18 ICU Patient deaths Due to Lack of Oxygen: Hospital held guilty of administrative negligence, slapped Rs 20 lakh compensation

Chennai: More than seven years after 18 ICU patients of MIOT Hospital died due to lack of oxygen, the Tamil Nadu State Consumer Disputes Redressal Commission held the hospital liable for administrative negligence.

The complaint alleged that the hospital failed to anticipate and manage flooding during the rainy season even though the government agencies warned about the same. This resulted in a power outage and life support systems such as ventilators in the Medical ICU located in the basement, failed during the flood. Among the 18 patients who died in the incident, the husband of the complainant was also one.

"...it is obvious that failure of both the power & back-up facilities and the life support system, which were under the management and control of the Hospital at the time of calamity, was due to the negligent ignorance of the hospital’s administration to diligently foresee the disaster despite prior information and thereby, they failed in averting the loss of human lives and protecting the infrastructure. A case of administrative negligence is thus clearly made out and there is no difficulty for this Commission to fix the liability upon the Hospital..." held the HC bench.

Therefore, the State Consumer Court directed the hospital to pay a compensation of Rs 20,00,000 to the complainant. Apart from the amount of the compensation, the hospital has been directed to pay an additional cost of Rs 2 lakhs.

The matter goes back to 2015 when the husband of the complainant suffered a head injury and when he was taken to a hospital, he was diagnosed with Acute Hemorrhagic Stroke as well as Brain Stem Hemorrhage. Later, to avail insurance coverage, the patient was shifted to MIOT hospital, where he was diagnosed with Hypertensive Brainstem Bleed with Status Epilepticus and he was admitted to the Intensive Care Unit (ICU).

He went into unconsciousness due to obstruction in breathing and, after undergoing a procedure called Tracheostomy and intubation, his breathing condition was stabilized with Ventilator Support.

There was a restriction on the side of the hospital regarding the attendant's presence after specific hours and on 1st December and the consecutive two days, the complainant could not gain access to the hospital due to heavy rains and the release of water in the Adyar River generating floods.

As per the complainant, the hospital authorities failed to inform her about the flood situation and it was only through media announcements on December 04, 2015 that she finally got to know about her husband's death.

Referring to the death certificate, the complainant alleged that it was cleverly cooked up indicating that the ailments diagnosed at the time of admission were the cause of death. However, in reality, the complainant's husband along with many other patients in the ICU had all died due to the non-availability of Ventilator Support. She claimed that her husband's death was not a direct result of head injury and complications and rather it was obviously due to non-supply of oxygen.

It was alleged that despite suffering severe inundation earlier in November, the hospital did not advise the patients to move to other Hospitals. It ignored all prior warnings issued by the State Government authorities and it was only on 3rd December evening when the management began to evacuate the patients. Referring to these factors, the complainant emphasised on clear negligence and carelessness on the part of the hospital authorities and argued it to be a fit case for applying the doctrine of res ipsa loquitor. 

Medical Dialogues had earlier reported about the case and at that time, the MIOT Hospitals had denied negligence on its part. While responding to a notice issued by the first bench, headed by Chief Justice Sanjay Kishan Kaul and Justice M M Sundaresh, who was considering a petition by social activist 'Traffic' Ramaswamy, the hospital had said there was no negligence on the part of the hospital and the patients had not died of lack of oxygen, as alleged.

Also Read: Chennai: MIOT Hospitals Denies Negligence Led To Death Of 18 Patients

Before the consumer court as well, the hospital denied negligence. It argued that the patient was an alcoholic and he had various severe health issues, including hypertension, diabetes, and lung complications. Addressing the issue of flood, they argued that they had to face a situation beyond their control as a result of the overflowing Adyar River. The overflowing of water from the said rover inundated the Chocolate Factory and thereafter, it breached the wall of the hospital and engulfed the building which led to a great loss.

They submitted that as a result of the heavy rains, the entire city of Chennai experienced power failure as well as Kancheepuram District and the hospital had no control over the rainfall or the release of water. However, they took necessary steps to rescue and assist the patients by shifting them to other hospitals in the City.

At this outset, the Hospital also referred to the decision of the Madras High Court in this regard. While considering the PIL filed in 2015, the HC bench had rejected all allegations made against the hospital regarding the deaths that occurred during the floods and directed the police authorities to file a final report after the due investigation.

Denying any kind of negligence on their part, the hospital submitted that the complainant's husband succumbed to his illness due to refractory status epilepticus, brain stem hemorrhage, septic shock, acute kidney injury – on acute peritoneal dialysis, type-II Diabetes Mellitus and Hypertension, after receiving a high-end medical care and treatment and the cause of death as given in the death certificate by the hospital was also endorsed in the Post-mortem certificate issued by the Government Hospital.

While considering the matter, the Consumer Court observed that for administrative negligence, the burden of proof lies upon the Hospital to establish that all necessary and reasonable care was taken by them to prevent the harm that was possible from a foreseeable calamity or danger.

Referring to the case at hand, where the complainant alleged that there was failure to take necessary prior preventive measures anticipating rains and floods, the Commission observed that "...merely because the power outage and the consequent life support failure was caused due to heavy flooding, the Hospital authorities cannot on that account alone seek to be absolved without showing something further to indicate that preventive and proactive measures were taken well in advance and that, despite their anticipatory measures, the mishap had become inevitable."

"...despite the ability to foresee and diligently prepare for any emergency situation that was well fathomable from the weather forecasts frequently updated, the administration of the Hospital deliberately failed to take any real anticipatory measure to protect the power units and the critically-ill patients kept at the lower floors from the floods of invasive nature and such obvious failure of the OP clearly depicts their glaring administrative negligence," opined the Commission as it held the Hospital liable.

The consumer court also held the hospital negligent for failure to shit the patients and noted, "With ordinary diligence and exercise of a little more care and caution, beforehand shifting of the patients at the Medical ICU could have been done either to other hospitals or to the elevated floors or to the international block which is said to have had the full-fledged facilities even when the other parts of the Hospital lacked the same; but, that was not done which again shows that there was a negligence which, in our view, although was not willful, had resulted in breach of duty to ensure continuous availability of life support to the patient/s, who was/were in dire need of the ventilator support which was alternated with a manual ventilator support that did not work for him/them for continuation of the medical treatment."

"Therefore, when the facts from different sources are appreciated collectively as highlighted above, it is quite apparent that there was a glaring failure on the part of the Hospital in foreseeing the danger despite clear information and warnings and in self-reading the weather atmosphere and, due to such negligent conduct, they remained indolent and fell short to show the anticipated preparedness expected of them as a distinguished medical care provider," it further observed.

The commission opined that the hospital's failure of life support facilities acted as a contributing factor to the death of most of the patients, who were critically ill.

Referring to the order by the High Court bench, the consumer court clarified that the order of the HC bench did not cover the "negligence" issue but focused only on the issue of unauthorised construction.

Although the Commission held the hospital liable for administrative negligence, it also noted that even though the magnitude of such negligence was undoubtedly high, it was not a willful negligence.

Granting Rs 20 lakh as compensation, the Commission noted, "...it should only be proportionate by considering the other side of the fact that the patient was already battling for his life with serious illness and that the negligence was not a direct cause of his death but it was only contributory in nature and accordingly, we are inclined to award a sum of Rs.20,00,000/- which, in our opinion, would meet the ends of justice."

The order stated, "In the result, by holding that the complainant has made out a case of administrative negligence on the part of the OP that served as a contributing factor for the death of her husband, we allow the Complaint in part, directing the OP to pay to the complainant a sum of Rs.20,00,000/- (Rupees Twenty Lakh only) as compensation besides costs of Rs.2,00,000/- (Rupees Two Lakh only), which shall be paid within a period of 6 (six) weeks from the date of receipt of a copy of this order, failing which, the said sum shall carry interest @ 9% p.a. from the date of the filing of the complaint till the date of realization."

To read the order, click on the link below:

https://medicaldialogues.in/pdf_upload/miot-hospitals-negligence-226718.pdf

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