CC No.1361.2015

Filed on 24.07.2015

Disposed on.18.06.2018

BEFORE THE III ADDITIONAL BANGALORE URBAN DISTRICT

CONSUMER DISPUTES REDRESSAL FORUM,

BENGALURU– 560 027.

DATED THIS THE 18^th DAY OF JUNE 2018

CONSUMER COMPLAINT NO.1361/2015

PRESENT:

Sri.  H.S.RAMAKRISHNA B.Sc., LL.B.

        PRESIDENT

             Smt.L.MAMATHA, B.A., (Law), LL.B.

                      MEMBER

                                       V/S

ORDER

BY SRI.H.S.RAMAKRISHNA, PRESIDENT

1. This Complaint was filed by the Complainant on 24.07.2015 U/s 12 of the Consumer Protection Act, 1986 and praying to pass an Order directing the Opposite Parties to pay the compensation towards expenses of Rs.16,00,000/-, to pay the litigation expenses and other expenses. 
2. The brief facts of the complaint can be stated as under:

In the Complaint, the Complainant alleges that the father of the Complainant, Sri.Chinnappa @ Gundu Chinnappa was admitted to St.John’s Medical College & Hospital for treatment is illness on 11.06.2013 and he was operated upto on 24.06.2013 for the first time under Dr.Sadashiv Patil in Department of Surgery.  Thereafter, the Complainant’s father was discharged holding that he was all right in all respects as confirmed by the Opposite Party hospital authorities and Dr.Sadashiv Patil. Again on 09.07.2013 when the Complainant’s father was admitted for the illness, the doctors have diagnosed it as appendix and he needs to undergo one more surgery. On 11.07.2013 at about 08.00 a.m, Complainant’s father was admitted and he was taken to the operation theatre for removal of appendix.  The Complainant’s father was operated till 04.00 p.m on that day and it was conducted for nearly 8 hours.  However, the exact reasons for taking such a long time, for such a small operation like appendix, were not given by the Opposite Party hospital authorities.  After the operation his father was transferred to the ward and he was being monitored by the Opposite Party hospital authorities.  When enquired by the Complainant about the status of his father, Dr.Sadashiv Patil and his team who conducted the operation assured the Complainant that the Complainant’s father is alright and there is nothing to fear about his health.    On 27.07.2013 at around 9.00 a.m. the Complainant’s father is in good condition and he was moving here and there.  Thereafter, at around 11.00 a.m., on the guise of inserting the feeding tube to Complainant’s father, Dr.Sadashiv Patil and his team once again took the Complainant’s father to the operation theatre without the consent or knowledge of the Complainant.   However at about 11.30 a.m, the Doctors informed the Complainant that his father is alright.  However, Complainant’s father was kept in the operation theatre all the day.  At around 7.30 p.m, Dr.Sadashiv Patil and his team informed the Complainant that his father is in serious condition and his survival was doubtful due to loss of blood and low blood pressure.  Thereafter, Complainant’s father was shifted to ICU unit and left him there.  Thereafter, Dr.Sadashiv Patil and his team never visited to see the condition of the patient.  The Opposite Party hospital authorities on 13.09.2013 asked the Complainant to take his father to home without assigning any reason.  Left with no alternative, the Complainant took his father home in an ambulance.  However, the Complainant’s father died within half an hour after reaching home.  Without consent of the family member’s third operation is done by Dr.Sadashiv Patil and his team.  The Complainant has issued a legal notice through registered post and the said notice was served. The patient is died only due to negligence of the Dr.Sadashiv Patel’s team and hospital authority.  Hence this complaint.

3. Even though notice was served on Opposite Party No.3, 5, 6 & 7, but the Opposite Party No.3, 5, 6 & 7 failed to put their appearance and placed them ex-parte.

4. In response to the notice, the Opposite Party No.1, 2, 4 & 8 put their appearance through their counsel and filed their common version. 

The Opposite Party No.1, 2, 4 & 8 in their version pleaded that Opposite Party No.4 Dr.Anjaneya and Dr.Abheesh, Opposite Party No.8, was working under Dr.Sadashiv Patil, Opposite Party No.2.  The decision taken to operate and treat the patient in all capacities was taken by Dr.Sadashiv Patil.  The role played by Opposite Party No.4 and 8 in treating this patient was in the capacity of junior team members following the in charge’s direct orders.  Dr.Sadashiv Patil, Opposite Party No.2 is currently not working at St.John’s Medical College hospital, who is the Chief Opposite Party in this case.  The Opposite Party No.1, 4 & 8 are responding to this complaint as per records and as far as the role of Opposite Party No.4 & 8 are concerned.  The allegations made in the above said complaint against them are false, frivolous and concocted.  On 11.06.2013, Sri.Chinnappa @ Gundu Chinnappa, the Complainant’s father visited St.John’s Medical College & Hospital with complaints of swelling in the lumbar region with pain and fever and consulted Dr.Sadashiv Patil.  The patient was advised to undergo the following investigations:FNAC-Smear showed chiefly mucoid material, USG-Abdomen-showed Large Right lumbar region abscess in the abdomen wall measuring 7.4 X 4.8 X 5.6, volume of 105 cc.  Abscess ill-defined and showed peripheral locules, with minimal deep extention noted to the right para colic gutter; CT Abdomen-showed organized walled off collection in retroperitoneum involving right psoas and iliac sheath with extension into the abdominal wall inter muscular plane in right posterolateral region with large subcutaneuous 8 X 5.1 cm collection in lumbar region communicating to retroperitoneal collection.  Tubular retrocaecal structure Appendix in close proximity to collection.  Carcino Embryonic Antigen-121.5 (normal range-0.2-5.2 ng/ml).  Based on the reports, the patient was diagnosed cancer (mucinous adenocarcinoma) of appendix.  Accordingly, advised admission on 11.06.2013 for further management and appropriate treatment.  As advised, the patient got admitted and underwent the required procedure on 15.06.2013.  The mucinous material and the wall was sent for biopsy the report of which stated Fibrous tissue with abundant extracellular dissecting mucin with no epithelial cells primary mucinous adenocarcinoma, probably from GI particularly appendix needs to be considered.  Similarly, the Biopsy report dt.12.07.2013 stated mucinous adenocarcinoma of the Appendix with infiltration into an adjacent adipose tissue.  He was treated appropriately and was discharged on 21.08.2013.  The patient came back on 02.09.2013 with renal failure and was treated for the same.  Patient’s condition worsened and he developed acidosis for which he was treated and the attendants were repeatedly counseled for ICU care for which they did not agreed and they also did not agreed for any further treatment and wanted to take the patient home and accordingly the patient was discharged on 13.09.2013 against medical advice.  Now, the Complainant has filed the instant complaint alleging negligence against the Opposite Parties due to which his father passed away and also has claimed a sum of Rs.16,00,000/- towards compensation.  The patient was diagnosed to have cancer of the large intestine, with CEA report being 121.5.  The prognosis and poor outcome of the disease was clearly explained to the attendants as well as the patient himself.  Relevant test reports will be produced before this Hon’ble Forum at the appropriate time. The patient and his attendants were clearly explained about the advanced stage of the disease which had also been confirmed by Biopsy Report.  The patient was taken for radical right Hemicolectomy surgery and not Appendicectomy as stated by the Complainant.   It may be noted that the Surgery was conducted after explaining the condition of the patient and obtaining due consent from the patient party.  The Opposite Parties submit that the surgery lasted for four hours and not eight hours as stated by the Complainant.  The patient and attendants were explained about the poor prognosis in view of the seriousness of the disease.  The patient had developed a high output enterocutaneous fistula and after explaining the condition of the patient, he was taken up for exploratory laparotomy and a feeding jejunostomy.  Immediately after the surgery, the patient was shifted to ICU for further monitoring and the surgical team visited the patient every day in the ICU and has provided appropriate care and treatment.   The patient was discharged on 21.08.2013 after he was shifted to the ward with advice that the patient should be on adequate hydration while at home and accordingly he was managed by his attendants at home.  However, the patient, without proper hydration at home came back on 02.09.2013 with complaints of renal failure and was admitted on the same day for further management.  Progressively, the patient’s condition got deteriorated and he developed acidosis for which he was treated appropriately.  The attendants were repeatedly counseled for ICU care for which, they were not agreeable.  The attendants did not want any further treatment and wanted to take the patient back home.  Despite explaining the condition of the patient and the care and treatment that is required, the attendants got discharged the patient on 13.09.2014 against medical advice.  The treating Doctor had explained the condition of the patient in detail and obtained from the Complainant prior to the third surgery.  The Opposite Parties submit that whatever diagnosis made and treatment rendered is according to the standard medical practice and that there is no negligence or deficiency of service on their part.  The Complainant had filed a complaint before the Directorate of Health and Family Welfare which was dismissed after detailed enquiry.  This it very clearly shows that negligence is not proved and the Opposite Parties are not liable for any claim of whatsoever nature.  Hence prays to dismiss the complaint.

5.   The Complainant, Sri.Francis Xavier G.C filed his affidavit by way of evidence and closed his side.   On behalf of the Opposite Party No.1, the affidavit of one Fr.Pradeep Kumar Samad has been filed.  On behalf of the Opposite Party No.8, the affidavit of one Dr.Abheesh has been filed.  Heard arguments of both sides.

6.   The points that arise for consideration are:-

1. Whether the Complainant has proved the alleged deficiency in service by the Opposite Parties ?

2. If so, to what relief the Complainant is entitled ?

7. Our findings on the above points are:-

                POINT (1):- Negative

                POINT (2):- As per the final Order

REASONS

8. POINT NO.1:- As seen from the allegations made in the complaint and also the version of the Opposite Parties, it is not in dispute that the Complainant’s father Sri.Chinnappa @ Gundu Chinnappa was admitted to St.John’s Medical College & Hospital for treatment on 11.06.2013 and also he was operated on 24.06.2013 under Dr.Sadashiv Patil in Department of Surgery.  Thereafter, the Complainant’s father was discharged.  To substantiate this fact, the Complainant in his sworn testimony, he has reiterated the same and produced Admission Record.  As looking into this document, it is clear that Sri.Chinnappa was admitted in the St.John’s Medical College & Hospital for Ruptured Lumbas Abscess and discharged on 24.06.2013.  This evidence of the Complainant has not been denied or disputed by the Opposite Parties.  To discard the evidence of the Complainant, there is no contra evidence.  Therefore, it is proper to accept the contention of the Complainant that the Complainant’s father Sri.Chinnappa @ Gundu Chinnappa was admitted to the St.John’s Medical College & Hospital for treatment on 11.06.2013 and he was undergone surgery conducted by Dr.Sadashiv Patil and discharged on 24.06.2013.

9. It is further case of the Complainant, again on 09.07.2013 when Complainant’s father was admitted for the illness, the doctors have diagnosed it as appendix and he needs to undergo one more surgery.  On 11.07.2013 at about 08.00 a.m, Complainant’s father was admitted and he was taken to the operation theatre for removal of appendix.  The Complainant’s father was operated till 04.00 p.m on that day surgery was conducted for nearly 8 hours.  However, the exact reasons for taking such a long time, for such a small operation like appendix, were not given by the Opposite Party hospital authorities.  After the operation his father was transferred to the ward and he was being monitored by the Opposite Party hospital authorities.  When enquired by the Complainant about the status of his father, Dr.Sadashiv Patil and his team who conducted the operation assured the Complainant that the Complainant’s father is alright and there is nothing to fear about his health.   Further to substantiate this fact, the Complainant in his sworn testimony, he has reiterated the same and produced the Admission Record of Surgical Departments.  As looking into this document, the Complainant’s father was admitted on 09.07.2013 for mucinous carcinoma appendix and the Complainant’s father was undergone surgery on 11.07.2013, after conducting the surgery, the Complainant’s father was shifted to ICU.  Even this evidence is also not been denied or disputed by the Opposite Parties, thereby, it is proper to accept the contention of the Complainant that the Complainant’s father Sri.Chinnappa @ Gundu Chinnappa again admitted in St.John’s Medical College & Hospital on 09.07.2013 and diagnosed as mucinous carcinoma appendix and he was undergone surgery on 11.07.2013.

10. It is further case of the Complainant that on 27.07.2013 at around 9.00 a.m. the Complainant’s father is in good condition and he was moving here and there.  Thereafter, at around 11.00 a.m., on the guise of inserting the feeding tube to Complainant’s father, Dr.Sadashiv Patil and his team once again took the Complainant’s father to the operation theatre without the consent or knowledge of the Complainant.   However at about 11.30 a.m, the Doctors informed the Complainant that his father is alright.  However, Complainant’s father was kept in the operation theatre all the day.  At around 7.30 p.m, Dr.Sadashiv Patil and his team informed the Complainant that his father is in serious condition and his survival was doubtful due to loss of blood and low blood pressure.   Thereafter, Complainant’s father was shifted to ICU unit and left him there.  Thereafter, Dr.Sadashiv Patil and his team never visited to see the condition of the patient.  The Opposite Party hospital authorities on 13.09.2013 asked the Complainant to take his father to home without assigning any reason.  Left with no alternative, the Complainant took his father to home in an Ambulance.  However, the Complainant’s father died within half an hour after reaching home.  To substantiate this fact, the Complainant in his sworn testimony, he has reiterated the same and produced the Intensive Care Unit-Admission.  By looking into this document, it is clear that the Complainant’s father Sri.Chinnappa was admitted to the Intensive Care, after conducting Surgery on 11.07.2013 and the Complainant’s father was Intensive Care upto 21.08.2013 and also produced the Anaesthesia Consent.  As looking into this document, the Complainant’s father undergone surgery on 27.07.2013 for Re-look laparotomy + FT+proceed.  After conducting Re-look Laparotomy on 27.07.2013 the Complainant’s father was in ICU till his discharge i.e., on 21.08.2013.  Further the other documents produced by the Complainant himself clearly shows that Complainant’s father was under the care and custody of doctors till his discharged that is 21.08.2013. On the other hand, the complainant has not produced any supporting evidence that on the guise of inserting the feeding tube to Complainant’s father, Dr.Sadashiv Patil and his team once again took the Complainant’s father to the operation theatre without the consent or knowledge of the Complainant, but this fact is falsifies.   As the evidence placed by the Complainant himself i.e., the Complainant gave consent for ICU treatment and also Anaesthesia consent and the Complainant has not produced any evidence to substantiate his contention that at about 11.30 a.m, the doctors informed the Complainant that his father is in serious condition and his survival was doubtful due to loss of blood and low blood pressure.  Thereafter, Dr.Sadashiv Patil and his team never visited to see the condition of the patient.   On the other hand, as the evidence placed by the Complainant himself, it is clear that the Complainant’s father was under the care and in proper monitory in St.John’s Medical College & Hospital till his discharge i.e., on 21.08.2013. But Complainant suppressing the true fact i.e., father was again admitted on 02.09.2013 and discharged on 13.09.2013.  On the other hand, the Complainant contending that the Opposite Party Hospital Authorities on 13.09.2013 asked the Complainant to take his father to home without assigning any reason, this is falsifies.  As seen from the Discharge Summary produced by the Complainant himself and also as seen from the allegations made in the complaint as well as the evidence placed by the Complainant, absolutely there is no allegation that there is a Medical Negligence on the part of the Opposite Parties while conducting surgery.  But on the other hand, the surgery was conducted by the Opposite Parties are successful and even the Complainant has not produced Death Certificate of his father this itself very clear that the Complainant is suppressing the facts to what are cause of death of the Complainant’s father.

11. On the other hand, Opposite Parties in their version taken a defence that on 11.06.2013, Sri.Chinnappa @ Gundu Chinnappa, the Complainant’s father visited St.John’s Medical College & Hospital with complaints of swelling in the lumbar region with pain and fever and consulted Dr.Sadashiv Patil.  The patient was advised to undergo the following investigations:FNAC-Smear showed chiefly mucoid material, USG-Abdomen-showed Large Right lumbar region abscess in the abdomen wall and showed peripheral locules, with minimal deep extention noted to the right para colic gutter; CT Abdomen-showed organized walled off collection in retroperitoneum involving right psoas and iliac sheath with extension into the abdominal wall inter muscular plane in right posterolateral region with large subcutaneuous 8 X 5.1 cm collection in lumbar region communicating to retroperitoneal collection.  Tubular retrocaecal structure Appendix in close proximity to collection.  Carcino Embryonic Antigen-121.5 (normal range-0.2-5.2 ng/ml).  Based on the reports, the patient was diagnosed cancer (mucinous adenocarcinoma) of appendix. Accordingly, advised admission on 11.06.2013.  As advised, the patient got admitted and underwent the required procedure on 15.06.2013.  The mucinous material and the wall was sent for biopsy the report of which stated Fibrous tissue with abundant extracellular dissecting mucin with no epithelial cells primary mucinous adenocarcinoma, probably from GI particularly appendix needs to be considered.  Similarly, the Biopsy report dt.12.07.2013 stated mucinous adenocarcinoma of the Appendix with infiltration into an adjacent adipose tissue.  He was treated appropriately and was discharged on 21.08.2013.  In support of his defence, Fr.Pradeep Kumar Samad, Associate Director of 1^st Opposite Party, he has reiterated the same and produced Admission Record, Consent for Hospitalization and Conduct of Procedures, consent of ICU Admission & Treatment, Case Summary and Discharge Record, it clearly reveals that the Complainant’s father Sri.Chinnappa @ Gundu Chinnappa admitted St.John’s Medical College & Hospital on 11.06.2013 for mucinous adenocarcinoma) of appendix and on 11.06.2013 to 24.06.2013 for Ruptured ® Lumbas mucinous cyst, Adenocarcinoma Appendix and he was operated on 24.06.2013 by Dr.Sadashiva Patil, Department of Surgery and the Complainant’s father was discharged, again the Complainant’s father was admitted on 09.07.2013 and he was discharged on 21.08.2013.  From this evidence, it is clear that the Complainant’s father under treatment in St.John’s Medical College & Hospital from 09.07.2013 to 21.08.2013, thereby it falsifies the contention taken by the Complainant that on 27.07.2013 the Complainant’s father was in good condition and he was moving here and there.  Thereafter, at around 11.00 a.m., on the guise of inserting the feeding tube to Complainant’s father, Dr.Sadashiv Patil and his team, once again took the Complainant’s father to the operation theatre without the consent or knowledge of the Complainant.   On the other hand, as stated earlier on 14.07.2013 itself the Complainant’s give his written consent and also falsified the contention that thereafter Dr.Sadashiv Patil and his team never visited to see the condition of the Complainant’s father is also falsifies. 

12. It is further defence of the Opposite Parties is that the patient once again came back on 02.09.2013 with renal failure and was treated for the same.  Patient’s condition worsened and he developed acidosis for which he was treated and the attendants were repeatedly counseled for ICU care for which they did not agreed and they also did not agreed for any further treatment and wanted to take the patient home and accordingly the patient was discharged on 13.09.2013.  In support of this defence, he has reiterated the same and produced Case Summary and Discharge Record.  By looking into these documents, it is clear that the Complainant’s father was admitted on 02.09.2013 and discharged on 13.09.2013 in St.John’s Medical College & Hospital, for Septic shock with severe metabolic acidulous and it is also further reveals that on 12.09.2013 at about 11.00 p.m the Complainant’s father developed respiratory distress and had falling saturations ABG done s/o severe Metabolic acidulous.  The patient attenders are not willing to any further escalation of treatment and wanted to take the patient to home, hence patient is being discharged at the request with Rylis Tube.  So from this evidence, it is clear that even though the Opposite Parties authorities advised for further treatment of the Complainant’s father, but the Complainant refused to give further treatment and the Complainant’s himself wanted to discharged his father as against their medical advice.    Therefore, it is proper to accept the defence taken by the Opposite Parties.  
13. As seen from the evidence placed by the Complainant and the contentions taken by the Complainant as well as the defence of the Opposite Parties, it is crystal clear that the Opposite Parties have given proper treatment to the father of the Complainant’s even from 11.06.2013 to 24.06.2014 and again 09.07.2013 to 21.08.2013 and further from 02.09.2013 to 13.09.2013 but absolutely there is no any negligence on the part of the Opposite Parties while treating the Complainant’s father and there is no deficiency of service on the part of the Opposite Parties. 
14. The learned Counsel for the Complainant argued that on 27.07.2013 at about 9.00 a.m, his father was in a perfect condition.  He was in a mobile state and he was able to move about.  At about 11.00 a.m, on the same day in the guise of inserting fitting tube Dr.Sadashiv Patil and his team once again took his father to the operation Theatre without their consent and at 11.30 a.m, it was informed that his father was alright and his father was kept in operation theatre all the day.  At about 7.30 p.m, it was informed by Dr.Sadashiv Patil and his team the Complainant’s father is in a serious condition and his survival was doubtful due to loss of blood and low blood pressure.  But this argument of the learned Counsel for the Complainant cannot be acceptable.  As stated earlier, absolutely the Complainant has not placed any evidence to substantiate this contention, thereby it is not proper to accept the argument of the learned Counsel for the Complainant. 
15. The learned Counsel for the Complainant further argued that the Complainant’s father was shifted to ICU and was left there Dr.Sadashiv Patil and his team, did not visit or notice the condition of the patient.  The authorities on 13.09.2013 asked the Complainant to take his father home without assigning any reason.  The Complainant took his father in Ambulance.  He died within ½ hour after he reached home.  Even it is not proper to accept this argument also since the Complainant has not placed any evidence to show that the Opposite Parties authorities asked the Complainant to take his father to home without assigning any reason.  On the other hand, as the evidence placed by the Opposite Parties, it is crystal clear that even though the Opposite Parties authorities advised the Complainant to give further treatment, but the Complainant himself wanted to discharge his father as against their advise, but Opposite Parties authorities discharged the Complainant’s father on 03.09.2013, thereby it is not proper to accept the argument put forth by the learned Counsel for the Complainant.  From these evidence on record and contentions, it is crystal clear that there is no any deficiency of service or medical negligence on the part of the Opposite Parties. Hence, we answer point No.1 in Negative.

16.  POINT NO.2:-  In the result, for the foregoing reasons, we proceed to pass the following order:

ORDER

The complaint is dismissed.  No cost.

Supply free copy of this order to both the parties. 

 (Dictated to the Stenographer, got it transcribed and corrected, pronounced in the Open Forum on this, 18^th day of June 2018).

MEMBER                                             PRESIDENT

LIST OF WITNESSES AND DOCUMENTS

 Witness examined on behalf of the Complainant:

1. Sri.Francis Xavier G.C, who being the Complainant has filed his affidavit.

 List of documents filed by the Complainant:

1. Admission Record.
2. Consent the hospitalizing and conduct of procedure.
3. Initial patent Evaluation.
4. Consent for ICU Admission and treatment.
5. Intensive care Unit-Admission Document.
6. Nurses Evaluation:Initial.
7. ICU transfer out note Doctor’s note Nurses Note.
8. Billing status.
9. Consultation Sheet.
10. Physiotherapy Record.
11. Case summary and discharge Record.
12. Cross matching Report.
13. Department of Radiology CT and MRI.
14. Anesthesia Consent.
15. Operation Record.
16. Case summary and Discharge record.
17. Drugs and investigations.
18. ICU-Doctor’s Progress Record.
19. ICU-Nurses Evaluation Daily.
20. Harmolyamic Monitoring chart.
21. CNS and respiratory Monitoring chart.
22. Medication Record.
23. Admission Record:Surgical Departments.
24. Case summary and Discharge Record.
25. Radiology Investigation Report.
26. Anesthesia Consent.
27. Operation Record.
28. Doctor’s Progress Notes.
29. Nurse’s Progress notes.
30. Medication Record.
31. Nurse’s note.
32. Monitoring Record.
33. Admission record.
34. Discharge Summary.
35. Nurses note.
36. Hematology Investigations.
37. Admission check list.
38. Medication Record.
39. Admission record.
40. Case summary and Discharge Record.
41. Radiology Investigation Report.
42. Consultation Sheet.
43. Doctor’s Progress notes.
44. Nurse’s progress notes.
45. Medication Record.
46. Monitoring Records.
47. Follow up OPD visit/cross reference.
48. Charge Slips.
49. Advance Slips.     

Witness examined on behalf of the Opposite Parties:

1. Fr.Pradeep Kumar Samad, Associate Director of the Opposite Party No.1 by way of affidavit.
2. Dr.Abheesh, Surgeon of the Opposite Party No.8 by way of affidavit.

List of documents filed by the Opposite Party:

1. Copy of the FNAC Report.
2. Copy of the CT Report.

3. Copy of the Biopsy Report (No.5795/13 dt.16.06.2013).
4. Copy of the Biopsy Report (No.6710/13 dt.12.07.2013).
5. Copy of the Consent Form for Right Hemicolectomy.
6. Incision Record.
7. Consent the hospitalizing and conduct of procedure.
8. Initial patent Evaluation.
9. Consent for ICU Admission and treatment.
10. Intensive care Unit-Admission Document.
11. Nurses Evaluation:Initial.
12. ICU transfer out note Doctor’s note Nurses Note.
13. Billing status.
14. Consultation Sheet.
15. Physiotherapy Record.
16. Case summary and discharge Record.
17. Cross matching Report.
18. Department of Radiology CT and MRI.
19. Anesthesia Consent.
20. Operation Record.
21. Case summary and Discharge record.
22. Drugs and investigations.
23. ICU-Doctor’s Progress Record.
24. ICU-Nurses Evaluation Daily.
25. Harmolyamic Monitoring chart.
26. CNS and respiratory Monitoring chart.
27. Medication Record.
28. Admission Record:Surgical Departments.
29. Case summary and Discharge Record.
30. Radiology Investigation Report.
31. Anesthesia Consent.
32. Operation Record.
33. Doctor’s Progress Notes.
34. Nurse’s Progress notes.
35. Medication Record.
36. Nurse’s note.
37. Monitoring Record.
38. Admission record.
39. Discharge Summary.
40. Nurses note.
41. Hematology Investigations.
42. Admission check list.
43. Medication Record.
44. Admission record.
45. Case summary and Discharge Record.
46. Radiology Investigation Report.
47. Consultation Sheet.
48. Doctor’s Progress notes.
49. Nurse’s progress notes.
50. Medication Record.
51. Monitoring Records.
52. Follow up OPD visit/cross reference.

    MEMBER                                                             PRESIDENT