Karnataka
Gadag
CC/26/2018
Sayed.H.Hussaini - Complainant(s)
Versus
Ashraya Hospital and Another - Opp.Party(s)
M.V.Mudgal
31 Aug 2020
ORDER
O R D E R
JUDGEMENT DELIVERED BY SMT.SAMIUNNISA.C.H., PRESIDENT:
This complaint is filed by the complainant against the OPs claiming certain reliefs by invoking Sec 12 of the Consumer Protection Act 1986.
2. The averments of the complaints in brief are:
The above complaint filed by the complainant, states that on 17-04-2018, he had visited the OP No.1 hospital for removing kidney stone. The OP No.1 scanned the kidney and Blood test by receiving the fee of Rs.700/- and Rs.1700/- for both tests respectively. Thereafter once again on 18-04-2018 Complainant had undergone ultra-scan and he was charged Rs.3,110/- for the same. Thereafter the Complainant was admitted in the OP No.1 hospital on 23-04-2018 vide Registration No.1819/0193, on the same day Anesthesia was given to the Complainant for operating surgery. The Complainant further averred that he was not given proper anesthesia at that time of removing 14 mm stone from right side and 4 mm on left side were blasted, removed and the Complainant was discharged on 26-04-2018. After coming out from the OP No.1 hospital Complainant started vomiting and there was pain in the stomach and down side of the back and he was feeling giddiness. Thereafter he returned to Koppal and continued the medicines, but there was unbearable pain he again admitted in the Koppal Government Hospital on 27-04-2018 and the Doctors again scanned the Kidney and informed that there are stones of 11 mm in right side and 6 mm in the left side of the kidney. Thereafter due to unbearable pain, Complainant again visited Mallige Hospital at Hospet on 08-05-2018, the Doctor in that Hospital informed that due to wrong operation, some stones entered inside the kidney and formed puss entered into the blood, so they gave immediate first aid and charged Rs.25,000/- and advised to meet the operated doctor and take the further treatment. Therefore the Complainant again visited the OP No.1 hospital on 05-05-2018, but the OP No.1 doctor has not properly responded only he has given prescription by charging Rs.400/-. Even after taking treatment, the pain of the Complainant was not cured. So the Complainant admitted in the S.D.M. Hospital Dharwad on 21-05-2018 and they scanned the complete body of the Complainant and informed that there are kidney stones in the right and left side of the kidney and they also removed the same, but due to wrong surgery and improper anesthesia some stones remained in the kidney and it is impossible to remove them, if they try to remove them, they may cause damage to the kidney and advised the Complainant not to lift the heavy weights and advised for rest. Hence the Complainant alleged that due to negligent treatment of the OP No.1 Doctor, he suffered lot of mental agony, torture and also incurred much money for treatment in many hospitals and even he is unable to drive the vehicle, due to this he is not earning his livelihood. Therefore the Complainant prayed for awarding compensation of Rs.1,00,000/-towards medical expenses, Rs.15,00,000/- towards mental agony and physical harassment and Rs.1,00,000/- towards deficiency in service together with Rs.20,000/- towards costs of the complaint.
3. The Forum registered a case and issued a notice to the OPs. After service of the notices the OP No.1 & 2 appeared through their counsels and filed their written versions separately.
4. The OP No.1 admitted about the Complainant admission in his hospital for the operation of the kidney stones, but it is denied that anesthesia was not given properly, if anesthesia was not given properly surgery for kidney stones cannot be performed. The OP No.1 contended that the whole complaint is totally false and specifically denied the contents of the Complaint as the Complainant has taken treatment under Government Scheme free of cost, as such he is not a consumer of the OPs. Hence the complaint is not maintainable and is liable to be dismissed.
The OP-1 further submitted that Complainant presented with complaints of pain in abdomen since few weeks, which increased since 5-6 days and he was also gave history of renal stones disease for 3 years ago which is evidence that he is prone to renal stones disease. On examination the Complainant was found to be clinically stable and was advised USG abdomen along with necessary investigation to help arrive at a proper diagnosis. The blood and unite investigations were found to be within acceptable range. But it was found that the Complainant had right proximal ureteric calculus on USG report. In order to evaluate better, Complainant was advised computed tomography of kidney ureter and bladder (CT KUB). The Complainant consulted again on 18-04-2018 with CT KUB report and it was found that patient was having 12 mm calculus in lower pole of left kidney, 4mm calculus in mid pole of right kidney. 12-13 mm calculus in right proximal ureter causing mild hydroureteronephrosis, based on the CT report, Complainant was advised surgery. Since the Complainant disclosed that he is a BPL card holder and wanted to get the surgery done in Government scheme. So he was asked to come back with all relevant documents to get pre-authorization from SAST and get admitted. Accordingly the Complainant got admitted on 23-04-2018 at 4.10 pm and documents were verified and uploaded the documents in SAST website on the same day to get permission for the surgery. On 23-04-2018 the Complainant was evaluated clinically and all the investigation reports were rechecked and Complainant was found to be fit for surgery. On 24-04-2018 the permission for surgery –Left PCNL with right URSL+B/L DJ Stenting was received. After preparation for surgery were done and patient was taken into OT at 7.00 pm and was given spinal anesthesia and then supplemented with general anesthesia. The Complainant was put in lithotomy position and first right retrograde pyelgraphy done and stone noticed at right upper ureter, right ureteroscopy done and right upper ureteric stone was fragmented with pnemotripter and large fragments retrieved. Left retrograde pylegraphy done and left lower pole calculus noticed. Then left ureteric catheter placed. 16Fr Foleys urethral Cather placed. The Complainant was put in prone position and left percutaneous nephron performed stone fragmented with pnemotripter and large fragments retrieved. The Complainant tolerated the procedure well . Subsequently the Complainant was shifted to post-operative ward. On evaluation in the post-operative ward period the Complainant was found stable clinically. In the following 2 days the Complaint was regularly clinically assessed and necessary treatment and care given as per standard protocol. The Complainant was discharged on 26-04-2018 in a stable condition by giving necessary medications along with discharge summary and instructions to the Complainant. It is further submitted that during the said period from 23-04-2018 to 26-04-2018, Complainant was not charged a single rupee, even food, travel expenses and necessary medications along with discharge medication were given free of cost to the Complainant as per SAST scheme rules. The Complainant was advised immediately to present to hospital, in case of any complications or any symptoms mentioned in discharge summary like fever with chills, vomiting. It is further submitted that during the follow up period the Complainant came after 05 days of discharge alone walking in hail and healthy condition. At that time he was evaluated clinically on OPD basis, he had no complaints and was found to be stable and had achieved expected recovery which is a testimony of the impeccable care and treatment received from the OP No.1. On 18-05-2018 the patient was advised relook URS, X ray KUB taken and it does not show any major stone fragments. Failing to turn up in subsequent days the patient was phone called on 20-05-2018 and 22-05-2018. The patient ignored the call and dint turn up for completion/follow up treatment in the form of check urtero-rescopy and DJ stent removal. The Complainant has never turned up in casualty or in emergency condition to the OP-1 Hospital and the OP No.1 believed that Complainant did not develop life threatening complications because of surgery. It is further submitted that following any endoscopic stone surgery, after breading the large stone into smaller fragments some of the smaller stone fragments may sit in remote inaccessible areas of the kidney. These are known to eventually expel once the DJ stent is placed or in some cases may require a relook or ancillary procedure. The aspects had been explained in detail during counseling prior to the surgery. The treatment protocol is to wait for 1-3 months especially after breading larger stones to smaller stone fragments to be expelled out. The Complainant had been counseled in this regard, but he chose not to come for follow up as advised. The OP No.2/Dr.Mayur Patil is an experience urologist practicing for more than 8 years. He has given his services in most of the prestigious medical institutes and he had given good treatment to the Complainant at OP-1 hospital at free of cost. Therefore there is no negligence, deficiency in service on the part of the OPs, hence the OP No.1 prayed for dismissal of the complaint with heavy costs.
5. The OP No.2 has also admitted about the Complainant admitted in OP No.1 hospital for the operation of the kidney stones, but it is denied that anesthesia was not given properly, if anesthesia was not given properly operation for kidney stones cannot be performed. The OP No.1 contended that the whole complaint is totally false and specifically denied the contents of the Complaint as the Complainant has taken treatment under Government Scheme free of cost, as such he is not a consumer of the OPs. Hence the complaint is not maintainable and is liable to be dismissed.
The OP-2 further submitted that the procedure done to patient underwent endoscopic procedure for removal of kidney stones on both sides on 24-04-2018 the permission for surgery –Left PCNL with right URSL+B/L DJ Stenting was done. Endoscopic fragmentation ofureteric and renal calculi (stones) and removal bigger fragments and placing D.J. Stents on both sides. These techniques are latest procedures and standard procedures done for treatment of kidney stones and Complainant seems to agree that correct procedures was done as he has not complained incorrect and wrong procedures. It seems his contention and complaint is residual caluculi (remaining of few small stones after procedure). It is further submitted that residual calculi post procedure is not a medical negligence. That invariably few fragments remain in kidney in these type of endoscopic procedures and many instances will need ancillary procedures (Further procedures like relook URSL ESWL) to achieve complete clearance of stones and in few cases, inspite of all these procedures few fragments may still remain in kidney and the same was also explained to the Complainant in kannda language. It is further submitted that in endoscopic procedure usually the bigger fragments are usually the bigger fragments are retrieved and the smaller stones will pass naturally after putting D.J. Stent or after removal of stents or can be removed while removing the D.J. stents in the ancillary procedure. The endoscopic procedure is a 1st step in procedure and the completion of procedure will be after the removal of both stents which are conventionally removed after 2 to 8 weeks after 1st procedure depending on clinical scenario with or without anesthesia and this is entirely at clinicians discretion. The patients next procedure for removal of D.J. stents and removal of residual calculi and B/L relook URSL was planned after one month, hence patient was called at later date, but the Complainant has not turned up for follow up treatment, inspite of hospital staff repeatedly calling on his phone, the Complainant did not bother to answer the calls and efforts to contact him were futile and lastly he was not reachable. It is further submitted that there was no any complication due to endoscopic procedures or anesthesia happen during or immediately post-operative period. It is further submitted that the Complainant had turned up for ancillary procedure after one month and the same procedure what the Complainant underwent at SDM Hospital would have been done by the OPs, if patient had turned up at their hospital at free of cost. It is further submitted that Complainant’s C.T. Reports done at SDM Hospital shows that left sided stones is 7 mm i.e. reduced from 12 mm compared to CT report prior to endoscopic procedure and right sided 2 stones 5mm and 6 mm i.e. single stone of 13 mm broken into two small fragments and these are very small fragments who chances of passing are significantly higher. It is further submitted that the Complainant visited to Koppal Medical College and Mallige Hospital Hospet for treatment of fever and head ache. These are all shows that there was no negligence or deficiency in treatment of the Complainant by the OPs. Therefore the OP NO.2 prayed for dismissal of the complaint with costs.
6. The complainant has filed his chief affidavit with documents which are marked as Ex.C-1 to C-41. The OPs also filed his affidavit evidence along with copy of reply notice given to the complainant.
COMPLAINANT FILED DOCUMENTS AS follows
Particulars of Documents | Date of Document | |
C-1 to C-1(c) | Ashraya Medical Hospital records | |
Koppal Medical Hospital records |
| |
Copy of ration card status |
| |
Ration Card |
| |
Aadhar Card |
| |
| ||
Procedure Claim Form |
| |
Certificate under Vajpayee Arogyashree Scheme |
| |
Daily Patient Visit chart |
| |
| ||
Proforma for Surgical Cases |
| |
C-12 to 15 | Case sheet |
|
Pre-operative orders/Check list |
| |
Consent for Anastasia with record |
| |
Consent for operation |
| |
Nursing assessment Form |
| |
Nursing and Drug chart |
| |
C-21 & 22 | Nurses Notes |
|
Drug chart |
| |
IP Billing Sheet |
| |
Discharge Summary |
| |
Operative Notes |
| |
Consolidated final bill |
| |
C-28 & 29 | Findings of abdominal ultrasound with photocopy |
|
C-30 to 32 | Laboratory report |
|
Report of CT scan of KUB |
| |
C-34 to 37 | 3 Outpatient bills |
|
List of procedures |
| |
Legal notice |
| |
Reply to legal notice |
| |
Reply to letter under RTI |
|
7. On the basis of above said pleading, oral and documentary evidence, the following points arises for adjudications are as follows:
1.
|
Whether the Complainant proves that there is deficiency in service on the part of the OPs? |
2. | What Order? |
8. Our Answers to the above points are:-
Point No.1: – In Negative
Point No.2: - As per the final order.
R E A S O N S
9. POINT NO.1: The complainant filed this complaint against the OP for the medical negligence. As per the complaint, complainant visited the Hospital of OP No.1 on 17.04.2018 due to heavy stomach pain. After consulting OP No.1, OP No.1 diagnosed that, there is a kidney stone and OP No.1 suggested him to admit in the Hospital. On 23.04.2018 complainant admitted in the Hospital and as per the previous report, the size of the stone of right side kidney is 14 mm and left side stone is 4 mm and the same had been removed by conducting operation and discharged the complainant on 26.04.2018. On the next day itself, he got the heavy pain and he moved to the Government Hospital, Koppal wherein the duty Doctor of the Government Hospital diagnosed and said that, the size of the right side kidney is 11 mm and left side kidney is 6 mm, since because of heavy headache he went to the Mallige Hospital, Hospet for further treatment. Further complainant submits that, the Mallige Hospital Doctors suggested and diagnosed that, some part of the stone had been scattered in the kidney and since because of this there is a pus mixed with blood and the said Hospital Doctor given an emergency treatment and complainant has spent Rs.25,000/- for the same and submits that, the said Doctor suggested him to move to the treated Doctor i.e., OP No.2 for further treatment. He visited OP No.1 and OP No.1 given some tablets to the complainant but, he cannot get proper treatment so, finally he went to SDM Hospital, Dharwad on 08.05.2018 and as per the complaint, he got treated in the Hospital.
10. On the other hand, OP No.1 submits that, complainant consulted OP No.1 on 16.04.2018 for the heavy pain in the abdomen since few weeks and he also gave history of renal stone disease three years ago and it is proving that, he is a patient of renal stone disease. On examination, the complainant found to be a clinically stable and the blood and urine investigation were found to be acceptable range and it was found that, complainant had proximal ureteric calculus on
11. Further the complainant was put in lithotomy position and first right retrograde pyelography was done and stone noticed at right upper uretric and right uretrascopy was done and right upper uretric stone was fragmented with pnemotripter and larger fragments retried. Left retrograde pyelography was done and left lower pole calculus notice done in left uretric catheter place. The complainant was put in prone position and left percutaneous nephrolithotomi performed, stone formatted nemotripter and large fragments retrieve. The complainant tolerated the procedure well and subsequently complainant was shifted to postoperative ward on evolution in the postoperative stage, the complainant was found stable clinically in the following two days, the complainant was regular clinically assessed and necessary treatment care was given as per the standard protocol. The complainant discharged on 26.04.2018. This treatment has been given to the complainant with free of cost as per the SAST Scheme Rule. During the fallow up period, complainant came alone by walking in hale and healthy condition after 5 days in reference to advice on discharge and patient was advised for fallow up treatment. Complainant visited the Hospital on 18.05.2018 and advised to relook Uretrorescope X-ray KUB taken on 18.05.2018 does not shown any major stone fragments and complainant is directed and called on phone subsequently for D and J removal and for follow up treatment uretrorescopy but, complainant was never turn up.
12. OP No.2 filed written version and submits that, the procedure followed by the OP No.1 is latest procedure for treatment of kidney stone. The complainant is residual calculi (remaining of few small stone after procedure) and submits that, the residual calculus procedure is not a medical negligency. That, invariably few fragments kidney in these type of endoscopy procedure and many instants will need ancillary procedure and further procedures like relook URSN, ESWL (shock wave lithoripsy, stage procedure) to achieve complete clearance of stone. That the complainant was aware of these possibilities and he agreed and given a written consent. To remove the stent it takes two to eight weeks after first procedure depending on the clinical scenario with or without Anastasia and it is entirely at clinical discretion. After one month, complainant is called but, the complainant did not bother to answer the call and he aws not reached.
13. Further the complainant had underwent for treatment at SDM Hospital which is a minor procedure that too with free of cost. At SDM Hospital, as per the CP report, the stone size is 7 mm i.e., reduced from 12 mm compare to CT report prior to the endoscopy procedure and right sided two stone 5 mm and 6 mm i.e., single stone of 13 mm broken into two small fragments.
14. Further OP No.2 submits that, except a fever which he suffered for one day admission in OP No.2 and treatment for fever of the record, he produced reveals that, there is no abnormality in patient condition about the previous treatment of OP No.1. Further on a surgical note in the SDM Hospital, there is no stone seen in left kidney and which proves that, left side stone was completely removed by OP No.2 and OP No.1.
15. The records filed before the Commission reveals that, there is doubt that, the patient was suffering for the kidney stone and he went to the Ashraya Hospital for treatment and treatment has been given only the summary report produced by the complainant himself i.e., pertaining to OP No.1 reviewed on 30.04.2018 and SOS, it is clearly mentioned that, “ in case of following the complaints, please visit to Hospital/contact Hospital”. Severe pain in abdomen, fever, omitting, abdomen soakage of wound in fever reminder for DJ stent removal before two months. Such being the direction given and even as per the complaint itself, complainant submits that, in the next day of discharge from OP No.1, he went to the Government Hospital, Koppal, the duty Doctor suggested him to visit OP No.1 for further treatment, but the complainant not did so. It is best known to him that, he went to the Mallige Hospital, Hospet, i.e., OP No.2, OP No. 2 also submits there is no negligency on behalf of OP No.1 since because, the surgery made to the complainant is a latest procedure and standard procedure done for treatment of kidney stone. To substitute the defence of OP No.1, fortunately complainant himself called a witness from the SDM Hospital, Dharwad to reveal the fact. One D.V. Bhuvanesh submits that, when the complainant came to him he observed that, he was hale and healthy, he entered to the OPD in a good health I suggested him for CT Scan to remove the stent I saw that, still there are two stones in both the sides i.e., 5mm and 6mm respectively and stent is also found, as per the discharge summary the stone size is 1.4mm and 12mm respectively for OP had given a treatment by way of different operation.
16. Further, CW-2 submits that, he had removed the stent by giving antibiotic to prevent the development of new infection. Further submits that, in the paragraph-5 it is stated that, it cannot say that, the operation made by the OPs is a failure because in the history these kind of operations patients suffer from little bit fever and infection and even 30% to 40% people have to undergo 2 time operation for the relief.
17. While cross-examining the Advocate for OP No.1 and 2, the Doctor said that, while visiting him, the complainant was not suffering from fever and he said that, he wanted to remove the DJ stent and after scanning, CW-2 found that, in the right side he found 7 mm stone and 4 mm stone in the left side and he removed it. Further submits that, if he went to the follow up treatment to OP No.1, it can be done by the OP No.1 himself. Further submits that, there is no negligency on the part of OP No.1 since because it is anything that, some stone pieces are left after operation also, it needs further laser treatment for entire removal of dust of stone. Further submits that, it is not a surgery, it is only an endoscopy, in these treatment operation cannot be made. Another witness, he is from Mallige Hospital, Hospet, the said Doctor said to be given treatment from 08.05.2018 to 10.05.2018, he submits that, he went for the treatment of fever and headache, after diagnose I found that there is a pus in the blood for that, he had sever shriving, fever and headache. So, I have given a treatment only to reduce the infection and while examination by the complainant, he submits that, while visiting to him, there were no complaints about the kidney, he was hale and healthy. While examining by the counsel of OP No.1, he suggested that, if a patient roaming in a dust place or in a bus, there is a chances of these types of infection. To this question, the said Doctor submits that “YES”.
18. While examining by counsel for OP No.2, the said Doctor (Dr.P.D. Vinayaka Gupta, Mallige Hospital, Hospet) reveals that, the Complainant had not visited for the kidney problem. While examining him, he cannot found any urinal infection and there was no problem in the kidney and it is working in good condition. He further submits that, if the patient had followed the direction of a Doctor, these types of complaints cannot be arrived. While observing the evidence and arguments of both the parties and expert opinion, the Commission observed that, there is a chance of remaining of dust of a stone after endoscopy also and the OP No.1 had taken a consent with the complainant explaining and counseling and informed for Anastasia as required by law and for that, complainant had accepted.
19. Another thing observed by the Commission is that, complainant had availed a Government Scheme which is free of cost, he had not paid a single paisa to OP No.1. Such being the fact, it is clear that, OPs have not made any negligency on behalf of them. Hence, we answer Point No.1 in Negative.
20. POINT NO. 2: In view of our findings on above point, we pass the following:
//O R D E R//
1. The complaint is dismissed. No order as to costs.
2. Send the copies of this order to the parties free of cost.
(Dictated to the Stenographer, transcribed by him, corrected and then pronounced by me in the Open Court on the 31st day of August-2020)
,,
(Shri B.S.Keri) (Smt.C.H.Samiunnisa Abrar)
Member President
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