C.D. No.67/2001

Between:-

• Dr.Sitaram

Aged about 63 years, Apollo Hospital,
Vikarampuri,Secunderabad

• Dr.Sangeetha Reddy,

Apollo Hospital, Jubilee Hills, Hyderabad

• Dr.Pratap C.Rath,Aged about 63 years,

Apollo Hospital, Jubilee Hills, Hyderabad

• Apollo Hospital

Vikram Puri, Secunderabad

• Apollo Hospital, Jubilee Hills,

Hyderabad. ……Petitioner/Opposite parties
And
1. T.S.Anand Kumar
S/o.Late Mr.V.T.S.Murthy
Aged about 45 years, Occ:Advocate,
R/o.Block No.10B,Behind Medchal R/y Station.
R.R.District. .... Respondent/Complainant

2. The Oriental Insurance Company ltd.,
DO-IV, Hyderabad first Floor,
6-2-976, Pavani Estates, Khairatabad,
Hyderabad. ….Proposed Respondent
This Petition coming on 02-09-2008 for final hearing before this Forum in the presence of M/s.Indus Law firm, Counsel for Complainant and having stood over till this date for consideration, this Forum pronounced the following:-

O R D E R

(Per Hon’ble President, Sri M.Vijaya Bhaskar Reddy on behalf of the Bench)
1. This is a Petition filed by the Petitioner filed by Petitioners (opposite party No.4&5) under order I Rule No.10 R/W section-151 CPC to implead the Oriental Insurance Company Limited as the 6th opposite party in the main case.


2. The petition hearin are the opposite party No.4&5 in the main case. One T.S.Anand Kumar filed the complaint against the present petitioners and three more others claiming compensation attributing medical negligence on their part. Of course all the Opposite parties have been resisting the claim of the complainant. We are not concerned with the merits of the case at this stage.


3. The contention of the present petitioners is that they were insured with the Oriental Insurance Company by way of Medical establishment errors and omissions policy for the period from 25-03-2000 to 24-03-2001. According to them the said Insurance Company would indemnify the claim made by the complainant and such it is necessary and proper party.


4. This bench entertained a serious doubt with regard to the maintainability of this petition in a consumer case and as such heard the Learned Counsel for the Petitioner at bench.


5.The Point for Consideration is:-
1.Whether this petition filed by one of the opposite parties to implead a 3rd party Insurance company is maintainable?


6.Point No:1:- The Learned Counsel for the petitioner raised only one contention namely that as the petitioners had insured the Hospital with the proposed party, the said Insurance Company would be liable to pay the compensation if any and as such the said Insurance Company is a necessary party.


7. We cannot appreciate the above contention for the reason that this case has been filed under C.P. Act and not under the Motor Vehicle Act. The attribution of the complainant in the main complaint is that there was negligence on the part of the opposite parties [the Doctors] in treating his Mother. Raising such an allegation he claimed compensation from the present petitioners and other three opposite parties. The complainant has no grouse or claim or cause of action or under any obligation to implead the proposed party Insurance Company, with which, the present petitioners had taken a professional indemnity policy. There is no vicarious liability in a consumer dispute. There cannot be any joint and several liability on the part of the Doctors and the Insurance Company in a consumer dispute under C.P.Act. Further, there is no allegation of negligence on the part of the proposed party. So, we cannot appreciate the contention of the present petitioners that the insurance Company, with whom they have taken a policy for indemnity, also should be impleaded. If there were to be any such policy and if we pass any award or decree against the present petitioners, they are at liberty to claim indemnity from the Insurance Company, if he is so advised. For a decision in a dispute of this nature, it is not necessary to implead the Insurance Company, which is said to cover the risk on behalf of the hospitals or the Doctors. There is absolutely no jural relation ship or privity of Contract between the complainant and the proposed party. As already noted, the complainant is not making any claim against the proposed party. Further, this forum cannot direct the proposed party to pay the compensation to the complainant on behalf of the present petitioners [Opposite party No.4&5]. It would be altogether a different cause of action and we cannot mix up different issues and causes of action or adjudicate the issues, which are extraneous. Vicarious liability may arise in accident cases under Motor vehicle Act, but not under C.P.Act. There is no such provision under C.P.Act to direct a 3rd party to pay compensation etc., to the complainant. Similarly, this Forum would have no power to direct one opposite party to pay compensation to another opposite party or to direct a 3rd party to indemnify the claim amount on behalf of opposite party. The scope under C.P. Act is limited. Liability of opposite parties cannot be substituted by the proposed party insurance company as there is no privity of contract between the complainant and the proposed party. The proposed party cannot be brought into the Picture-(referred 1(2006) CPJ 182 State Bank of India Vs. P.Andrews & others).


8. Further, this case has been pending since 2001. Filing of this petition after a lapse of 8 years is highly objectionable. The intention of the petitioners is to protract the litigation are some more years. Add to that even the names all the petitioners were also different when the proposed party issued a policy in their favour. It would lead to several obligations which cannot be decided in this Consumer Forum.

On 11th May 2009, my father Mr. V. Gangadharan who was admitted in Apollo hospital as an emergency case on 8th May 2009, expired due to renal failure and probably some other complications. It is very natural in India to accept such happenings as the will of the god and continue with your rat race called ‘Life’. It is for the family and other near ones to take the loss in their stride and continue with the rat race.
However, I have been forced to think differently and strongly believe that there has been medical negligence on the part of Apollo hospital. The reasons are as follows:-
• My father who had been on a silicon catheter, inserted at Apollo hospital on 25th April 2009, came for his first post cardiac bypass surgery review on 4th May 2009 at Apollo hospital. The bypass surgery was done at Apollo hospital on 18th May 2009. The cardiac team expressed satisfaction on his recovery process. He then proceeded to keep his appointment with Dr. Ajit Saxena, Head of Urology department, around 1300 hours.
• The trouble started when he visited OPD to consult Dr. Ajit Saxena, Head of Urology. An already stressed out patient was asked to undergo CBG test which incidentally his junior refused to complete when he saw that the patient was bleeding. He was of the opinion that since the patient had undergone a bypass surgery very recently it was wrong on the hospital’s part to further traumatise him with such tests and suggested postponement of the test. However, by this time they had removed the catheter.
• A new silicon catheter was inserted after lots of struggle. In fact the juniors were not able to insert the catheter and Dr. Ajit Saxena personally had to get the same inserted. By the time the catheter was inserted it was 1800 hrs. It had really taken a heavy toll on my father who was now feeling completely stressed out and tired. Dr. Ajit Saxena was well aware about my father’s condition as his haemoglobin level and other reports were shared with him before he started the process.
• On 7th May 2009 around 0800 hrs my father collapsed and by the time they took him to the nearest hospital, his pulse was almost gone, he was nearing cardiac arrest. The Orchid hospital doctors did a commendable job reviving him by using CPR. They also confirmed with an ultrasound that he was bleeding somewhere from the urinary bladder and that there was a big clot forming in the bladder. They removed the silicon catheter and skilfully inserted a normal catheter, bypassing the clot, within minutes and with the least discomfiture to my father. They immediately found out that his haemoglobin level was around 3.4 and started blood transfusion and at the same time also started irrigation of the bleeding in the bladder. On reaching accepted level of stability in consultation with Apollo Doctor Dr. Deepak Kapoor, he was shifted to Apollo hospital under emergency on 8th May 2009.
• The Apollo cardiac team of Mr. Naresh Trehan also confirmed the above findings. They confirmed that his bladder has been bleeding and my father’s critical condition was due to the negligence of the Urology department. Though the clot was removed from the bladder by Dr. Ajit Saxena on 10th May 2009, it seems the harm was already done.
During the period 4th to 6th May 2009 we were in constant touch with Dr. Ajit Saxena as there was blood in my father’s urine and urine output was low. My father did not die because of God’s whim. He was killed by Dr. Ajit Saxena’s negligence. He overlooked my father’s existing condition, did not take due care while inserting the catheter, did not take any proactive measure to pre-empt the possibility of bladder bleeding due to insertion of catheter, did not even suggest routine checking of haemoglobin level, did not suggest any ultrasound despite our request, did not take any step to find out whether the blood in the urine was due to fresh bleeding and suggested washing of the bladder whenever we complained regarding low urine output and blood.
I want to know from you as to what happened on 4th May 2009 at the Urology department with my father and why it happened? How could a reputed hospital like yours be so careless? What do you plan to do with Dr. Ajit Saxena who is not in his best of health? Is he going to continue treating hapless patients like my father? How could a reputed hospital engage a doctor who himself is not fit? Does his poor health have anything to do with his careless attitude?
I would like to get a detailed report from your side and your action pertaining to the same. My intention is that no other patient should suffer the way my father did in the hands of Dr. Ajit Saxena and his team.

Sir,

My father passed away at 00.30 am on 11th June, 4 days prior to his 67th birthday, due to carlessness of the doctors in Apollo Hospital Bangalore. He may have made it to see his birthday through, if the cardiologist and other doctors were a bit more compassionate and used basis commonsense.

My dad underwent a CABG with 2 by-passes and a Mitral Valve repair at Narayana Hrudyalaya on 17th of April. After a long and painfull recovery, he was discharged. However, his graft site on the leg was not healing well. The doctors suggested a simple skin graft procedure. We opted for Apollo as I believed that the treatment will be par excellent. He was admitted on Saturday, 6th June and his surgery was performed on Monday 8th June. He was in acute pain- the machine dispensing morphine was not functioning properly. On 10th June 2009, he was complaining of breathlessness and was administered Lasix at 5.30 pm and we were told that if he was not stable, he will be shifted to ICU. He continued to be breathless and at 9.00 pm or so, my mom requested that he be shifted to ICU. The doctor assured her that he was ok. At 12.15 he had to pass stools, he sweat and he passed away. when i reached at 12.30, he was lying dead with a pipe in his mouth and with all doctors around him. No senior doctors was present at the time.

The most astonishing part of the whole episode is that at a hospital that speaks so highly of its cardiology capabilities, a cardiologist did not even examine the patient who had a CABG and Mitral valve repair 52 days and was admitted for a skin graft surgery either pre or post surgery. Dr Umesh Gupta came in and did speak of how his leg had clots and he may need stenting. When the patient complained of breathlessness, even then, a Registrat checked him and did not think it necessary to call a cardiologist- this was because, he was an expert in assisting Cardiac emergencies. He was not shifted to a ICU even at as late at 9.pm when he was unstable.

The Doctors at Apollo claims that the incident was not due to negligence. They are not responding to mails sent to the Chairman's office.

My mother-in-law is a cancer patient and had finished her radio therapy and chemotherapy in apollo hospital about 2 months back. On 3rd February morning she was complaining about a severe stomach pain and we took her to apollo hospital. she

was admitted to Apollo Hospital emergency and was diagnosed for a Hernia problem. It was decided in the emergency to operate the hernia the next day in laparoscopic mode of surgery.

For an admission procedure, we were asked to pay the approximate total sum of the operation at the billing counter as the patient was not covered under any insurance at that time. When asked about the sum at the billing counter, they advised that it comes under a package and for a four bedded cabin, the package of Hernia operation including 3 days stay is around 52000 (Fifty Two Thousand) + some buffer. So they took a deposit of Rs60000 (Sixty Thousand).

Surgery was successfully done on 4th Feb.

On the day of discharge, ie, on 6th, when we went to get the clearance in the morning at about 11.30AM, it was told that the balance was Rs88000 at the In-Patient Billing section at 3rd floor. This was a bolt from the blue to us.

When we told them about the package, they replied that probably the new amount (1 Lakh 46 Thousand) was done by mistake and the bill should be within 60K. They also informed that the discharge letter was still not sent by the concerned department from 6th floor and asked us to come after half an hour.

When we went there at about 12.30PM they informed that the balance amount was Rs99000 and some odd amount... We were shocked. Again we told them about the package and they wanted us to get a clarification from the doctor and the concerned department. Finally we caught hold of the doctor who performed the operation at around 2PM and he told that there were some specific expensive consumables used during the operation which shot up the price and he told sorry about it that he could not inform us about the details prior to the operation. He never discussed with us about the approximate expenditure anytime on the day of admission. We again told him about the package but could not get any satisfactory answer. He only told that he used some better materials during the operation and some other expensive consumables had to be used. Now when the operation was over, he told that the same operation done in open-surgery would have costed us 1lakh less.

Annoyed by this we went to the billing counter to speak to the billing manager. This person admitted that there was a lack of communication from their side and decided to give us a discount of 10% on the outstanding amount. We never spoke to them about any discount. They inflated the bill by 300% and now they were talking about a mere 10% discount.

It was ridiculous and disgusting. We decided to talk to the operation manager. That person listened to us and said sorry for the whole episode and admitted that there was a mistake from their side. We told him that we were ready to accomodate 10%-20% of human error, but it was an error of 300%. For a minor hernia operation the bill was 1lac 60 thousand and being known as a professional hospital, we didn't expect any such things to happen, this is as good as cheating. Had we knew about it during admission, we would have at least ventured about other alternatives/avenues. He said he understood all our points and finally said that he would reduce Rs20000 (Twenty Thousand)... It was already 4PM then. We gave up and paid the balance amount 80000. We told him that we would not stop there and would pursue it further for justice.

We have few questions:

1. Since they admitted that it was a mistake from their side, why don't they stick to the package, instead of passing on the burden to the patient?

2. Who told the doctor to use expensive material without any consent from the patient? Why did he conceal the fact and mislead us at the time of discharge?

3. Since the doctor told that he used better materials for this surgery, does he mean that he has been using inferior materials so far?

4. Why the Billing section did not speak to the doctor before saying that it comes under a package of Rs52000?

Apollo Hospital do not have any answer for these, so I have written this in a blog so that people are aware about the incidence and think twice before admitting somebody to Apollo Hospital. I'll not stop here and would rather plan to go to consumer court for this. I would definitely want my money back.

Please feel free to write if you have any suggestion.

I’ll also ask my wife to write about the other inconveniences we have faced during pre and post surgery.

Dear Concerned,

Read your anguished feedback about our Hospital. We feel sorry for falling short of your expectations. We would request you to please place your complaint on record in our Apollo website in the feedback section by writing to our management team and raising the issue. Your feedback is important to us, looking forward to hearing from you.

Best Regards,

The Apollo Management Team

My mother in law was admitted to Apollo Hyderabad on Saturday. Today is monday morning and the bill amount we have is 48000. The only treatment she had till now is Endoscopy. Everyone can read the charges of endoscopy on the net.

She was supposed to be operated today. But below is the best reply i have heard in my life for not being operated today :

"There is some problem in the operation theatre so we have to operate tomorrow"
I just want to know : 1) r u people not operating anyone today? 2) Whose mistake is it if the operation theatre is not ready? 3) Do you have just one operation theartre? 4) How can all the operation theatre stop functioning together? 5) she was admitted immediately saying the condition is bad, who will be responsible if something goes out of hand?


This wasnt an sudden operation. The doctors were preparing for this since friday.

We also went to the Helpdesk to ask who pays for the extra one day. The obvious answer is : "US" since it is the hospital's mistake so we should pay for it because i am stuck and i got to get her treated there itself.

We also went to inquire how can the bill be so high?
The answer was we can only tell you the intermediate bill and not bill the breakup unless whole of the bill is ready. Right you people need time to properly distribute the money.

To begin with, We were not alloted to the correct room that we opted for. We asked for a single sharing and they told us to wait in the lobby for a day/two since they didnt have any rooms available. But the doctor disagreed and told that the treatment should start immediately hence they shifted us to the deluxe room with the promise that there are no extra charges. We made sure of this for 100 times atleast. .

But we again have the bill of 48k without any major thing done and no one is explaining why and not showing us the bill too.

again whose mistake is it ?

I am stunned that one of the best reputed hospitals in India has such a poor management. People told us not to go to Apollo and I am sure next time we will never come here.

Waiting for your reply for all of the above situations.