The National Consumer Dispute Redressal Commission (NCDRC) has dismissed a complaint against Vishakhapatnam-based Care Hospital’s Institute of Medical Sciences, and its doctors including a cardiologist Dr GSR Murthy and general physician Dr Swaroopa Rani and held that there was no deficiency on part of the hospital and doctors.The complainant had accused all of them of not admitting the patient in intensive care unit (ICU) till the arrival of the cardiologist, that oxygen was not given and there was a delay in the treatment of the patient. The complainant, Devarakonda Surya Sesha Mani, wife of the patient, Raja Ram Mohan, had alleged that proper injections were not administered to the patient leading to his death.
After considering the submissions of both the parties, NCDRC declined to accept the submission of the petitioner that Raja Ram Mohan was not admitted to ICU or that oxygen was not given till the arrival of the cardiologist as the records revealed that the cardiology resident doctor was present on duty and was regularly briefing the relatives of the patient's status.
“It should be borne in mind that we are dealing with a case of alleged medical negligence and thus need to analyse whether the treating doctors or hospital failed in their reasonable duty of care. The medical record of the Care Hospital is a vital document to prove the medical negligence, if any. It is apparent from the record that the Annexure C5 - the medical report, issued on 4 November 2013 is a normal report. We note after nine months of that report the patient got admitted in serious condition in Care Hospital,” the Commission noted in its order.
The apex commission observed “There was past medical history of diabetes and the ECGs were confirmatory of acute MI (STEMI). Therefore, we cannot rule out the possibility that the patient developed cardiac problems during the nine months. We note that the doctors made all efforts to resuscitate the patient from the cardiac arrest but could not revive the patient. In our view, they performed their duty with reasonable standard of care. We do not find any deficiency either from the hospital or the treating doctors.”
The case relates to a patient, who was taken to the hospital for vomiting in 2014. The complainant had alleged that the general physician examined the patient in the casualty and kept him there for three hours. The hospital authorities collected Rs5,000 at the time of admission. In the casualty, the patient again vomited and for the first time complained of breathlessness. The complainant claimed that the patient and she requested for oxygen mask but the doctors did not pay any heed.
The complainant further alleged that she and the other attendants were directed by the physician to stay away from the casualty ward and, therefore, they were observing the patient through a glass window from outside. The counsel for the petitioner contended that the doctor gave one injection to the patient upon which he immediately developed convulsions, cramps and he became unconscious.
The complainant alleged that at 10.20pm, one assisting doctor came outside the casualty and informed that due to 70% of blockage of arteries of the heart, the patient became unconscious. It was further submitted that the doctor demanded medicines worth Rs40,000 and the complainant paid the same on the spot.
The complainant repeatedly requested the hospital staff to call the cardiologist but without any success. Eventually, the patient was shifted to ICU, however, the patient expired on 19 June 2014. On inquiry, the hospital did not give a proper explanation for the cause of death of the patient, the complainant alleged.
As per the petition, precious time was wasted in casualty for non-administration of initial injection, non-supply of the oxygen mask, and they delayed shifting the patient to the ICU. It was further alleged that, despite requests for the entire medical record, the Hospital supplied only three documents. The complainant also requested to provide CCTV camera recording for 19 June 2014 but it was not provided. The petition claimed that the doctors and the hospital treated the patient casually. The aggrieved complainant filed a petition alleging medical negligence and deficiency in service during treatment of the patient and demanded Rs10 crore as compensation.
The counsel for the Hospital and the doctors denied all the allegations of medical negligence and submitted that the consumer complaint be dismissed as it was frivolous and further stated that the patient and his wife at the time of admission suppressed that the deceased was suffering from diabetes for the past 20 years. The patient was an alcoholic and tobacco chewer. It was further submitted that the patient was brought to the hospital with complaints of severe back pain and vomiting and proper medications were administered for nausea and vomiting. The doctors also called the cardiologist.
The counsel for the doctors and the Hospital further contended that as the patient's relatives were creating unruly behaviour, they were asked to leave the casualty. The counsel submitted that, since the patient developed severe breathlessness followed by respiratory arrest, Code Blue was announced and immediately, CPR was started with ambuventilation. “The cardiologist came to the hospital and took control of the situation and the patient regained rhythm and the second ECG was taken which showed the patient had suffered a massive heart attack. The patient was immediately intubated with ETT No 8 and connected to a mechanical ventilator. The cardiac monitor showed ventricular fibrillation, therefore, 360 joules shock was given. The cardiac massage was also started; the patient was given bolous dose of injection adrenaline every three minutes. However recurrent ventricular fibrillation continued and showed cardiac asystole. Tenecteplase 40 mg IV bolus was given which was worth Rs40,000. Thus, under the supervision of the doctor, the entire critical care team treated the patient but the patient could not be revived and passed away,” the counsel contended.
The cause of death was cardiogenic shock and acute extensive anterolateral STEMI and there was no negligence on part of the hospital or the doctor.
The counsel further added that on 30 July 2014, the complainant issued a legal notice with false allegations and demanded a compensation of Rs96 lakh. However, she later filed a consumer complaint before NCDRC with an inflated claim to the tune of Rs10 crore.
NCDRC referred to another judgement by the SC and stated, "The court held that a professional might be held liable for negligence either if they do not possess the requisite skills that they claimed to have, or they don’t exercise the skill which they have. While referring to the judgements, the court said that the human body is like a highly complex machine and a doctor could not assure full recovery of a patient. The only assurance that such a professional can give or can be understood to have given by implication is that he possessed the requisite skill in that branch of the profession which they are practising and while undertaking the performance of the task entrusted to them, they would be exercising their skill with reasonable competence.”
The apex commission observed that the SC had in another case Achutrao Harbhau Khodwa Vs State of Maharashtra, (1996) held that “The skill of medical practitioner differs from doctor to doctor. The nature of the profession is such that there may be more than one course of treatment which may be advisable for treating a patient. Courts would indeed be slow in attributing negligence on the part of a doctor if he has performed his duties to the best of his ability and with due care and caution. Medical opinion may differ about the course of action to be taken by a doctor treating a patient, but as long as a doctor acts in a manner which is acceptable to the medical profession, and the court finds that he has attended on the patient with due care skill and diligence and if the patient still does not survive or suffers a permanent ailment, it would be difficult to hold the doctor to be guilty of negligence.”