A. Jayalaxmi & 2 Ors vs Ayush Hospital & 2 Ors

Dr. S. M. Kantikar, Presiding Member

The present Complaint has been filed under section 21 of the Consumer Protection Act, 1986 (for short “the Act”) by A. Jayalaxmi & 2 Ors. (hereinafter to be referred as the ‘Complainants’) against Ayush Hospital & Ors. (hereinafter to be referred as the ‘Opposite Parties’) seeking compensation amounting to Rs. 1,01,00,000/- for medical negligence and deficiency in service on the part of the Opposite Parties.

Mr. A.L.N. Rao (since deceased, hereinafter to be referred as, the ‘patient’), about 61 years old, fell unconscious and was taken to Amit Hospital (in short, the ‘OP-3’) on 13.06.2010. Initially the doctors treated him for Malaria even though no symptoms of malaria and blood test were negative. Since, there was no improvement, on the next day, (14.06.2010) patient was admitted to Ayush Hospital (in short, the OP-1’) at Bhubaneswar. There, he was kept under Dr. Samir Misra (OP-2) who advised for MRI of Brain. However, the MRI Machine in the Hospital was not working, therefore it was done at Aditya Care Hospital.

The MRI revealed “Brain Infarct” and accordingly, the OP-2 started the treatment, assuring the Complainants from time to time for a quick recovery of the patient. However, the treatment for malaria was also continued by OP-2. On 27.06.2010, all of a sudden, the patient was declared dead and antecedent cause of death was “CVA with (LT) MCA INFARCT, ARF”.

It was alleged that at the time of handing over the dead body of the patient, the OP-1 did not give complete medical record; not even the copies of the prescriptions etc. Thereafter, the OPs-1 & 2 refused to the repeated requests made by the Complainants.  Therefore, on 21.07.2010, a Legal Notice was issued to the OPs -1, 2 & 3 demanding complete treatment record. The Deputy Medical Superintendent of the OP-1, vide letter dated 18.08.2010, sent some copies of the documents (total 55 pages).

The Complainants further alleged that the documents were incomplete. There were lots of discrepancies in the entries and supply of material, but billed. At many places there were overwriting in the noted date and records were also manipulated.

The Complainant No.1 consulted several doctors of National repute along with the medical records. They expressed that when the Neurologist was not available in the OP-1 hospital, the patient should not have been accepted and at the first instance, he should have been referred to the hospital having facilities of Neurology/Neurosurgery, where he could have been saved. Being aggrieved by the gross medical negligence of OPs, the Complainants filed this Complaint to claim total compensation of Rs. 1.01 Crores.

Defense:

The Opposite Parties filed their written versions and denied the allegations of negligence.

The Opposite Party No. 1-Ayush Hospital filed reply through its Managing Director, Mr. Ashok Acharya. He submitted that the Complainants had concealed the previous treatment taken by the patient. However, at Amit Hospital, Serum Bilirubin (Total) was of 3.6 and Serum Bilirubin (Direct) was of 1.8, which was suggestive of Liver Damage and the  Serum Creatinine was of 2.8, suggesting Kidney Damage.  As per the discharged summary of Amit Hospital dated 14.06.2010, the diagnosis was CEREBRAL MALARIA, ALCOHOLIC, HEPATIC FAILURE, AND ACUTE RENAL FAILURE. The patient was suffering from signs of multi-organ dysfunction due to already damaged liver and kidney.  In fact, the patient was brought in an unconscious state, he already exhausted two days (13 & 14.6.2010) at Amit Hospital. Regarding MRI, he denied that the hospital MRI machine was not working on 14.06.2010.  In fact, the patient was not taken to Aditya Care Hospital as it did not have MRI machine at that point of time.

The OP-2 kept the provisional diagnosis of Cerebro Vascular Accident (CVA). MRI was advised on 14.06.2010 and the patient was sent for MRI at 4.30 p.m. in Ayush Hospital itself. But due to the high irritability of the patient, the MRI could not be carried out on the same day and next day also.

The Opposite Parties Nos. 2 & 3 submitted that they have not committed any deficiency of service. The OPs No. 2 & 3 treated the patient with proper care and due diligence and as per the set medical standards.

The Opposite Party No. 3- Amit Hospital submitted that patient was admitted to OP-3 hospital at about 9:30 a.m. in a semi-conscious irritable state. The patient had history of alcoholism. On examination, the patient was found to be irritable, his blood pressure was stable at 116/78 mm Hg, temperature 1020F, pulse 98/min and respiration at 32/minute. The blood test revealed jaundice. Accordingly, the patient was treated with antiemetic, antibiotic and antipyretic drugs. The patient's irritability reduced after 6 pm, Temp 99.4oF and around 200 ml of urine was passed. Thereafter the vital signs were stable. The patient was advised to get CT scan of the brain done, but the attendants of the patient wanted to take the patient to some higher center. Therefore, at the request of the attendants, next morning at about 6 a.m. the patient was referred to higher center in Vishakhapatnam /Bhubaneswar. The patient's condition was stable.

The Opposite Party No. 4- United India Insurance Co. Ltd. submitted that the allegations against OPs-2 and 3 were false. The Complainant has no cause of action as against the United India insurance co. Ltd. The insurance claim shall be subject to certain term and condition to be complied by insured.

Arguments:

We have heard the arguments from the learned Counsel for the Parties. No one appeared on behalf of OP-1 despite having given several opportunities. Perused the material on record, inter alia, the Medical Record and gave our thoughtful consideration.

The learned Counsel for the Complainants reiterated their facts and evidence and vehemently stressed upon the medical negligence, which the OPs deviated from the accepted medical practice.

The learned Counsel for the OPs-2 and 3 reiterated their evidence and brought our attention to the medical record and treatment given to the patient.

Discussion:

We gave our thoughtful consideration to the arguments from the Parties. We have perused the few receipts of MRI done at OP-1 hospital during 14.06.2010 to 16.06.2010. Thus, it proves that the MRI machine was in working condition. The allegation of the Complainant was not sustainable. It should be borne in mind simply because a patient had not favorably responded to a treatment given by a doctor or a surgery had failed, the doctor cannot be held straightaway liable for medical negligence by applying the doctrine of res ipsa loquitur. No sensible professional would intentionally commit an act or omission which would result in harm or injury to the patient since the professional reputation of the professional would be at stake. A single failure may cost him dear in his lapse. The abovesaid observation was made by the Hon’ble Supreme Court in the case of Martin F. D’Souza vs. Mohd. Ishfaq[(2009) 3 SCC 1]. We further put reliance upon the case of Kusum Sharma & Ors. v. Batra Hospital & Medical Research Centre & Ors.[ (2010) 3 SCC 480], wherein, the Hon’ble Supreme Court held as below:

"a medical practitioner would be liable only where his conduct fell below that of the standards of a reasonably competent practitioner in his field. It would not be conducive to the efficiency of the medical profession if no doctor could administer medicine without a halter round his neck. It was further held that it was our bounden duty and obligation of the civil society to ensure that the medical professionals are not unnecessarily harassed or humiliated so that they can perform their professional duties without fear and apprehension."

Similarly, in another case, Devarakonda Suryasesha Mani v Care Hospital, Institute of Medical Sciences[IV (2022) CPJ 7 (SC)], it was held as below:

“..2. Unless the appellants are able to establish before this Court any specific course of conduct suggesting a lack of due medical attention and care, it would not be possible for the Court to second-guess the medical judgment of the doctors on the line of medical treatment which was administered to the spouse of the first appellant. In the absence of any such material disclosing medical negligence, we find no justification to form a view at variance with the view which was taken by the NCDRC. Every death in an institutionalized environment of a hospital does not necessarily amount to medical negligence on a hypothetical assumption of lack of due medical care.”

In the instant case, we find the OP-2, one of the treating doctors in OP-1 hospital was competent to treat such patient and perform his duties to best of his field. The patient was in critical condition at the time of admission, was investigated and diagnosed, requisite consultations were given and treatment was given as per accepted reasonable standard of practice. We do not find medical negligence.

The Complaint is dismissed. There shall be no Order as to costs.