DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION

PATIALA.

                                      Consumer Complaint No. 384 of 15.9.2016

                                      Decided on:         5.2.2021

Karamjit Singh S/o Sh.Jagir Singh R/o Kishanpura Basti, Nabha Gate, Sangrur, District Sangrur.

                                                                   …………...Complainant

                                      Versus

1. Dr.Krishan Yadav, Consultant and Head of the Department, Department of Pediatrics and Neonatology, Amar Hospital, Patiala.
2. Amar Hospital, Income Tax Office Road, Bank Colony, Patiala through its Manager.
3. New India Assurance Co. Ltd.Patiala, Divisional Office, Opposite Income Tax Office, Leela Bhawan, Patiala.

                                                                   …………Opposite Parties

                                      Complaint under Section 12 of the

                                      Consumer Protection Act, 1986.

QUORUM

                                      Sh. Jasjit Singh Bhinder, President

                                      Sh.Vinod Kumar Gulati, Member    

ARGUED BY

                                       Sh.S.S.Virk, counsel for complainant.

                                      Sh.Ranjan Gupta, counsel for OPs No.1&2

                                      Sh.D.P.S.Anand, counsel for OP No.3.

 ORDER

                                      JASJIT SINGH BHINDER, PRESIDENT

1. This is the complaint filed by Karamjit Singh (hereinafter referred to as the complainant) against Dr.Krishan Yadav and others (hereinafter referred to as the OP/s).
2. Briefly the case of the complainant is that he being father of deceased Jaskaran Singh (11 years) who has died on 17.12.2014 is fully competent to file the present complaint.
3. It is averred that on 6.12.2014 his son namely Jaskaran Singh felt fever and body pain and was vomiting and was admitted in Rajindra Hospital, Patiala for treatment, where he was diagnosed Malaria but the doctors of Rajindra Hospital, Patiala referred him to PGI, Chandigarh on the next day. It is averred that thereafter complainant consulted Dr.Krishan Yadav of Amar Hospital, Patiala regarding the treatment of his son Jaskaran Singh who assured that there is decent treatment arrangement at Amar Hospital, Patiala for the ailment of Malaria. He further assured that he would himself give the treatment to the patient. Accordingly the patient Jaskaran Singh was admitted in Amar Hospital, Patiala immediately on 7.12.2014 and was again diagnosed as patient of Malaria where Dr.Krishan Yadav gave treatment to him.
4. It is further averred that during the treatment of Jaskaran Singh, OP No.2 charged Rs.2,20,000/- as hospital and doctor’s fee and charges of medicines and injections. Dr.Krishan Yadav also received Rs.30,000/- separately for two injections to be given to Jaskaran Singh. Hence total Rs.2,50,000/- was received by the OPs up till 17.12.2014 in lieu of the treatment of Jaskaran Singh.
5. It is averred that after passing of three days of admission of patient Jaskaran Singh in Amar Hospital, Patiala there was no improvement in his ailment. Complainant asked OPs No.1&2 for permitting him to shift his son to any big hospital like PGI, Chandigarh or Fortis Hospital, Mohali for his proper treatment but OP No.1 assured that his son would be all right within one or two days. It is averred that on 13.12.2014 the condition of his child became more critical. The complainant again requested OPs No.1&2  for referring the patient to PGI, Chandigarh but again OP No.1 assured the complainant and his family that the condition of Jaskaran is improving and there is no cause of worry about his health and he will be fine in next 72 hours. OP No.1 also asked the complainant to depositRs.30,000/- with him for arrangement of two injections. Accordingly complainant after arranging Rs.30,000/- gave the same to OP No.1 for purchasing the injections. It is further averred that on 14.12.2014 the OPs did not allow the complainant and his family to meet the patient Jaskaran Singh and told to complainant by OP No.1 that there is need to keep the patient in isolation to protect him from infection and nobody can now meet the patient or enter his room. It is also told by Op No.1 that platelets of Jaskaran Singh are under control. It is averred that during the treatment from 7.12.2014 to 14.12.2014 the platelets were decreasing. On 15.12.2014 and 16.12.2014, the OPs again did not allow the complainant and his family members to meet the patient rather on 16.12.2014  the complainant was told by OP No.1 to clear all the bills of hospital and charges of the treatment and the complainant cleared all the bills. It is averred that on 17.12.2014 in the evening at about 2PM Dr.Krishan Yadav called the complainant in his office at the hospital and told that the condition of Jaskaran Singh is serious as his platelets are not increasing hence he is being referred to PGI, Chandigarh for further treatment. OP No.1 also prepared discharge slip in this regard. It is averred that the OPs No.1&2 kept the complainant and his family members in dark as when they reached at PGI, Chandigarh, the doctors of PGI declared the patient brought dead. It is averred that the OPs No.1&2 in connivance with each other did not refer the patient earlier to big hospital for treatment in greed of money. The death of Jaskaran Singh was caused by OP No.1 by committing medical negligence. Hence this complaint with the prayer to accept the same by giving direction to the OPs to pay Rs.20lacs as damages/compensation of loss.
6. Upon notice OPs appeared through counsel and contested the complaint by filing written reply.
7. In the reply filed by OPs No.1&2 preliminary objections have been raised that the complaint is bundle of lies and is based on distorted facts; there has been no negligence on the part of OP No.1 as the best possible treatment was given to the patient.
8. On merits, it is submitted that OP No.1 was not employee of OP No.2 but was working as a consultant in the hospital. It is admitted that Jaskaran Singh was suffering from cerebral Malaria. It is admitted that Jaskaran Singh was admitted in Amar Hospital, Patiala and was diagnosed patient of Malaria and was treated by OP  No.1.It is submitted that it was a case of cerebral malaria in which his brain, blood, kidney, lung and lever were involved. When admitted in the hospital it was a case of cerebral malaria and thrombocytopenia (decrease in platelet counts). It is further pleaded that condition of the patient was explained to his attendants. It is stated that Cerebral Malaria is the most severe neurological complication of infection in which mortality is very high. The clinical hall mark of cerebral malaria is impaired consciousness with coma, the most severe manifestation. Cerebral malaria collectively involves the clinical manifestation  of plasmodium falciparum malaria that induce changes in mental status and coma and there are acute seizures also. It is submitted that it was a case  of cerebral malaria so the diagnosis of OP No.1 were right and the treatment was also given as per the medical jurisprudence. The main stay of malaria therapy is artesunate and the patient was treated with the said medicine. Best possible treatment was given to him. It is submitted that when the patient was progressing and was recovering from the disease, the attendants of the minor wants to take the child to PGI and as such the OP also issued a reference slip in the name of the doctor at PGI. It is further pleaded that whatever was charged from the complainant for the treatment of the patient was duly acknowledged and the receipts were being issued to him. It is pleaded that total sum of Rs.2,20,000/- was charged from the complainant . The OPs after denying all the averments of the complainant have prayed for the dismissal  of the complaint.
9. In the written reply filed by OP No.3 preliminary objections have been raised that the present complaint is not maintainable. It is submitted that Professional Indemnity Policy was issued  in favor of Dr.Krishan Yadav for the period from 2.5.2014 to 1.5.2015 for a sum of Rs.20lac. As most of the contents of the complaint relate to OPs No.1&2, OP No.3 did not give any reply and after denying all other averments made in the complaint, the OP No.3 prayed for the dismissal of the complaint.
10. In support of the complaint, the ld. counsel for the complainant has tendered affidavit,Ex.CA of the complainant alongwith documents Exs.C1 to 37 and closed the evidence.
11. The ld. counsel for OP No.3 tendered in evidence Ex.OPA affidavit  of Smt.Gurveen Kaur, Sr.Divisional Manager alongwith document Ex.OP1 and closed the evidence.
12. No evidence has been lead on behalf of OP No.1.
13. The ld. counsel for OP No.2 tendered in evidence Ex.OPB affidavit of Dr.Jaskaran Singh Saran, Dy.Medical Superintendent, Amar Hospital, Patiala alognwith documents Ex.OP2 and closed the evidence.
14. All the parties have submitted written arguments alongwith law on the file. We have gone through the same,  heard the ld. counsel for the parties and have also gone through the record of the case, carefully.
15. The ld. counsel for the complainant has argued that complainant is father of deceased Jaskaran Singh whose age was 11 years and who was died on 17.12.2014 due to negligence of OPs No.1&2.The ld. counsel further argued that on 6.12.2014 the son of the complainant Jaskaran Singh felt fever and body paid due to which he was admitted in Rajindra Hospital, Patiala for treatment and he was diagnosed malaria but the doctors of Rajindra Hospital ,Patiala referred him to PGI, Chandigarh on the next day. The ld. counsel further argued that the complainant then consulted Dr.Krishan Yadav, OP No.1 of Amar Hospital, Patiala regarding treatment of Jaskaran Singh and said doctors assured the complainant that there is decent treatment arrangement at Amar Hospital, Patiala. So Jaskaran Singh was admitted in the Amar Hospital, Patiala on 7.12.2014 and he was diagnosed of malaria. During the treatment OP No.2 received Rs.20,20,00/- as hospital and doctor’s fee and OP No.1 separately charges Rs.30,000/- total amount of Rs.2,250,000/- was received up till 17.12.2014.The ld. counsel further argued that after three days of admission of Jaskaran Singh, as there was no improvement, the complainant requested Dr.Krishan Yadav for shifting his son to PGI, Chandigarh or Fortis Hospital, Mohali but OP No.1 assured that the complainant that his son would be all right within one or two days. Again on 13.12.2014, the complainant requested OP No.1 to shift his son to PGI, Chandigarh. The ld. counsel further argued that from 14.12.2014 to 17.12.2014 the complainant and his family members were not allowed to meet Jaskaran Singh. The ld. counsel further argued that on 17.12.2014 the condition of Jaskaran Singh became serious and he was referred to PGI, Chandiarh where he was declared brought died. The ld. counsel further argued that there was late referral on behalf of OPs No.1&2 due to which his son died . The ld. counsel has relied upon the citation V.Kishan Rao Vs. Nikhil Super Specialty Hospital & Another 2010(4)JT 630, Arun Kumar Manglik Versus Chirayu Health And Medicare Private Ltd. & Anr. 2019(2) R.C.R.(Civil) 225 and Sheela Hirba Naik Gaunekar Versus Apollo Hospitals Ltd. & Anr. 2016(6) Recent Apex Judgments 62.
16. On the other hand, the ld. counsel for OPs No.1&2 has argued that there was no medical negligence on the part of OPs No.1&2.The ld. counsel further argued that when the patient was referred from Rajindra Hospital, Patiala, it was a case of cerebral malaria in which his brain, blood, kidney, lung and lever were involved. The ld. counsel further argued that the condition of the patient was explained to  his attendants and cerebral is the most severe neurological complication of infection in which mortality rate is very high. The ld. counsel further argued that clinical hall mark of cerebral malaria is impaired consciousness with coma and is most severe manifestation and there are acute seizures also. The ld. counsel further argued that the main stay therapy is artesunate and the patient was treated with the said medicine. It  is further argued that this medicine is also  recommended in the medical jurisprudence and WHO guidelines. The ld. counsel further argued that the patient was referred from Rajindra Hospital Patiala, he was already in a serious condition and there is no pleading on the file to prove that medical negligence is on the part of OPs No.1&2.The ld. counsel further argued that OPs No.1&2 treated the patient as per the guidelines issued by the WHO and medical line is follow .The ld. counsel further argued that there was increase in platelets counts of the child and it is proved on the file. The ld. counsel for OPs No.1&2 relied upon the citations Bijoy Sinha Roy (D) by Lr. Versus Biswanath Das & Ors. 2017(3) Apex Court Judgments 574 (SC)  and Dr.S.K.Jhunjhunwala Vs. Mrs.Dhanwanti Kumar & Anr. 2018(3) Apex Court Judgments 633(SC).
17. On behalf of OP No.3, the ld. counsel has argued on the same lines as argued by the ld. counsel for OPs No.1&2.
18. To prove this case, complainant Karamjit Singh has tendered his affidavit,Ex.CA and he has deposed as per his complaint, Ex.C1 is the discharge card supplied by Govt. Rajindra Hospital, Patiala,Ex.C2 is the slip of Amar Hospital, Patiala,Ex.C3 is also letter written by Dr.Krishan Yadav when the child was referred to PGI,Ex.C4 is the death certificate of PGI Chandigarh of the child, Ex.C5 is bill of Amar Hospital, Patiala, Exs.C6 & C7 are the receipts of Amar Hospital,Patiala,Exs.C8 to C15 are also the receipts of Amar Hospital, Patiala, Exs.C16 to C32 are the lab. reports of Amar Hospital, Patiala, Ex.C33 to Ex.C37 are the report of Lal Path Lab.
19. On behalf of OP No.3 Gurveen Kaur has tendered his affidavit, Ex.OPA and she has deposed as per the written statement, Ex.OPB is the affidavit of Dr.Jaskaran Singh Sra of OP No.2 and he has deposed as per his written statement,Ex.OP1 is policy schedule of OP No.3,Ex.OP2 is record of OP No.2 hospital regarding the admission of Master Jaskaran Singh.
20. The main document to decide this complaint is record of Govt. Rajindra Hospital, Patiala,Ex.C1 dated 6.12.2014 when child Jaskaran Singh was admitted for the first time. From this record, it is clear that child was diagnosed  cerebral malaria with thrombocypperia .The platelet counts were shown as 10,000 and the child was complaining abnormal body movement. It is further mentioned in this Ex.C1 that everything was explained to patient attendants and the child was referred to PGI, Chandigarh. So from this report/diagnoses of Rajindra Hospital, Patiala it is clear that child was not suffering from malaria but was suffering from cerebral malaria and thrombocypperia and platelet counts were 10,000.Injection artesunate was started at Rajindra Hospital, itself. Parents of the child instead of taking him to PGI, Chandigarh took him to Amar Hospital, Patiala of their own. There is evidence on the file that the complainant was  forced to take his child to Amar Hospital, Patiala. The receipt of hospital is 7.12.2014, in which it is mentioned that the patient was referred to PGI, Chandigarh and the diagnosis have been mentioned by Amar Hospital as “Cerebral Malaria with stocks epileptics with DIC with septic shock”. So it is clear that the child was admitted to Amar Hospital Patiala and his condition was serious.
21. Ex.C3 is the referral letter vide which the child was referred to PGI, Chandigarh with the complete detail/ complete history. It is mentioned that  for cerebral malaria .Artesunate injections were given to him. Other medicines were also mentioned. Ex.C4 is the medical certificate of cause of death of Jaskaran Singh of PGI, Chandigarh. It is mentioned that he was brought dead.Ex.C5 is the patient bill dated 17.12.2014 of Rs.2,20,000/-. From this document, it is clear that child was given all the medicines including artesunate injection and  he was also put on ventilator. The entire detail of medicines is mentioned in Ex.C5 as the bill of medicine was taken from the complainant.Exs.C6 to C15 are also bills.
22. The ld. counsel for the complainant has argued that from the clinical lab reports , it shows that SGOT count was continuously on the higher side. The ld. counsel has drawn our attention to Ex.C18 where SGOT count was 51 whereas normal has to be 40 and SGPT 39 when the normal range is 35.But these counts are not such higher in nature. There is another report,Ex.C22 of Amar Hospital, where TLC counts has been shown as 3600 whereas the maximum requirement is 4000.In Ex.C23, the clinical report of Amar Hospital, SGPT is 51 and the maximum requirement is 35.At the time when the child was brought to Rajindra Hospital, Patiala his platelet counts were 10,000 but as per Ex.C26, the clinical report of Amar Hospital his platelets counts on 12.12.2014 were 1.46,000. So, it is clear that platelet counts has come to a normal range on 12.12.2014.
23. From the reports, Exs.C27,C28,C29 and C30 of clinical lab of Amar Hospital, it is clear that the reports were normal. As per report,Ex.C31 which is dated 16.12.2014 his TLC count was 13700 whereas maximum range has to be 11000.In the report, Ex.C32 SGOT has risen to 114 and SGPT was 71 and this report is dated 16.12.2014 and he was referred to PGI Chandigarh on 17.12.2014.
24. The OPs No.1&2 has exhibited the entire medical record of Master Jaskaran Singh as Ex.OP2. This is voluminous and all the medicines which were given to child are mentioned daily from time to time when child was admitted. It is mentioned that patient was admitted in semiconscious state from Rajindra Hospital, Patiala and he was having fever and seizures .There was abnormal body movements. It is clearly mentioned that injection artesunate was started but seizure was still continuing .
25. So it is clear as already stated above, the child was in a serious condition when he was admitted in the Amar Hospital, Patiala and entire record till the time he was shifted has been brought on the file. The entire medicines which were given to him time and again has been mentioned and this is a detailed chart. So it is clear that best medical treatment was given to the child but unfortunately he was died in such a tender age.
26. OPs No.1&2 have attached Nelson Textbook of Pediatrics , in which it is mentioned that  in case cerebral malaria  Artesunate is the treatment of chose. The OPs have also attached the medical jurisprudence on the cerebral malaria in which it is also mentioned that ‘cerebral malaria is the most severe neurological complication of infection with Plasmodium falciparum malaria and mortality is very high in this ailment’. The OPs have also attached guidelines of World Health Organization , in which it is also mentioned that Artesunate is the best treatment for this ailment and as already stated above this treatment was given in Rajindra Hospital, Patiala and this treatment is also given at Amar Hospital. Voluminous medical record of Amar Hospital is placed on the file.
27. No doubt death of a child in the age of 11 is a big loss to the parents but in this case it has to be seen whether there was any medical negligence on the part of OPs No.1&2.The ld. counsel for the complainant has further argued that there was delayed referral by them to PGI, Chandigarh. As already stated above, the complainant on their own come to Amar Hospital, whereas they were referred to PGI, Chandigarh and the best available treatment as per the medical jurisprudence and as per the WHO guidelines were given to the child and the child was already in a serious condition. This fact is clearly proved from the medical record of Amar Hospital when he was admitted in this hospital on 7.12.2014. It is clearly held by the Hon’ble Supreme Court of India in the case of Bijoy Sinha Roy(D) by Lr. Vs. Biswanath Das and Ors.(Supra) that “so long as doctor follows a practice acceptable to the medical profession of the day, he cannot be held liable for negligence merely because a better alternative course was available. A professional may be held liable for negligence if he does not possess the requisite skill…” This judgment of Hon’ble Supreme Court of India is full applicable to this case as OPs No.1&2 have followed the guidelines of medical jurisprudence and WHO guidelines for giving treatment to the child and the doctor (OP No.1) was a child specialist. It is not the case of the complainant that he was not competent to deal with this case.
28. Further the ld. counsel for the complainant has tendered judgment of Hon ‘ble Supreme Court of India but that judgment of Hon’ble Supreme Court of India is not applicable as the best treatment was given to the child.
29. So due to our above discussion, the medical negligence is not proved due to following facts:

1. That already the child was diagnosed for cerebral malaria when he was admitted to Rajindra Hospital, Patiala and as per the record of Rajindra Hospital there was abnormal body movement and the platelet counts were 10000.
2. When the child was admitted in Amar Hospital, it is clearly mentioned in the record of Amar Hospital, which has been produced by said hospital on the file that the patient was in semiconscious state. He was referred from Rajindra Hospital Patiala. The patient was having fever and abnormal body movement. The Amar Hospital has produced all the record vide which he was given medicines.
3. The platelet counts has risen to 1,50,000 from 10,000.
4. The patient was young boy was already on the ventilator.
5. The Best medical treatment in the form of artesunate which was used worldwide in the patient of this disease was given to the child alongwith other medicines.
6. There is also no delay for referring the child to PGI where he died.
7. It is also not pleaded in the complaint and it is also not proved that wrong line of treatment was given to the child.

30. So due to our above discussion there was no medical evidence on behalf of  OPs No.1&2 on the file and the complaint is hereby dismissed with no order as to costs, although it is very sad that a young boy has lost his life due to serious disease of cerebral malaria.           

ANNOUNCED

DATED:5.2.2021         

                             Vinod Kumar Gulati             Jasjit Singh Bhinder

                                    Member                                       President