Chandigarh

StateCommission

CC/856/2017

Harpreet Kaur - Complainant(s)

Versus

Post Graduate Institute of Medical Sciences and Research - Opp.Party(s)

Balwinder Singh, Adv.

19 May 2020

ORDER

STATE CONSUMER DISPUTES REDRESSAL COMMISSION,

U.T., CHANDIGARH

 

Complaint case No.	:	856 of 2017
Date of Institution	:	20.12.2017
Date of Decision	:	19.05.2020

 

1. Harpreet Kaur aged about 24 years, widow of  Sh.Sachdeep Singh.
2. Paraspreet Kaur, aged about 3 years, minor daughter of deceased Sh.Sachdeep Singh.
3. Harbhajan Kaur aged about 58 years mother of deceased Sh.Sachdeep Singh.

All residents of Village and Post Office- Kauli, Tehsil and District Patiala (Punjab).

 …..Complainants

Versus

 

1. Post Graduate Institute Medical Sciences and Research, Sector 12, Chandigarh through its Director/Medical Superintendent.
2. Dr.Naveen Sargi, Senior Resident
3. Dr.Amrinder, Junior Resident
4. Dr.Ganga Ram Verma, Consultant.
5. Dr.Jeetender, Consultant.

All working at ‘PGI’ , Sector 12, Chandigarh.

…..Opposite Parties

 

Complaint under Section 17 of the Consumer Protection Act, 1986

BEFORE:             JUSTICE RAJ SHEKHAR ATTRI, PRESIDENT.

                             MRS. PADMA PANDEY, MEMBER.

                             MR.RAJESH K. ARYA, MEMBER.

 

Present:               Sh.Balwinder Singh, Advocate for the complainants.

       Sh.Gaurav Bhardwaj, Advocate for the opposite parties.

 

JUSTICE RAJ SHEKHAR ATTRI, PRESIDENT

                   This is a case relating to an unfortunate and untimely death of Sh.Sachdeep Singh (aged 23 years) with a gunshot injury, allegedly fired by himself, by mistake. He left behind his widow Smt.Harpeet Kaur; minor daughter Paraspreet Kaur; and his mother Harbhajan Kaur, who have filed this complaint under Section 17 of the Consumer Protection Act, 1986 (in short the Act), for grant of compensation, alleging that the doctors of respondent- Post Graduate Institute of Medical Education and Research, Chandigarh (in short the ‘PGI’), delayed the surgical operation which resulted into death of Sh.Sachdeep Singh.

2.           Factual scenario:-

It has been alleged in the complaint that on 17.01.2016 a religious ceremony Shri Akand Path was kept in the house of Sh.Sachdeep Singh, therefore, the family members were shifting the luggage from one place to another. At about 3.30 pm., Sh.Sachdeep Singh was keeping loaded 12 bore gun belonging to his father, when by mistake, trigger of the said gun was pressed and all of sudden shot got fired, which hit between his thumb and first finger and then on the left side of the front of his chest. As a result he was seriously injured.

3.           After the incident, Sh. Sachdeep Singh was immediately taken to the Gian Sagar Medical College and Hospital, Ramnagar, Rajpura (in short Gian Sagar Hospital), where he was provided first aid and was referred to the ‘PGI’, for the opinion of Cardio Thoracic Surgeon. It has been averred in the complaint that he was then brought to the ‘PGI’,  on 17.01.2016 at about 5.00 p.m. and doctors started investigations on him. It is alleged that at the time of admission in the ‘PGI’, his pulse rate, blood pressure and other body parameters were within the permissible limits but the doctors of the ‘PGI’  wasted time in investigation and could not perform surgery in time, inspite of the fact that father of the deceased made number of requests for performing the surgery. However, at about 10 p.m. on 17.01.2016, patient was taken to emergency operation theater for emergency laparotomy and surgical operation was initiated but the patient suffered acute cardiac arrest at about 12.29 a.m. on 18.01.2016 and was declared dead.
4.           According to the complainants, there was deficiency in providing service and adoption of unfair trade practice  on the part of the opposite parties, resulting into the death of Sh.Sachdeep Singh therefore, this complaint has been filed seeking following relief:-
   1. “to pay the amount of Rs.30 lacs alongwith interest @12% p.a. from the date of death.
   2. Rs.5 lacs as mental and physical harassment.
   3. Rs.50,000/- as cost of travelling to the office of the opposite party.
   4. Rs.32,000/- as litigation expenses.”

 

5.           This complaint has been contested by the opposite parties by filing joint reply, on the following grounds, inter-alia that the complaint filed is misconceived; and that the complainants have no cause of action to file this complaint. It was specifically stated in para no.6 of the reply as under:-

“The patient Sachdeep Singh 23/M was admitted on 17/01/2016 at 5.10 pm in Advanced Trauma Centre with the diagnosis of Gunshot injury while cleaning the gun at around 4.00 pm at his house. Earlier, he was taken to Gyan Sagar Hospital where after initial treatment and intubation he was referred to PGI Chandigarh.

At arrival, his BP was low 80/50 mm Hg, Pulse was feeble. Examination by one resident recorded that his pulse and BP were un-recordable. He was on intermittent positive pressurerespiration via Endo tracheal tube.

There was a gunshot wound 5x3 cms in left chest through which internal organs were visible.

Patient was immediately resuscitated by 2 L IVF+3 units PRBC + 2 UNITS FFP. Beside FAST was performed. He was monitored by duty doctors. CTU SR consultation was taken, ICDT was inserted and urgent CECT chest and abdomen was done. This diagnosed major left lung injury, extensive muscular injury involving chest muscles. Large intestine and fat was seen to be herniating through the defect. There were fractures of 7-9 ribs. Multiple gun pellets were seen in chest and abdominal wall. SR (Gen. Surg.) on call examined the patient, planned for exploratory laparomy in consultation with CTVS.

With continuous aggressive resuscitation, his BP improved transiently; hence, he was shifted to operation theatre at 10.00 PM for emergency surgery. In view of his very critical condition, the attendants were explained about the possibility of death on table, in consent for surgery. In operation theatre, his BP became un-recordable prior to surgery. Inotropes were started and he was put on ventilator. He later developed bradycardia and seizures. Which were started controlled. Seizures subsided. It was followed by bradycardia and his BP again became un-recordable. VT shock was given. For two hours every attempt was made to resuscitate him. However, his condition did not improve, In view of very critical condition, surgery was deferred and he was shifted back to ward, where after unsuccessful CPR, he was declared dead.”

 

6.           Thus, according to the opposite parties, on the arrival of the patient at about 5.00 p.m. on 17.01.2016, his BP was low i.e. 80/50 mm Hg, pulse was feeble and infact the BP was un-recordable. He was on intermittent positive pressure respiration via Endo tracheal tube. He was shifted to emergency operation theatre at about 10.00 p.m. The attendant was explained about the possibility of death of the patient on operation table and therefore consent was taken for surgery, but, in the operation theatre, his BP became un-recordable prior to surgery and as such operation could not be conducted and ultimately he died.
7.           We have heard the contesting parties and carefully gone through the evidence available on record, as well as the written submissions submitted by the complainants.
8.           It may be stated here that the medical history, available  on the  record (Annexure C-3), reveals that initially, the patient was taken to Gian Sagar Hospital, on 17.01.2016 at 3.36 p.m.  In the surgery notes given by Gian Sagar Hospital, it has been specifically mentioned that there was history of gunshot injury; wound cut over pericordim; yellowish mass protruding out; subcutaneous swelling present. At that time BP was 130/80 mg Hg.; HR was 90/min and Spo2 (Spo2 stands for peripheral capillary Oxygen saturation, an estimate of the amount of oxygen in the blood) was 98%. Keeping in view the critical condition of the patient, he was  referred to the ‘PGI’ for cardio thoracic surgeon’s opinion.
9.           Thus, it is evident from the bare perusal of Annexure C-3 that condition of the deceased was highly serious, therefore, the doctors of Gian Sagar Hospital did not perform surgery and they noted down yellowish mass protruding out of the wound and there was swelling in the internal organs, albeit, no action has been taken against the doctors of Gian Sagar Hospital for not performing the immediate surgery.
10.           In this case, the complainants have sought the opinion of Dr. Harish Tulli, MBBS, MD, Ex-Prof and HOD (Govt. Medical College, Patiala), now Consultant at Amar Hospital, Patiala. The said doctor has given the following opinion:-

 

1. “That deponent was working as Prof & HOD, Govt. Medical College, Patiala and having 35  years of experience and during service I have dealt with number of different types of cases and performed number of operations.
2. That deponent is at present serving as Consultant at Amar Hospital, Patiala since 16 years.
3. That I checked the treatment record of Sachdeep Singh son of Sh. Jagjit Singh, who had received gun shot injury on 17.01.2016, thereafter first Aid was given at Gian Sagar Hospital, Rajpura and after first Aid he was referred  to ‘PGI’ , Chandigarh for further treatment/operation.
4. That I have checked the medical treatment record and in my opinion, if immediate emergency major operation would have been performed by the super specialists, the life of Sachdeep Singh would have been saved.
5. That the Certificate Ex. Cw2/l dated 02.02.2018 is issued by me and I have signed the same, which is true and correct”

 

11.           Even a bare perusal of the said opinion, given by Dr. Harish Tulli, transpires that if, immediately, emergency major operation would have been performed by the super specialists, there was a remote possibility of chances of survival of the patient. According to Dr. Harish Tulli – if super specialists had performed surgery upon the patient immediately on his arrival on his hospital, even then there was remote possibility of chances of his survival. In the present case, much time was wasted in Gian Sagar Hospital i.e. more than 2 hours but no surgery was performed by the doctors thereat, especially when the gunshot injury caused severe damage to the heart organs- which shows wound cut over pericordim; yellowish mass protruding out; and subcutaneous swelling was present, surprisingly, no action has been taken against the doctors of Gian Sagar Hospital. Even none of them has been impleaded as a party in this case.
12.           When the patient was admitted in the ‘PGI’ , at about 5.00 p.m., the doctors medically investigated him and noted that “his BP was unreadable; pulse was feeble; respiration was IPPR (intermittent positive pressure respiration); temperature was A/F with initials as 13-NS 2 1.5 Lf Rushed”. After ten minutes i.e. 5.10 pm. his BP was 80/50; pulse was feeble; respiration was IPPR; temperature was A/F with initials as 2. Immediately, blood was transfused which resulted into improvement i.e. at 7.40 pm his BP was 100/60; pulse was 100/min.; respiration was IPPR; temperature was 30C. Again, at 8.30 pm- his BP was 120/70; pulse was 98/min.; respiratory was IPPR; temperature was 37C. At 9.30 pm his BP was 100/0; pulse was 96/min; respiratory was IPPR; temperature was 37C. The result of investigation at the spot and the condition of the patient was informed to the doctor by the attending staff. Immediately, thereafter, the patient was taken to operation theatre but when doctors started performing operation, his BP was not recordable. In this view of the matter, the surgery could not be performed as the condition of the patient was not suitable for the same and unfortunately, the patient had collapsed at about 00.29 hours on 18.01.2016.
13.           Further, the post mortem report of the deceased transpires that the gun shot caused huge and incurable damage to the vital organs. The relevant part of the same  is reproduced hereunder:-

Ribs/Sternum and Cartilage	An almost circular entry wound 3.5cm in diameter with abraded, inverted margins surrounded by burning and blackening in a teardrop shaped area of 8.5 cm x 4cm over the left side of the front of the chest, 2cm below the left nipple with omentel tissue protruding out. The tip of the teardrop shaped area is directed downwards and outwards. Singeing of surrounding hairs present. The wound path sequentially passed through the skin, subcutaneous tissues, underlying chest muscles, 7th ,8th and 9th left ribs, left parietal pleura and left lung, pericardium, apex of the heart. There was herniation of stomach, intestines and omentum into the thoracic cavity through the rent in the left diaphragm caused by the path of the pellets. Pellets were recovered from the pericardium, apical cardiac muscles, left lung, left side of diaphragm, costal surface of the spleen. A red colored plastic piston cup was also recovered from the upper surface of the left side of the diaphragm. The anatomical direction of the wound path was backwards, downwards and slightly outwards. The distance of the wound from the foot is 134 cm. A big circular defect was observed on the left side of the chest wall involving the 7th 8th and the 9th ribs and corresponding intercostal spaces with bony chips from the said ribs penetrating the parenchyma of left lung, left diaphragm, omentum and spleen
Pleura/Pleural Cavity	As described, about 200 ml of blood tinged fluid present in left pleural cavity.
Lung (Rt.)	Pale
Lung (Lt.)	Lower lobe of the left lung shows multiple contusions and is collapsed. On cut section hemorrhagic consolidation
Pericardium	Extravasation of blood seen over the apical region
Heart	Pale. Shows contusion over the apical region posteriorly with pellet wounds
Coronary Arteries and Large Blood Vessel	NAD
Abdomen
Peritoneum, Retroperitoneum	About 500 ml of blood tinged fluid present in peritoneal cavity. Mesentery as described. Omentum as described.
Stomach and its contents	25 ml of yellow colour fluid present. Mucosa is normal
Small intestine and its contents	Pasty material present
Large intestine and its contents	Fecal matter present
Liver and Gall Bladder	Pale

 

                   Thus, form the  bare perusal of the postmortem report reveal that there was herniation of stomach, intestines and omentum into the thoracic cavity through the rent in the left diaphragm caused by the path of the pellets in the body of the patient. The pellets had caused huge damage to the internal organs of the deceased i.e. Ribs/sternum and cartilage, chest wall, heart, gall bladder, lungs and liver. We are therefore of the opinion that in such a situation, surgery could not be performed and unfortunately, the patient collapsed at about 00.29 hours on 18.01.2016.

14.           We are of the considered opinion, that all the attending doctors of the ‘PGI’ exercised a reasonable degree of skill and knowledge and a reasonable degree of care, while handling the case of Sh.Sachdeep Singh. As stated above, the pellets had caused such a huge damage to the internal organs of Sh.Sachdeep Singh and also his BP became unreadable and under that situation, it was not feasible for the doctors of the ‘PGI’  to perform surgery. In these circumstances, the sad demise of the young patient does not itself establish negligence on the part of the doctors of the PGI. The Hon’ble Supreme Court in Martin D’ Souza Vs. Mohd. Ishfaq, (2009) 3 Supreme Court Case (Civ) 735 in para no.112 as under:-

 

“It must be remembered that sometimes despite their best efforts the treatment of a doctor fails. For instance, sometimes despite the best effort of a surgeon, the patient dies. That does not mean that the doctor or the surgeon must be held to be guilty of medical negligence, unless there is some strong evidence to suggest that he is.”

 

15.           However, in the present case, the complainants have failed to prove that the opposite parties were negligent or they failed to perform their duties with due care.
16.           For the reasons recorded above, we are of the considered opinion that this complaint is devoid of any merit and as such the same deserves dismissal. Consequently, this complaint is hereby dismissed with no order as to costs.
17.           Certified copies of this order be sent to the parties, free of charge.
18.           The file be consigned to Record Room, after completion.

Pronounced

19.05.2020 

Sd/-

[RAJ SHEKHAR ATTRI]

PRESIDENT

 

 

Sd/-

 (PADMA PANDEY)

          MEMBER

 

 

Sd/-

 (RAJESH K. ARYA)

 MEMBER

 Rg.