Lack of proper diagnosis,treatment for gastrointestinal ailment: Hospital told to pay 8 lakh

HYDERABAD: Holding the treating doctors and city-based hospital guilty of medical negligence and deficient in service; the Hyderabad District forum has directed them to pay over Rs 8 lakh as compensation to the kin of the patient who died during treatment.

The case goes back to the year 2014 when the patient was admitted in the Mediciti Hospital with the complaints of vomitings, loose motions, with white mucoid sputum. He was found to be suffering from Acute-Gastroenteritis (GE/GI) and CUDD, cystitis, hyponatremia, urine retention problem, pneumonia (LRTI).

Unfortunately, the patient had died due to massive gastrointestinal bleed during treatment at the hospital. The son of the patient; i.e. the complainant in the case alleged medical negligence and deficiency in service on part of the treating doctors and the hospital administration.

Via his petition with the court, he stated that though the doctor conducted various tests, his father was feeling uneasy and he was not able to sleep or sit as he continued to sweat heavily and has a feeling of passing urine. In spite of his repeated requests, the doctor did not tell him the diagnosis of the ailment suffered by the patient. On his insistence, the patient was shifted to MICU, by the doctor. Doctors, thereafter shifted him to AC Cubicle. There was no improvement in the health condition of the patient, which only worsened with time.

He alleged further that after he was shifted to AC Cubicle, the patient's stomach bulged out like balloon, cremafin syrup, was given to him and he had 6 to 7 episodes of loose motions.

He further stated that the patient after having lunch, one day, had bleeding from his nose along with the yellowish fluid. No doctors were available at that time till 05: 00 P.M. Several times he went to the duty nurse to request her to call the doctor. Meanwhile, the patient was vomiting following which dentures also came out.

As the stretcher or wheelchair was not readily available to take the patient to ICU situated in the ground floor, there was delay in shifting his father to ICU. He was shifted there at 5:30 P.M. He further deposed that a few minutes thereafter, he was informed that his father passed away.

He further alleged that the hospital had wrongly mentioned the name of the patient in the death report due to which he had to visit the hospital several times for correction further causing him agony.

However, denying any medical negligence from their side, the doctor and the hospital submitted before the court that the patient was evaluated in emergency department and appropriate treatment was started and was admitted to AC cubicle ward and later he was shifted to MICU for monitoring his health condition. Multiple investigations were carried out including blood test urine test, CT scan Ultra Sound, ECG, 2D-echo and was found to be suffering from pneumonia in both lungs, severe hyponatremia and was in sepsis.

They submitted that he was treated with antibiotics and other appropriate medicines and was also started on “Pan” for prevention of peptic ulcer. Multiple consultations were taken from other departments including pulmonology, cardiology neurology, nephrology, radiology, physiotherapy and nutrition. It was submitted that inspite of intuadation and connecting him to mechanical ventilator and cardio pulmonary resuscitation as per ACLS guidelines, the complainant’s father could not be revived.

After going through the submissions and arguments made before the court, the bench of Justices Sri Nimma Narayana as President and Smt Meena Ramanathan as Member observed that the hospital and the treating doctor had indeed caused medical negligence and were deficient in service.

The bench observed that the necessary investigation for locating the ulcer and its size had not been carried out. Having given medication for prevention of peptic ulcer from day one of hospitalization, the doctors and the hospital ought to have carried out endoscopy for locating ulcer in his stomach and its dimension. Tablet PAN must had been given to the patient from day one of hospitalization as a precautionary measure. Further, no steps have been taken by them to carry out endoscopy to locate the ulcer/lesions, so as to provide necessary treatment.

Not only the hospital and doctor failed to mention in their evidence about acute gastroenteritis/gastrointestinal ailment, referred to on 17.09.2014 and 18.09.2014, in Ex.B1, but also have not taken steps for carrying out endoscopy of the stomach, which is a standard protocol for diagnosis and treatment of the said ailment according to the literature filed by the opposite parties themselves. Had endoscopy been carried out, necessary treatment would have followed, for prevention of GI bleeding and possibly the complainant’s father would not have massive GI bleeding as on 25.09.2014 which resulted in his death. There is therefore, no proper diagnosis and necessary treatment to the complainant’s father for acutes GE/GI, which he was suffering from Opposite party No.3 hospital therefore failed to minimize the delay in shifting the complainant’s father from the AC cubical in the third floor to the ICU on the ground floor where the doctors examined him before his death.

Mentioning that The factum of medical negligence on the part of the opposite parties is glaringly borne out from the evidence that showed in as much as they have not provided treatment for GE/GI and have not taken steps for necessary investigation, the bench held them both guilty of medical negligence and deficient in service and stated:

Thus apart from negligence in diagnosing and providing treatment to the complainant’s father in opposite party No.3 hospital, delay was caused in shifting the complainant’s father from AC cubicle to the ICU on the ground floor and wrongly mentioning the name of the grandfather of the complainant in Ex.A14 death report amounts deficiency of service. It also caused mental agony and loss of time to the complainant. There is therefore, medical negligence and deficiency of service on the part of the opposite party No.1 to 3 in diagnosing and providing treatment to the complainant’s father.

On the compensation part, the bench stated

...the death of his father on account of negligence of opposite parties No. 1 to 3, this Forum is of the considered view that the complainant is entitled for compensation. In view of the facts and circumstances of this case, the Forum is of the further view that ends of justice would be met if compensation of Rs. 8,00,000/- (Rupees Eight Lakh only) is awarded.