In the Court of the
Consumer Disputes Redressal Forum, Unit -I, Kolkata,
8B, Nelie Sengupta Sarani, 4th Floor, Kolkata-700087.
CDF/Unit-I/Case No.325/2007.
1) Smt. Krishna Pal,
Flat No.G-3, ASWINI, Neelachal Abasan,
98, Rajdanga Gold Park, Kolkata-700107.
(Previous address 140/9, NSC Bose Road, Kolkata-40). ---------- Complainant
---Versus---
1) Woodlands Medical Centre Ltd.,
8/5, Alipore Road, Kolkata - 27, P.S. Alipore.
2) Dr. Subrata Maitra,
FD-22, Salt Lake Sector-I, Kolkata-64.
3) The Medical Supdt.-cum-Vice Principal,
IPGMER-SSKM Hospital,
244, A.J.C. Bose Road, Kolkata-20. ---------- Opposite Parties.
Present : Sri Sankar Nath Das, President.
Dr. Subir Kumar Chaudhuri, Member.
Smt. Samiksha Bhattacharya, Member
Order No. 24 Dated 10-10-2013.
The case of the complainant in short is that the mother of the complainant was admitted in Woodland Medical Centre Ltd. i.e. o.p. no.1 for her treatment under Dr. Subrata Maitra i.e. o.p. no.2 for treatment of various ailments for 44 days and o.p. no.3 is the SSKM Hospital against whom no relief has been prayed for by the complainant.
The mother of the complainant viz. Nilima Rani Bardhan was admitted in the said o.p. no.1 nursing home on 6.9.05 at 9-30 p.m. with complaint of acute renal failure and other ailments and the patient was in o.p. no.1 nursing home upto 3-30 p.m. of 19.10.05 and complainant had to transfer her mother to o.p. no.3 hospital for financial reason. It is a specific case of the complainant that due care was not taken by o.p. nos. 1 and 2 for the treatment of the mother of the complainant during the entire period of 44 days in o.p. no.1 nursing home.
Further case of the complainant is that the patient was transferred to o.p. no.3 hospital on 19.10.05 and there it was detected that the patient developed two bedsores of about 10 inches diameter each under her buttock and there was no mention when the last dialysis was done and when the next was due in the discharge summary of o.p. no.1 nursing home and as a result o.p. no.3 hospital had to depend on their Nephrologists which consequently delayed the dialysis in o.p. no.3 hospital which caused delay in treatment and the patient was having temperature of 101 degree Fahrenheit and this too was not mentioned in discharge summary. Ultimately, the patient expired in o.p. no.3 hospital on 22.10.05.
Further case of the complainant is that the deceased while undergoing treatment in o.p. no.1 nursing home was always tested to have blood sugar level within normal limits and she was fully conscious yet unable to speak as tracheotomy was performed on her throat and the extend of pain, the patient had suffered due to bedsores was beyond nobody’s imagination. The specific case of the complainant is that the patient was not given adequate medical attendance to the mother of the complainant during her stay in o.p. no.1 nursing home under o.p. no.2 for entire 44 days and for that reason bedsores developed on the buttock of the patient. Hence the case was filed by the complainant with the prayer contained in the petition of complaint.
O.p. nos.1 and 2 had entered their appearance in this case by filing w/v and denied all the material allegations labeled against them and prayed for dismissal of the case. Ld. lawyer of o.ps. in the course of argument submitted that the case has got no merit and the same is liable to be dismissed. No relief has been sought for against the o.p. no.3 by the complainant.
Decision with reasons:
We have gone through the entire materials on record , w/v, evidence and questionnaires as well as replies by the parties and we find that Mrs. Nilima Rani Bardhan 77 years of age was admitted in o.p. no.1 nursing home under o.p. no.2 with multiorgan failure, hypertension, hypothyroidism, acute chronic renal failure with regular haemo dialysis, asthma with respiratory failure and was receiving artificial ventilator support initially daily and later on intermittently and had tracheotomy, metabolic encephalopathy and she had multifaceted problems with multi organ failure with a estimated mortality of nearly 100% . It is seen from the record that during the stay of the patient in o.p. no.1 nursing home she was meticulously nursed by the nursing staff of the o.p. no.1 nursing home with nursing care which included posterior portion of the patient, maintenance of proper nutrition and protection of skin which will be evident from the Bed Head Ticket of o.p. no.1 as well as nursing notes of o.p. no.1 nursing home.
The day before discharge as we find from the record a small area of skin peal off was noticed by the nurses while sitting her out in the bed side chair with the help of physiotherapist which was immediately intimated to the complainant and judging the overall situation of the case it was considered absolutely trivial where bedsore is a common complication in such a high risk absolutely bed ridden patient with poor subcutaneous fat amount and where the life is sustained with artificial gadgets along with so many co-morbidities.
It is also seen from the record that for some medical reasons the patient was transferred to o.p. no.3 hospital on 19.10.05 and at the request of the relatives and for the interest of the patient discharge summary was prepared under heading transferred to another medical facility instead of discharge under risk bond and in discharge summary the incidents of superficial skin peal off was not mentioned although the complainant was aware of the same and in the discharge summary it was mentioned that receiving dialysis on alternate days and the next date of dialysis was not mentioned as the complainant being a doctor as told about the date and she has knowledge about that.
A complaint was lodged by the complainant with the West Bengal Medial Council in July 2007 against the o.p. no.2 and the verdict of the West Bengal Medical Council was “not to proceed any further” after hearing both sides. It is seen from the record that the patient was admitted in o.p. no.3 hospital at 5-45 p.m. on 19.10.05 well after three hours from the discharge from o.p. no.1 nursing home and it is not made clear what had happened during those three hours. From the record we find that the patient was first seen by the doctor of emergency of o.p. no.3 hospital. But there is no mention of bedsore although she had the highest chance of developing bedsore and it is the common practice of the doctor to examine the pressure sore areas of such critically ill patient who have been bed bound for a long period of time for medico legal purpose as well as for the patient sake and the patient was seen by an RMO after her arrival in the ward in detailed there was no mention of bedsore in that note too.
We find from the record that on the same date i.e. 19.10.05 there was a note at the bottom end of the Bed Head Ticket in different hand writing other than who initially examined the patient on her arrival to the ward where there was mention of 10 inches bedsores of each buttock and there was no mention of the depth of the bedsores nor any treatment offered for the bedsores. It appears to us a clear case of interpolation. Then again we find that in the Bed Head Ticket as against dt.20.10.05 at 11-10 a.m. there was another similar noting of 10 inches bed sores of each buttock and we fail to understand the reason for repetition of such noting without advice of any treatment to that effect.
Dr. Pal, a witness of the complainant under whom the patient was admitted in o.p. no.3 hospital stated in witness box that he did not see the patient on 19.10.05 and he admitted that he did not know how to measure a bedsore. Now a question peeps through the sleeves who noted bedsore in the Bed Head Ticket on 19.10.05 and how could he mention the said bedsore of 10 inches size on 20.10.05 when he did not know how to measure bedsore. But no treatment was offered. Then again we find from the record that on the same date there was another noting in the Bed Head Ticket and the same was identified to be of Dr. Ujjwal Sarkar who mentioned about the bedsore without mentioning the size and depth of bedsore nor offered any treatment, but referred to plastic surgeon and plastic surgeon saw the patient on 21.10.05.
We find from the record that on 19.10.05 and 20.10.05 there were many recordings of different doctors but nowhere else there was mention of any bedsore on those recordings and plastic surgeon Prof. B.K. Majumder examined the patient on 21.10.05 and he mentioned it as dermoepidermal pressure sore, indicating the depth of the pressure to be superficial and it is a superficial bedsore and Dr. Majumder offered treatment like frequent change of posture, good nutrition, ripple mattress, application of Sucral-M ointment and the treatment that was suggested by Dr. B.K. Majumder was earlier offered as a preventive measure in o.p. no.1 nursing home by the nursing staff.
Witness of the complainant i.e. Supdt. of SSKM Hosital clearly mentioned that bedsore was recorded on 20.10.05 and this piece of evidence of the said witness leaves room, for arrival at a conclusion that noting of bedsore on 19.10.05 was a case of clear of insertion. Dr. B.K. Majumder did not mention the size of the bedsore. Both doctors viz. Dr. S. Pal and Dr. Ujjwal Sarkar had admitted that they had not seen the patient on 19.10.05. Dr. Tripathy who also deposed on behalf of the complainant admitted on witness box that he had not seen the patient himself while giving certificate of bedsore of 10 inches size. Death certificate does not mention about the existence of any bedsore and death certificate clearly showed that the alleged bedsore was in no way related to the death of the patient either primary or secondary or even a remote association related to the death of the patient.
Complainant in her evidence admitted that the doctors found that there was a bedsore on her mother’s buttock 10 inches each and that it could just develop in few hours. It is seen from the record that the patient did not have any temperature during her stay in o.p. no.1 nursing home at all. It is seen from the record that two Nephrologists were consulted by o.p. no.2 for the treatment of the patient and adequate medical facilities and attendance were given to the patient by the o.p. nos.1 and 2 during her stay in o.p. no.1 nursing home and the condition of the patient got better and the patient was able to communicate through writing sitting on bed. Complainant filed evidence of an expert viz. Dr. Ajay Kumar Gupta who is an expert of foreignsic medicine and does not have any experience in treating bedsore and the said Dr. Gupta is neither clinician, surgeon nor a plastic surgeon and this expert i.e. Dr. Gupta was found guilty of professional misconduct an was warned by the West Bengal Medical Council and his opinion cannot be construed as an expert as per provisions of Sec 45 of the Indian Evidence Act and we fail to accept such as an expert’s opinion as Dr. Gupta does not possess specially skilled in such science or question and does not have adequate knowledge of the subject such as bedsore. We find that some doctors of o.p. no.3 hospital came forward to support the case of the complainant and the statements of those doctors have virtually dug the grave of the case of the complainant and from the witness it became evidence that there was straight way insertion on 19.10.05 in Bed Head Ticket of o.p. no.3 hospital as regards bedsores.
On perusal of the entire materials on record meticulously we do not find even an iota of negligence on the part of o.p. nos.1 and 2. Ld. lawyer of o.p. no.1 in the course of argument referred to page 179 para 4 of the Surgical Critical Care edited by Jerome H Abrams and stated that 40% of the critical care patient can develop bedsore. And further we referred to a case law of the Hon’ble National Commission in R.P. No.3068 of 2010 and submitted that complainant should have produced some cogent, convincing and plausible evidence to show that the doctors were negligent at any time and apprehensions cannot take the place of proof and summed up stating that herein the instant case complainant has failed to produce cogent, convincing, plausible evidence. Ld. lawyer of o.p. no.2 referred to some case laws published in (2010) 3 Supreme Court Cases 480, (2009) 9 Supreme Court Cases 709 and (1999) 7 Supreme Court Cases 280 and submitted that the complainant has miserably failed to prove her case and the instant case is liable to be dismissed.
In view of the findings above and on perusal of the entire materials on record we find and hold that the complainant has miserably failed to substantiate the prove her case and the instant case is liable to be dismissed and we do not find any negligence on the part of the o.p. nos.1 and 2.
While arriving at a decision we have relied upon (2010) 3 Supreme Court Cases 480, (2009) 9 Supreme Court Cases 709 and (1999) 7 Supreme Court Cases 280 and these case laws are highly applicable so far as the facts and circumstances are disclosed on record in this case. In result complaint fails.
Hence, ordered,
That the case stands dismissed on contest without cost against the o.p. nos.1 and 2 and ex parte without cost against the o.p. no.3.
