Tamil Nadu

North Chennai

67/2014

Rajesh Kumar,S/o.Radhakrishnan - Complainant(s)

Versus

Rep by its Administrative Officer - Opp.Party(s)

V.Balaji

23 May 2018

ORDER

                                                            Complaint presented on:  12.09.2013

                                                                Order pronounced on:  23.05.2018

 

DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, CHENNAI (NORTH)

    2^nd Floor, Frazer Bridge Road, V.O.C.Nagar, Park Town, Chennai-3

 

        PRESENT: THIRU.K.JAYABALAN, B.Sc., B.L.,        PRESIDENT

              THIRU. M.UYIRROLI KANNAN B.B.A., B.L.,      MEMBER - I

 

WEDNESDAY THE 23^rd DAY OF MAY 2018

 

C.C.NO.67 /2014

 

Rajesh kumar,

S/o. Radhakrishnan,

Panapakkam Village,

Kavaraipattai Post,

Thiruvallur-601 206.                                                            ….. Complainant

 

..Vs..

1. Joseph Nursing Home,

Rep.by its Administrative Officer.

10-A, Dr.Gurusamy Road,

Chetpet, Chennai-600 031,

  

2. Dr. Rekhakurian,

10-A, Dr.Gurusamy Road,

Chetpet, Chennai-600 031.

 

3.Dr.Sivasankari,

10-A, Dr.Gurusamy Road,

Chetput,

Chennai – 600 031.

 

4. Apollo First Med Hospital,

 Rep by its Administrative Officer.

 154. P.H.Road, Chennai-600 010,

                                                                                           .....Opposite Parties

 

Date of complaint                                 : 03.04.2014

Counsel for Complainant                      : M/s. V.Balaji & A.Sermaraj

Counsel for 1 to 3 Opposite Parties          : M/s. N.S.Manoharan & I.Lakhsmana

                                                                     Shankar                                                                   

 

Counsel for 4^th opposite party                         : M/s.T.M.Pappiah

 

O R D E R

 

BY PRESIDENT THIRU. K.JAYABALAN B.Sc., B.L.,

This complaint is filed by the complainant to refund the sum of Rs.7,83,874.57 towards hospitalization charges and also to pay a sum of Rs.10,00,000/- as compensation for mental agony with cost of the complaint  u/s 12 of the Consumer Protection Act.1986.

1.THE COMPLAINT IN BRIEF:

          The complainant’s wife was admitted in the first opposite party hospital on 09.08.2010. She had last menstrual period been on 04.11.2019 and her expected date of delivery was on 11.08.2010. From the time of admission till 2.15 p.m on 09.08.2010 FHR was recorded as good. The variation in FHR was noticed at 12.15 p.m. However, the opposite parties 2 & 3 have not taken any steps to deliver the baby by caesarean. From 10.08.2010 at 9.00 a,m onwards the 2^nd opposite party has not recorded FHR. It is the duty of opposite parties 2 & 3 /doctors to record FHR every half an hour from the time of admission and every 15 minutes when the patient developed labour pain.  They have also carried out BTCT test before delivery.

          2. On 11.08.2010 at 5.34 p.m the opposite parties 2 & 3 have conducted normal delivery and delivered a deeply asphyxiated female baby. The pediatrician was called at 5.38 p.m to assess the baby and at 5.55p.m the baby was declared dead. The reason for death of the baby was recorded as birth Asphyxia and severe shock. The death was not intimated to the complainant relatives immediately. There were manipulation records regarding time of intimation of death. The postmortem for the baby was not done to know about the cause of death. The case sheet reveals that the child was deprived of oxygen and hence it is a case of res ipsa loquitor.

          3. Immediate to the birth of the baby within one minute the opposite parties 2 & 3 failed to administer Oxytocin. At 6.00 p.m they noticed Atonic PPH. After noticing the same, they should have arranged blood beforehand. There was delay of one hour in transfusing the blood. Further in the absence of blood haemocel should have been given as an interim measure till the blood is secured. Further, to arrest the bleeding they ought to have taken the procedures to clamp the blood vessels that supply the uterus. The 2^nd opposite party has not resorted the hysterectomy as a life saving measure.      

4.   The complainant’s wife had undergone haemodialysis and developed ARDS and DIC. Consequently she was suffered with multi-organ failure resulting the death on 15.08.2010 at 11.00 a.m. The 4^th opposite party also not arrested the bleeding by known surgical procedure and not properly managed DIC and ARDS.

5. The opposite parties have committed the following deficiency in service that

 

 

     a.   Patient was not anemic. The normal Hb is 11 gm/DL. However the     

           patient Haemoglobin is 6.8 gm on 14.08.2010.

 

2. Blood not arranged before hand for normal deliveries.
3. When the distress was noticed the LSCS was not performed.
4. The delay of one hour in transfusing blood.
5. Haemecel was not given as interim measure.
6. CTBT test was not done.
7. Clamping blood vessels not done.
8. Hysterectomy was not done.

6. Hence the complainant filed this complaint to direct the opposite parties to refund the sum of Rs.7,83,874.57 towards hospitalization charges and also to pay a sum of Rs.10,00,000/- as compensation for mental agony with cost of the complaint.

7. WRITTEN VERSION OF THE 1 to 3 OPPOSITE PARTIES IN BRIEF:

The opposite parties admit that the patient was admitted on 09.08.2010 at 6.27p.m. From the time of admission till 12.15 p.m FHR was recorded  as good and variation in FHR was noticed at 12.15 p.m is an error apparent on the face of the record. There was no need to consider delivery by caesarean. The FHR was monitored continuously, every four hours after admission and every 2 to 3 hours after the pain started. The Hemoglobin level was tested and it was normal. The BTCT test is done in case of surgery only. The patient was normal during regular periods prior to pregnancy.

8. It is clearly recorded that at 5.55 p.m, baby’s heart sound was not heard, pulse not felt and pupil not reacted to light. Baby expired and the complainant and his relatives were informed at 6.00 p.m. Over writing due to bad ball pen is sought to be magnified as manipulation. There is nothing to indicate that the baby was deprived of oxygen, at any time. After Atonic PPH was noticed, appropriate medictation was started and senior doctor Dr.Kurian Joseph was contacted at once and normal saline infusion was started 6.20 p.m and fresh was arranged and drip was started at 6.30 p.m, anesthetist was informed at 6.40 p.m and the patient was ventilated. Then blood arrived and blood transfusion was started at 7.00 p.m and there was no delay at any point of time. Haemocoel has side effects in some patients. The opposite parties did not resort to hysterectomy for similar reasons on a proper assessment of the condition of the patient. The FHR was always good and it was recorded periodically. There was no inconsistence in the report of the opposite parties and the death summary issued by the 4^th opposite party. The complainant on his own admitted his wife suffered with multi organ failure, resulting in her death.  The complainant has not attributed specific incidents of negligent on the part of the opposite parties and hence they pray to dismiss the complaint.

9. WRITTEN VERSION OF THE 4^th  OPPOSITE PARTY IN BRIEF:

          This opposite party received the patient on 11.08.2010 in ICU in shock, DIC with multi organ failure and severe metabolic acidosis. Blood products were transfused and vaginal packing was also done. Hematologist was consulted. However, patient was not responding to blood transfusion and persistent bleeding present. On 12.08.2010 the patient continued to be in shock with severe metabolic acidosis. A nephrologist was consulted and dialysis was advised.  She had gastro intestinal bleeding and nasal bleeding. Echo and ultrasound was done.

          10. On 13.08.2010 also the patient continued to be in shock and hemoglobin count was low. The patient was unstable to shift for CT Brain Scan. On 14.08.2010 vaginal bleeding was stopped and she continues to have shock and condition was worsened. All the days the condition of the patient was informed to her family member. On 15.08.2010 the patient was in refractory shock with high dose of vaso pressors and persistent DIC and very low GCS. At 10.20 a.m the patient had a cardiac arrest and could not be revived. The other averments made in the complaint are denied. Even before admission with this opposite party, the patient had several complications as per her medical records. Hence there was no deficiency on the part of this opposite party and prays to dismiss the complaint with costs.

11. POINTS FOR CONSIDERATION:

          1. Whether there is deficiency in service on the part of the opposite parties 1

              to 4?

 

          2. Whether the complainant is entitled to any relief? If so to what extent?

12. POINT NO :1        

          The complainant married one Thulasi and out of their wedlock she got conceived and she consulted with the 2^nd opposite party who is attached with the 1^st opposite party hospital. Her last menstrual period was on 04.11.2009 and her expected date of delivery was on 11.08.2010. Till delivery she was keeping good health. On 09.08.2010 she had labour pain and she was admitted in the 1^st opposite party’s hospital at 12.15 p.m and the 2^nd opposite party is her consultant. Ex.A1 is the Antenatal Card issued by the opposite parties for medical examination during the pregnancy of the complainant’s wife.

13.  At the time of admission of the complainant’s wife at 12.15 p.m the fetal heart rate (FHR) was recorded as good. On 11.08.2010 at 5.30 p.m the opposite parties 2 & 3 has conducted normal delivery and the baby was declared dead by 5.55 p.m. Thereafter the 1^st opposite party/ hospital sent the patient to the 4^th opposite party for further management. At the time of admission in the 4^th opposite party’s hospital, the complainant’s wife condition went critical. Even though treatment was given, she was died on 15.08.2010 at 10.20 a.m in the 4^th opposite party hospital. These are all the above facts are commonly admitted by both the parties.

14. The complainant alleged several deficiencies against the opposite parties are that

     a.   Patient was not anemic. The normal Hb is 11 gm/DL. However the     

           patient Haemoglobin is 6.8 gm on 14.08.2010.

 

2. Blood not arranged in before hand for normal deliveries.
3. When the distress was noticed the LSCS was not performed.
4. The delay of one hour in transfusing blood.
5. Haemecel was not given as interim measure.
6. CTBT test was not done.
7. Clamping blood vessels not done.
8. Hysterectomy was not done.

     I. the second opposite party is not a qualified gynecologist to perform the

        surgery.

 

          In view of the above deficiencies alleged by the complainant the following issues are arises to determine that the opposite parties have acted negligently in treating the complainant’s wife at the time of delivery and subsequently.

1. Whether the 2^nd opposite party is a qualified gynecologist to perform delivery to the complainant’s wife?
2.  Whether death of the child was due to not monitoring FHR?
3. Whether the death of the complainant’s wife due to not taking proper steps to arrest PPH by the opposite parties?

15. ISSUE NO: 1.

Ex.B10 is the resume of the 2^nd opposite party. In the said resume, the 2^nd opposite party qualification was given as follows:

1985-M.B.S.S, - First Class.

1993 – Diploma – National Board of Medical Sciences – Part – 1.

1995 – M.R.C.O.G.

2007 – F.R.C.O.G.   

The complainant would argued that the 2^nd opposite party  had got through Diploma Course conducted by the National Board of Medical Sciences, Part-1 alone and she has not got through part – II and hence she cannot be a qualified Gynecologist and not competent to perform the delivery and thereby committed deficiency. Apart from the aforesaid part – I course; she had also having M.R.C.O.G  as membership & fellowship and F.R.C.O.G in the Foreign University. According to the opposite parties possessing the said MRCOG is  qualified as Gynecologist. Further the complainant has not disputed that the 2^nd opposite party has not qualified in the above said two courses. However, he would contend that the said courses were not registered in the medical council. The complainant had not shown any authority to establish that only after completing  D.G.O. Part – II course only, one can be considered as a qualified Gynecologist. Further the complainant raised it first time, only during oral arguments that the 2^nd opposite party is not a qualified Gynecologist to perform delivery and to that effect there is no pleading in the complaint. When there is no pleading, any amount of evidence or argument cannot be accepted. Therefore, we hold that without pleading, the argument of the complainant that the 2^nd opposite party is not a qualified Gynecologist has not been proved and the same is rejected.

16. ISSUE NO:2

          Admittedly the complainant’s wife Thulasi was consulting in the 1^st opposite party hospital from the beginning of her pregnancy was confirmed and she was attended by the 1st opposite party doctors/opposite parties 2 & 3 and during the consulting period of her pregnancy. The Ex.A1, Antenatal card was issued to her. On 09.08.2010 she was admitted in the hospital at 6.27 p.m  and till 12.15 p.m the FHR was recorded as good. The normal FHR should be between 110 -160. In Ex.A2, inpatient record at 12.15 p.m on 09.08.2010, FHR recorded as 140-100. Therefore, in the said FHR recorded in Ex.A2 there is variation. In Ex.A2 at page 8 on 11.08.2010 at 5.34 p.m it was recorded normal delivery. Hence, as per that entry the child was bone at 5.34 p.m. Further below it was recorded the patient delivered a deeply asphyxiated female baby. The said entry of opposite parties proves that the baby was delivered  ‘Still’ with lack of oxygen. As the patient got admitted on 09.08.2010 evening with labour pain, she made waited for normal delivery till 11.08.2010 evening by the doctors of the hospital. It is the doctor’s duty to suggest the course of delivery considering the condition of the fetus and patient. Here as they failed to suggest the same leads them as deficiency on their part.

          17. The complainant would argued that having noted the variation in the FHR, the doctors ought to have done caesarean and delivered the baby and on the other hand without doing the same waited for  two days for normal delivery is deficiency on their part. Dr.A.M.Mudaliar dealt Asphyxia Neonatorum in Chapter 46 in his book Mudaliar and Menon’s Clinical Obstetrics (Ninth Edition). In the said chapter at page 377 reads as

A persistent fetal heart rate of 100 or less between contractions of the uterus is a sure sign of fetal distress. If it happens to be irregular also, the distress is no longer suspect but confirmed. Less important is a rapid fetal heart; but if it is more than 160 and continues to be so, it may be taken as indicating fetal distress. The slow fetal heart is, however, of greater importance.

It is further stated the same reference at page 380 as follows:

During labour, the fetal heart must be listened to frequently – every 15 minutes – after rupture of the membrane. When asphyxia threatens as made out by auscultation, immediate steps should be taken to complete the delivery. In case where it is not certain and delivery is likely to take a little time, administration of oxygen to the mother may help to prevent respiratory depression due to anoxia.

The above references clearly states that having noted FHR is 100, the doctors should have done the procedures of caesarean. Having the opposite parties 1 to 3 admits that the baby delivered in an asphyxiated condition, they should have delivered the child by caesarean and failed to do the said procedure is deficiency on their part. Further, they have also failed to record the FHR every 15 minutes proves their negligent act.

          18. In Ex.A2 nowhere mentioned the cause of death of the baby. They have simply recorded at page 8 in Ex.A2 that a deeply asphyxiated female baby is delivered. Even in the written version of the opposite party 1 to 3 they have not stated that the baby was died before delivery or after delivery. They only stated in their written version at 5.55 p.m baby’s heart beat was not heard, pulse not felt and pupil not reacted to light. Then they informed the complainant and his relatives at 6.00 p.m that the baby was expired. Ex.B11 is the referral   from the 1^st opposite party hospital. In the said referral it was recorded as “baby still born”. This document proves that the baby was delivered only after death. In Ex.A2 inpatient record at 5.34 p.m it was recorded as the patient delivered deeply asphyxiated female baby. When Ex.B11 speaks that the baby was born after death, at the time of delivery at 5.34 p.m i.e the baby was delivered only after death at 5.34 p.m as in Ex.A2 at page 8. When the baby itself delivered after death at 5.34 p.m, why the opposite parties 1 to 3 have taken so much time to inform the baby’s death to the patient relatives at 6.p.m nearly after 25 minutes has not been explained. Therefore, the opposite parties 1 to 3 have not informed about the fact that the baby was born after death and also belatedly informed to the complainant and his relatives is deficiency on their part.

          19. Further, the opposite parties 1 to3 having noticed the variation in the FHR, they should have taken measures to deliver the baby through caesarean procedure and then the baby would have been saved Therefore, it is held that due to the negligent act of the opposite parties 1 to 3 by not maintaining the FHR properly, the baby was delivered after death and hence, it is further held that the opposite parties 1 to 3 have committed deficiency.

 20. ISSUE NO: 3

          The complainant would allege that the opposite parties 1 to 3 were not taken proper test to arrest PPH (Post Partum Haemorrhage) of his wife and hence she was also died.  PPH means loss of blood following after child birth. In this case also after delivery of the baby the mother was having bleeding. The opposite parties would argue that after delivery they have started blood transfusion at 7.00 p.m and second unit blood was started at 7.30 p.m and further arranged 4 more units of blood as per Ex.A2 inpatient record. After delivery at 8.00 p.m it was recorded no undue bleeding. However, at 7.00 p.m in Ex.A2 it was recorded CT-not measurable. CT means clotting time i.e the clotting of blood is not measurable. This recording proves that the complainant wife was continuously having bleeding and the same was not controlled by the opposite parties.  Further as per Ex.B5 the mother was having bleeding from 6.00 p.m after delivery. The opposite parties have not arranged blood for the mother before delivery. Only after delivery only they have arranged for blood in the Indian Red Cross Society. They issued blood at 7.20 p.m as in Ex.B8 report at Egmore. The 1^st opposite party hospital is at Chetpet. So after receiving the blood at Egmore and to reach the 1^st opposite party hospital it will take some time. So, at any cost before 7.30 p.m it would not have been possible to transfuse the blood to the mother. But, in Ex.A2 at page 12 it is noted as at 7.00 p.m blood transfusion was started is false. Therefore, with respect to transfusion of blood timing, the opposite parties have started the wrong time is deficiency on their part.

          21. The mother was having bleeding 6.00 p.m onwards as in Ex.B6. As discussed above only after 7.30 p.m they should have started the transfusion of blood. Therefore, after bleeding started, nearly 1½ hour the opposite parties 1 to 3 have not taken any steps to arrest the bleeding. The complainant argued that when the blood was not available the accepted mode of Haemocel should have been given to arrest PPH and for the same the counsel relied on an order of our State Commission passed in FA No.369/2010 dated 10.12.2011 (Dr.Selvambal Rajkumar Vs.S.Selvam). The State Commission categorically held that in the absence of blood, it is medically accepted, a substitute for blood viz., Haemocel, is to be given as an interim measure, till the blood is secured. The opposite parties 1 to 3 would reply that Haemocel is having side effect and that is why they have not given the same. For such contention there is no proof or any literature filed by the opposite parties. Since, Haemocel is the substitute for the blood and from 6.00 p.m to till 7.30 p.m they have not given blood, the opposite parties doctors failed to given Haemocel is deficiency on their part.    

22. The complainant relied on an order of the National Commission reported in III (2012)  CPJ  154 (NC) (Deep Nursing Home & Ans. Vs. Manmeet Singh Mattewal and others) argued that within one minute of delivery oxytocin should have been given to the mother and surgery also should have been done to control the bleeding. The above referred order of the National Commission supports the above contention of the complainant. Absolutely there is no explanation on the part of the opposite parties that why Oxytocin was not given to the mother immediate after the delivery. Further the haemoglobin range of the mother  is 5.8 gms on 11.08.2010 at 7.00 p.m. The normal range is 11.05 -16.05 as in Ex.B7 at page 61 for female. When the haemoglobin level is very low, the opposite parties should have taken proper care to transfuse the blood to the mother immediately and failed to do the same is deficiency.

23. The opposite parties would argued that the complaint has not filed within a period of two years and this complaint is not a competent person to speak about the negligence and only wife is competent and there was no undue bleeding and further no expert evidence produced to prove the negligent acts of the opposite parties 1 to 3 and in support of such contention relied an order of the National Commission reported in 2007 (2) CPJ 259 (Naseem Mohamed Bashir Ansari Vs.Dhange Hospital and Others and 2008 (1) CPJ 473 (Prasanta Kumar Chakraborty and Ors. Vs. Jahar Debnath (Dr.) and another) and also relied on another judgment of the Supreme Court of India reported in III (2010) CPJ 1(SC) and argued that in the judgment they have accepted Bolam test as correctly laying down the standards for judging cases of medical negligent, we follow the same and refuse to depart from it and therefore the opposite parties 1 to 3 have not committed any deficiency in service.

24. The complainant during reply relied on judgment of the Supreme Court of India I (2013) CPJ 6 (SC) where in held that the Jacob Mathew case limited only with record to prosecution of doctors under section 304 -A IPC and judgment rendered in III (2010) CPJ 1(SC)   the above referred is per incuriam. In view of above, the judgment referred by the opposite parties reported in III (2010) CPJ 1(SC) is not applicable to this case.

25. As far as expert evidence is concerned, from the available evidence and the documents filed by the either party, if the Forum is unable to find or determine the case, then the expert evidence is necessary. In this case the documents filed by  both the parties clearly speaks about their deficiency committed by them as discussed above. Therefore, in such circumstances the expert evidence is not necessary in this case and therefore the opposite parties relied on two orders of the National Commission is not applicable and such contention of them is rejected.

          26. Though the complaint is filed after two years with necessary condoning delay petition was filed and the same was allowed and in view of the same such arguments cannot hold good. The complainant wife was died due to the negligent act of the opposite parties 1 to 3 and therefore the complainant filed this complaint for her death and baby’s and hence the complainant is the only competent person to speak about the same.

          27. The complainant admitted his wife in the 1^st opposite party’s hospital and the opposite parties 2 & 3 were treated her for delivery and the baby was born as still born baby and due to continuous bleeding (PPH), after delivery the mother condition become worsen and unable to manage by those opposite parties they themselves referred to the 4^th opposite party/hospital for further management after informing Dr. Nirmala Jaishankar in that hospital.  The 4^th opposite party hospital even after treatment the complainant wife has died. They have issued Ex.B39 death summary in which they have stated that on arrival to ICU she was put on ventilator support, BP was un-recordable and peripheral pulses were not felt and Haemocel was given and in spite of that she was died.  The cause of death was given as 1.Post Partum Haemorage 2. DIC and 3. Multi Organ Dysfunction. Nearly after one and a half hour after delivery blood was not transfused or Haemocel was not given immediately and therefore she continued vaginal bleeding and due that organs were failed and she was collapsed.  When the opposite parties 2 & 3 attending delivery in the operation theatre, what  happened for about 25 minutes i.e from the time of  still born and informing the same to the patient relatives have not been explained by the opposite parties 1 to 3 either in their written version or in their proof affidavit.  The opposite parties 1 to 3 not only taken care to save the baby by way of properly monitoring FHR and  they could done the same and they should have done the caesarean procedure and saved the baby and likewise for the mother also they could have immediately given Haemocel substitute for blood they could saved the mother and also failed to give proper treatment to them  and negligently treated them proves that the opposite parties 1 to3 have committed deficiency in service.

          28. As for as the 4^th opposite party concerned, they received the patient in a critical condition and immediately they put on ventilator support and all treatments were given and however the patient condition became worse due to failure of multi organ and consequently she died. In view of the above circumstances, we hold that the 4^th opposite party  has not committed any deficiency in service.

29. POINT NO:2

          The complainant not only lost his baby and also lost his wife.   Any human being normally very anxious   and was happy to see the new born baby. In this case the baby was born in dead condition, due to the negligence of  opposite parties 1 to 3.Further the opposite parties unable to save the life of the complainant’s wife also. In such circumstances nothing to compensate the complainant, who has lost his beloved wife and new born baby. However, to certain extend the complainant can be compensated by way of money. The complainant spent a sum of Rs.6,06,874.57 rounded to Rs.6,06,875/-  by way of medical expense as per Ex.A3 and such amount he is entitled to get refund from the opposite parties 1 to 3 towards medical expenses. The complainant suffered with mental agony due to the medical negligence committed by the opposite parties cannot be measured due to loss of both his wife and baby and therefore in such circumstances, it would be appropriate to direct the opposite parties 1 to 3 to pay a sum of Rs. 10,00,000/- towards compensation for mental agony, besides a sum of Rs.5,000/- towards litigation expenses. The complaint in respect of  the 4^th opposite party is liable to be dismissed.

          In the result the Complaint is partly allowed. The Opposite Parties 1 to 3 jointly or severally  are ordered to pay a sum of Rs.6,06,875/- (Rupees six lakhs six thousand eight hundred and seventy five   only) towards the medical expenses to the Complainant and also to pay  a sum of Rs. 10,00,000/- (Rupees ten lakhs  only) towards compensation for mental agony, besides a sum of Rs. 5,000/- (Rupees five thousand only)  towards litigation expenses. The complaint in respect of the 4^th opposite party is dismissed.

The above amount shall be paid to the complainant within 6 weeks from the date of receipt of the copy of this order failing which the above said  medical expense and compensation amount shall carry 9% interest till the date of payment.

        Dictated to the Steno-Typist transcribed and typed by her corrected and pronounced by us on this 23^rd day of May 2018.

 

MEMBER – I                                                                PRESIDENT

LIST OF DOCUMENTS FILED BY THE COMPLAINANT:

Ex.A1	dated NIL	Antenatal Prescription
Ex.A2	dated 09.08.2010	Inpatient case Record
Ex.A3	dated 15.08.2010	Consolidated Bill
Ex.A4	dated 15.08.2010	Death Summary
Ex.A5	dated 15.08.2010	Death Certificate

 

LIST OF DOCUMENTS FILED BY THE 1 to 3  OPPOSITE PARTIES :

 

Ex.B1	dated 18.12.2009               to10.08.2010	Various Test Reports during Antenatal Care (Series)
Ex.B2	dated 09.08.2010      to 11.08.2010	Fetal Heart Rate Record (Series)
Ex.B3	dated 09.08.2010      to 11.08.2010	Nurising Chart (Ward)
Ex.B4	dated 09.08.2010        to 11.08.2010	Temperature Chart
Ex.B5	dated 11.08.2010	Nursing Chart (Labour Ward)
Ex.B6	dated 09.08.2010               to 11.08.2010	Medicine Chart
Ex.B7	dated  11.08.2010	Blood Test Report
Ex.B8	dated  11.08.2010	Blood Bank (Compatibility Report)
Ex.B9	dated  11.08.2010	Blood Bank Receipt
Ex.B10	dated NIL	Personal Resume of Opposite party-2
Ex.B11	dated NIL	Referral from Joseph’s Nursing Home
Ex.B12	dated NIL	Department of Accident & Emergency Service (Patient’s Trip Report)
Ex.B13	dated NIL	Initial Patient Record
Ex.B14	dated NIL	Patient Registration Details
Ex.B15	dated NIL	Admission Form
Ex.B16	dated NIL	Admission Slip
Ex.B17	dated NIL	Admission Checklist
Ex.B18	dated NIL	Case Sheet
Ex.B19	dated NIL	Consent form for transfusion of blood/ Blood Components
Ex.B20	dated NIL	Consent to Follow Critical Care (ICU) Policies and Guidelines
Ex.B21	dated NIL	Informed Consent for Transportation of Critically Ill Patients
Ex.B22	dated NIL	IP Consultation Request
Ex.B23	dated NIL	Progress Report
Ex.B24	dated NIL	Clinical Chart
Ex.B25	dated NIL	Haemodialysis Unit
Ex.B26	dated NIL	Consent for Haemodialysis
Ex.B27	dated NIL	Immuno Haematology
Ex.B28	dated NIL	Cumulative Chart
Ex.B29	dated NIL	Diabetic Chart
Ex.B30	dated NIL	Department of Dietetics
Ex.B31	dated NIL	Cumulative Chart
Ex.B32	dated NIL	Subjective Global Assessment (Adults)
Ex.B33	dated NIL	Doctor Instruction Sheet
Ex.B34	dated NIL	Drug & Diet Chart
Ex.B35	dated NIL	CCU Master Chart
Ex.B36	dated NIL	Nurses Chart
Ex.B37	dated NIL	Consent for Procedures Under Local Analgesia
Ex.B38	dated NIL	Investigation Reports
Ex.B39	dated NIL	Death Summary
Ex.B40	dated NIL	Death Information
Ex.B41	dated NIL	Death Certificate

 

 

MEMBER – I                                                               PRESIDENT