B.N. Goel vs Dr. M.K. Goel And Ors.

COMPLAINT was filed, inter alia, alleging that Ashok Kumar Goel, son of the complainant who was having pain in his upper abdomen, was admitted by OP No. 1 - Dr. M.K. Goel in his Nursing Home on 5.5.1997 After completion of various tests, exploratory laparotomy was done in the evening on 6.5.1997 by OP No. 1 who was assisted by opposite party Nos. 2 to 4. Amount of Rs. 25,000 was deposited with OP No. 1 towards fee and other charges by the complainant in the morning of 6.5.1997. Tests and pre -operative notes showed that Ashok Kumar Goel was having random blood sugar of 195 and blood pressure of 150/110 which were not conducive for performing exploratory laparotomy. At 8.10 p.m., the opposite party No. 1 asked the complainant to arrange one unit of blood as the same was not available at Bulandshahar. It was, further, alleged that OP No. 1 advised the complainant to shift Ashok Kumar Goel to a better centre for further management. He was, therefore, taken to Apollo Hospital, New Delhi on 6.5.1997 itself. Though he remained admitted in that hospital till 11.5.1997 but there was no improvement in his condition. Doctors in Apollo Hospital suggested laparotomy for Necrosectomy which was to cost Rs. 6.00 lakh. Complainant being a poor person could not afford to incur that expenditure and, therefore, he shifted his son to Kailash Hospital, Noida on 11.5.1997 where he died on 17.5.1997. Cause of death given in Death Certificate was Acute Nectrotizing Pauereatiti, Septicaemic Shock & Mueli Organ failure''. It was alleged that it was impermissible under the Rules for OP Nos. 2 to 4 who were Government servants to have assisted OP No. 1 in performing the said procedure. Further, OP No. 3 being an Ayurvedic doctor was not qualified and trained to conduct surgery. OP No. 1 had not taken assistance of any anaesthetist while performing the procedure. OP No 4 was in Government Hospital, Utravali at the time the procedure was done. It was pleaded that OPs were negligent/deficient in service in performing the said procedure. Direction was sought to be made against them to pay amount of Rs. 33,75,000 towards compensation, pay Rs. 2.00 lakh towards the expenditure incurred on the treatment of the deceased, etc. and also pay Rs. 3.00 lakh as compensation towards mental agony.

OPPOSITE parties contested the complaint by filing separate written versions. In the written version filed by OP No. 1, it was alleged that Ashok Kumar Goel had consulted OP No. 2 on 5.5.1997 at about 7.00 p.m. for pain in upper abdomen, nausea and vomiting for which he had prescribed certain medicines. At about 8.45 p.m. he was brought to OP No. 1 who gave him conservative treatment. On Ashok Kumar Goel''s again being brought with the same complaint on 6.5.1997, the opposite party No. 1 suggested for exploratory laparotomy as he suspected that he was having perforated appendicitis. After pre -operative investigations, Ashok Kumar Goel was taken to the operation theatre and was given general anaesthesia by OP No. 4. He was assisted by OP No. 3. Opposite party No. 2 attended the procedure a bit late at the request of the complainant. On opening the peritoneal cavity appendix was found to be normal but greater -omentom was found centered in the center of abdomen above the umolicus level with fat Necrosis and haemorrhagic spots indicative of "Acute haemorrhagic Pancreatitis". Abdomen was, therefore, closed after putting a drain in the right lower abdomen in pelvic cavity to drain out further collection of discharge. Complainant was advised to shift Ashok Kumar Goel to a better centre for treatment. Complainant was told that treatment would be costly and Ashok Kumar Goel be, therefore, taken to a Government hospital. However, the complainant asked for reference to Apollo Hospital, New Delhi which OP No. 1 made. It was stated that OP No. 1 is M.S. (Surgeon) and had experience of more than 20 years. It was asserted that sugar and blood pressure levels were not contra -indicative of performing exploratory laparotomy. It was denied that there was any negligence or deficiency in service on the part of OP No. 1.

IN his written statement, OP No. 2 alleged that he is B.A.M.S. from Kanpur University. Surgery was one of the subjects taught. He had worked as Resident Surgical Officer in Rishi Kul Rajkiya Ayurvedic College, Hardwar for one year. He had been allowed private practice by the Joint Secretary, U.P. Government. He had only assisted OP No. 1 in performing exploratory laparotomy. Op No. 4 in his written version alleged that he had done MBBS and MD (Anaesthesia) in 1996. He left the Government job in 1997. He has been working as Anaesthetist in private Nursing Homes and was called by Op No. 1 on 6.5.1997 to provide anaesthesia to Ashok Kumar Goel which he administered.

IN his written version, OP No. 2 stated that he had not assisted OP No. 1 in performing the procedure.

COMPLAINAN T has only filed his affidavit by way of evidence in support of the averments made in the complaint.

PURSUANT to the order dated 28.7.2008, matter was referred to a Medical Board to be constituted by the Director, AIIMS for giving opinion. Report dated 29.9.2008 received from AIIMS would show that the Medical Board consisted of the Addl. Prof. of Surgery, Associate Prof. of Gastroenterology, Associate Prof. of Anaesthesiology and a Doctor from the Department of Hospital Administration. Conclusion reached by the Board being material is reproduced below: "The Committee felt that Mr. A.K. Goel suffered from acute abdominal pain and presented to Dr. M.K. Goel with signs and symptoms of peritonitis. Mr. Ashok Goel had hemoglobin of 11.4 and TLC of 11200. On the basis of physical signs of Mr. Ashok Kumar Goel, he merited an exploratory laprotomy which was done by Dr. M.K. Goel. On exploration, signs of acute pancreatitis were found and Dr. Goel, recognizing the deficiencies in his centre, referred the patient to a better equipped centre. He was admitted at the Apollo Hospital, where he was advised surgery but due to financial constraints taken to Kailash Hospital where he died due to sepsis. Acute pancreatitis is a serious medical illness with a mortality of 15 -30%. The Committee was of the unanimous opinion that there was no deficiency in medical care provide to the deceased."

WE have heard Mr. Pattjoshi for the complainant, Mr. Ashish Vohra for OP No. 1 and Mr. Amit Swami for remaining OPs and have considered the written argument filed by Mr. Pattjoshi. Thrust of the argument advanced on behalf of complainant was that the medical parameters of Ashok Kumar Goel were not conducive for exploratory laparotomy his random blood sugar being 195 and blood pressure being 150/110. The Medical Board in its report has not commented on the parameters. At the cost of repetition, it may be mentioned that in written version the OP No. 1 has asserted that the said sugar and blood pressure levels were not contra -indicative for performing exploratory laparotomy. Complainant has not led any expert evidence to show that with the above levels of sugar and blood pressure, the OP No. 1 should not have proceeded to conduct exploratory laparotomy, a diagnostic procedure. In absence of such an evidence and the report of Medical Board that Ashok Kumar Goel merited an exploratory laparotomy, OP No. 1 who was assisted by the other OPs cannot be held negligent/ deficient in service. Decision in Poonam Verma v. Ashwin Patel and Ors., II (1996) CPJ 1 (SC), is of no help to the complainant.

ACCORDINGL Y , the complaint is dismissed. No order as to cost. Complaint dismissed.