Dr. S.M. Kantikar, Member
1. The present Revision Petition has been filed by the Petitioners under Section 21(b) of the Consumer Protection Act, 1986 against the Order dated 14.08.2013 passed by the State Consumer Disputes Redressal Commission, Andhra Pradesh (hereinafter referred to as the “State Commission”) in Appeal No. 3529 of 2013, whereby the Appeal filed by the Petitioner was dismissed and the Order dated 30.04.2013 passed by the District Consumer Disputes Redressal Forum, Ranga Reddy (hereinafter referred to as the “District Forum”) in Consumer Complaint No. 126 of 2008 was affirmed.
2. For the convenience the Parties are referred as in the Complaint filed before the District Forum.
3. The facts in brief are that the patient Baby Shaistha, for her congenital heart disease, underwent Cardiac Surgery at Wockhardt Heart Centre (hereinafter referred to as the “Opposite Party No. 1 Hospital”) on 07.03.2007 and in the hospital during the course of her treatment, on 16.03.2007, she developed Celebral Malaria with enteric fever (Typhoid). On 17.03.2007 she was shifted to Kamineni Hospital (hereinafter referred to as the “Opposite Party No. 3”) for paediatric ICU care under Pediatrician, Dr. K. Satyanarayan (hereinafter referred to as the “Opposite Party No. 4). The patient was diagnosed as post-operative complications like cerebral malaria, kidney failure and hepatitis. She was discharged on 20.04.2007. Being aggrieved by the negligence during treatment from the all Opposite Parties, the minor Complainant filed a Complaint before District Forum through her father.
4. The Opposite Parties have filed their respective written versions and denied the negligence. They submitted that the Cardiac surgery was uneventful and development of malaria is not related to the cardiac surgery.
5. The District Forum after hearing the Parties partially allowed the Complaint against the Opposite Party No. 3 and directed to refund Rs. 62,000/- collected towards the medical charges, to the complainant with interest at 6% p.a. from the date of the Complaint. The Complaint against the other Opposite Parties Nos. 1, 2 and 4 was dismissed.
6. The Appeal filed by the Complainant for enhancement of compensation was dismissed by the State Commission.
7. Being aggrieved the Complainant filed this revision petition. During pendency of this Revision Petition Baby Shaistha expired on 14.04.2016 and the legal heirs were taken on record.
8. We have heard the arguments from the learned counsel for both the sides. None present for Opposite Party No. 1. Perused the entire material on record inter alia, the discharge summary of the Wockhardt Hospital and Kamineni Hospital. The short delay in filing this Revision Petition is condoned.
9. We have given our thoughtful consideration to the arguments advanced before us. The point for our consideration is that, during post-operative period the baby contracted malaria; was it due to negligence during Cardiac surgery or the care thereafter?
10. If baby Shaistha contracted malaria prior to admission (05.03.2007) to the Opposite Party No. 1 Hospital then it would have been detected during pre-operative tests. However, the patient was not exhibiting fever or any symptoms of malaria; therefore during pre-operative check-up the test for malaria was not advised.
11. From the facts on record it is clear that the Opposite Party No. 2 diagnosed the patient as suffering from Cyanotic congenital heart disease with Ventricular Septal Defect (VSD) and Patent Ductus Arteriosus (PDA) with severe pulmonary hypertension. The Opposite Party No. 2 explained the risk of mortality / morbidity to the parents of the patient and performed VSD closure and PDA interruption (Transpulmonary) on 07.03.2007. The surgery was uneventful. Thus the congenital defects of the child were surgically corrected. Thereafter, the patient was given proper ICU Care. In the meantime, on 13.03.2007, she had spike of fever, therefore, blood culture alongwith the central venous catheter tip culture was done and which turned out to be sterile. The patient was given higher antibiotics. She showed another spike of fever on 16.03.2007. And on 17.03.2007 morning, the patient fell asleep. She was opening her eyes and responding to the painful stimuli. She was uncommunicative and drowsy. The Pediatrician, Dr. K. Satyanarayan (Opposite Party No. 4) examined the baby and advised certain investigation, it was suspected as Hepatic Encephalopathy and dyselectrolytemia. The patient was showing signs of jaundice and electrolyte imbalance which could affect the brain. The cerebral malaria was also suspected and for specialized pediatric ICU management, the patient was shifted to Kamineni Hospital (Opposite Party No. 3). The prognosis and course of treatment were explained to the patient’s relatives. The patient was further investigated for IGM Salmonela, malarial parasite, blood and urine culture, CT Scan of brain and X-ray chest. The investigations revealed the patient was positive for typhoid and also Falciparum malaria. The CT Scan of brain was normal. The chest X-ray showed cardiomegaly with left ventricle predominance, pulmonary plethora and pulmonary arterial hypertension. Accordingly the patient was given treatment for malaria, typhoid encephalopathy.
12. It is pertinent to note that affidavits and two expert opinions are on record, one by Dr. B. T. Prasad Rao, Professor and Head of Cardiology Department, who opined that the Opposite Party No. 2 performed surgery as per standard medical protocol and the patient died due to sequel of encephalopathy. Another expert Dr. N. C. Joshi, the Paediatrician, categorically stated that the patient was adequately investigated before the cardiac surgery. He also stated that the treatment of cerebral malaria was given as per standard. We do not find any lapses or dereliction of duty of care during treatment of malaria.
13. It should be borne in mind that the malarial parasite Plasmodium falciparum is transmitted through the bite of a female Anopheles mosquito. In the severe cases P. falciparum malaria develops serious complication like cerebral malaria. The signs and symptoms of cerebral malaria are similar to those of toxic encephalopathy as altered mental status, or multiple seizures and progress to coma. The Cerebral malaria is the most common cause of death in patients with malaria. Even with treatment, 15% of children and 20% of adults who develop cerebral malaria die. Due to hemolysis patient develops jaundice and anemia.
14. In view of the entire position described above, it is held that the charge of medical negligence against the opposite parties –doctors does not stand proved.
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The scope of revisional jurisdiction has been discussed by the Hon'ble Supreme Court in Rubi (Chandra) Dutta Vs. United India Insurance Co. Ltd (2011) 11 SCC 269, and reiterated by this Commission in several judgments, viz Satyendra Narayan Singh vs. RICOH India Ltd [2015 SCC OnLine NCDRC 4443] and Roshan Lai Chhabra vs. United India Insurance Co. Ltd [2016 SCC OnLine NCDRC 1316]. We find the Orders passed by both the fora below to be well-appraised and well-reasoned. No jurisdictional error or legal principle ignored or miscarriage of justice is evident, as may require interference in the exercise of the Revisional Jurisdiction of this Commission. 16. Based on the forgoing discussions we find no merit and the Revision Petition is dismissed.