(The Appellant as complainant filed a complaint before the District Forum, against the opposite party praying for the direction to the opposite party to pay a sum of compensation of Rs.9,60,000/- for loss of life and Rs.40,000/- for mental agony. The District Forum dismissed the complaint, against the said order, this appeal is preferred praying to set aside the order of the District Forum dated 29.10.2009 in C.C.No.09/2005.
The appeal coming before us for hearing finally on 20.3.2012, upon hearing the arguments of both sides and perused the documents, written submissions as well as the order of the District Forum, this Commission made the following order :-)
TMT.VASUGI RAMANAN, MEMBER :
1. The unsuccessful complainant is the appellant.
2. Complainant filed a complaint against the opposite party claiming direction to pay a sum of compensation of Rs.9,60,000/- for loss of life and Rs.40,000/- for mental agony.
3. The complainant admitted his wife Mrs.Nagavalli aged 48 years at the hospital belonging to the opposite party. The complainant’s wife was suffering from Jaundice. The complainant submitted that after seeing an advertisement in a Tamil Daily of ‘Dinakaran’ wherein was stated that the jaundice would be cured irrespective condition.
4. The opposite party confirmed that he will cure his wife within 5 days. Believing his word the complainant admitted his wife on 19.06.04. His wife was suffering from initial stage of jaundice with the total Bilrabin of 1.5%. Day by day the percentage of Bilrabin went to the level of 15.2%. The complainant alleged that the doctor did not give suitable treatment and that he was negligent and did not give food and medicine in time.
5. The complainant stated that on 24.6.04, the doctor shouted at him and asked to take his wife immediately. The complainant had paid Rs.25,000/- as Hospital fees and consulting fees. While the complainant was away, his wife was discharged forcibly in unconscious condition due to wrong treatment given by the doctor. The patient was handed over to the complainant’s daughter who did not know what was in the discharge summary.
6. The patient died on 5.7.04. The complainant alleged that the patient was discharged in his absence and handed over to his daughter. The discharge summary was not read over in full and the discharge summary stated that the patient was discharged at request. The complainant submitted that no husband would be willing to take the patient at the unconscious stage. The complainant alleged negligence and deficiency in service against the opposite party whom he held liable for his wife’s death. The complainant said that his wife working in BSNL was earning Rs.11,200/- per month and her death was a huge loss to him to the tune of Rs.20,00,000/- till retirement. The complainant caused a legal notice and filed a consumer dispute. The complainant prayed for the direction to the opposite party to pay a sum of compensation of Rs.9,60,000/- for loss of life and Rs.40,000/- for mental agony.
7. The case of the opposite party is as follows :- The opposite party submitted that his Hospital is a dedicated Super Speciality Hospital and he is an expert in gastroentrology and as founder Chairman of the Hospital, he had 20 years of experience in the field. He was managing the unit with continuous supervision of medical and paramedical team. Opposite party denied all the allegations. The opposite party denied that the complainant paid Rs.25,000/- but it was only Rs.6,961/- paid by him. He denied that he had given the advertisement in Dinakaran. He denied that he promised to cure the patient within 5 days.
8. The opposite party submitted that the patient was brought on 17.6.04 with complaints of vomiting one week, yellowish discolouration of eyes and high coloured urine for 3 weeks, high fever for two weeks. Clay coloured stools, loss of weight/appetite all which he had entered in the discharge summary. The opposite party further added that the patient was suffering from asthma, hypertension diabetes heart disease and tuberculosis. The opposite party advised her to perform biochemical investigation of blood. The opposite party advised the patient to get admitted when she came earlier for treatment. But they refused admission citing her daughter’s marriage. So the opposite party prescribed medicines and asked her to come for review.
9. On 19.6.2004 the complainant was brought again and her condition was found worsening. Ultrasonogram of abdomen revealed altered echotexture of liver and contracted gall bladder. The patient was suffering from enteric hepatitis. Patient and her relatives were explained by opposite party about the disease and proposed conservative management procedures, alternative treatment methods and after effects of treatment and option of not undergoing any treatment.
10. The opposite party averred that the patient and the complainant were willing to undergo the appropriate standard and document treatment schedule proposed by the opposite party and thus denied any alleged magical cure. The patient’s condition was monitored by a team of doctors. The patient and her relatives pressurized the duty medical officers to get her discharged because of the forth-coming marriage of her daughter and so the patient was discharged on 24.6.2004. The medical reports and discharge summary was handed over to the complainant’s daughter Vidya.
11. The opposite party came to know that the patient died on 5.7.2004. The opposite party strongly averred that he treated the patient as is expected of a prudent Gastroenterologist. He denied that he was negligent in giving treatment. The opposite party alleged that the patient suffered from enteric jaundice and was discharged against medical advise. As to the allegation of increase in biliburin level of the patient from 1.5 to 15.2, the opposite party answered that it takes time for serum bilirubin to come to normal level.
12. The opposite party listed many disorders affecting liver and biliary system and jaundice might be due to following causes:-
1) Over ingestion of Alcohol
2) Viral Hepatitis
3) Malarial fever
5) Lepto sirosis
6) Stone or Cancer affecting biliary jaundice might some times get system cured, without treatment or endanger a persons life leading to coma, kidney failure and bleeding disorders in 24 hours. The opposite party alleged that the complications are bound to occur in 1% to 5% of the patients, suffering from jaundice in spite of the best medical care. The opposite party denied that he forcefully discharged the patient in an unconscious condition on the other hand the patient was discharged against medical advice.
13. The opposite party argued that if the patient was discharged in an unconscious condition he wondered what happened to her in the 11 days till her death. The opposite party allegd that no detail was given as to whether she was admitted in some other hospital. The opposite party denied all the charges and prayed for dismissal of the complaint. The District Forum dismissed the complaint. The District Forum discussed rival contentions at length. The District Forum observed after perusing Exhibit A10. An article by the opposite party/doctor in Tamil Daily Dinakaran. The District Forum pointed out that it is not an advertisement as alleged by the complainant. The article explained symptoms of jaundice, course of treatment and precautions to avoid jaundice. So the District Forum brushed aside the complainant’s contention that on seeing the advertisement which was alleged to state that the opposite party would cure jaundice within 5 days is not proved. The District Forum relied on the contention of the opposite party that in spite of medical advice, the patient was forcibly discharged for the forth coming marriage of the complainant’s daughter.
14. The District Forum observed that the complainant had not taken any steps to prove that no such insistence was made no such marriage took place in his family. The District Forum’s findings is that the complainant had failed to prove medical negligence on the part of the opposite party since the complainant had not produced any expert opinion. The learned counsel for the complainant cited a decision II (2009) CPJ 92 to establish the failure on the part of the opposite party by discharging his wife before she was completely recovered would amount to negligence. The District Forum held that the order cited by the complainant would not apply to the facts of this case. The order cited was regarding repudiation of claim by insurance company on the basis of suppression of material facts. Another judgment I (2009) CPJ 92 filed by the complainant was with regard to pregnant lady discharged in a critical condition without making arrangements for any transport to another hospital.
15. The District Forum’s finding is that the patient was discharged on request, the District Froum also observed that after discharge the patient died only on 5.7.2004. The complainant had not taken any steps to put her in a hospital for treatment. The District Forum dismissed the complaint on the basis that the complainant has failed to examine any expert. The District Forum dismissed the complaint.
16. Aggrieved by the order of the District Forum the complainant preferred an appeal before this Commission. The complainant filed 10 documents. The opposite party filed one document. The opposite party was cross examined, in the Forum below.
17. The learned counsel for appellant argued that the opposite party’s article on 9.6.2004 in Dhinakaran with his photo and address is against the norms of his medical profession. He further contended that during the treatment the patient’s Bilirubin level increased day by day and on 24.6.2004 it was 15.2. The counsel for complainant/appellant argued that the patient should not be discharged at this stage. He further contended that the patient was admitted by the complainant but in his absence the opposite party discharged the patient urgently getting signature from his daughter. The appellant/complainant brought to our attention that 'In the discharge summary it has been stated that the patient’s general condition is fair. The appellant/complainant found fault with the difference in hand writing in the discharge summary.
18. The learned counsel for Respondent argued that the article published could not be termed as advertisement. The Respondent claimed that he treated the patient for 5 days only. The Respondent submitted that the patient was suffering from many deceases. She was discharged by the patient’s daughter when she was in a critical condition. The Respondent counsel further submitted that jaundice cannot be cured within just 5 days. The opposite party/respondent argued that there is no such practice in medical field to get the request for discharge in writing.
19. The Respondent argued that this complainant did not take any treatment for 11 days. She died 11 days after discharge and so the opposite party/respondent is not liable for the death of the patient. The Respondent/opposite party prayed for confirming the order of the District Forum. After perusing material records, rival contentions and appeal grounds, Respondent’s deposition before the forum, District Forum’s order, this commission makes the following observations.
20. The Appellant/complainant’s contention that the matter published in Tamil Daily Dhinakaran Exhibit A11 is an advertisement against Medical Ethics is not correct as it is only an article by the opposite party who had explained the nature of Jaundice, and there is no mention of curing jaundice in 5 days as alleged by the appellant/complainant. The complainant’s wife was treated by the doctor from 19.6.2004 to 24.6.2004. The level of Biliburin had increased from 1.5 to 15.2. But the complainant has not produced any document or expert evidence to prove that the Respondent/opposite party has been negligent in treating the patient. The allegation regarding discharge of the patient forcefully by the Respondent/ opposite party is not clearly established by the complainant. The District Forum has rightly concluded that the complainant has not established his case.
21. The complainant’s wife’s medical records disclose that she was suffering from Jaundice. The opposite party/Respondent had given her treatment only for 5 days. From 19.6.2004 to 24.6.2004. After discharge from the hospital, the complainant’s wife was not given any treatment. The complainant/appellant’s averments did not make any mention of such treatment given her during the eleven days. It is really surprising that the complainant alleged that his wife was discharged forcibly by the opposite party/respondent at a critical condition. But the complainant has neither chosen to admit her in some other hospital nor render her necessary treatment.
22. The patient died 11 days after discharge from the opposite party’s hospital. The only point which raised our eyebrows was that the opposite party had stated in para 7 of his version that she was suffering from bronchial asthma, hypertension, diabetic, heart disease cerebrovascular accident and tuberculosis. But the discharge summary does not disclose presence of any of these diseases. Surprisingly the discharge summary reads as only 'altered echo texture of liver – contracted Gall Bladder' indicating severe jaundice. But the discharge summary had recorded patient as 'haemodynamically stable at the time of discharge'.
23. Though, the case sheets are filed as investigation chart by opposite party as Exhibit B1 'The chief complaint recorded by opposite party 'Patient’s case study' Exhibit B1. discloses only
Vomitting - 1 week
Jaundice - 3 weeks
Fever - 2 weeks
Loss of Appetitite
and other symptoms, the opposite party/respondent had not established that complainant’s wife was suffering from the diseases, as alleged by the opposite party/respondent. In the present case, it appears clearly that the complainant did not die due to any negligence of the opposite party/respondent. But the opposite party’s listing of diseases, attributing to the patient, without any proof of medical records, indicates
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that while the opposite party/doctor in his attempt to prove that he had acted as a prudent doctor and that he has adopted the accepted procedure while treating the patient he has added many diseases to the account of the patient. Such an averment appears to be highly imaginative and uncalled for. However, the opposite party is not liable for negligence since the complainant has not established his case by any documentary evidence or expert opinion. The allegation that the patient was discharged forcibly is answered by one line 'patient discharged at request:. Though the opposite party/respondent is absolved from liability of discharging the patient forcibly, the opposite party could have been more convincing if the discharge summary had indicated that the patient was discharged against medical advice. 24. But such small commissions or omissions do not add strength to the complainant’s allegation. Death is an inevitable factor. It is not necessary that all deaths should be attributed to medical negligence. In spite of best efforts, there might be deaths or loss of organs. The treating doctor is not liable for medical negligence provided he is a qualified person for rendering necessary treatment to the patient and also if he acted with utmost care as any prudent doctor would do under the circumstances. The District Forum has rightly adjudicated the matter in the proper prospective. Hence no interference is required. 25. In the result, this appeal is dismissed, confirming the order of the District Forum, Chennai (North) in C.C.No.9/2005 29.10.2009. No order as to costs in this appeal.