NCDRC

NCDRC

RP/2206/2016

CHIEF MEDICAL SUPERINTENDENT - Complainant(s)

Versus

POORAN CHAND AGARWAL - Opp.Party(s)

MR. RAJIV RANJAN DWIVEDI

14 Sep 2016

ORDER

NATIONAL CONSUMER DISPUTES REDRESSAL COMMISSION
NEW DELHI
 
REVISION PETITION NO. 2206 OF 2016
 
(Against the Order dated 18/05/2016 in Appeal No. 604/2015 of the State Commission Delhi)
1. CHIEF MEDICAL SUPERINTENDENT
NORTHERN RAILWAY HOSPITAL, S.P.M. MARG,
NEW DELHI-110006
...........Petitioner(s)
Versus 
1. POORAN CHAND AGARWAL
A 3/98, JANAKPURI
NEW DELHI-110034
...........Respondent(s)

BEFORE: 
 HON'BLE MR. JUSTICE AJIT BHARIHOKE,PRESIDING MEMBER

For the Petitioner :MR. RAJIV RANJAN DWIVEDI
For the Respondent :IN PERSON

Dated : 14 Sep 2016
ORDER

This revision is directed against the order of the State Commission Delhi dated 18.05.2016 in First Appeal No. 604 of 2015, whereby the State Commission allowed the appeal preferred by the respondent complainant, set aside the order of District Forum and directed the petitioner Opposite Party to reimburse a sum of Rs.1,22,659/- alongwith 6% interest thereon w.e.f. 01.01.2012 till the realization of amount.

2.         Briefly put, the facts relevant for the disposal of the revision petition are that respondent complainant was beneficiary of Health Scheme run by the opposite party being a retired employee of the petitioner opposite party.  On 28.09.2011, the complainant had bout of giddiness and he passed blood through urine.  The complainant alarmed by the situation went to Sir Ganga Ram Hospital and took treatment there.  The complainant spent a sum of Rs.1,22,659/- on treatment at Sir Ganga Ram Hospital. He submitted the bill for reimbursement but opposite party declined it on the ground that complainant had taken treatment in private hospital without taking prior permission and against the rules.

3.         Being aggrieved of refusal of the petitioner opposite party to reimburse the medical expenses,  respondent filed consumer complaint.  The complaint was contested by the opposite party on the plea that complainant had taken treatment at private hospital against the rules in particular he did not take prior permission before going in for treatment at Sir Ganga Ram Hospital.

4.         The District Forum on consideration of the pleadings, disposed of the complaint with the direction that treatment record of complainant be sent to Medical Board of Maulana Azad Medical College for seeking their opinion as to whether the ailment of the complainant required emergency treatment and directed that if it was a case of medical emergency, then the claim of the complainant be reimbursed.

5.         Being aggrieved of the said order, respondent complainant preferred an appeal.  By the time State Commission heard the appeal, opinion of Medical Board of Maulana Azad Medical College was received.  The State Commission on consideration of opinion of medical board came to the conclusion that complainant had gone to Sir Ganga Ram Hospital for treatment of ‘haematuria’ which was a medical emergency and accordingly directed the petitioner opposite party to reimburse the medical expenses incurred by the complainant on his treatment.   

6.         Being aggrieved of the said order, petitioner has preferred the instant revision petition.

7.         Learned Shri Rajiv Ranjan Dwivedi, Advocate for the petitioner has taken me through the report of Medical Board and submitted that report is incomplete and no firm opinion has been given  whether the case of the respondent complainant required emergency treatment.  It is contended that matter may be referred to some qualified medical board to be constituted by this Commission

8.         Respondent on the contrary  has argued in support of the impugned.

9.         I have considered the rival contentions and perused the record.  It is admitted that complainant being retired employee of Indian Railways was covered under the health scheme and he was issued a card in this regard.  It is also not disputed that petitioner had taken treatment at private hospital without seeking any permission or approval from the concerned authorities as required under the Rules.  The only question which needs determination in this revision petition is whether or not, condition of the respondent complainant at the time of admission in Sir Ganga Ram Hospital was a medical emergency?

10.       It may not be out of place to mention at this juncture that District Forum while disposing the complaint had directed the Maulana Azad Medical College to constitute a Medical Board with the direction that Board shall consider the medical record of the complainant and opine whether his condition at the time of admission in Sir Ganga Ram Hospital was a medical emergency.  Admittedly, the Board constituted by Maulana Azad Medical College had submitted a report which is the basis of the finding of the State Commission.  On perusal of the report, we find that Medical Board has observed as under:

“1.        As per item no.10 of the Order of Consumer Court dated 12th May 2014, the board has been asked to give  opinion on the limited mater of whether the condition for which the patient was admitted to Sir Ganga Ram Hospital was an emergency or not in medical terms.

2.         That after having gone through the records so submitted, the patient was admitted on 28.09.2011 by Dr. Wadhwa on emergency basis and the reason given for admission was haematuria.

3.         That, any medical or surgical emergency entails that either the suffering of the patient is relieved, or surgery / procedure is done to save the life or part of the body, or to prevent further worsening of the condition.

4.         That, in this case, though haematuria is a medical emergency, there is no record to show that any procedure was done for relieving haematuria for the next two days and he was directly taken up for surgery on 01.10.11 during which a definitive procedure for prostate enlargement was done.”

 

11.       On reading of the above, it is clear that ‘haematuria’ for which the complainant was taken to at Sir Ganga Ram Hospital for treatment is a medical emergency.  The Board after opining this has stated that there is no record to show that any procedure was done for relieving the complainant of haematuria for next two days and surgery was done on 01.10.2011.  Merely because the doctor concerned at Sir Ganga Ram Hospital delayed the surgery of the complainant for two days,  it cannot be said that there was no medical emergency for which complainant was admitted in Sir Ganga Ram Hospital. Passing of blood through urine obviously is an alarming situation because it could be due to renal failure.  So far as delay in surgery is concerned, it could be due to several reasons like undertaking necessary pathological tests to ensure that patient is fit for surgery.   Therefore, I do not find any fault with the order of the State Commission directing the petitioner opposite party to reimburse the complainant.  No jurisdictional error or material irregularity has been shown in the impugned order which may call for interference in exercise of revisional jurisdiction. Revision Petition is, therefore, dismissed.

 
......................J
AJIT BHARIHOKE
PRESIDING MEMBER

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