IN  THE  CONSUMER  DISPUTES  REDRESSAL  FORUM,  KOLLAM

            Dated this the   31^st   day of October  2018

Present: -    Sri. E.M.Muhammed Ibrahim, B.A, LL.M. President

         Sri. M.Praveen Kumar,Bsc, LL.B ,Member

       CC.No.318/12

Adv.P.R.Nandakumar                                         :         Complainant

S/o Late  Sri.K.Ramachandran Nair @ K.R.C. Nair

Ambadi, S.K.Nagar-202

Asraman West, Kollam-691002

[By Adv.Varinjam N.Ramachandran Nair]

V/s

1. The Chairman                                             :         Opposite parties

        Sree Narayana Trusts Medical Mission

        Kollam-691001.

2. The Secretary

         Sree Narayana Trusts Medical Mission

         Kollam-691001.

3. The Manager(HR)

         Sankar Institute of Medical Science & Research Centre

        Kollam-691001.

       [By Adv.George Mathews & Adv.S.Riyas]

FAIR ORDER

E.M.MUHAMMED IBRAHIM , President

          This is a case based on a consumer complaint filed under Section 12 of the Consumer Protection Act 1986. 

The averments in the complaint in short are as follows:-

       1.The complainants father Sri.K.Ramachandran Nair  was admitted as in patient at the 3^rd opposite party hospital on 13.06.2012.  The 1^st and 2^nd opposite parties are the Chairman, Secretary and Manager of Sankar Institute  of Medical Science and Research Centre, Kollam who are  responsible for conducting the hospital and all other activities.  It was in connection with performing angiogram in both legs  and  also  for planting of stents for removing the blocks,

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if any as per the advise given and diagnosis made by the interventional cardiologist Dr.Sreekala working under the opposite parties hospital.  The doctor has explained the details of the treatment and expenses that may incur for the angiogram procedure by accepting the procedure and expenses narrated by the  doctor, the complainant remitting Rs.7500/- as directed by the doctor for conducting angiogram.   On 14.06.2012, the doctor conducted angiogram and as blocks were detected on both legs, the doctor decided to do balloon angioplasty as a temporary measure and it was done on the left leg immediately.  Later the doctor informed the complainant that “stents” could not be installed due to medical reasons and the balloon angioplasty for the right leg was postponed to 18.06.2012. 

2. After the balloon angioplasty on left leg, the complainant’s father was shifted  to  the  ICU  and  on  15.06.2012  he  was  taken to Room No.502.  On 17.06.2012, at around 3.30 am the complainant’s father fainted and the complainant’s mother informed the matter  to the nurses station and they shifted him to the PUNARJANI Ward and after 4 am the staff of  Punarjani ward informed the complainant and family members that the father of complainant died due to heart attack at about 4 am.  The staff of punarjani ward also informed the complainant  that  the dead body cannot be released until the entire bills are settled as directed by the hospital authorities.  The complainant and his mother was shocked on hearing this threat and at about 5.30 am the complainant was served with two bills, a computerised one for Rs.12,891/- and a handwritten one for Rs.58,000/-.  The total amount claimed was Rs.70,891/-.  The inhumane attitude of the hospital authorities at odd hours added to the grief of the complainant and his family.  Since the death was unexpected at that early morning hours, the complainant made all out efforts and remitted the amount of Rs.70,891/- by 05.33 hours.  It was only after the payment, that the body of the complainant’s father was released to the family members.   Such acts constitute

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criminal offences  punishable  under  the  Indian  Penal  Code  and  the  hospital authorities who committed the same as well as the opposite parties are equally responsible  and liable to be punished.  The complainant and his family members were unable to react to such inhumane criminal acts due to the unpleasant situation they were facing during those moments  of grief.  The hospital staff who acted as narrated above will not do so unless they are directed  so by the opposite parties herein who are at the helm of affairs of the hospital and the trust.

3. After days of mourning and other related ceremonies, the complainant and his friend had visited the hospital on 26.06.2012 at about 1.30 pm and reported the matter to the 2^nd and 3^rd opposite parties and also requested for a detailed statement of the handwritten bill given for an amount of Rs.58,000/-.  The 2^nd opposite party directed the complainant  to the 3^rd opposite party for the same.   The  3^rd  opposite party was unable to explain  the details of the  bill and stated that details could not be given from the hospital as it was a package.  The complainant had demanded for the details and also made it clear that if the details are withheld, he  will be constrained to initiate appropriate legal  proceedings.  The 3^rd opposite party then stated that Rs.30,000/-  was given as fees to the doctor, Rs.25,000/- was charged for consumables and Rs.3000/- was charged for dye.  The 3^rd opposite party was unable to answer the queries made by the complainant regarding the details of consumables and its costs.

4. The complainant thereafter met Dr.Sreekala who attended his father and conveyed the grievances of the complainant  and his family.  The complainant also disclosed that the 3^rd opposite party had informed him that Rs.30,000/- was paid to Dr.Sreekala as her fees.  Dr.Sreekala had rushed to the office room of the 3^rd opposite party and clarified the issue in the presence of the complainant as she was totally disturbed  by such false information being given to the complainant by the 3^rd opposite party.  Dr.Sreekala also warned  the

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3^rd opposite party to refrain from such further false propaganda regarding the fees paid to her by the hospital.  She also told the 3^rd opposite party that she will give the details of  her fees, the details of consumables used and the dye used so that a detailed true statement can be given to the complainant.  But the 3^rd opposite party refused to budge from his stand that a detailed statement cannot be given to the complainant.  Later Dr.Sreekala informed the complainant that she did not receive even half the amount as fees as claimed to have been given to her by the hospital. 

5. The attitude of the 3^rd opposite party revealed that the handwritten bill for an amount of Rs.58,000/- was a false and fabricated bill.  The complainant was forced to pay such a false bill amount at an odd hour under threat of detaining the dead body of his father, which is a grave crime committed by the hospital authorities concerned.  The subsequent conduct of the 3^rd opposite party is not rendering a detailed statement of the impugned bill proved the malpractice which is  highly  deplorable.  The  complainant  believed  that   this attitude is being continuously adopted by the hospital and poor patients and their family.  Being the son of a well known social activist, the complainant believes that it is his duty to take up the issue for the best interests of the society.  Therefore a legal notice dated 06.08.12 was issued to the opposite parties, along with a copy of the same to Dr.Sreekala for information, calling upon the opposite parties to disclose the true facts of the issue and to compensate the complainant for all the aforesaid misdeeds, malpractices and cheating committed against the complainant and his family.  Through the legal notice, the opposite parties were informed that if they are interested in avoiding any litigation in the issues stated supra, a detailed true statement of accounts with respect to the handwritten hospital bill for Rs.58,000/- be issued to the complainant and the complainant is to be convinced of the actual amount involved.  The balance amount was to be repaid to the complainant, all of which

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was called upon to be done within ten days of receipt of the said legal notice.  An amount of Rs.1,00,000/- was also sought as compensation for the mental agony and harassment  to the complainant and his family.

6. The opposite parties issued a reply notice dated 21.08.2012 containing absolutely false averments.  The said reply notice revealed the malafide of the opposite parties.  The opposite parties stated that the handwritten bill was prepared by the doctor.  Thereafter it was stated that an estimate was made by the doctor in activity  record  for  billing  attached to the case sheet.  It was  also stated  in the reply notice that Dr.Sreekala has not submitted a certified list of consumables used during the procedure.  It was further informed through the reply notice that the complainant can avail the details from Dr.Sreekala.   It could be seen that even after receipt of the legal notice, the opposite parties have not gathered  the list of consumables from Dr.Sreekala so as to convey it to the complainant. 

7. Dr.Sreekala had not issued any letter in response to her being served  with  a  copy  of   the  legal notice  addressed  to the opposite parties.  It means that Dr.Sreekala is not denying the allegations  and averments made in the said legal notice issued to the opposite parties  by the complainant.  It is unbelievable that the opposite parties are unable to gather details from a doctor working at their institution under their command. Hence the complaint.

          8. The opposite parties 1 to 3 resisted the complaint by filing a detailed joint written version by raising the following contentions.

          The complaint is not maintainable since there is no allegation of deficiency in service or negligence on the side  of opposite parties.  However opposite parties would admit the following facts. One patient by name K.R.C Nair was admitted in  cardiology department on  13.06.12 as OP No.7118641, that angiogram was done by Cardiologist by name Dr.Sreekala on 14.06.2012, that the complainant remitted  the charge of Rs.7500/-,  that  on  the same day a

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balloon angioplasty was performed  by the said Dr.Sreekala,  that the patient expired on 17.06.2012 at 3.45 am, that  two bills were generated.  The 1^st bill for Rs.58000/- was  prepared on the basis of the report from the Cardiologist Dr.Sreekala.  A separate discharge bill was also given.  The above details were generated at 5.33 am on 17.06.12 and it was paid at about 6.21 am on the same day.  Hence according to the opposite parties there is no chance of  stating  any staff of the hospital to the deceased that  dead body cannot be released until  the entire bill amount  were settled.   However  the  opposite  parties  denied having committed  any criminal offence as alleged in the complaint.  According to the opposite parties neither the complainant nor any members of his family made any complaint regarding the remitting of  the bill amount as there was no situation as alleged in the complaint, that  there were no inhuman acts on the side of the hospital authorities as alleged in the complaint.

9. The opposite parties would also admit that on 26.06.2012 the relatives of the deceased came to the hospital and enquired about the details of the bill and thereupon the HR Manager(opposite party No.3) informed them that the details of the bill  could  be  furnished by  Dr.Sreekala  who prepared the hand written statement based on the nature of procedure and consumables used.  Hence the HR Manager directed them to meet the said doctor to clarify their doubts and the HR Manager is    not competent to explain the details of the procedure and consumables used.  They would also content that the hand written bill  prepared by Dr.Sreekala was not fabricated or false one.  Dr.Sreekala had given the estimate  and not given the details of the consumables used while preparing the estimate as usual.  The complainant being an advocate know that interventional cardiologist is not competent to give the details about the allegations.

10. It is further contented that the complainant intentionally did not implead the said  doctor  in the party array, that  the opposite party sent a  reply

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notice stating the facts to the complainant, that  the complainant did not approach the doctor even after received the reply notice.  There is no chance of causing any mental agony or harassment to the complainant or his family and hence not eligible to get compensation of Rs.1,00,000/- as alleged in the complaint.  The  complaint  has been filed without any bonafides.   The opposite parties are not liable to pay compensation as claimed in the complaint.  The prayer in the complaint is in the form of a settlement of account and there is no allegation   of   deficiency  in   service   and   negligence  on   the  part  of  the opposite parties.  There is no cause of action  for filing this complaint.  The opposite parties further pray to dismiss the complaint with their costs.          

11.     In view of the above pleadings the points that arise for consideration are:-

1. Whether there is any deficiency in service on the side of the opposite parties?
2. Whether the opposite parties have collected  excess amount by issuing hand written hospital bill of Rs.58000/- to the complainant and whether he is entitled to get refund of the excess amount collected?
3. Whether the complainant is entitled to get compensation? If so what would be the quantum of compensation to be awarded?
4. Reliefs and costs.

12. Evidence on the side of the complainant consists of the oral evidence of PW1 and PW2 and Ext.P1 to P8 documents.

Evidence on the side of the opposite parties consist of the oral evidence of DW1 and Ext.D1 to D3 documents.

13. The learned counsel appearing for the complainant and opposite parties have filed notes of arguments.

14. Learned counsel appearing for both parties were not ready for advancing any oral argument,  though sufficient opportunity was granted.  Hence the matter has been taken up for  pronouncing order.

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Point No.1 to 3

15.         For avoiding repetition of discussion of materials these 3 points are considered  together.  The following are the  admitted facts in this case.  The opposite party No.1&2 are the Chairman and Secretary of  Sree Narayan Trust Medical Mission and the 3^rd opposite party is the HR Manager, Sankar Institute of Medical Science and Research Centre, Sree Narayan Trust Medical Mission, Kollam.  The father of the complainant Sri.Ramachandran Nair @ KRC Nair was admitted  as  an  inpatient  at the 3^rd  opposite party hospital on 13.06.12 for performing  angiogram  in both the legs and also for implanting stents for removing blocks if any as advised by the Cardiologist Dr.Sreekala working under the 3^rd opposite party hospital.   It  is  also  an  admitted  fact  that the said

Dr.Sreekala has conducted angiogram on the complainant on 14.06.12 and  blocks were detected on both legs.  She had performed balloon angioplasty also in the left leg on the same day and balloon angioplasty for the right leg was postponed to 18.06.12.  But after having done balloon angioplasty in the left leg the patient was shifted to ICU and on the next day ie, 15.06.12 he was shifted to room No.502.  But unfortunately on 17.06.12 at about 3.30 am the patient fainted and was shifted to the Punarjani ward.  However he died due heart attack at about 4 am on that day.

16. The main  allegation of the complainant is that immediately after the death of his father who was the patient admitted at Punarjani ward, the staffs of the Punarjani ward informed him that they shall not release the dead body of the diseased until and unless the entire bill amount is settled.  At about 5.30 am the complainant was served with 2 bills out of which one was computer generated bill for Rs.12691/- and the other was hand written bill for Rs.58000/-.  The in human attitude of the hospital authorities caused much mental agony to the complainant and his family members apart from the grief caused due to the death of his father.  However at the early morning at about 5.33 am he  managed

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to remit the full bill amount of Rs.70691/-  and only after remitting the entire bill amount the dead body of the diseased father was released to the family members.  The hospital staffs who committed the above in human act could not have acted without the knowledge of the opposite parties who are at the  helm of affairs of the hospital  and the trust.

17. It is the further case of the complainant that after the days of mourning  and other related ceremonies the complainant  and his friend visited the hospital on 26.06.2012 at about 1.30 pm and approached the 2^nd and 3^rd opposite party and requested for a detailed statement of hand written bill issued for Rs.58000/-.  The 3^rd opposite party was unable to explain the details of the bill and stated that details could not be given from the hospital as it was alleged as a package.  As the complainant insisted for getting the details the 3^rd opposite party explained that out of the total amount of Rs.58000/-, Rs.30000 was  given as fee to the doctor, Rs.25000/- was charged for consumables and Rs.3000/- was charged for the dye.  However the 3^rd opposite party  failed to give reasonable explanation to the query raised by the complainant regarding the details of consumables used for conducting surgery and its costs.  According to the complainant hospital authorities have realised excessive amount on this count and hence he sought the details of the hand written bill.  PW1 is none other than the complainant in this case.  He has sworn in the proof affidavit strictly in tune with allegations in the complaint and also proves Ext.P1,P2, P3 series, P4,P5 series, P6 series, P7 and P8 documents.  Ext.P1 is the bill dated 17.06.12 for Rs.12691/- and Ext.P2 is the disputed bill dated 17.06.12 for Rs.58000/-.

18. The complainant in the argument note would content that Ext.P2 is a forged and fabricated bill without any basis.  In view of the materials available on record we find merit in the above contention. According to PW1, he has sought for the details of P2 bill.  But  the  hospital  staffs  have  not  given  the

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same.  Hence he approached the 3^rd opposite party HR Manager who has also refused to give the details of Ext.P2 bill.  The contentions of the opposite party in this regard is that the details of  P2 bill is with the doctor  who conducted surgery and PW1 has not approached the doctor and sought for the details of P2 bill.  According to PW1 the 3^rd opposite party has also taken another stand that he is unable to explain the details of the  bill as the details could not be given bythe hospital as it was a package.  According to the complainant when he informed the 3^rd opposite party that if the details are withheld he will be constrained to take legal proceedings and there upon the 3^rd opposite party informed that  out of Rs.58000/-  collected as per P2 bill Rs.30000/- was given as fee to the doctor and Rs.25000/- was charged for the consumables and Rs.3000/- charged for dye.   However the 3^rd opposite party failed to explain what are the consumables worth Rs.25000/- used for conducting the surgery.  It is an admitted fact that the cardiologist who performs surgery used to keep the details of consumables used in each case.  Hence it is clear that the details of consumables are available at the hospital itself and the same can be easily obtained by PW3 or the person who prepared Ext.P2 bill.  But even according to 3^rd opposite party he has not received any such details of consumable from the doctor who performed surgery.

19. It  is also brought out in evidence through PW1 that unsatisfied by the reply given by 3^rd opposite party he meet Dr.Sreekala who conducted  the surgery and conveyed the  grievance of  himself and his family members regarding the excessive bill amount and also passed the information obtained from the 3^rd opposite party that out of Rs.58000/-, Rs.30000/- was paid as fee to herself.  By hearing the above information Dr.Sreekala was  totally disturbed and rushed to the office of the  3^rd opposite party and told in the presence of the complainant that the information regarding her fee is totally incorrect and also warned the 3^rd opposite party  to refrain  from  such  false propaganda regarding

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the fees paid to her by the hospital and also informed the complainant that the hospital has given less than half of the  said amount as her fee.  She has also agreed to furnish the details of the consumables and dye used so as to enable the 3^rd  opposite  party  to  give  a  true  statement  to the  complainant.  But  the 3^rd opposite party refused to give  a detailed statement  of consumables to the complainant for the reasons best known to him.  

20.The stand of the opposite parties that it is the doctor who has to furnish the details of the consumables and doctor’s fee to the patient and the relatives of the patient is not in accordance with the practice and procedure followed  in any hospital.  The doctor who treated the patient and conduct surgery  can  at the most furnished information regarding the fee charged and consumables used etc. to the hospital authorities and the doctor who treating the patient  is not expected to give any such  details to the complainant or to any other relative of the patient.  It is also brought out in evidence  that Dr.Sreekala was ready and willing to furnish such information to the hospital authorities including opposite party 3.  In the circumstances it is highly unfair to saddle the entire responsibility upon Dr.Sreekala  for not furnishing the information required by the complainant. 

21. The oral evidence of  PW2 who accompanied PW1 at the hospital on 26.06.12 would corroborate the version of PW1 regarding his request to issue  the details of Ext.P2 bill refusal of the opposite party 3 to issue the same and also the conversation between the complainant and  Dr.Sreekala who treated the diseased father of the complainant and her clarification that the allegation of the opposite party 3  that she has received Rs.30000/- is  incorrect  etc.  Though PW1 and PW2 have been subjected to severe cross examination nothing materials has been brought out to disbelieve their testimony.

22. It is highly unfair to state that the hospital authorities are not expected to issue a detailed bill regarding the charge they levied from the patient or from

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the relatives of the patient.  The patient undergoing treatment or his relatives are expected to know the details of the treatment and the fees collected by the hospital authorities including doctor’s fee and the items of consumables used and its price etc.  In the  circumstance it is clear that  the opposite party 3 who is  bound to issue a true statement of accounts in  respect of Ext.P2 hand written  hospital bill for  Rs.58000/- to the complainant and also to refund the amount excessively collected from the complainant.  Unfortunately no data is available to find out the excess amount collected by the hospital authorities.  The same can be ascertained only on  the receipt of a detailed true statement of accounts in respect of Ext.P2 hand written bill. 

23. It is true that the complainant has not alleged any negligence or deficiency in service regarding the treatment given to his father nor the complainant has any allegation that  their  father Sri.K.Ramachandran Nair has died as a result of improper negligent or careless treatment of  Dr.Sreekala. 

24. It is equally true that the complainant has not used the terms like deficiency in service, negligence or unfair trade practice against the opposite parties instead he used the term criminal offence regarding the acts of the opposite parties. But the complainant would allege that due to the death of his father while undergoing treatment  at the opposite party’s hospital the complainant and other family members were grief sticken  and at that time the staff of the  hospital  behaved  improperly  and  also  directed the complainant and his relative not to remove the dead body  till the hospital bill is completely paid and also given an improper bill by claiming huge  expenses and as the complainant and other family members were grief sticken due to the demise  of their father,  they were forced to pay the amount at an odd hour under the threat of detaining the dead body of his father which would constitute unfair trade practice and deficiency in service though the complainant has not used those terms  but  termed  the said acts as  grave  crime  committed  by  the   hospital

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authorities.  The opposite parties  denied  having  told the complainant  and his relatives that the dead body will be retained if the bill amount is not paid.  However it is clear from the available materials that the complainant is forced to pay the bill amount even though the details of the consumables used for a  huge  amount  is  not  available  in Ext.P2hand written bill.  Hence it is clear from the non issuance of a proper bill stating the amount charged under each head itself would amount to deficiency in service.  In view of the reasons stated above we find that the complainant is entitled to get a detailed true statement of account in respect of Ext.P2 hand written bill and also entitled to get refunded the excess amount collected from the complainant in respect of the treatment of his father.

25. Furthermore it is clear from the available materials that the attitude of  the hospital  authorities in realising the excessive bill amount by placing the complainant and other relatives of the deceased in a gun point by stating that they would not release the dead body of the deceased until and unless the bill amount which according to the complainant is highly excessive is paid.  In view of the materials available on record it is clear that the  above attitude of the opposite parties  have caused much mental agony to the complainant and his relatives especially when the complainant and others were in a grief sticken state of mind.  In the circumstance we have no hesitation to hold that there is unfair trade practice and deficiency in service on the part of the opposite parties and therefore the complainant is entitled  to get compensation from opposite party 1 to 3 who are jointly and severally responsible for the unfair trade practice, deficiency in service and consequent mental agony caused  to the complainant.

26.In view of the facts and circumstance of the case we are of the view that compensation  to the tune of  Rs.50000/- will be reasonable and sufficient.  In the circumstance of  the case we are of the view that an amount  of Rs.5000/-

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will be adequate costs and the complainant is entitled to get the same.  These  3 points answered accordingly.

Point No.4

In the result the complaint stands allowed in the following terms:-

1.  The opposite party No.1 to 3 are directed to issue a detailed true statement of the account in respect of Ext.P2 hand written bill to the complainant and also to refund the excess amount  collected  from the complainant in respect of  the treatment of his father.
2. The opposite party No.1 to 3 are further  directed to pay Rs.50000/- as compensation to the complainant.
3. Opposite party No.1 to 3 are also directed to pay  Rs.5000/- as costs of the proceedings to the complainant.

Opposite party 1 to 3 are directed to comply with direction No.1 to 3 within 30 days from the date of receipt of copy of this order failing which the complainant is at liberty to realise Rs.25,000/- in lieu of not furnishing  settlement of accounts and also in lieu of excess amount collected for the treatment of his father Rs.50,000/- as compensation along with interest at the rate of 9% per annum from the date of complaint till realisation along with costs Rs.5000/- from opposite party No.1 to 3 jointly and severally and from their assets.

Dictated to the  Confidential Assistant  Smt.Deepa.S transcribed and typed by her corrected by me and pronounced in the  Open Forum on this the  31^st   day of  October  2018. 

E.M.Muhammed Ibrahim:Sd/-

 M.Praveen Kumar:Sd/-

Forwarded/by Order

Senior Superintendent

INDEX

Witness Examined for the Complainant

PW1           :         Adv.P.R.Nandakumar

PW2           :         H.Harikumar

Documents marked for the  complainant

Ext.P1                  :         Receipt dated 17.06.12

Ext.P2                  :         Report dated 17.06.12

Ext.P3                  :         Receipt and Discharge bill

Ext.P4                  :         Legal  notice

Ext.P5                  :         Postal receipt

Ext.P6                  :         Acknowledgement card

Ext.P7                  :         Reply  notice

Ext.P8                  :         Receipt and report

Witness examined for the opposite parties        

DW1                    :         Dr.Jayadevan

Documents marked for the  opposite parties

Ext.D1                 :         Consumables

Ext.D2                 :         Copy of report

Ext.D3                 :         Copy of cath lab register

E.M.Muhammed Ibrahim:Sd/-

                                                                                   President

          M.Praveen Kumar:Sd/-

          Member

                                                                                 Forwarded/by Order

          Senior Superintendent