NATIONAL CONSUMER DISPUTES REDRESSAL COMMISSION
NEW DELHI
 
CONSUMER CASE NO. 774 OF 2015
 
1. RADHEY SHYAM PRAJAPAT & ANR.
S/o. Late Sh. Goverdhan, R/o. Ward No. 23, Shiv Colony, Churu,
Rajasthan.
...........Complainant(s)
Versus 
1. SANTOKBA DURLABHJI MEMORIAL HOSPITAL CUM MEDICAL RESEARCH INSTITUTE & 3 ORS.
Bhawani Singh Marg, Bapu Nagar,
Jaipur,
Rajasthan.
2. Dr. Madhulika Sharma
Sr. Consultant Medicine, Santokba Durlabji Memorial Hospital Cum Medical Research Institute Bhawani Singh Marg, Bapur Nagar, Jaipur,
Rajasthan.
3. Dr. Neetu Ramknianai
Santokba Durlabhji Memorial Hospital Cum Medical Research Institute Bhawani Singh Marg, Bapu Nagar,
Jaipur,
Rajasthan.
4. Dr. Suresh Gupta
Santokba Durlabhji Memorial Hospital Cum Medical Research Institute Bhawani Singh Marg, Bapu Nagar,
Jaipur
Rajasthan.
...........Opp.Party(s)

BEFORE: 
 HON'BLE MR. JUSTICE J.M. MALIK, PRESIDING MEMBER
 HON'BLE DR. S.M. KANTIKAR, MEMBER

For the Complainant :
Mr. Rakesh Dahiya, Advocate
For the Opp.Party :

Dated : 02 Feb 2016
ORDER

ORDER

 

DR. S.M. KANTIKAR, MEMBER

          The complainants Radhey Shyam Prajapat and Vandana Prajapat filed this complaint  under Section 21 of the Consumer Protection Act, 1986 for alleged medical negligence against the Santokba Durlabhji Memorial Hospital cum Medical Research Institute (in short SDM hospital), the OP-1 and other three doctors working there. The complainants prayed for compensation of more than rupees two crores.

1.       The brief facts of the case are that; Sonia (since deceased, referred herein as ‘the patient’) daughter of the complainants a bright academic student got admitted in SDM Hospital (OP1) on 15.05.2013. She was suffering from headache and fever. After a clinical examination, laboratory investigations and CT scan study, she was diagnosed as a case of tubercular meningitis(TBM). Without complete treatment and without recovery, she was discharged from the hospital on 22.05.2013. The Dr. Madhulika Sharma -OP2, a senior consultant in medicine treated her. Despite regular medication, there was no improvement, but every time it was assured that the patient will recover soon. The patient was again on 28.05.2013 admitted in the ICU at SDM Hospital. Again CT scan was performed which showed damage to the brain, but hospital did not refer the patient to Neurologist, but it was seen by the physician in the OP1-hospital. On 29.05.2013, the patient stopped responding to the treatment and there was no further recovery.

2.       On 30.05.2013, at OP-1 ECG was performed, but due to carelessness and negligence OP’s staff, ECG report of Sonia was interchanged with some other male patient about 35 years of age. On the basis of that changed report, OP-2 wrongly treated the patient. The Cardiologist Dr. Milind Shrivastava seen the ECG and noted in the medical record as under :-

“Thanks of reference. 160/pm, 94/56 mm., Sinus tachycardia, on high pressor support, gradually decrease Nor Ad, keep SBP-90 MM.”

3.       The next allegation was that, the OP deliberately kept the patient in hospital despite repeated requests of the complainants and the other family members. There was no proper treatment from the competent neurologist and cardiologist which caused death of patient.

4.       We have heard the learned counsel for complainants at admission stage. Counsel submitted that, the IPD Number mentioned in the ECG report was 277421 whereas; patient’s actual IPD Number was 277424. Thus, on the basis of wrong ECG report, medication was started by OP-2, whereas, Dr. Milind Shrivastava advised to taper down the vasopressors. The vasopressors are commonly administered intravenously in the critical care setting to treat conditions such as severe hypotension and cardiac arrest. It is clear that the heart rate and blood pressure of patient was low prior to it, for which ‘Vasopressors’ were being administered. As per report on 30.05.2013 Tab. Inapure’ was started for ‘tachycardia’. Therefore, patient developed severe ‘bradycardia’ and hypotension on 03.06.2013, further patient could not be recovered from the   severe ‘bradycardia’, and was declared dead at 11 am on 03.06.2013.

5.       The counsel further brought our attention to the Rajasthan Medical Council order dated 16.06.2014 issued a warning to OP2 herein to improve patient care. The counsel also submitted that, the State Government vide it’s order dated 03.07.2014 constituted a committee to examine the matter and give a report. The said committee adopted a highly casual approach and gave its report based on the slipshod enquiry conducted without associating the family of the deceased and adverting to the specific allegations made by the complainant. Therefore, the complainants filed the complaint upon OP1 as vicarious liability for OP2 to 4.

6.       Regarding  negligence and carelessness of the OPs causing  death of their daughter, complainants have made several representations and complaints to various authorities including the Chief Minister of Rajasthan, the State Women Commission and Rajasthan State Human Rights Commission,   On 8.9.2013, the complainants approached the Medical Council of India. The case was investigated by Rajasthan State Medical Council. Whereupon the OP2, Dr. Madhulika Sharma filed reply before the Registrar, Rajasthan Medical Council giving details of the treatment given to the deceased Sonia. She admitted in her  reply that the ECG report dated 30.05.2013 is of some other patient.

7.       We have perused the medical record filed along with this complaint. On 15.05.2013 the patient was admitted in the OP-Hospital. She was diagnosed as Miliary tuberculosis with tuberculomas in the brain. The treatment given was Anti Koch’s therapy and she was discharged on 22.05.2013. The ECG showed sinus tachycardia.

8.       As per Harrison’s Textbook of Principles of Internal Medicine, the vasopressors are used in the treatment of hypotension, which is assessed by blood pressure monitors, but not by single point ECG. Vasopressors cause sinus tachycardia; these changes were noted in the instant ECG, under such circumstances, use of Inapure was correct.  Monitoring of vasopressin infusion is not usually not done on the basis of  single point ECG readings. Even if we assume that, after reading the ECG the patient was advised for tapering dose of vasopressor, it should borne in mind that, the patient was in the ICU since 30.05.2013.  In the ICU patient will be kept under Cardiac monitors, therefore prudent doctor or physician will never totally rely upon the single point ECG as alleged .  Therefore, we do not accept the complainants’ allegation that the OP-2 treated the patient on the basis of the mistaken ECG only. According to medical record, the   patient was comatosed and was kept on ventilator, with continuous cardiac monitoring since 30.05.2013. The patient’s precarious condition was due to meningitis and tuberculoma in the brain which was already diagnosed, and a fatal one.

9.       It should be kept in mind that, in the critical care/emergency units, the doctor’s paramount intention is to treat the patient, therefore sometimes for each case, it could be difficult to change the name and patient’s ID in the ECG machine. The emergency ECG will be taken in presence of treating consultant and he instantly reads and interprets the same. Thus, the complainants’ allegation will not sustain, it was a just technical allegation. 

10.     We have perused the enquiry report regarding death of Sonia given by Enquiry Committee at SNS Medical College. It is reproduced as follow:

“We the member of the enquiry committee have gone through the records & CD provided to us in the above mentioned matter.

“It appears from the records provided to us that Patient Sonia Prajapat, 27 yrs, w/o Vijay Kumar was suffering from military tuberculosis with neurological involvement and she was managed adequately including investigations, multidisplinary opinion & treatment relevant to her condition. In our opinion, no medical negligency was found from the records made available to us.”

11.     There is a tendency of patients to blame the doctor if there is no cure. Our view dovetails from the Hon’ble Supreme Court Authority in case of Martin F. D’Souza Vs. Mohd. Ishfaq, AIR 2009 SC 2049, wherein it was held as under:

    “A medical practitioner is not liable to be held negligent simply because things went wrong from mischance or misadventure or through an error of judgment in choosing one reasonable course of treatment in preference to another. He would be liable only where his conduct feel below that of the standards of a reasonably competent practitioner in his field.”

12.     Also, In Hucks v. Cole & Anr. (1968) 118 New LJ 469, Lord Denning speaking for the court, observed as under:-

“a medical practitioner was not to be held liable, simply because things went wrong from mischance or misadventure or through an error of judgment in choosing one reasonable course of treatment in preference of another. A medical practitioner would be liable only where his conduct fell below that of the standards of a reasonably competent practitioner, in his field.”

13.     Therefore, on the basis of forgoing discussion we do not find any negligence caused by OP2 during treatment. The treatment given by OP2 was correct. Also, the Rajasthan Medical Counsel warned the OP2 for technical mistake. Therefore, we are hesitant to admit this case. Accordingly, this complaint is dismissed at admission stage.

 
......................J
J.M. MALIK
PRESIDING MEMBER
......................
DR. S.M. KANTIKAR
MEMBER