Punjab

Patiala

CC/17/215

Charanjit Kaur - Complainant(s)

Versus

Prime Multispeciality Hospital - Opp.Party(s)

Vipin sharma

05 May 2023

ORDER

DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION

PATIALA.

 

                                     

Consumer Complaint No.	:	CC/215/2017
Date of Institution	:	2.6.2017
Date of Decision	:	5.5.2023

 

 

1. Charanjit Kaur aged about 50 years wife of Baldev Singh
2. Nachhattar Singh aged about 28 years son of Baldev Singh
3. Manpreet Singh aged about 26 years son of Baldev Singh

Residents of House No.185-F, Ranjit Nagar, Seona Chowk, Patiala.

 

 

                                                                   …………...Complainants

                                      Versus

1. Prime Multispecialty Hospital, Patiala, Opposite Khalsa College Colony, Badungar Road, Patiala Punjab through its Managing Director/Manager.
2. Dr.Upinder Singh, Prime Multispecialty Hospital, Opposite Khalsa College Colony Badungar Road, Patiala.
3. Dr.Meenakshi, Prime Multispecialty Hospital, Opposite Khalsa College Colony, Badungar Road, Patiala.
4. The Oriental Insurance Co. Ltd. Divisional Office, Sai Market, Patiala through its Divisional Manager.

                                                                   …………Opposite Parties

 

Complaint under the Consumer Protection Act

 

QUORUM

                                      Hon’ble Mr.S.K.Aggarwal, President

                                      Hon’ble Mr.G.S.Nagi, Member        

 

 

PRESENT:                   Sh.Vipin Sharma, counsel for complainants.

                             Sh.Sukhdeep Singh Sahni, counsel for OPs No.1&2.

                             Opposite party No.3 exparte.

                             Sh.Amit Gupta, counsel for OP No.4.                                    

 ORDER                                          

1. The instant complaint is filed by Charanjit Kaur and others (hereinafter referred to as the complainant) against Prime Multispecialty Hospital and others (hereinafter referred to as the OP/s) under the Consumer Protection Act (for short the Act).
2. The averments of the complainants are as follows:
3. That Baldev Singh was having pain in left knee and was having difficulty in walking. He approached OPs No.1&2 who advised him to undergo Total Knee Replacement. Complainant was admitted to the hospital of OP No.1 on 26.5.2016and various pathological tests were conducted. He was also referred to heart clinic and was declared fit for surgery.
4. After the surgery i.e. on 28.5.2016 one unit of blood transfusion was done. After some time Baldev Singh started feeling burning sensation in urine and felt uneasiness accompanied with hypertension, which was conveyed to OPs No.2&3 The condition of Baldev Singh became serious and deteriorated  but the OPs No.1to3  failed to provide proper treatment to Baldev Singh and  told to take the patient to some other hospital.. In the treatment card OPs obtained in writing from complainant No.2 forcibly that deceased was having chronic liver disease, whereas all the tests reports were normal.
5. Baldev Singh was shifted to Columbia Asia Hospital, Patiala on 29.5.2016 at about 11:00 P.M. where his treatment was continued but he died on 30.5.2016 at 7:40 P.M.Cause of death was Septic Shock Multi Organ Failure and Type 1 respiratory failure which occurred due to Post Total Knee Replacement surgery and Post Blood transfusion reaction as the treatment carried out by OPs No.2&3 at the premises of OP No.1 was done in a negligent manner without due care and caution.
6. Postmortem of the deceased Baldev Singh was got conducted from the department of Forensic Science, Govt. Medical College, Rajindra Hospital, Patiala to ascertain the cause of death through police of  police station Tripuri whereby death of Baldev Singh was disclosed  due to Septic Shock, Multi Organ Failure. Thereafter complainants approached OPs No.1&2 and told the entire facts but OPs instead of expressing sympathy starting abusing the complainants. Legal notice dated 31.1.2017 was served upon the OPs but of no avail. There was imperfection, inadequacy in quality, nature and manner of performance of duties, sheer negligence and deficiency in service on the part of OPs No.1to3. Consequently, prayer has been made for acceptance of complaint.
7. Upon notice OPs No.1&2appeared through their respective counsels and filed their written statements having contested the complaint whereas OP No.3 failed to appear and was accordingly proceeded against ex-parte. Thereafter, OP No.4 was impleaded who also upon notice appeared and filed written statement.
8. In the written statement filed by OP No.1 certain preliminary objections have been raised. In the factual matrix and medical facts it is submitted that patient was admitted with OP No.1 on 26.5.2016 with the complaint of difficulty in walking. Investigation was done. On 27.5.2016 patient was given 1 unit of blood. He was advised for total knee replacement surgery. Prior to the surgery patient was taken to Dr.Manmohan Singh for cardiac clearance which was OK. Thereafter 2^nd unit of blood was transfused and started at 4.30 PM and completed at 7.30PM.Blood level was tested and HB was found 10.2.Patient was taken for surgery of left knee replacement at 8.00PM, which was done diligently, prudently with utmost due care and caution. Thereafter patient was shifted to a room in stable condition. On 27/28.5.2016 one more unit of blood was given to the patient. The patient was taken for x-ray which was satisfactory. At 6.30 PM patient was having breathlessness and hypotension with tachycardia for which medicine was started and the patient was shifted to ICU and became stable. The patient had 2^nd episode of hypotension at night which was controlled. On 29.5.2016 patient again had breathlessness for which he was examined and treated by Dr.Tarun and Dr.Upinder Singh and was put up on Bi-Pap Ventilator at about 1.30PM on 29.5.2016. Various tests were conducted. Patient was stable but the attendants of the patient wanted to shift him to Columbia Asia Hospital. No signature was ever obtained forcibly from the complainants on any blank paper.
9. After reiterating the facts as were taken in the preliminary objections (which are not repeated for the sake of brevity), OPs submitted that patient died due to the consequences of the disease which he was harboring as chronic liver disease. There is no connection between TKR and chronic liver disease. There is no deficiency in service or negligence in treating the patient. Ultimately OPs prayed for dismissal of complaint.
10.  In the written statement filed by OP No.2 it also raised certain preliminary objections. It filed reply on the same lines of OP No.1, which need not to be repeated for the sake of brevity and prayed for dismissal of complaint.
11. In the written statement filed by OP No.4 it raised preliminary objections. It denied all the averments made in the complaint and prayed for dismissal of complaint.
12. In evidence complainant Charanjit Kaur alongwith her counsel complainant has tendered in evidence, her, Ex.CA , affidavit of Manpreet Singh, Ex.CB, copies of test reports, Exs.C1 & C2, copy of echocardiography report,Ex.C3, copy of blood group report & RH factor, Ex.C4, copy of blood test report dated 28.5.2016,Ex.C5, copy of treatment card of Prime Hospital,Ex.C6, report of Columbia Asia Hospital,Ex.C7, laboratory report of Columbia Asia,Ex.C8, blood gas analysis report,Ex.C9, urine examination report, Ex.C10, serum report, Ex.C11, CBC prothrombine report, Ex.C12 , Blood gas analysis,Exs.C13 and C14, radiology report,Ex.C15, copy of death summary,Ex.C16, copy of postmortem report,Ex.C17, copy of pathological report,Ex.C18, copy of death certificate,Ex.C19 copy of legal notice,Ex.C20, original postal receipts,Exs.C21 to C23, bills and receipts, Exs.C24 to C233 and closed evidence.
13. On behalf of OPs No.1&2, ld. counsel tendered affidavit Ex.OPB of Dr.Upinder Singh alongwith documents (copies) Exs.OP2 to OP45 and closed evidence.
14. On behalf of OP No.4, ld. counsel tendered in evidence Ex.OPA, affidavit of Mukesh Malhotra alongwith, Ex.OP1 copy of policy alongwith terms and conditions and closed evidence.
15. We have heard ld. counsel for the parties and have also gone through the record of the case, carefully.
16. The husband of the complainant namely Baldev Singh was having pain in the left knee. He approached OP No.2 who was practicing as a specialist doctor in the hospital of OP No.1, for the treatment. Baldev Singh was advised to undergo  total knee replacement. On the advice of OP No.2, Baldev Singh got himself admitted in the hospital of OP No.1 on 26.5.2016. Various preliminary tests Exs.C1 to C5 alongwith cardiac clearance from Dr.Manmohan Singh a Cardiologist were carried out and he was declared fit for surgery. He was operated by Op No.2 on 27.5.2016. One additional unit of blood was transfused after surgery on 27.5.2016. However, after transfusion of blood, Baldev Singh felt uneasiness and burning sensation in the urine. It is alleged that he was not properly attended to by OP No.2 and his condition deteriorated. He was finally referred to Columbia Asia Hospital, Patiala for further treatment and was shifted there  at about 11:00PM on 29.5.2016. Baldev Singh breathed his last on 30.5.2016 with cause of death being septic shock and multiple organ failure as per report,Ex.C16.Postmortem of the deceased alongwith viscera examination was got carried out from Govt. Medical Rajindra Hospital, Patiala wherein cause of death was again declared to be due to septic shock and multiple organ failure and viscera report,Exs.C17 & Ex.C18.
17. Complainant has alleged that the OPs were negligent in treating the deceased and death had occurred due to negligence on the part of OP No.2 in not treating the deceased properly. It is also alleged that the report of chronic kidney disease as per the admission summary prepared by OP No.2 is an afterthought and the complainant was not having any such disease at the time of admission on 26.5.2016. Legal notice Ex.C20 was also served upon the OPs but no fruitful purpose was served. The complainants have as such prayed for compensation.
18. OPs No.1&2 in their written statement have denied the allegations leveled by the complainants and have taken almost similar defence in their written statements. OPs have submitted that deceased was admitted to the hospital of the OPs on 26.5.2016 with the complaint of difficulty in walking. Various pathological tests alongwith ECG etc. were carried as per the test result submitted by complainants. As per report, Ex.C1, his hemoglobin was 7.7 at the time of admission against minimum required value of 13.5 to 18. The attendants of Baldev Singh were asked to arrange for four units of blood as per the history, Ex.C6 produced by the complainants. One unit of blood was transfused in the morning of 27.5.2016 and 2^nd unit was transfused in the evening on the same day. Hemoglobin was then found to be 8.0 as per report and not 10.2 as alleged by the OPs, Ex.C2. Report of Echocardiography and colour Doppler, Ex.C3 carried out by Dr.Manmohan Singh M.D. cardiology was found to be normal and Baldev Singh was taken up for surgery at 8:00P.M. on 27.5.2016. His surgery was successful and was shifted to a room in stable condition. Another unit of blood was transfused at 12 hours on 28.5.2016. Baldev Singh reported uneasiness and breathlessness with hypertension and tachycardia on 28.5.2016. He was then shifted to I.C.U. at 18.30 hours and due care was taken by OP No.2 alongwith Dr.Tarun. Various tests were carried out on the deceased as per reports, Exs.OP30, OP31, OP32, OP33 & OP34. However, complainants were not satisfied with the treatment and they shifted Baldev Singh to Columbia Asia Hospital on 29.5.2016 at about 12:00P.M. where the deceased breathed his last on 30.5.2016.
19. The OPs have further argued that OP No.2 is a qualified orthopedic surgeon and has placed on record copy of Registration Certificate with Punjab Medical Council (Ex.OP3). He had further argued that OP No.2 is highly expert and had carried out 330 operations successfully and there was no negligence on the part of OP No.2 in treting the deceased (Baldev Singh).
20. OP No.2 has further submitted that he is insured with United India Insurance Co. through Professional Indemnity Policy No.272200/48/2016/13454 from 6.10.2015 to midnight 5.10.2016.
21. A perusal of the above facts indicates that the deceased was having low hemoglobin of 7.7 at the time of admission on 26.5.2016. The attendants of the deceased were asked to arrange for four units of blood for performing surgery. Blood was arranged by the attendants of the deceased with two units each from Govt. Rajindra Hospital, Patiala, as per Ex.OP40 and Life Line Blood Centre, Ex.OP41. Cross match of the blood was carried out in the respective blood banks as per slips, as above. Two units of blood was transfused to the deceased before surgery  leading to improvement in the hemoglobin of the deceased from 7.7 to 8.0. The 3^rd unit of blood was transfused at 12:00 hours on the mid day of 28.5.2016 after surgery. After transfusion of 3^rd unit of blood deceased developed complications. He reported uneasiness with burning sensation in urine and developed hypo tension and tachycardia at about 6.30 in the evening. Deceased was shifted to ICU where he was put on ventilator and his vital parameters were monitored. However, The deceased had again an episode of hypo tension leading to a sharp fall in the blood pressure which was recorded as 80/37. The incident was reported to Dr.Tarun Bhatia. The deceased was attended to as per his advice and vital para meters of the deceased improved on 29.5.2016. The B.P. was 120/50 with pulse rate 115 at 8.35AM on 29.5.2016 and a summary of the tests results produced by the OPs reveal that the liver function test of the deceased were abnormal on 29.5.2016 as per Ex.OP33, which clearly indicates that liver of the deceased had got damaged on 29.5.2016.
22. A perusal of the admission summary reveals that the deceased was then discharged on 29.5.2016 for further treatment from Columbia Asia Hospital, Patiala with the remarks that there has been reaction due to blood transfusion. It has also remarked in the patient history/ admission summary that the deceased was addict to alcohol and at the time of discharge the deceased has been declared to be suffering from chronic liver disease.
23. It is thus, clear from the above admission summary of the deceased that there was reaction due to blood transfusion after performance of surgery. The blood transfusion can lead to various reactions and complications leading to respiratory distress, high fever, hypotension (low blood pressure) and red urine (hemoglobinnia) etc. which were observed in deceased Baldev Singh. More so, after the performance of the surgery when the patient is under anesthesia and is more prone to develop infections/reactions. The reaction due to transfusion of blood is a common occurrence in the field of the medicine which does not prove that the doctor was negligent in performing his duties. In fact deceased was duly attended to by the OPs after the reaction due to blood transfusion.
24. The plea of the complainants that OPs were negligent in performing surgery and attending to the deceased post surgery is not proved. The deceased was duly attended to after development of complications and was immediately shifted to ICU and was attended by Dr.Tarun who was specialist in such cases. Complainants have also not produced any expert opinion on the record to prove their case. As such we find that OPs were not negligent in treating the deceased.
25. In this regard reliance can be placed on the judgment passed in the case titled as Mr.Arun K. Engineer Vs. Dr.Milind Karmarkar decided by the Hon’ble State Consumer Disputes Redressal Commission, Maharashtra on 5 June, 2009, wherein reference has been made to the ruling of  the case of Kiran Bala Rout Vs. Christian Medical College and Hospital & Ors., reported in II(2002) CPJ 131(NC), wherein it has been held that, absence of expert evidence on behalf of the complainant, no negligence or deficiency in service could be found against affidavits filed by the doctors. It has been held in several cases that negligence must be established and not presumed.’ In the instant case also the complainant has neither produced sufficient material nor examined any expert witness to show that OP/Dr. was negligent in treating the deceased. It is found that serious charges leveled by the complainant against the OP doctor remained on papers only.
26. Reliance can also be placed on the judgment dated 5.12.2023, passed by the Hon’ble State Consumer Disputes Redressal Commission, Hyderabad in the case titled as Yusupova Saodat, Hyderguda Vs. Dr. Sowjanya Kancha, decided on 5 December,2013, wherein reference of orders of the Hon’ble Commission passed in FA 1258/2008 dated 23.3.2009 has been made having held that, simply because a patient has not favorably responded to a treatment given by a doctor or a  surgery has failed the doctor cannot be held straight way liable for medical negligence by applying the doctrine of res ipso loquitor and that no sensible professional would intentionally commit an act or omission which would result harm or injury to the patient since the professional reputation of the professional would be at stake and that a single failure may cost him dear in his lapse.’
27. Also in C.P.Sreekumar(Dr.), MS(Ortho) Vs.S.Ramanujam, reported in (2009)7 SCC 130, the Hon’ble Supreme Court has held that ‘onus of proving medical negligence lies on complainant. Mere averment in complaint is not evidence and it is to be proved by cogent evidence. The Hon’ble National Commission, in Mrs.Shantaben Muljibhai Patel and others Vs. Beach Candy Hospital and Research Centre and others, reported in 1(2005)CPJ 10(NC), came to the conclusion that when the hospital equipped with necessary equipment and doctors performed duties to best of their ability and with due care and caution, something if goes wrong, no negligence/deficiency in service is to be proved. In Subhashis Dhir and Another Vs. Smt.Sanjukta Sengupta and others, reported in 1999(3)CPR 13(NC), the Hon’ble National Commission opined that doctor should not be held guilty of giving wrong treatment without some medical evidence to that effect. In a decision reported in 2009(2)SCCLA 629 in Martin F D Souza Vs. Mohd Ishfaq, it was held that medical practitioner would be liable  only where his conduct fell below that of the standards of a reasonably competent practitioner in his field and that standard of care has to be judged in the light of knowledge available at the time of the incident and not at the date of the trial. It was also held that in the said decision that Test in fixing negligence is the standard of the ordinary skilled  doctor exercising and professing to have that special skill, but a doctor need not possess the highest expert skill.’
28. In this case also there is no dependable evidence from the side of the complainant that the OP/Dr. conduct fell below that of the standard of a reasonable competent practitioner in this field. The doctor being expert and having requisite qualification on the subject in this case, cannot be held guilty for gross medical negligence or deficiency of service lightly. Consequently, the instant complaint fails and the same is hereby dismissed with no order as to costs.
29.           The instant complaint could not be disposed of within stipulated period due to Covid protocol and for want of Quorum from long time.
85109252238716.  
85109252238717.  

                                              G.S.Nagi                           S.K.AGGARWAL

                                              Member                          President