Chandigarh

DF-I

CC/562/2017

Vinod Kumar - Complainant(s)

Versus

Post-Graduate Institute of Medical Education & Research (PGI) - Opp.Party(s)

Pankaj Chandgothia

10 Jan 2020

ORDER

DISTRICT CONSUMER DISPUTES REDRESSAL FORUM-I,

U.T. CHANDIGARH

 

                    

Consumer Complaint No.	:	CC/562/2017
Date of Institution	:	28/07/2017
Date of Decision	:	10/01/2020

 

Vinod Kumar s/o Dharam Singh, Village Dohli, Chamrori (54), Yamunanagar, Jagadhri, Haryana-135133.

… Complainant

V E R S U S

1. Post Graduate Institute of Medical Education & Research (PGI), Sector 12, Chandigarh through its Medical Superintendent/Director
2. Department of Neurosurgery, Post Graduate Institute of Medical Education & Research (PGI), Sector 12, Chandigarh through its Head of Department.
3. Department of Neurology, Post Graduate Institute of Medical Education & Research (PGI), Sector 12, Chandigarh through its Head of Department.
4. Department of Ophthalmology, Advanced Eye Centre, Post Graduate Institute of Medical Education & Research (PGI), Sector 12, Chandigarh through its Head of Department.

… Opposite Parties

CORAM :	SHRI RATTAN SINGH THAKUR	PRESIDENT
	MRS. SURJEET KAUR	MEMBER
	SHRI SURESH KUMAR SARDANA	MEMBER

 

                                               

ARGUED BY	:	Sh. Pankaj Chandgothia, Counsel for complainant
	:	Sh. Guarav Bhardwaj, Counsel for OPs

 

Per Rattan Singh Thakur, President

1.      The long and short of the allegations are, prior to June 2015, wife of the complainant, Smt. Kamla Devi (deceased), aged about 45 years, had problem of diminishing eye sight and other vision related problems. She was treated in Goyal Eye Care Center, Jagadhri, Yamuna Nagar and other eye clinics from May 2015.  However, there was no prognosis of the vision related problem. On being referred, she was got admitted in OP Hospital (PGI) on 11.6.2015. At the time of admission, the initial history/diagnosis noticed by the OPs involved optical nerve and no other kind of problem in the form of fungal or bacterial infection. She was admitted in the PGI on 11.6.2015. Various tests were performed, but, the patient developed a fatal infection during her stay in the hospital i.e. bacterial and fungal infection which were not in existence on the date of her admission in the PGI. Complainant’s case is, his wife succumbed to the medical negligence of the OPs and had expired on 30.7.2015 during the course of treatment. Various documents were obtained alongwith the medical certificate of cause of death.  Forms were also filled up after death regarding the insurance claim and it was opined, Smt. Kamla Devi, deceased had developed mucormycosis in the hospital which is result of fungal infection. This disease was developed in the third week of July 2015 and it was reported Ventilator Associated Pneumonia caused by bacterial infection was the cause of death. She was admitted for a different problem but had infected with other problems during her stay in the hospital. The death report reveals cause of death as refractory septic shock.  The complainant had paid the expenses, but, later on was approved as a poor free treatment, therefore, he is a consumer. It is the case of the complainant, there were unhygienic conditions and lack of nursing care, therefore, Smt. Kamla Devi, deceased suffered sepsis due to the negligence of the OPs.  As such, her death had a nexus with medical negligence on the part of the OPs. Hence, the complainant filed present consumer complaint and prayed for directing the OPs to pay Rs.2.00 lakhs towards hospital bills; compensation of Rs.1.00 lakhs for avoidable pain, disability etc.; Rs.10.00 lakhs as compensation for mental agony and harassment; compensation of Rs.3.00 lakhs for loss of companionship; deterrent damages of Rs.1.00 lakhs and Rs.55,000/- as legal expenses.
2.     OPs furnished their joint written statement signed by one of the OPs i.e. Assistant Professor of Department of Neurology and raised preliminary objections of consumer complaint being not maintainable and admitted deceased Smt. Kamla Devi was presented in Advanced Eye Care Centre on 21.5.2015 and the previous record shows complained of painless and progressive diminution of vision in left eye for the last one month. Different tests were done and she was referred to Neurology consultation and MRI was also done which showed left optic nerve suggestive of optic atrophy.  She was also examined in the Glaucoma clinic on 16.6.2015 and it was found a known case of hypocalcemic periodic paralysis for which she was on treatment from elsewhere.  Their case is, her condition was deteriorating, therefore, she was also put on steroids treatment under compelled circumstances. It was admitted, infection was developed and steroids may have contributed to this infection, but, it was not avoidable and was necessitated to be administered to save her life.  The infection was also treated, but, she could not be saved. Hence, OPs maintained whatever was in their command, they employed the skill and treated her, but, she expired.  On these lines, the cause is sought to be defended.
3.     Rejoinder was filed and averments made in the consumer complaint were reiterated. It was also highlighted that some surgical procedure was done for which the consent was not obtained. 
4.     Written interrogatories were also raised which were replied by the OPs. 
5.     Parties led evidence by way of affidavits and documents.
6.     We have heard the learned counsel for the parties and gone through the record of the case. After scanning of record, our findings are as under:-
7.     Per pleadings of the parties and the evidence led, we have to examine the record and the evidence led within the parameter of law laid down by the Hon’ble Supreme Court under which circumstances hospital could be held guilty for medical negligence. In case titled as Laxman Balkrishna Joshi vs Trimbak Bapu Godbole, 1969 AIR 128(SC), the Hon’ble Apex court had held the breach of following duties on the part of doctors and hospital constitutes medical negligence :-
   1. A duty of care in deciding whether to undertake the case;
   2. A duty of care in deciding what treatment to give; and
   3. A duty of care in administration of that treatment

If these duties are breached by the OPs/hospital only then they will be under the noose of law to say guilty of medical negligence and liable to be punished in the form of damages/compensation to the legal heirs of deceased, Smt. Kamla Devi. Now let us scan the pleadings as well as the evidence led by the parties on the point of due care or say its breach on the part of the OPs. 

8.     A glance of the record and the pleadings of the complainant shows, before admission in the PGI, Chandigarh (OPs), she was under treatment of Goyal Eye Care Centre, Jagadhri and Sh. Suresh Chandra Memorial Eye & General Charitable Hospital, Yamuna Nagar and other hospitals.  It is on their reference, she was taken to the PGI, Chandigarh (OPs) where she was treated.  It is not the case, any wrong treatment was given by the OPs to deceased, Smt. Kamla Devi.  It is also not the case, PGI was not capable to undertake the said case of the complainant in view of the disease with which she had suffered.  There are no such pleadings, OPs were not capable to undertake the case of deceased, Smt. Kamla Devi. Even otherwise, PGI is an institution of repute in medical treatment as well as research work and she was treated in the Ophthalmology as well as Neurosurgery units which were well equipped with competent doctors and other apparatus for the purpose of settlement of the diagnosis and undertaking the treatment. Thus, per pleadings and the evidence led, there was no breach of duty on the part of the OPs not to undertake the case of deceased, Smt. Kamla Devi for the purpose of treatment. 
9.     Per pleadings of the parties and the evidence led, it is neither the case of the complainant nor does it appear from the record, OPs mistreated the patient and they had not administered the treatment to Smt. Kamla Devi which was not warranted as per medical science to be administered to her for the cure of the disease or to say to control it.  There are no standards produced that for the loss of vision any other treatment was required which was not administered.  Thus, under these circumstances it is not for the patient or to say her attendants to refer what should be the course of treatment.  As per medical text, standards have not been highlighted and what treatment after diagnosis was to be undertaken which had not been undertaken or administered by the doctors of the OPs has not been shown for eye problem and treatment of infection. Thus, we hold, on this legal parameter in deciding what treatment was to be given, there has been no such breach, pleaded or proved on record from the side of the complainant.
10.     The last duty which was cast upon OPs was duty of care in administration of the treatment contemplated to be administered to deceased, Smt. Kamla Devi. A meticulous perusal of the averments made in the consumer complaint as well as the record produced does not show, while administering the treatment of eye problem and sepsis, there was any lapse on the part of the OPs so as to say there was a breach of duty of care in administration of the treatment. Thus, these legal parameters do not prove, OPs were lacking off in care of administering the treatment or say wrong treatment was given or say they were not possessed with the skill or say infrastructure for the purpose of treatment of the said disease and breach of duty of care is not established on record.  This is one aspect of the case we have to take into consideration.
11.     The learned counsel for the complainant argued, wife of the complainant, deceased Smt. Kamla Devi was admitted with the OPs for the treatment of loss of vision related problem to her.  The history of the case, she was earlier treated in a private hospital in District Yamuna Nagar and the treatment had not responded to her and on their failure she was referred to the PGI/OPs, itself shows her diagnosis was not finally settled and in this situation, it could not be said, principle of res ipsa loquitur could be pressed into service by holding her death itself speaks of negligence on the part of the doctors.  It is not the case, alien treatment was undertaken which was far away from the medical text books or to say apparently OPs were not eligible to undertake the said allopathic or surgical treatment.
12.     The learned counsel for the complainant further argued, infection was suffered by deceased Smt.Kamla Devi during her stay in the OP hospital/ PGI as an indoor patient which itself shows there were unhygienic conditions in the general ward.  The cause of death is refractory septic shock which speaks of infection or say septicemia.  OPs in their written statement as well as the documents produced on record had highlighted her condition was critical, therefore, they had to take the aid of last therapy i.e. steroids which weakens the defence mechanism of the body and may have contributed to formation of sepsis to deceased, Smt. Kamla Devi. It is a mode of treatment to be done by the doctors and patient or her attendant is nobody to question it or dictate the terms of treatment to the doctors, which is their field and they have expertise in the matter.  We may say no science on this earth is perfect so is the case with medical science and there may be 101 idiopathic reasons on which medical science has not identified and simpliciter research work, which has been incorporated in the medical text books, has to be the standard of medical science.
13.     The case of the complainant is the conditions in the OP hospital were not hygienic. It is a Government hospital and numerous persons takes treatment in general ward and it is over flooded. It is not the case of the complainant or say any other evidence led that apart from deceased Smt. Kamla Devi, any other patients in majority or say all had suffered from sepsis during that period. If there was unhygienic conditions, other patients also ought to have suffered from hospital acquired infection.  Some may have been cured; some may have succumbed and some may have prognosis in the disease but the luck of the deceased was the disease was such, she could not recover.
14.     Per record, it is also the case, on post mortem conducted, evidence was found that she was also suffering from cancer and it is on this score it was argued by the learned counsel for the complainant OPs failed to detect the cancer.  The basic treatment starts from clinical examination and the signs and symptoms were loss of one eye vision and there were no symptoms to say diagnosis of cancer or its investigation had also to be undertaken. Even the help of steroids was also taken as she was not responding to the treatment and there is also record and assertion made there was paralysis of her nerve. In the situation when she singly suffered infection, which proved to be fatal, it cannot be said OPs were at fault and they had administered treatment as per medical text books. 
15.     It was also highlighted and our attention was drawn to the medical certificate of cause of death (Annexure C-11) which shows there was ‘Primary Sjogren’s Syndrome’ in deceased Smt. Kamla Devi, which is an auto immune system disease when the immune system of the body of the human being acts against it and there is also reference of bilateral optic atrophy. Every disease is never cured and the treatment was administered by the OPs with which they were possessed of skill and if they had undertaken any medical surgical procedure for detection of a disease for that written consent was not required as it was not with regard to the treatment of the disease, but, to detect the disease which deceased, Smt. Kamla Devi had suffered and not for treatment purpose. Non taking of consent for such a minor surgical procedure to detect the disease for research work does not in any way show OPs failed to take her written consent so as to constitute medical negligence.   
16.     Our attention was also drawn by the learned counsel for the complainant to the interrogatories put to the OPs and the reply furnished vide which in reply to the question she was admitted to Advanced Eye Centre of PGI on 21.5.2015 but her condition/diagnosis of hypocalcemic period paralysis was noted for the first time on 16.6.2015 it was mentioned she was not admitted to the Advanced Eye Care Centre of PGI.  It could be a neurology problem and it is also the case on reply furnished to the questions raised that she had also suffered sugar problem.  We have already referred, Sjgren’s disease was also a disease related to the immune system and when her system is acting against the immune system, in such a situation any disease, may be in the form of sugar or diabetes, could be suffered by her.  She may have developed a sepsis while she was being treated in the Neurology Department.  There are micro bacteria in the environment and her resistance in the body had already fallen weak, may be contributed due to steroids therapy, therefore, suffering of sepsis does not mean there was negligence on the part of OPs when no other patient admitted in the same ward suffered such sepsis so as to conclude hygiene conditions were poor in the general ward. CPC is not strictly applicable in consumer pleadings of parties.  Even otherwise, any of the parties may verify pleadings as per order 6 Rule 15 of CPC, 1908. Hence, the objection raised of written statement being not signed by all the four OPs is baseless.
17.     In view of the above discussion, examining the case from any angle whatsoever, we do not find any medical negligence on the part of the OPs.  There is no merit in the present consumer complaint and proceed to dismiss the same with no order as to costs.
18.     Certified copies of this order be sent to the parties free of charge. The file be consigned.

	Sd/-	Sd/-	Sd/-
10/01/2020	[Suresh Kumar Sardana]	[Surjeet Kaur]	[Rattan Singh Thakur]
hg	Member	Member	President