BEFORE THE DISTRICT FORUM: KURNOOL
Present: Sri. T.Sundara Ramaiah, B.Com B.L., President
And
Sri. M.Krishna Reddy, M.Sc., M.Phil., Male Member
And
Smt. S.Nazeerunnisa, B.A., B.L., Lady Member
Friday the 25th day of May, 2012
C.C.No.65/2011
Between:
A.Sreenivasulu,S/o. A.V. Ramana Goud,Constable,
H.No.45/24 K - 25 D M, Sreekrishna Colony,Kurnool-518 004.
…Complainant
-Vs-
1. The Proprietor,Apolo Medical Centre,
H.No.43/67/A1,Narasinga Rao Pet, Kurnool - 518 004.
2. Dr.S.Surya Babu, M.D., Pathologist, H.No.43/67/A1,
Appolo Medical Centre, Narasinga Rao Pet, Kurnool - 518 004.
…OPPOSITE PARTies
This complaint is coming on this day for orders in the presence of Sri P.Siva Sudarshan, Advocate for complainants and Sri M.Sivaji Rao, Advocate for opposite parties 1 and 2 and upon perusing the material papers on record, the Forum made the following.
ORDER
(As per Sri. M.Krishna Reddy, Male Member) C.C. No. 65/2011
1. This complaint is filed under section 11 and 12 of C. P. Act, 1986 praying a direction on opposite parties for the payment of:-
- Rs.20,00,000/- as a compensation;
- Cost of the case;
And
- Any other relief as the Forum deems fit and proper.
2. The complainant was suffering from fever. Under the care and direction of Dr.Isreal Raju he got examined his blood and urine at opposite part No.1 by opposite party No.2. In the clinical report opposite party No.2 opinioned that the complainant was suffering from Typhoid. He approached Dr.S.Chandrasekhar Proof of Medicine, Kurnool with this report for treatment. Basing on the report Dr.S.Chandrasekhar gave him treatment for typhoid up to 14-06-10. As the fever was not in control Dr.S.Chandrasekhar advised the complainant again to go to opposite parties for blood, urine re-examination along with Ultrasonography of Abdomen. Opposite party No.2 gave a report with an entry ‘negative’ for Cancer. On the next day i.e., 15-06-10 on the advice of Dr.S.Chandrasekhar the complainant went to KLR Pathology laboratory, Kurnool for the same tests, where it was suspected that the complainant was suffering from ACUTE MYELOID LEUKAEMIA. On seeing the report, Dr.S.Chandrasekhar and Dr.Siva Rajappa advised the complainant to go to CMC Vellore or NIMS Hyderabad for immediate better treatment. Accordingly the complainant went to CMC Vellore on 18-06-2010 took treatment for two days, came back to Kurnool and moved to M.S.Ramaiah Memorial Hospital, Bangalore on 23-06-2010 where he took treatment for Leukaemia stage M2 for 4 months. He paid Rs.7,00,000/-lakhs towards hospital charges and spent Rs.5lakhs for other expenses. The complainant says that, had he not approached KLR lab, he would have died due to Leukaemia. The opposite party No.2 was negligent in giving blood report as typhoid instead of Leukaemia. Hence there is deficiency of service on the part of opposite party No.2 entitling him to receive reliefs as prayed for.
3. Opposite party No.2 is unaware of the fact that the complainant took treatment for typhoid with Dr.S.Ckandrasekhar basing on the blood report given by him. He is unconcerned about approach of the complainant to KLR Pathology laboratory on 15-06-2010 for the same blood tests on the advise of Dr.S.Chandrasekhar and the report of KLR laboratory that the complainant was suffering from Acute Myeloid Leukaemia and basing on the report Dr. S Chandrasekhar and Dr.Siva Rajappa advised the complainant to go to CMC Vellore or NIMS Hyderabad for immediate treatment for Leukaemia. He has no knowledge about the visit of complainant to CMC Vellore, afterwards to M.S.Ramaiah Memorial Hospital, Bangalore, took treatment for Leukaemia M2 stage for 4 months and spent Rs.12,00,000/- for treatment etc. The facts are complainant approached opposite party No.1 for blood examination which was prescribed by Dr.Isreal Raju on 03-06-2010. Opposite party No.1 handed over the report to the complainant. The allegation that in the report it was noted by opposite party No.2 as positive for Typhoid is false. The report actually contains widal positive. Widal positive does not mean that the patient is suffering from Typhoid. It is a non specific Test for Typhoid. But blood culture is only the confirmative for Typhoid. Widal is positive in many cases such as
1. Chronic active hepatitis
2. Ulcerative Colitis,
3. Rheumatoid Arthritis,
4. Tuberculosis,
5. Multiple Myeloma,
6. Malaria,
7. Rheumatic Fever and
8. Acute febrile illness.
including Typhoid. The report contains Typhi ‘O’ and Typhi ‘H’ are positive in a particular dilution. It means that there is clumping due to Antigen and Antibodies reaction. Unknown Antigen and unknown Antibodies also sometimes give clumping giving impression that the patient is suffering from Typhoid. Therefore only method for Typhoid confirmation is blood culture, which takes a week time. Widal test is quicker but gives only 60% information. The physician has to correlate the results with the symptoms of the patient. So the allegation of the complainant that opposite party No.2 confirmed Typhoid fever is false and baseless. Again the complainant gave blood to opposite party No.1 for peripheral smear examination on 14-06-2011. The peripheral smear of the patient showed Normal Study with reduced cell count. The procedures adopted for doing peripheral smear is a drop of blood out of 5 lits of blood of the patient is taken and examined under microscope. On 14-06-2011 no blast cell was detected by him. On 15-06-2010 in KLR laboratory the blood examination suspected Acute Mycloid Leukaemia (M1) and the patient was advised to go for Bone Merrow Study. According to a medical book “de Gruchy’s clinical Heamatoloby in Medical Practice” in sub Leukaemic Leukaemia the diagnostic problem arises in the sub Leukaemia group when there are very few or no blast cells (cancer cells) evident in the blood film. So a drop of blood of complainant taken on 14-06-2010 did not contain the blast cells and accordingly report was given. But in KLR lab another drop of blood taken on 15-06-2010 might have contained one or two blast cells, so the doctor suspected Acute Myeloid Leukaemia and advised the patient to go for further investigation and confirmation. According to book “Atlas and Text of Heamatology” also in a Leukaemic Leukaemia TLC is low. No blast cells in blood, but marrow contains more than 20% blast cells. The report of peripheral smear dated 14-06-2010 of the complainant given by opposite party No.2 no way caused the complainant to suffer from Acute Myeloid Leukaemia, resulting him to spend huge amount. In fact there is less than 24 hours gap between his report dated 14-06-2010 and the report of KLR lab dated 15-06-2010 which suspected cancer. Further the complainant is a Government servant and has got facility for reimbursement of medical expenditure. The claim of the complainant is exorbitant and fanciful. In view of the above mentioned reasons the opposite party No.2 pleaded that there is no negligence on his part and prayed for the dismissal of the case with exemplary costs. Opposite party No.1 filed a memo adopting the written version of opposite party No.2.
4. Both parties filed their sworn affidavits along with documents marked as Ex.A1 to A16 and Ex.B1 to Ex.B4 by the complainant and opposite party No.2 respectively. Dr.K.Lakshmi Reddy was examined as PW1 and Dr.Surya Babu was examined as RW1.
5. Complainant and opposite parties filed their written arguments.
6. Hence the points for consideration are:
- Whether the complainant has made out a case to prove the deficiency against opposite parties?
- Whether the complainant is entitled for any relief?
iii. To what relief ?
7. Points i & ii:- Admittedly the complainant approached opposite party No.1 for blood test which was prescribed by Dr.Isreal Raju on 03-06-2010. Opposite party No.2 who was working with opposite party No.1 gave the report indicating widal positive (Ex.A3). Basing on the report Dr.S.Chandrasekhar gave treatment for Typhoid to the complainant (Ex.A1). As the complainant did not get any relief, Dr.S.Chandrasekhar sent him to opposite party No.1 on 14-06-2010 for the examination of peripheral blood smear. Opposite party No.2 found the peripheral smear normal with reduced cell count. Again on 15-06-2010 the complainant was asked to go to KLR Pathology laboratory for peripheral blood smear test, where the doctor suspected Acute Myeloid Leukaemia stage M1 (Ex.A7). Dr.S.Chandrasekhar and Dr.Siva Rajappa basing on the report of the pathologist of KLR laboratory directed the complainant to go for bone marrow test at either CMC Vellore or NIMS Hyderabad (Ex.A2). Accordingly the complainant went to CMS Vellore took treatment for two days came back to Kurnool and moved to M.S.Ramaiah Memorial Hospital Bangalore. The complainant took treatment for Leukaemia stage M2 for four months and got him self discharged from the hospital after getting the decease cured (Ex.A8 and Ex.A9). According to the complainant he spent 7,00,000/- towards treatment (Ex.A12) and 5,00,000/- for other expenses. The contention of the complainant is that opposite party No.2 was negligent in giving blood report, had he not gone for blood examination at KLR laboratory, the cancer decease would have not been indentified, the death would be the ultimately consequence and hence he is entitled for compensation. Per contra the opposite party No.2 pleaded that he did not give positive report for Typhoid on 03-06-2010 but indicated widal positive in his report. In many cases such as
1. Chronic active hepatitis
2. Ulcerative Colitis,
3. Rheumatoid Arthritis,
4. Tuberculosis,
5. Multiple Myeloma,
6. Malaria,
7. Rheumatic Fever and
8. Acute febrile illness.
including Typhoid, widal is positive. It gives only 60% information. The physician has to correlate the results with the symptoms. Blood culture which takes one week time is only the confirmative for Typhoid. So the allegation of the complainant that, opposite party No.2 confirmed Typhoid is baseless. Again the peripheral blood smear is done to the patient on 14-06-2010 with a drop of blood on a slide under a microscope and could not identify the blast cells, but the same test by preparing a new slide was done at KLR laboratory on 15-06-2010 and the pathologist suspected Acute Myeloid Leukaemia PW1 also deposed that bone marrow test can only confirms cancer. In this contest opposite party No.2 relied on two medical books. According to a book by “de Grachy’s clinical Heamotology in Medical practice,” in sub Leukaemic Leukaemia the diagnostic problem arises in sub Leukaemic group when there is very few or no blast cells evident in the blood film. In another book “Atlas and Text of Heamatology” also it is written as in a leukaemic Leukaemia TLC is low, no blast cells in blood, but marrow contains more than 20% blast cells. In the present case also the peripheral blood smear study is normal, but bone marrow contains blast cells, which were identified at a higher medical institute (Ex.A8). Up on the perusal of arguments of both parties and the material evidence placed on record it is evident that widal test is only a suggestive test but not confirmative for Typhoid. Opposite party No.2 did not record any where in the report that the complainant is suffering from Typhoid (Ex.A3). The physician has to correlate the test results with the symptoms of the patient before confirming the decease and starting treatment. Test of peripheral blood smear was done to the patient by opposite party No.2 on 14-06-2010 and by the KLR laboratory on 15-06-2010. Opposite party No.2 could not recognize the blast cells in the film of a drop of blood on a slide though KLR lab suspected them (Ex.A7). As per theory written in the above mentioned two reference books the chance of missing to identify blast cells by opposite party No.2 can not be found fault. The time lapse can be ignored as it is less than 24 hours between the report of opposite party No.2 and that of KLR laboratory, where cancer was suspected (Ex.A6 & Ex.A7). The report of opposite party No.2 is not at all connected to the expenditure incurred by the complainant for the treatment of the decease. In view of what is stated above the contention of the opposite parties is acceptable and this Forum holds that complainant failed to prove deficiency of service on the part of the opposite parties. Hence the complainant is not entitled for any relief.
8. Point No.iii:- As the deficiency of service on the part of the opposite parties is not proved, no relief is granted to the complainant. So the claim of the complainant is rejected.
9. In the result, the complaint against opposite parties is dismissed without any cost.
Dictated to the stenographer, transcribed by her, corrected and pronounced by us in the open bench on this the 25th day of May, 2012.
Sd/- Sd/- Sd/-
MALE MEMBER PRESIDENT LADY MEMBER
APPENDIX OF EVIDENCE
Witnesses Examined
For the complainant : Nil For the opposite parties : Nill
List of exhibits marked for the complainant:-
Ex.A1 Prescription of A.Sreenivasulu issued by Dr.S.Chandra
Sekhar dated 04-06-2010.
Ex.A2 Prescription of A.Sreenivasulu issued by Dr.Siva Rajappa
dated 14-06-2010.
Ex.A3 Blood Test Report of A.Sreenivasulu issued by Apollo
Medical Centre, Kurnool dated 03-01-2010.
Ex.A4 Blood Test Report of A.Sreenivasulu issued by Apollo
Medical Centre, Kurnool dated 14-06-2010.
Ex.A5 Investigation Report of ULTRASONOGRAPHY of Abdomen
of A.Sreenivasulu issued by Apollo Medical Centre, Kurnool
dated 14-06-2010.
Ex.A6 Test Report of A.Sreenivasulu issued by Apollo Medical
Centre, Kurnool dated 14-06-2010.
Ex.A7 Report of A.Sreenivasulu issued by KLR Phology Laboratory
dated 15-06-2010.
Ex.A8 Photo copy of Discharge Summary issued by M.S.Ramaiah Courier Centre of Oncology, Bangalore dated 19-07-2010.
Ex.A9 Report of A.Sreenivasulu issued by Christian Medical
College, Vellore dated 18-06-2010.
Ex.A10 Office copy of Legal Notice dated 18-12-2010 along with
postal Acknowledgements.
Ex.A11 Letter by opposite party No.1 to complainant
dated 08-01-2011.
Ex.A12 Photo copy of A Bunch of Medical Bills.
Ex.A13 Letter Rc.No.A/73/2010, dated 05-01-2011 by complainant
to Secretary to Commissioner of Prohibition & Excise, A.P., Hyderabad.
Ex.A14 Photo copy of Letter by The Director of Medical Education,
Government of A.P., Hyderabad to The Commission of
Prohibition & Excise, Excise Department, A.P., Hyderabad.
Ex.A15 Office copy of Representation Letter of Sri A.Srinivasulu
Rc.No.A/73/2010, dated 05-01-2011 by complainant to Secretary to Commissioner of Prohibition & Excise, A.P.,
Hyderabad.
Ex.A16 Photo copy of Letter dated 19-12-2011 by complainant to
The Commissioner of Prohibition & Excise, A.P.,
Hyderabad.
PW1 Deposition of Dr.K.Lakshmi Reddy
dated 31-10-2011.
List of exhibits marked for the opposite parties:-
Ex.B1 Blood Test Report of A.Sreenivasulu issued by Apollo
Medical Centre, Kurnool dated 03-06-2010.
Ex.B2 Investigation Report of ULTRASONOGRAPHY of Abdomen
of A.Sreenivasulu issued by Apollo Medical Centre, Kurnool
dated 14-06-2010.
Ex.B3 Photo copy of Provisional Certificate of S.Surya Babu
issued by University of Health Sciences, A.P. Vijayawada
dated 06-07-2000.
Ex.B4 Photo copy of Letter Rc.No.A/73/2010, dated 05-01-2011
by complainant to Secretary to Commissioner of
Prohibition & Excise, A.P., Hyderabad.
RW1 Deposition of opposite party No.2 of Dr.Surya Babu
dated 07-02-2012.
Sd/- Sd/- Sd/-
MALE MEMBER PRESIDENT LADY MEMBER
// Certified free copy communicated under Rule 4 (10) of the A.P.S.C.D.R.C. Rules, 1987//
Copy to:-
Complainant and Opposite parties :
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