DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION, PALAKKAD
Dated this the 06th day of March, 2023
Present : Sri.Vinay Menon V., President
: Smt.Vidya A., Member
: Sri.Krishnankutty N.K., Member Date of filing: 04/09/2020
CC/99/2020
Vasantha
W/o Francis, Nallur
Kozhipara, Palakkad – 678 557 - Complainant
(By Adv. Sureshkumar.K)
V/s
The Manager
DDRC SRL Diagnosistic Services
Near District Hospital
Palakkad - Opposite parties
(By Adv. Vikas V B)
O R D E R
By Smt. Vidya.A, Member
1. Pleadings of the complainant in brief
On 19/06/2020, the complainant approached her doctor for consultation and the doctor prescribed blood test G-6 PD level after consultation. On the same day, the complainant went to the opposite party and they conducted the test and charged Rs. 640/- as fee. When the test result was shown, the doctor told that the test prescribed by him was G6PD level Quantitative, but the result was given for G6PD activity only and asked to do the test once again.
The complainant again went to the opposite party and requested to conduct the test prescribed by the doctor. But they were not ready to do it and demanded that if the complainant wants to do the test again, she has to meet the expenses. So the complainant and her son asked for the refund of the amount already paid; but they were not ready to repay and also misbehaved towards them.
On 24/06/2020, the complainant went to Vithayathil Diagnostic Centre and did the test prescribed by the doctor by expending an amount of Rs. 1,000/-
The act of the opposite party amounts to clear deficiency in service. So the complainant approached this Commission for an order directing the opposite party to
- Refund Rs. 640/-, being the fee charged by them for conducting the test.
- To pay Rs. 1,000/- as the fee incurred by the complainant in doing the test in another lab and to pay Rs. 20,000/- towards compensation for their deficiency in service and mental agony suffered by the complainant and Rs. 2,000/- as cost of the litigation.
2. Complaint was admitted and notice issued to the opposite party. They appeared and filed their version.
3. Opposite party in their version contended that the complainant approached them for blood test with a prescription which mentioned only “G6PD” and the test name “G6PD level” is not mentioned anywhere in the prescription. G6PD (Glucose-6-Phospate Dehydrogenase) is an enzyme and is useful when the same is active. Hence enzyme activity determination is the most clinically relevant and globally accepted test with regard to enzyme estimation. The opposite party admit that they collected Rs. 640/- for the G6PD activity test sought to be done by the complainant.
The complainant and her son again come to their laboratory and requested to conduct the G6PD level test. But it was declined by the opposite party because as per the prescription G6PD level quantitative test was not mentioned. The opposite party explained these to the complainant and she was convinced. The opposite party is providing accurate laboratory results and they had conducted the test as per the prescription and not liable to repay the amount collected for conducting the test.
The complainant has not produced the prescription used for conducting the test at Vithayathil Diagnostic Centre.
The opposite parties are doing the Gold Standard method i.e. V V Spectrophotometric method for measuring the enzyme activity (G6PD). An enzyme is only useful when it is active. That is why activity of an enzyme is assessed, not its just presence (numerical levels). So it is understood that enzyme activity determination (G6PD) is the most clinically relevant test, in regard to Enzyme Estimation. Universally G-6PD levels are assessed in terms of its activity. The amount of enzyme is not defined by its mass rather by its function. The results issued by the opposite party is accurate and there is no deficiency in service on their part. So the complaint has to be dismissed with the cost of the opposite party.
4. From the pleadings of both parties, the following points arise for consideration
- Whether the opposite party had conducted the test as per the prescription given by the doctor?
- Whether there is any deficiency in service on the part of opposite party?
- Whether the complainant is entitled to the reliefs sought for?
- Reliefs if any, as cost and compensation.
5. Complainant filed proof affidavit and Ext. A1 to A4 marked. Marking of Ext. A1 is objected to on the ground that it is a photocopy and that it is a prescription issued by a doctor. It is to be marked through the person who issued it. Ext. A4 is objected to on the ground that it is a photocopy. Objection is overruled as photocopy is admissible in evidence unless the other party has a case that the document is forged or fabricated. Complainant was examined as PW1. The Doctor who treated the complainant was examined as PW2. Ext. A1 is confronted through the Doctor on examination and admitted in evidence.
Opposite party also filed proof affidavit. No documents were marked from their side. Opposite party’s witness (Doctor-DDRC SRL) was examined as DW1. Evidence closed. Both parties filed notes of argument. Heard both parties.
6. Complaint averment is that the complainant’s doctor after consultation prescribed blood test G-6PD level and she approached the opposite party for conducting that test. They conducted the test and collected Rs.640/- as fee. On seeing the result, the doctor told that the test prescribed by the doctor is G-6PD level Quantitative; but the result was given for G6PD activity only and instructed to do the test prescribed. When she approached the opposite party again, they were reluctant to conduct the test or refund the money. They demanded the complainant to meet further expenses for conducting the test again. So she went to another lab and conducted the test by expending an amount of Rs. 1,000/-
7. Opposite party’s contention that complainant approached the opposite party with a prescription for blood test which mentioned only G6PD. The test name G6PD level is not mentioned anywhere in the prescription. G6PD is an enzyme and is useful when it is active. Enzyme activity determination is the most clinically relevant and globally accepted test with regard to Enzyme estimation. They admit that second time complainant and her son came to their laboratory and requested to conduct the G-6PD level test. The said request was declined by them because as per the prescription, G-6PD level Quantitative test was not mentioned. The fact was explained to the complainant and she was convinced by the explanation given by the opposite party. Their contention is that the results issued by them to the complainant is accurate.
8. In support of her contention, the complainant produced 4 documents which were marked as Ext. A1 to A4 and the doctor who treated the complainant and issued the prescription was examined as PW2.
In Ext. A1 prescription, the test is mentioned as G-6PD. Doctor during the chief examination deposed that page 2; 7th line “Dapsone എന്ന മരുന്ന് prescribe ചെയ്യുന്നതിന് മുമ്പായി standard protocol ആയി G-6PD എന്ന Enzyme test prescribe ചെയ്തിരുന്നു. Standard ആയി G-6PD Enzyme Level Units/Haemoglobin ആയിട്ടാണ് report ചെയ്യേണ്ടത്. Patient report കൊണ്ടുവന്നപ്പോൾ അതില് Units/Erithrocytes എന്ന് കണ്ടതിനെ തുടർന്ന് അത് ലാബിൽ പോയി confirm ചെയ്യാൻ ആവശ്യപ്പെട്ടിരുന്നു. ആദ്യം ഹാജരാക്കിയ result ആണ് Ext. A3. രണ്ടാമത് ഹാജരാക്കിയതാണ് Ext. A4. Ext. A4 ല് പറഞ്ഞിരിക്കുന്നതാണ് standard report.”
During cross examination doctor further deposed that (Page:3 - 8th line) “ഞാൻ Ext. A1 പ്രകാരം prescribe ചെയ്തിരിക്കുന്നത് G-6PD ആണ്. G-6PD ഒരു Enzyme activity test ആണ്............... (21st line onwards) Ext. A1 prescription അനുസരിച്ച് തന്നിട്ടുള്ള Lab report ആണ് A3. ഞാൻ Ext. A3 report പരിശോധിച്ചു. ഈ report പരിശോധിച്ച ശേഷം പുതിയ Lab test prescribe ചെയ്ത് കൊടുത്തിട്ടില്ല. പക്ഷേ prescription നിൽ note ചെയ്തിട്ടുണ്ട്........... ആദ്യം prescribe ചെയ്യുന്ന സമയത്ത് G6PD Level എന്ന് prescribe ചെയ്തിരുന്നില്ല. Prescription നു ശേഷം ശരിയായ രീതിയില് സമർപ്പിച്ചിട്ടുള്ള റിപ്പോർട്ട് ആണ് A3 എന്നു പറഞ്ഞാല് ശരിയല്ല.
On the reverse of Ext. A1 the doctor has noted (1) G-6PD level (2) Haemoglobin.
9. Opposite parties witness DW1, Doctor deposed that (page:2) Ext. A3 യിൽ G-6PD Activity ആണ് determine ചെയ്തിരിക്കുന്നത്. ഈ report ൽ Enzyme Activity determine ചെയ്യാൻ base ആയി എടുത്തിട്ടുള്ളത് ഈ patient ന്റെ RBC ആണ്. Erythrocytes എന്നു പറയും.” He further deposed Ext. A4 “ഹീമോഗ്ലോബിന്റെ അടിസ്ഥാനത്തിലാണ് G-6PD activity യെ പറഞ്ഞിരിക്കുന്നത് G-6PD Enzyme Activity determine ചെയ്യാൻ ഹീമോഗ്ലോബിനെയോ Eritrocytes നെയോ depend ചെയ്യാം. Ext. A4 ലെ G-6PD Enzyme activity യെ സൂചിപ്പിക്കുന്ന measurement ആണ് G-6PD Activity level നിർണ്ണയിക്കുന്നത്. Patient ന് കൊടുക്കേണ്ട മരുന്ന് നിർണ്ണയിക്കുന്നതിനു വേണ്ടിയും നടത്തുന്നതാണ്. ഏറ്റവും കൂടുതൽ medication നിർണ്ണയിക്കുന്നതിനു വേണ്ടിയാണ് അത് നടത്തുന്നത്.”
10. So from the deposition of PW2 and DW1 it is understood that opposite party had done the G-6PD test based on erythrocytes and the prescription was for determining G-6PD based on haemoglobin. The PW2 Doctor clearly mentioned this on the reverse of Ext. A1 when the complainant approached the opposite party with this prescription second time. The doctor prescribed it as a standard protocol before prescribing the medicine. The opposite party had not done the test prescribed by the doctor. Point No: 1 is decided accordingly.
Points 2 to 4 are considered together
11. So from the conclusion arrived at Point No:1, we found that opposite party had not done the test prescribed by the doctor. Eventhough both the test determines the Enzyme activity, the Opposite party had done the test based on Erythrocytes. The 2nd time when the Doctor had clearly mentioned it based on haemoglobin, they could have done it and charged the difference amount if any. Instead of that they did not do anything and demanded full amount for doing the test. It is a deficiency in service on their part. Complainant being an ordinary person do not know the methods in conducting the test. She is not aware of the technicalities involved in the test. What they want is the test prescribed by the doctor. Opposite party eventhough conducted the test based on another factor, did not comply the requirements of the doctor. This made the complainant to approach another lab to conduct the test spending additional amount. The complainant suffered financial loss and mental agony due to the conduct of the opposite party and they are bound to compensate the complainant for that.
In the result, the complaint is allowed.
We direct the opposite party to refund Rs. 640/- being the fee taken for conducting the test and to pay a compensation of Rs. 5,000/- for their deficiency in service, Rs. 5,000/- for the mental agony suffered by the complainant and Rs. 3,000/- being the cost of the litigation.
The opposite parties shall comply with the directions in this order within 45 days of receipt of this order, failing which opposite party shall pay to the complainant Rs. 250/- per month or part thereof until the date of payment in full and final settlement of this order.
Pronounced in open court on this the 06th day of March, 2023.
Sd/-
Vinay Menon V
President
Sd/-
Vidya.A
Member
Sd/-
Krishnankutty N.K.
Member
APPENDIX
Documents marked from the side of the complainant
Ext. A1 – Copy of prescription dated 18/05/2020.
Ext. A2 – Copy of receipt issued by opposite party dated 19/06/2020.
Ext. A3 – Copy of the test description dated 20/06/2020.
Ext. A4 – Copy of the final test report dated 24/06/2020.
Documents marked from the side of opposite parties: Nil
Witness examined from the complainant’s side:
PW2 – Dr. Surya Ravindran – Dermatologist
Witness examined from the opposite parties side:
DW1 – Dr. Hari Shankar – Doctor
Cost- Rs. 3,000/-
NB: Parties are directed to take back all extra set of documents submitted in the proceedings in accordance with Regulation 20(5) of the Consumer Protection (Consumer Commission Procedure) Regulations, 2020 failing which they will be weeded out.
