K.Aditya vs Images Dignostic & Pathology Centre & Anr

Dr. S. M. Kantikar, Presiding Member

The Petitioners/Original Complainant has filed the instant Revision Petition under section 21(b) of the Consumer Protection Act, 1986, against the Order dated 15.11.2016 passed by the State Consumer Disputes Redressal Commission, Chhattisgarh in First Appeal No.393 of 2016, wherein the State Commission allowed the Appeal filed by the Respondent No.1 / Opposite Party No. 1 and set aside the judgement passed by the District Forum, Durg, Chhattisgarh.

For the convenience, the parties are referred to as placed in the original Complaint filed before the District Forum.

On March 29, 2015, K. Aditya (for short, the ‘patient’), the son of the Complainant, was taken to Dr. P.C. Aggarwal for his ill-health who advised to get some pathology tests done.  The tests were carried out at the Images Diagnostic & Pathology Centre (OP) on March 30, 2015. The reports were normal, but K. Aditya's health did not improve. On April 2, 2015, he was taken to Pandit Jawahar Lal Nehru Medical and Research Centre (for short ‘PJLNM’) and admitted in ICU.  The pathological tests were done again and found to be diabetic.  His blood sugar was 520 m.g.% dangerously high. He was treated there and discharged on April 9, 2015. It was alleged that the OP’s Centre was negligent, it reported normal sugar level, and therefore, treatment for diabetes was delayed.  The life of Aditya was in danger.  The Complainant alleged that the OP was responsible for the mental agony and financial losses.  Being aggrieved the Complainant filed a Complaint to claim Rs.50,000/- for the treatment expenses and Rs.1,00,000/- towards mental agony, and costs etc.

The OP No. 1 filed a Written Statement and denied any negligence or deficiency in service. The blood sugar was tested as per the standard specified procedure and report was correct. The OP further submitted that blood sugar level can vary depending on various factors such as meal intake, stress, etc.  It was not proved that the life of the patient was under threat due to such report. The OP No. 1 further stated that the complainant has not produced any document to prove that the reading taken by the PJLNM itself was correct. The OP-1 submitted that their centre is insured from United India Insurance Company Limited.

The District Forum partly allowed the complaint and directed the OP-1 to pay Rs. 50,000/- with 12% interest till the date of payment, Rs.1 lakh towards mental agony and Rs.5,000/- for litigation expenses.

Being aggrieved by the Order of the District Forum, the OP-1 filed the First Appeal No. 393 of 2016 before the State Commission at Raipur. The State Commission allowed the Appeal and set-aside the Order of the District Forum with the following observation:

“…21. In this case also, no allegation has been made in connection with the appellant/non-applicant No. 1 that he was not qualified pathologist and any report of Medical Board has also not been produced, which contradicts the report of the Medical Board and in these circumstances, only on the basis of Statement of the respondent No. 1/complainant, it cannot be stated that the appellant/non-applicant No. 1 has committed any kind of medical negligence.

In pursuance to above analysis, the respondent No. 1/complainant has completely failed in proving this that the appellant/non-applicant No. 1 has committed any kind of medical negligence and due to which itself, there had been fall in the health of the respondent No. 1/complainant and due to which, the respondent No. 1/complainant was admitted in Pandit Jawahar Lai Nehru Medical and Research Centre, Sector -9 Bhilai on dated 02.04.2015 and there his blood sugar level was high, on that ground itself, report given by the appellant/non applicant No. 1 cannot be considered false and erroneous and in these circumstances, the District Forum has given this conclusion that the appellant/non-applicant No. 1 has committed medical negligence, which is erroneous and doesn't deserve to be upheld.”

Being dissatisfied by the impugned Order of the State Commission, the Complainant filed the instant Revision Petition.

Heard the learned Counsel for both the sides. Perused the entire material on record inter-alia Orders of both the fora.

The learned Counsel on both the sides reiterated their evidence.

Admittedly, the prescription of Dr. P.C. Agarwal revealed the patient approached him with the complaint of weakness and giddiness and on investigation the blood sugar value was 71.6 mg%.  Therefore, Dr. P.C. Agarwal didn’t suspect or give medication for diabetes. It was the random blood sugar (RBS), therefore, it is not certain whether the patient approached the laboratory at fasting level.  After two days the patient was hospitalized in PJLNM with the complaints of breathlessness, vomiting, abdominal pain and excessive water intake.  He was investigated and diagnosed to be diabetes mellitus on the basis of blood sugar 584 mg% and the HBA1C 13.6.

Now, the question whether the RBS report of 71.6 mg% given by OP-1 was wrong?  In this context, I have gone through literature on endocrinology of diabetes and the standard book on medicine (Harrison’s internal medicine).  The blood sugar values in the body show fluctuations and depend upon various factors including the food habits, medication and other comorbidities.  In the instant case, it was not clear how much time the patient was on fasting.  Secondly, the relevance of blood sugar and the high value of HbA1c has been explained in the standard medical text books.  The HbA1c is used as an index of average blood glucose measurement over a period of months and is a mainstay of blood glucose monitoring. It represents the percentage of circulating hemoglobin that is glycated. It does not accurately reflect the glucose pattern at the individual level.  The HbA1c is the current gold standard for assessing glycemic control.  However, this index only provides an average measure of Glycemic status over a period of 2-3 months.  In addition, HbA1c does not address glycemic variability (GV) and hypoglycemic events.

The next question is whether the blood sugar was performed by an unqualified person or in the illegal laboratory run without Pathologists. In India, rampant malpractices in the laboratory services are known.  The laboratories having no accreditation or license which are illegal and most are run by unqualified persons or technicians. However, in the instant case, I find that the blood sugar test was done at the OP’s diagnostic centre wherein the qualified MD pathologist was available and the tests were done under his supervision.  The OP’s diagnostic centre has facilities with automated biochemistry analyzers and other systems.  Therefore, the blood sugar report of 71.6 mg% was not conclusively wrong and the OP’s centre shall not be liable.

From the various literature and standard books of medicine, there are various factors influencing the blood sugar levels. Therefore, the laboratory reports give fluctuating blood sugar values. Those factors are:

·         What you eat

·         Not drinking enough water

·         Drinks such as coffee, energy drinks, alcohol and tea

·         Artificial sweeteners

·         Too many unhealthy carbohydrates

·         Insufficient doses of glucose lowering medication

·         Medications like ante-depressant, steroid and diuretics

·         The amount of and type of exercise the person do

There are several factors beyond the control of the person like:

·         Physical or emotional stress

·         Sleep disturbances

·         Infections like common cold

·         Injury or surgery

·         Travel to another time zone

·         Extreme weather

·         For women – hormonal fluctuations

·         14. It should be borne in mind that every mistake does not amount to negligence.  The Hon’ble Supreme Court in Jacob Mathew’s case [(2005) SSC (Crl) 1369] exhaustibly discussed about medical negligence.  It observed that:

“When  a  patient  dies  or  suffers  some  mishap,  there  is  a  tendency  to  blame  the  doctor  for  this.   Things have gone wrong and, therefore, somebody must be punished for it. However, it is well known that even the best professionals, what to say of the average professional, sometimes have failures. A lawyer cannot win every  case  in  his  professional  career but surely  he  cannot be  penalized for  losing  a  case  provided  he appeared in it and made his submissions.”

Based on the foregoing discussion, I don’t find any error apparent in the Order of the State Commission which requires any interference in revisional jurisdiction under Section 21(b) of the Consumer Protection Act, 1986.

The Revision Petition is without merit and it is dismissed.

The parties to bear their own costs.