Andhra Pradesh

Chittoor-II at triputi

CC/51/2017

N.Bhanu Prasad Naidu - Complainant(s)

Versus

Sri Krishna Super Specialty Hospital, Rep. by its Office in Charge - Opp.Party(s)

K.Syamala

16 Nov 2018

ORDER

Filing Date: 13.10.2017

Order Date:16.11.2018

 

 

 

BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM-II,

CHITTOOR AT TIRUPATI

 

 

      PRESENT: Sri.T.Anand, President (FAC)

               Smt. T.Anitha, Member

 

 

 

FRIDAY THE SIXTEENTH DAY OF NOVEMBER, TWO THOUSAND AND EIGHTEEN

 

 

 

C.C.No.51/2017

 

 

Between

 

 

N.Bhanu Prasad @ N.Bhanu Prasad Naidu,

Hindu, aged about 28 years,

D.No.3-92, Annamayya Nagar,

Satyanarayanapuram,

Jeevakona,

Tirupati,

Chittoor District.                                                                              … Complainant.

 

And

 

 

1.         Sri Krishna Super Specialty Hospital,

            Rep. by its office in charge,

            No.10-25-M9-89, Tilak Road,

            Beside ICICI Bank,

            Tirupati – 517 501,

            Chittoor District.

 

2.         Dr.Pavani,

            Consultant Nephrologist,

            C/o. Sri Krishna Super Specialty Hospital,

            No.10-25-M9-89, Tilak Road,

            Beside ICICI Bank,

            Tirupati – 517 501,

            Chittoor District.

 

3.         Sri Sasi Ganesha Scan Centre,

            Rep. by its office incharge,

            No.10-3-206/L, Reddy & Reddy Colony,

            Tirupati – 517 501,

            Chittoor District.

 

4.         Dr. S.Chennakesavulu,

            Consultant Radiologist,

            C/o. Sri Sasi Ganesha Scan Centre,

            No.10-3-206/L, Reddy & Reddy Colony,

            Tirupati – 517 501,

            Chittoor District.                                                                  …  Opposite parties.

 

 

 

 

            This complaint coming on before us for final hearing on 24.10.18 and upon perusing the complaint and other relevant material papers on record and on hearing Kanchi Syamala, counsel for complainant, and Sri.M.Rama Chandra Reddy, counsel for opposite parties 1 and 2, and Sri.S.Adinarayana, counsel for opposite parties 3 and 4, and having stood over till this day for consideration, this Forum makes the following:-

ORDER

DELIVERED BY SRI. T.ANAND, PRESIDENT (FAC)

ON BEHALF OF THE BENCH

           

            This complaint is filed under Section –12 of C.P.Act 1986, seeking direction to opposite parties, to return the entire fee collected by the them from the complainant and to pay Rs.5,00,000/- as compensation towards mental agony caused to him and also to pay costs of the complaint. 

            2. The facts in brief are as follows:-  Opposite party No.1 is super specialty hospital, in which opposite party No.2 is consultant nephrologist. The complainant, who is a student aged about 28 years, approached opposite party No.1 on 21.08.2017, as he was suffering from backache, and paid Rs.300/- towards consultation fee for consulting nephrologist. He was allotted registration No.35933 by opposite party No.1 and appointment was given to consult opposite party No.2. On examination by opposite party No.2, complainant was directed to undergo ultrasonography of abdomen in Sri Sasi Ganesh Scan Centre (O.P.3 herein) and for urine routine examination. Accordingly, he approached the lab belonging to opposite party No.1 and gave samples for urine test and paid Rs.950/- towards fee.  On the same day opposite party No.1 gave report and in the said report RBC level is mentioned as 5-8/hdf and serum cretinine level is shown as 1.7m/dl, and further he approached opposite party No.3 for ultrasonography of abdomen and paid Rs.959/- and the ultrasonography report shows that complainant is having stones in his right kidney measuring 9 mm. The complainant thereafter approached opposite party No.2 with the reports and opposite party No.2 told the complainant that he was suffering from chronic nephro problem and prescribed some medicines to him, which costs Rs.600/-. Further, he was warned that if he does not follow the treatment, he had to undergo surgery and if he failed to undergo surgery, his life will be in danger. The complainant underwent mental agony due to the advice given by nephrologist. On the advice of his friends and parents, he approached SVIMS hospital, Tirupati, for second opinion on 02.09.2017. The doctors suggested him to undergo relevant tests i.e. ultrasonography of abdomen and urine tests, and the reports are different and contradictory with the earlier reports obtained from opposite parties 3 and 4. The doctors of SVIMS informed him that his right kidney is normal and urine test report is also found to be normal and he has no kidney ailments. It is submitted that opposite party No.1 unnecessarily put him in fear that he was suffering from chronic kidney problem  though his health condition is normal. Had he not approached SVIMS hospital, Tirupati, for second opinion, he would have lost huge money due to unnecessary medication and surgery. The complainant caused legal notice to opposite parties on 18.09.2017 calling upon them to return entire fee collected by them in the name of medical tests and also to pay damages to a tune of Rs.5,00,000/- for causing mental agony to him. Having acknowledged the notice, opposite parties 1 and 2 issued reply with false allegations. Hence, the complainant is left with no option but to approach this Forum seeking necessary directions as stated above.

            3.  Opposite party No.1 filed the written version, which was adopted by opposite party No.2 by filing memo, which is part and parcel of the written version. Opposite party No.4 filed the written version, which was adopted by opposite party No.3 by filing separate memo.

            4.  Opposite parties 1 and 2 contended as follows -  At the outset opposite parties 1 and 2 denied the averments in the complaint. It is admitted that opposite party No.1 is running super specialty hospital under the name and style Sri Krishna Super Specialty Hospital, in which he is the consultant specialist doctor in Gastro Enterology, and opposite party No.2 is consultant nephrologist. The complainant approached opposite party No.2 on 21.08.2017 with loin pain on the left side of the abdomen. As the case history does not disclose any disease, in order to rule out all possible causes, complainant was asked to undergo clinical tests, so as to come to correct conclusion about his health. He was asked to undergo complete urine examination, renal function test, random blood sugar and ultra sonography of abdomen. They never asked the complainant to get the tests done in any particular lab or diagnosed centre. He himself approached opposite party No.3 for ultra sonography test. It is denied that urine R.B.C level mentioned as 5-8 / hpf and serum croatinine level 1.7 m/dl. The test results do not indicate any chronic disease and the consultant doctor never said that it is chronic. It is equally false to state that opposite party No.4, who is a consultant radiologist gave a report that in ultra sonography it was detected that complainant was having stones in his right kidney measuring 9 mm size. It is further false to say that opposite party No.2 stated that complainant was suffering from chronic nephro problem. The complainant is called upon to prove the said allegations. The doctor never informed the complainant that if he fails to take medicine as prescribed, he had to undergo surgery or else his life will be in danger. It is denied that the complainant did not use the medicine. Infact the complainant had purchased the medicine on 21.08.017 in the medical shop located in the premises of the hospital. The complainant did not deny the usage of medicines in his legal notice. It is denied that he underwent mental agony due to the advice given by opposite party No.2. As seen from clinical reports, opposite party No.2 did not diagnose any serious ailment of complainant. As per the reports, there is formation of small stone in gall bladder. Opposite parties 1 and 2 are not aware of complainant approaching SVIMS hospital, Tirupati, for second opinion on 02.09.2017 on the advice of his parents and friends, and had underwent relevant tests again in SVIMS hospital. The complainant had gone to SVIMS hospital for checkup in pre-planned manner, in order to file complaint against the opposite parties to gain wrongfully. The averment in the complaint that SVIMS doctors on examining him with reference to urine test and ultra sonography test found that he had no ailment and told that his right kidney is functioning normally, is false and untrue. Infact the reports of the blood, urine and ultra sonography tests conducted on the complainant in SVIMS hospital discloses that kidneys are not normal and showed mild increased echogenesity which means that they are not normal. Further normal size kidneys CMD MAINTAINED is the report, which means that the Cortico Medullary Difference maintained is acute in nature. Finally, the impression of the test results noted that “B/L RPD changes to correlate with RFT”. “RPD means Renal Panchrymal Disease” suggestive of grade-1 ailment. Urine protein test done in SVIMS discloses high count which indicates kidney ailment. Hence, the complainant has to prove the truth and correctness and tenability and relevancy of the clinical reports of SVIMS hospital. It is false to say that had he not approached SVIMS hospital for second opinion, he would have lost huge money due to wrong medication and surgery. In respect of allegations in para.8 of the complaint, opposite parties 1 and 2 submit that complainant issued legal notice dt:18.09.2017 with false allegations calling upon them to return entire fee collected by them and also to pay damages to a tune of Rs.1,00,000/-, but infact in the complaint he had claimed Rs.5,00,000/- towards compensation and it shows that with malafide intention he filed the complaint to extract huge money from the opposite parties. The opposite parties sent suitable reply dt:25.09.2017 stating that neither there is medical negligence nor deficiency in service on the part of opposite parties. There is no cause of action to file the complaint. A doctor does not have to ensure that every patient, who comes to him, is cured. However, a doctor has to exercise a reasonable degree of care while treating the patient. The Hon’ble Supreme Court in number of judgments observed that “All that we are doing is to emphasize the need for care and caution in the interest of society, for, the service which the medical profession renders to human beings is probably the noblest of all, and hence there is a need for protecting doctors from frivolous or unjust prosecutions. Many a complainant prefers recourse to criminal process as a tool for pressurizing the medical professional for extracting uncalled for or unjust compensation. Such malicious proceedings have to be guarded against. We propose to lay down certain guidelines for the future, which should govern the prosecution of doctors for offences. A private complaint may not be entertained unless the complainant has produced prima facie evidence before the court in the form of a credible opinion given by another competent doctor to support the charge of rashness or negligence on the part of the accused doctor. The investigating officer should obtain an independent and competent medical opinion preferably from a doctor in government service qualified in that branch of medical practice, who can normally be expected to give an impartial and unbiased opinion”. The allegations made by the complainant were not established by way of any expert opinion. In the absence of such expert opinion, the contention of complainant that there is deficiency in service on the part of opposite parties 1 and 2 fails. The complainant does not know the difference between kidney and gall bladder. The complainant used the medicines prescribed by opposite party No.2 for 11 days from 21.08.2017 to 02.09.2017 and thereafter approached SVIMS for second opinion. It is quite possible that between 21.08.2017 and 02.09.2017 the medicines taken by him would have given positive effect, but without knowing the effect of the medicines, complainant came to the wrong conclusion that he had no ailment prior to consulting opposite parties 1 and 2. No doubt the test results of opposite parties and SVIMS differ. But even the reports of the SVIMS did not give any clean chit to complainant that he is free from kidney problems. The complainant is therefore not entitled to seek any relief and as such complaint is liable to be dismissed.

            5.  Opposite parties 3 and 4 contended as follows – At the outset, the allegations made in the complaint are denied. Opposite party No.3 is running Sasi Ganesh Scanning Centre in Reddy and Reddy colony, Tirupati, and the same is being maintained by Dr.S.Sasikala, MD. Opposite party No.4 is part time consultant to opposite party No.3. The complainant approached opposite party No.3 and opposite party No.4 conducted scanning. As per the report against gall bladder it is mentioned distended. Wall thickness is normal. No percholecystic fluid connection. Multiple Calculi noted largest measuring 5 mm as evidenced by the scanning film. The scanning report further shows that right kidney is normal in size and echotexture corticomedillary differentiation maintained. No e/o calculi/hydronephrosis. Cortical thickness of lower pole is 9 mm. So far as left kidney is concerned, it is normal in size and echotexture corticomedillary differentiation maintained. No e/o calculi / hydronephrosis. Cortical thickness at lower pole is 7 mm. But the complainant alleged in para.4 of the complaint that opposite party No.4 gave report of ultrasonography stating that complainant is having stones in his right kidney measuring 9 mm. The complainant handed over the report given by opposite party No.4 to opposite party No.2, and opposite party No.2 given treatment on the basis of the said report for multiple calculi. Opposite party No.4 never mentioned in the report that there are stones in the kidney. Thus there is no deficiency in service on the part of the opposite parties 3 and 4, and as much as there is no wrong report or misrepresentation. Opposite parties 3 and 4 have nothing to do with the report given by SVIMS authorities dt:02.09.2017, which is subsequent to treatment. Hence, there is no cause of action to file the complaint and the same is liable to be dismissed.

            6.  The complainant filed the chief affidavit as P.W.1 and marked Exs.A1 to A11. No documents are marked on behalf of the opposite parties. However, on behalf of opposite parties Dr.S.Pavani and S.Chennakesavulu, have filed chief evidence as R.W.1 and R.W.2.

            7.  The point for consideration is whether there is deficiency in service and negligence on the part of the opposite parties 1 to 4, as alleged by the complainant? If so, to what extent the complainant is entitled for the reliefs sought in the complaint?

            8.  Point:-  As per the written arguments filed by the complainant, it is argued that when the complainant approached opposite party No.1 on 21.08.2017 due to backache, he was asked to consult nephrologist in the same hospital. As per the advice of nephrologist, he had undergone urine test by paying Rs.950/- and further underwent ultrasonography of abdomen by paying Rs.959/- in opposite party No.3 scan centre, and that ultrasonography report reveals stones in right kidney measuring 9 mm, and that on the said report, opposite party No.2 told him that he was suffering from chronic kidney problem and prescribed medication to him by charging Rs.600/- and further the doctor informed that in case if he fails to follow the treatment, he had to undergo surgery or else his life will be in danger. It is further argued that the complainant decided to take second opinion and hence approached SVIMS hospital on 02.09.2017 and the same tests were undergone by him in the said hospital and the results of the test were found to be different from the reports of the tests conducted in opposite party No.3 scan centre. It is argued that SVIMS reports shows that right kidney functioning is normal and there is no disease pertaining to his kidneys. It is further contended that in view of contrary reports, it is clear that complainant was unnecessarily put in fear by opposite parties 1 and 2 on the wrong diagnose basing on the reports from opposite party No.3, and therefore it is clear case of medical negligence and the complainant has to be adequately compensated for undergoing mental agony due to wrong diagnose by opposite parties 1 and 2. Further it is argued that had the complainant not approached SVIMS hospital, Tirupati, for second opinion, he would have lost huge money unnecessarily.

            9.  As per the written arguments filed by the opposite parties, it is argued that opposite party No.1 hospital is a reputed hospital in Tirupati, and opposite party No.1 is the consultant super specialist doctor in gastro enterology, whereas opposite party No.2 is the consultant super specialist in nephrology in the same hospital. On studying the case history and examining complainant, it was found that he was not having symptoms of vomiting, dysurea, oliguria, swelling of body or feet, cardiac or pulmonary complaints, but in order to rule out all possible causes, he was advised to undergo clinical tests so as to come to correct conclusion with regard to his health problem and accordingly he had undergone tests of ultra sonography in opposite party No.3 scan centre, apart from urine test. On examination of test results, it revealed that urine R.B.C mentioned as 5-8/hpf and serum croatinine level 1.7m/dl do not indicate any chronic disease and the consultant doctor never informed that it is chronic disease. Opposite party No.4, who is a consultant radiologist gave a report that stones were found in right kidney measuring of 9 mm in size. Thus, it is contended that opposite party No.2 never put the complainant under fear by stating that he was suffering from chronic kidney problem. Further, opposite party No.2 never informed the complainant that if he fails to take medicines as prescribed by her, he has to undergo surgery or else his life will be in danger. Further, it is argued that complainant is falsely stating that he did not use the medicines prescribed by opposite party No.2. It is the case of the opposite parties that since there is a gap of 12 days between complainant approaching opposite party No.1 and later undergoing tests in SVIMS hospital, and in between 12 days, the complainant might have taken the medicines and as such the stones in gall bladder measuring 5 mm. must have disappeared.  It is pointed out that even the reports of the blood, urine and ultrasonography tests conducted in SVIMS hospital discloses that the kidneys of the complainant are not normal and it is mentioned that both kidneys shows mild increased echogenesity, which means that they are not normal. Further, Cortico Medullary Difference (CMD) maintained is acute in nature. Further RPD mentioned in the report means Renal Panchrymal Disease suggestive of grade-1 ailment. The complainant with malafide intention had filed this complaint in order to extract money from opposite parties. Even in the legal notice dt:18.09.2017 he claimed Rs.1,00,000/- towards compensation and while filing complaint he claimed Rs.5,00,000/- and this shows that complainant had concocted story of medical negligence only to extract huge money. The counsel for opposite parties further argued that medicines were given by opposite party No.2 for treating calculi in gall bladder and not for kidney ailment, and in 12 days time there is possibility of calculi in gall bladder melting since it is measuring only 5mm.

            10.  We have perused the documents filed. Ex.A1 is consultation cum prescription issued in the name of complainant. Ex.A2 is urine routine examination dt:21.08.2017. Ex.A3 is ultrasonography of abdomen dt:21.08.2017, which reveals that there is cortical thickness at lower pole of right kidney measuring 9 mm., so also left kidney. It is further revealed that urine bladder distended. The impression of ultrasonography stated as cholelithiasis, which means gallbladder ailment. Ex.A4 is receipt dt:01.09.2017 issued by Nephrology Department of SVIMS. Ex.A5 is ultrasound report issued by Department of Radiology, SVIMS, wherein it is mentioned that gallbladder is normal in size and no evidence of any calculi. Both kidneys shows mild increased echogenicity and CMD maintained. The impression of the report is stated as BLRPD changes to correlate with RFT. Ex.A6 is urine examination report given by SVIMS hospital dt:02.09.2017. Ex.A7 is legal notice dt:18.09.2017, wherein the complainant claimed Rs.1,00,000/- towards compensation for wrong diagnosis. Ex.A8 is acknowledgement signed by opposite parties 1 and 2. Ex.A9 is reply notice dt:25.0.2017 issued by opposite parties 1 and 2. Ex.A10 is returned postal cover. Ex.A11 is bank statement issued by Canara Bank pertaining to payment of fees to opposite parties. No documents are marked on behalf of the opposite parties.

            11.  It is well established principle of law that there should be expert evidence of some material in the form of excerpt from medical text books to connect the consequence with the treating doctors. In K.S.Bhatia Vs. Jeevan Hospital and Another reported in 2003(IV) CPJ 9(NC), it is observed that the Commission cannot constitute itself into an expert body and contradict the statement of the doctor unless there is something contrary on the record by way of an expert opinion or there is any medical treatise on which reliance could be based. The burden of proving the negligent act or wrong diagnosis was on the complainant and the appeal was dismissed. As per the settled law, the onus to prove that there was medical negligence, deficiency in service on the part of the opposite parties while diagnosing and treating the complainant, lay heavily on the complainant.

            12.  We have perused the reports issued by opposite party No.3 scan centre, as well as reports issued by SVIMS hospital. The test reports obtained from opposite parties and test reports obtained from SVIMS are differed to some extent. In such cases, it is not the complainant, who is competent to decide that the reports of SVIMS are correct and reports of opposite parties are not correct. No expert evidence is produced by the complainant to show that opposite parties 1 and 2 arrived at wrong diagnosis on the basis of the reports issued by opposite party No.3 and on account of that he suffered mental agony. In this connection, it is necessary to extract certain portion of cross examination of P.W.1, which is as follows – “ I consulted nephrologist instead ortho doctor. The nephrologist (O.P.2) advised me to take ultrasonography of abdomen. The doctor mentioned in the prescription, the name of O.P.3 scan centre and asked me to go to that centre. I have not filed the prescription in this court. I do not know whether in the report (Ex.A3), it is mentioned that there are kidney stones measuring 9mm size, but Dr. Pavani informed me orally that there are kidney stones measuring 9mm size in my kidney. I did not mention in the complaint that there are stones in gallbladder as per scan report. It is true that in Ex.A3 it is mentioned that both left and right kidneys are normal. I have not filed any document to show that doctor told me that if medicines are not taken, I have to undergo surgery. It is not true to suggest that since I took medicines, as prescribed by nephrologist (O.P.2) the gallbladder stones disappeared. I have not filed any document to show that I did not use the medicines as prescribed by nephrologist. It is true that in Ex.A5 it is stated that both kidneys shows mild increased echogenicity. In Ex.A5 it is stated “Impression: RPD CHANGES TO CORRELATE WITH RFT”. I have not filed any expert opinion to show that the report of opposite parties 1 and 2 is false”. The admissions made by P.W.1 in the cross examination clearly shows that even as per SVIMS reports, some kidney problem was there. The contention of complainant that opposite party No.2 prescribed medicines for kidney ailment and further told him that if he did not follow the prescription given by her, he had to undergo surgery or else his life will be in danger, has no basis, in the absence of any proof. It is clear from Ex.A3, which is ultrasonography abdomen, issued by opposite party No.3 dt:21.08.2017, that complainant is suffering from gallbladder stones. It is stated that multiple calculi of measuring 5 mm. is present in gallbladder and the impression is stated as “Cholelithiasis”, which related to gallbladder. The complainant had approached SVIMS 12 days subsequent to Ex.A3 report. Opposite party No.2 has given prescription to P.W.1 for the disease. It is true that SVIMS hospital report shows that gallbladder is normal in size. But it is the case of the complainant that opposite party No.2 informed him that he had kidney stones and prescribed medicines, for that no evidence is placed before this Forum. Dr.C.Sateesh Chandra, who filed affidavit on behalf of opposite parties 1 and 2, clearly stated that there is possibility of gallbladder stones disappearing, if the medicines prescribed by opposite party No.2 were taken even within 12 days gap. The complainant had not examined any expert to contradict the evidence of  Dr.C.Sateesh Chandra. It is settled law that a doctor does not have to ensure that every patient, who comes to him is cured, and he is only to ensure that he confers a reasonable degree of care and competence.

            13.  Hence, in view of above discussion and following the legal principles, we are of the opinion that the complainant had failed to prove that there is medical negligence and deficiency in service on the part of opposite parties 1 to 4. Accordingly, we hold that the complaint is liable to be dismissed.

            14.  In the result, complaint is dismissed. No costs.                                                                 

Dictated to the stenographer, transcribed and typed by him, corrected and pronounced by me in the Open Forum this the 16^th day of November, 2018.

 

        Sd/-                                                                                                                     Sd/-                                      

Lady Member                                                                                               President (FAC)

 

 

 

APPENDIX OF EVIDENCE

 

Witnesses Examined on behalf of Complainant/s.

 

PW-1: N. Bhanu Prasad (Chief Affidavit (Cross Examination was Conducted) filed)

 

Witnesses Examined on behalf of Opposite PartY/S.

 

RW-1: Dr. S. Pavani (Chief Affidavit filed).

RW-2: S. Chennakesavulu (Chief Affidavit filed).

 

 

 

EXHIBITS MARKED ON BEHALF OF THE COMPLAINANT/s

 

Exhibits (Ex.A)	Description of Documents
	Original copy of Consultation cum Prescription of Sri Krishna Super Speciality Hospital, Tirupati in the name of the complainant N. Bhanu Prasad.  Dt: 21.08.2017.
	Sri Krishna Super Speciality Hospital, Tirupati –Original copy of Urine Routine Examination Report of the petitioner. Dt: 21.08.2017.
	Original copy of Ultrasonography of Abdomen Report given by SRI SASI GANESA SCAN CENTRE. Dt: 21.08.2017 and Scan Images.
	Original copy of OPD Bill & Cash Receipt of SVIMS Hospital, Tirupati. Dt: 01.09.2017.
	System generated print of Ultrasound Report given by SVIMS, Tirupati to the Petitioner N. Bhanu Prasad. Dt: 02.09.2017.
	System generated print of Urine for Routine and Micros Examination Report given by the SVIMS, Tirupati. Dt: 02.09.2017.
	Office copy of the Legal Notice issued by the complainant to the opposite parties with postal receipts (5 in Number). Dt: 18.09.2017.
	Acknowledgement Cards (3 in No’s) in Original.
	Served copy of Reply Notice issued by the Opposite Party 1 and 2 to the Complainant. Dt: 25.09.2017.
	Return Cover along with Ack. Due. Dt: 28.09.2017.
	True copy of Bank Statement issued by the Canara Bank pertaining to the payment to the Opposite Party. Dt: 07.09.2017.

 

EXHIBITS MARKED ON BEHALF OF THE OPPOSITE PARTY/s

 

-NIL-

 

 

                                                                                                                       Sd/-     

                                                                                                                President (FAC)

      // TRUE COPY //

// BY ORDER //

 

Head Clerk/Sheristadar,

          Dist. Consumer Forum-II, Tirupati.

      

             

 Copies to:-    1.  The complainant.

                        2.  The opposite parties.