BEFORE THE A.P.STATE CONSUMER DISPUTES REDRESSAL

COMMISSION:HYDERABAD.





F.A.No.1159/2006 against C.D.No.130/2005 Dist.Forum,Guntur .



Between:



Varagani Rama Rao,

S/o.Akkaiah, Hindu, aged 78 years,

Islampet, Bapatla,

Guntur District. … Appellant/

Complainant



And



Dr.K.Srinivasa Reddy,

Karumuri Hospitals, Old Club Road,

4th Line,Gunturuvarithota,

Guntur, Guntur District. …Respondent/

Opp.party





Counsel for the appellant : Mr. K.V.Rajendra Prasad



Counsel for the respondent : M/s.V.Gowrisankar Rao



CORAM:THE HON’BLE MR.JUSTICE D.APPA RAO, PRESIDENT,

SMT.M.SHREESHA, HON’BLE MEMBER

AND

SRI SYED ABDULLAH , HON’BLE MEMBER



WEDNESDAY, THE FIFTEENTH DAY OF APRIL,

TWO THOUSAND NINE.



Oral Order : (Per Smt. M.Shreesha , Hon’ble Member. )

***



Aggrieved by the order in C.D.No.130/2005 on the file of District Forum, Guntur the complainant preferred this appeal.



The brief facts as set out in the complaint are that the complainant’s wife, aged 72 years, was admitted in opposite party’s hospital on 5.10.2004 for chest pain and she was treated in the hospital till 11.10.2004 and was kept in ICU for four days . The complainant submits that on 6.10.2004 the patient slipped from her bed and sustained fracture of right hip due to non attendance of the staff of the opposite party in ICU of the hospital . The complainant and other attendants were not allowed to be in ICU to lookafter the needs of the patient . The opposite party collected Rs.5000/- towards charges and the opposite party advised the complainant to avail the services of Orthopaedic Surgeon, Dr.Amarnath. Thereafter the patient was shifted to the hospital of Dr.V.V.Narayana Rao, but the patient went into un conscious state on 14.10.2004 . The C.T. Scan report dt.18.10.2004 indicates haemorrhage and she ultimately died on 29.11.2004 at Bapatla in the Government Hospital, as the doctors at Guntur indicated the bad position of the patient and referred the patient to the Government Hospital, Bapatla . The complainant submits that the cause of death is only on account of small fall from her bed in the I.C.U. of hospital of the opposite party . The complainant submits that the beds in ICU of opposite party hospital are about 2 ½ to 3 ft. in height whereas the normal beds in General Ward are only 2 ft. The complainant incurred an amount of Rs.60,000/- for the treatment of the deceased and submits that it is only due to the negligence of the opposite party in ICU the patient expired and seek Rs.1 lakh towards compensation, Rs.25,000/- towards special damages, subsequent interest @ 18% p.a. from the date of complaint till realization and costs of litigation.



The opposite party filed written version stating that the complainant’s wife, aged 72 years, was admitted in their hospital on 5.10.2004 for chest pain and she was treated in the hospital upto 11.10.2004 and during the said treatment she was kept in ICU for four days. In the ward of ICU, World Class Beds are available and for each and every bed there is railing for all four sides with a small gap of half feet to prevent accidental falls. The complainant’s wife occupied bed no.3 in ICU and her husband and a lady attendant were present through out the entire period . There was no fall from the bed and patient had Rheumatoid Arthritis problem which made the bones very weak and any violent movement can cause fracture. The hospital also arranged bed pans and the deceased suffered fracture when she tried to stand on the floor and the fracture was immediately attended to by Dr.Amarnath and a temporary cast was given. When the patient was still in acute stage of heart attack, temporary measures were given by the management for fracture with an idea to do surgery after the patient recovers. From there onwards the patient stayed for three days and she was conscious and coherent and when she was discharged from the hospital with an advise to attend M/s. Amaravathi Institute of Medical Sciences where ICU facilities, surgery facilities, are available. Thereafter they are not aware of the complainant’s treatment. Brain stroke can occur in any elderly patient at any time because of several reasons like old age and opposite party deny that the patient went into coma due to head injury and submit that they have given concession in the fees and collected Rs.5000/- only for the entire treatment and contend that there is no deficiency in service on their part and pray for dismissal of the complaint with costs.



The District Forum based on Exs.A1 to A29 and Ex.B1 documents dismissed the complaint.



Aggrieved by the said order the complainant preferred this appeal. The learned counsel for the appellant/complainant submitted that as per para 7 of the counter of the opposite party, the deceased sustained fracture during her treatment in ICU which was only identified in the morning hours and this clearly establishes the deficiency in service on the part of opposite party in treating the patient who was admitted in ICU and Ex.A21 establishes injury on head when the deceased slipped down from her bed and therefore the District Forum ought to have allowed the complaint as prayed for.





We have gone through the material on record . The facts not in dispute are that the complainant’s wife Smt.Prameela, aged 72 years, was admitted in opposite party’s hospital on 5.10.2004 with a complaint of chest pain and was treated in opposite party hospital upto 11.10.2004 on which day she was discharged. During the said treatment she was kept in ICU for four days and it is the complainant’s case that the patient slipped from her bed and sustained fracture of right hip due to the non attendance of the staff of opposite party in ICU. Since the patient was in ICU the complainant and other attendants were not allowed to be at the bed side to look after the needs of the patient . It is the opposite party’s contention that each and every bed has railing on four sides with small gap of half feet to prevent accidental falls and complainant’s wife occupied bed no.3 in ICCU and on the request of the complainant, her husband and a lady attendant were allowed to be at the bed side of the patient. It is the further contention of the respondent/opposite party that the patient has chronic Rheumatoid Arthritis and her bones have become very weak because of long standing disease and submit in their counter as follows:

“ On the intervening night of 6th and 7th days of October,2004, it seems the patient has moved from the bed and tried to stand on the floor. In consequence of her weakness and bone disease, the deceased sustained fracture, which was identified in the morning rounds.

This said fracture was immediately attended by taking consultation with Dr.Amaranath and a temporary cast was given.

As the patient is still in acute stage of Heart Attack, temporary measures were given by the management of fracture with an idea to do surgery after the patient recovers.

From then onwards the patient stayed for three days conscious and coherent and talking normally.”





It is evident from the afore mentioned admission in their counter that the patient indeed sustained fracture while she was in ICU of opposite party hospital . It is not in dispute that the patient was admitted for a complaint of chest pain and was being treated for the same in I.C.U. It is pertinent to note that the opposite party has admitted that on the intervening night of 6th and 7th October,2004 when the patient had moved from the bed and tried to stand on the floor, she had sustained a fracture . We are of the considered view that when a patient is being treated in I.C.U. she has to be assisted by the hospital staff and the contention of the opposite party that the fracture is only due to the consequence of her weakness and bone disease is unsustainable. It is also pertinent to note that the opposite party admitted in their counter that this fracture was identified in the morning hours. There is no substantial explanation as to how this patient had sustained the fracture when their hospital staff is supposed to attend on her and it is also not explained as to how the fracture was identified only in the morning rounds, if ICU staff had really attended on the patient there is no possible explanation as to why the fracture was not attended to immediately, instead of it being identified only the next day morning . We are of the considered view that the act of the opposite parties in not assisting the patient in ICU and also not attending to the fracture immediately, in view of their own admission that it was identified in the morning rounds , amounts to professional negligence .



We rely on a judgement in Dr.Laxman Balkrishna Joshi v. Dr.Trimbak Bapu Godbole and Anr. reported in (1969) I SCR 2006 wherein the Apex court discussed the “duty of care” a doctor should undertake

a) A duty of care in deciding whether to undertake the case

b) A duty of care in deciding what treatment to be given

c) A duty of care in the administration of that treatment



We also rely on another judgement in Mc.Nair J. in Bolam v. Friern Hospital Management Committee (1957) 2 All ER 118, 121 which is widely known as the “Bolam test” which reads as under:

“But where you get a situation which involves the use of some special skill or competence, then the test whether there has been negligence or not is not the test of the man on the Calpham Omnibus, because he has not got this special skill. The test is the standard of the ordinary skilled man exercising and professing to have that special skill. A man need not possess the highest expert skill at the risk of being found negligent… it is sufficient if he exercises the ordinary skill of an ordinary competent man exercising that particular art.”



On perusal of Ex.A1 which is a discharge summary shows that there was “fall on the ground and fracture of Rt.hip”. Keeping in view the afore mentioned judgements wherein the Apex Court had discussed clearly the ‘Duty of Care’ to be taken by the Hospital and Doctor, we are of the considered view that in the instant case this duty of care according to professional standards of medical parlance, has not been adhered. To reiterate, when admittedly the patient is in I.C.U. and admittedly in their discharge summary, the opposite party stated that there was fall from the bed and there was a fracture in the right hip and when there is no substantial explanation from the opposite party as to why their staff in ICU did not assist the patient and as to why the fracture was not admittedly noticed by them but was seen only in the morning rounds and was not attended to immediately though the patient was in ICU, we are of the view that it amounts to professional negligence and we award an amount of Rs.75,000/- as compensation together with costs of Rs.5000/-



In the result this appeal is allowed and the order of the District Forum is set aside directing the opposite party to pay Rs.75,000/- to the complainant towards professional negligence together with costs of Rs.5000/-. Time for compliance four weeks.





PRESIDENT LADY MEMBER MALE MEMBER(SA)

Dt.15.4.2009