Kishan Singh vs Military Hospital & 3 Ors

Dr. S.M. Kantikar, J

Heard learned counsel for the petitioner - complainant at admission.

Brief facts are that the complainant took his son, Ajay Singh ('patient') aged about 22 years, to the Military Hospital, Dehradun-opposite party no. 1 on 16.11.2007. He was examined by Dr. Ajay Lamba-opposite party no. 2 and Dr. A. K. Rajput-opposite party no. 3. Thereafter, the health of the patient deteriorated day by day. Therefore, on 29.11.2007, he was admitted in the Military Hospital. The complainant alleged that without conducting blood glucose test, opposite parties no. 2 and no. 3 (doctors) administered intravenous IV glucose, which further worsened the condition of the patient and he breathed his last on 30.11.2007. The complainant came to know that his son died due to excess blood sugar level.

Being aggrieved, the complainant filed a complaint before the District Forum, Dehradun and prayed for compensation of Rs. 15 lakh from the opposite parties.

The opposite parties filed their written statement and denied the allegations made by the complainant. According to the opposite parties the treatment was given as per the standard norms. The patient was treated free of cost as the complainant was a member of the Ex-serviceman Contributory Health Scheme (ECHS). He was receiving treatment since 1999 on OPD basis at ECHS Polyclinic, and at Military Hospital, Dehradun. The patient was a known case of Mental Retardation (MR) and suffering from various other health ailments. The patient was severely emaciated and had undergone treatment for Pulmonary Tuberculosis with repeated infections. In the OPD, on 08.11.2007 and 10.11.2007, the patient was attended to by opposite parties no. 2 and no. 3 and prescribed treatment for chronic constipation. On 29.11.2007, the patient was brought to the OPD with history of low grade fever, cough, and difficulty in breathing. Accordingly, primary treatment with antibiotics and IV fluids Dextrose-Normal Saline (DNS)- two units was given. The necessary blood investigations were performed and, based on the blood sugar report, the patient was administered IV insulin and DNS. The patient subsequently suffered diabetic ketoacidosis and pneumonia of left lung. However, in spite of their best efforts, the condition of the patient did not improve and he expired.

The District Forum, after hearing the parties, allowed the complaint against the opposite parties no. 1, no. 2 and no. 4 and directed them to pay Rs. 5 lakh as compensation along with Rs.15,000/- as litigation costs.

Being aggrieved, the Military Hospital (opposite party no. 2) filed First Appeal No. 52 of 2016, whereas the complainant filed First Appeal No. 91 of 2016 for enhancement of compensation, before the State Commission. The State Commission allowed the appeal filed by the Military Hospital (opposite party no. 2) and dismissed the appeal filed by the complainant. Consequently, the consumer complaint filed before the District Forum was dismissed.

Being aggrieved, the complainant filed the instant revision petitions before this Commission.

The learned counsel submitted that the treating doctors - opposite parties no. 2 and no. 3 were negligent and had administered IV glucose without prior testing of blood sugar level of the patient. This caused the blood sugar to rise and the patient suffered diabetic ketoacidosis with severe pneumonia of the left lung, which subsequently resulted in his death.

We have perused the material on record.

As per the affidavit evidence of the treating doctors the patient was a known case of mental retardation. Since 1999, he was receiving treatment from ECHS Polyclinic, Dehradun and Military Hospital, Dehradun. On 29.11.2007, at the time of admission in the Military Hospital, Dehradun, the patient had low appetite, moderate to low grade fever, with cough, and increased respiratory rate, for the past few days. The patient had no oral intake for the past 6-7 days and the patient was unable to stand / sit on his own. Therefore, the patient was initially managed with IV DNS two bottles of 500 ml. each and multivitamin injections and antibiotics. The IV DNS was given to correct the dehydration. On the same day, at about 10.20 p.m., the blood reports revealed high blood sugar. Accordingly, diagnosis of diabetic ketoacidosis with severe pneumonia of left lung was made and the required treatment was provided to the patient but, unfortunately, the patient could not be saved.

The State Commission summoned the original record from the District Forum. After making its appraisal the State Commission inter alia made the following observations:

The original record summoned by us shows that the District Forum has called for the record of the treatment provided to the deceased . In response thereto , Col. S.I. Subhani , Senior Registrar and OC Tps for Commandant has submitted the written comments dated 21.11.2011 on behalf of Military Hospital, Dehradun (Paper Nos. 54ka/1 to 54ka/2 ). In the said comments, it has clearly been stated that depending on the above history of the patient and clinical findings, the patient was provisionally diagnosed (C/I i.e clinical impression) by the treating physician who attended the case as mentioned in the case sheet. It has further been stated that keeping in view the extreme debilitated condition and history of no oral intake for past 6-7 days , the patient was initially managed with IV fluid DNS - 2 bottles of 500 ml. each : multi vitamin injection - 1 ample : cap Multivitamin and Antibiotic injections etc. It has also been mentioned that it is very important to administer IV DNS (Glucose combined with normal saline) to provide instant condition and energy and to correct associated dehydration in form of intra Venous fluid , as the patient did not have any food orally for past 6-7 days. The report of investigations received at night at about 10:20 p.m on 29.11.2007 and the patient was found to have high blood sugar. It has been stated that the diagnosis of Diabetic Ketoacidosis with severe pneumonia left lung came to light only at 10 :20 p.m. of 29.11.2007 after receipt of blood reports of the patient.

(emphasis supplied by us)

Thus, admittedly, at the time of admission to the Military Hospital, the patient was in a severally dehydrated state and, thus, the decision of the treating doctors to give IV supplements immediately cannot be said to be incorrect. In the meantime, the blood investigations were received in the night at 10.20 p.m., which clealry indicated diabetic ketoacidosis. Thereafter, the doctors treated the patient accordingly. This was neither negligence nor deficiency on the part of the hospital or the treating doctors. As written by the treating doctors in the medical record, the patient had undergone treatment for Pulmonary Tuberculosis with repeated infections. He was also suffering from severe emaciation. Thus, the treatment given by opposite parties no. 2 and no. 3 (doctors) was proper under such facts and circumstances. Evidently, the doctors did their duty with care.

On the basis of the foregoing discussion, we concur with the Order of the State Commission, which is well-appraised and well-reasoned. We find no ground to interfere with it in revisional jurisdiction under Section 21(b) of the Consumer Protection Act, 1986.

The revision petitions are dismissed. There is no order as to costs.