522
(By Adv.S.Sijin)
3.Dr.Rajan.S.P. MS Mch
Department of Urology
P.K.Das Institute of Medical Sciences,
Vaniyamkulam,
Ottapalam – 679 522
(By Adv.V.K.Venugopalan)
4.The District Medical Officer
Civil Station, Palakkad
5.Director of Health Services
Department of Health
Government of Kerala
Office of the Director of Health
Services, Secretariat
Thiruvananthapuram - Opposite parties
O R D E R
By Smt.Shiny.P.R. President.
Brief facts of complaint.
Complainant is one of the legal heirs of the Smt.Umaiba and is the younger brother of Umaiba. Smt. Umaiba was admitted in the opposite parties hospital on 22/3/2015 for a severe stomach discomfort coupled with abdominal pain at about 7 am. The daughter and relatives of Umaiba have insisted to consult with 1st opposite party. But the duty doctor on the causality has not even consulted with 2nd opposite party over telephone but has admitted her in the hospital. Later on the next day i.e. on 23/3/2015 the 2nd opposite party came and after conducting necessary tests have operated her.
The complainant submits that at the time of admitting her in the hospital she was not having any serious disease or illness for which an immediate surgery as done by the opposite parties has necessitated. Complainant further submits that before consulting the opposite parties the deceased had performed Umra by going to Mecca and Madeena, which is situated in Saudi Arabia as a precondition for travel a mandatory medical checkup was essential and that has been done by Umaiba by the competent doctors and the doctors have consented Umaiba to travel abroad especially by air travel. This fact reveals that she was having sound health at that time.
The opposite parties have never disclosed discussed and revealed about her physical condition in and for which the surgery was necessitated. The complainant respectfully submits that after admitting the complainant throughout the period and procedures i.e. pre-operative period, clinical diagnosis during the surgery and post operative period and management of the opposite parties have shown utter carelessness and callousness and culpable negligence which has resulted within timely death of Umaiba. The complainant bonafidely believes that the opposite parties have never taken any efforts and have never used or administered any life saving drugs or devises to save her life. For all these mishaps the opposite parties 1 to 3 are liable and also have a legal bounden duty to explain the reason of death. Apart from that they have never informed but rather has suppressed all facts and seriousness if any occurred or complications arose which they could not handle or manage.
The untimely death of Umaiba is only due to the severe carelessness, lack of concentration and attention and care which amounts to deficiency of service.
Necessary information and statistics and information provided by the Secretary, Vaniyamkulam Grama Panchayath, P.O.Vaniyamkulam in an answer to the Right to information Act asked by the complainant has revealed that during the period of 1/1/2014 to 28/3/2015 approximately 351 deaths have reported in this hospital in connection with treatments of patients. This statistics has caused to implead the opposite parties 4 and 5 as necessary parties being Govt.of Kerala and Director of Health Services, they got a bounden duty to enquire and probe about the mishaps which are continuously occurring in opposite parties 1 and 2’s hospital. The complainant is not seeking any specific relief against them as no cause of action for this incident has happened at their instance or negligence. But the complainant bonafidely believe that they are necessary parties in this case as functioning as “functus official” and is impleaded with an intention to draw the kind attention of the authorities of the State about these gruesome incidents happening in the opposite parties hospital.
The complainant has sent a lawyer notice to the opposite parties to pay Rs.50 lakhs on account of damages due to the negligence committed by them. The opposite parties have received the lawyer notice, the 3rd opposite party Dr.Rajan has sent a reply denying all the allegations contained in the lawyer notice.
Hence complainant prays for an order directing the opposite parties 1 to 3 to pay Rs.20,00,000/- for the deficiency in service which they have committed and also to pay the cost of this litigation.
After admitting the complaint notices were issued to opposite parties. After receiving the notice opposite parties 1 to 3 appeared before the Forum through their counsel. Authorized persons appeared for opposite parties 4 and 5.
1st and 2nd opposite parties filed version contending the following:
The complainant has no locus standi and he will not come within the purview of definition of complainant as per the act. The complainant could not be termed as one of the beneficiaries contemplated as per the Act.
These opposite parties admitted that Umaiba was admitted in the hospital on 22/3/2015 with left sided abdominal pain and the duty doctor in the causality done what is necessary on the basis of information supplied to him. All the department of the hospital as usual worked unitedly together for the treatment of the patient. The prompt, skillful expert service of the hospital provide to the patient. There is no negligence, laches on the part of the hospital. The required treatment for the patient was rendered without any lapses or laches. The patient as well as his relatives were convinced with regard to the disease and obtained consent for the surgery. Patient who known diabetic with recurrent UTI and had treatment for that purpose. Under such conditions the doctors and the staff of the hospital rendered necessary prompt care for the patient and quick services were provided then and there.
The records will reveal what all services are rendered by the hospital for the patient during the course of treatment. Full care attention for the well being of the patient was given. Hence there is no deficiency in service on their part and complaint is to be dismissed.
Third opposite party filed version contending the following:
The complainant has no locus standi to file the present complaint claiming compensation on account of death of his sister on the ground that the primary heirs of the deceased are not joined as parties to the proceedings. It is for the complainant to prove that he is a legal heir of the deceased entitled to for benefits under her. Without producing documentary evidence with regard to the relationship and the entitlement the complaint is not maintainable in law and is to be dismissed in limine. When the deceased has close relatives without any complaint the present complaint is not maintainable.
The deceased patient aged 57 years was a known case of diabetic patient with history of recurrent urinary tract infection. She reported to the causality in the first opposite party hospital on 22/3/2015 at about 7 am with complaint of left sided abdominal pain. On 22/3/15 the third opposite party was on leave and out of station on personal cause and the causality medical officer attended the patient and gave necessary primary treatment. It was duly informed to the patient and her relatives that the third opposite party would come and attend the patient only on the next day so that they could take the patient to some other centre at their choice. But the relatives did not prefer to go elsewhere rather they insisted for admission to the first opposite party hospital., the causality medical officer had informed the third opposite party about the case over phone and as per bystander’s request the patient was admitted to the hospital and started on parenteral antibiotics and other supportive measures as per advice of the third opposite party.
On 23/03/2015 third opposite had seen the patient and her condition was evaluated on the basis of clinical examination and investigations. Since blood investigation report showed normal results she was advised intravenous Urogram/CT and the patient was managed conservatively with IV fluids, antibiotics pending further confirmative radiological investigations. The clinical condition and the required investigations and the treatment measures were discussed with the relatives. The patient had 2-3 bouts of fever and associated vomiting, the CBC, rental parameters and serum electrolytes were rechecked on 24/03/2015 morning. As per repeat investigation total WBC count and renal parameters were found elevated and BP was low and based on the investigation findings possibility of obstructive Pyelonephritis with early septicaemia was considered. In view of increased blood urea and creatinine, CT Kidney and urinary bladder(KUB) was taken in early morning on 24/03/2015 instead of intravenous Urogram planned earlier. CT report and other investigations the patient was diagnosed to have diabetic mellitus, papillary necrosis, left obstructive pyelonephritis, sepsis and uremia.
The condition of the patient and the diagnosis were well explained to the relatives of the patient in the morning on 24/03/2015 and the patient was advised cystoscopy and stenting. As discussed in the previous day and the available relative’s consent the third opposite party conducted Cystoscopy and stenting under spinal anaesthesia. The cystoscopic procedure was uneventful. After some time the patient developed severe hypotension, decreased urine output and patient became restless but she was conscious.
Based on the diagnosis of severe sepsis the patient was immediately referred for specialist consultation with medicine, cardiology and nephrology. The physician, cardiologist and nephrologists had seen the patient and as per their advice the patient was managed with medicines and supportive medical measures. But in spite of supportive measures hypotension and anuria persisted and hence as per advice of nephrologists nor-adrenalin drip was started along with IV fluids and the patient was resuscitated with all supportive medical measures as per protocol and her condition was closely monitored and assessed by specialist doctors and the third opposite party. The critical condition caused by rapid progression of gram negative sepsis and possible multi organ dysfunction and poor prognosis were explained to the bystanders. BP became normal with nor-adrenalin and IV fluids but the patient remained restless and anuric suggestive of multi-organ dysfunction and hence resuscitation continued with supportive medicines, high pressure oxygen and medical measures. By 5.30 pm the patient developed sudden cardiac arrest and the same was managed with endotracheal intubation and cardio-pulmonary resuscitation and supportive medicines as per standard protocol by the anesthesiologists’ and the surgical team. The occurrence of sudden cardiac arrest and resuscitation procedures were explained to bystanders and they were well versed with the emergency supportive care given to the patient by the third opposite party jointly with physician, anesthetist and cardiologist. But in spite of timely resuscitative measures the patient condition worsened rapidly and did not respond to treatment and she was declared dead at 7.10 pm on 24/03/2015. The cause of death of the patient was explained to the relatives and they had no dispute regarding cause of death of the patient on clinical side and never demanded for autopsy.
The patient was a known diabetic with recurrent urinary tract infection previously and had treatment from this opposite party. In the present situation the patient presented with complicated UTI (infection associated with obstruction) in a state of immune-compromised condition and she developed rapid progression to a systemic inflammatory response syndrome with multi-organ dysfunction which has high mortality rate. The third opposite party had timely diagnosed the disease condition and aggressively treated with antibiotics, effective drainage of kidney and supportive medical measures in consultation with physician, nephrologists, cardiologist and anesthesiologist. But death happened solely due to severity and rapid progressive state of the disease condition and she did not respond to treatment and medication and died due to sudden cardiac arrest. The third opposite party had attended and treated the patient with reasonable skill and care in strict regard to accepted medical practice and protocol and there was no negligence or deficiency in service at any point of time in the management of the patient. In the light of the actual facts and circumstances stated above, death of the patient was not happened due to any act or omission on the part of the third opposite party and he is not liable to compensate the complainant either jointly or severally.
The complaint is filed by misrepresenting facts with a view to extract money from the third opposite party without any just or sufficient cause. The compensation is demanded by a person who claimed to be a relative when the close relatives of the patient have no such case. There was absolutely no deficiency in the service of the third opposite party and he is not liable to compensate the complainant.
Complainant and 3rd opposite party filed their respective chief affidavit. Opposite parties 1 and 2 not filed their affidavit. Ext A1 to A8 series were marked from the side of the complainant. Opposite parties filed interim application seeking permission to cross examine the complainant. Even though we allowed the application, complainant did not appear before the Forum for cross examination.
The following issues are considered.
1.Whether the complainant has the locus standi to file the compliant?
2.Whether there is any deficiency in service on the part of opposite party?
3.If so, what is the relief?
Issues 1
Complaint is filed for getting compensation from the opposite parties 1 to 3 for their deficiency in service in treating the elder sister of the complainant. Complainant has not produced any document to show that the deceased Umaiba was his elder sister and he is one of the legal heirs of Umaiba. Moreover he has not produced authorization of the primary legal heirs of deceased Umaiba. On perusal of Ext A8 series it is revealed that deceased Umaiba’s daughter had given consent for operation to the opposite parties 1 to 3 and the presence of complainant is not found anywhere in the case sheet. At the time of evidence opposite parties filed interim application for the cross examination of the complainant. In the interest of justice application was allowed. But the complainant failed to appear before the forum for cross examination. In the above circumstances we are of the view that the complainant has no locus standi to file the present complaint claiming compensation on account of death of his sister Umaiba. In the light of the above observation other issues need not be considered. Hence complaint is dismissed.
Pronounced in the open court on this the 28th day of April 2017.
Sd/-
Shiny.P.R.
President
Sd/-
Suma.K.P.
Member
Sd/-
V.P.Anantha Narayanan
Member
Appendix
Exhibits marked on the side of complainant
Ext.A1 – Photocopy of certificate of death of Umaiba died on 24/3/15
Ext.A2 - Statement issued by Dr.C.S.Rajan, 3rd opposite party connected with this
incident
Ext.A3 – Copy of lawyer notice sent by Adv.CV Sureshkumar to the opposite parties
Ext.A4 - Reply sent by 3rd opposite party
Ext.A5 – Photocopy of death card issued for and on behalf of opposite parties 1 & 2
showing the death of Umaiba
Ext.A6 – Reply issued to the RTI sought by the complainant regarding the deaths
reported from opposite parties hospital during the period 2013 Jan to
31/3/2015 issued by the Secretary, Vaniyamkulam Grama Panchayath
Ext.A7 – Photocopy of the reply issued to the Registrar, Kerala Medical Council,
Trivandrum regarding the allegation of untimely death happened in OP1 and
2’s hospital
Ext.A8 series – Lab Reports
Witness examined on the side of complainant
Nil
Exhibits marked on the side of Opposite parties
Nil
Witness examined on the side of opposite parties
Nil
Cost
No cost allowed.
Forwarded/By Order,
Senior Superintendent
