Consumer Court Exonerates Doctor, Hospital on Failure to diagnose Hepatitis E

Hyderabad: The District Consumer Disputes Redressal Commission-III, Hyderabad recently exonerated a doctor and private hospital accused of negligence while providing treatment to a patient who was later diagnosed with Hepatitis E.

While the patient alleged that the doctor and hospital did not provide proper treatment or refer her to a gastroenterologist, the consumer court exonerated them after taking note of the fact that the inquiry committee by DM&HO also exonerated the doctor and the hospital after going through the medical records.

The history of the case goes back to 2019 when the complainant was suffering from fever, stomach pain, and body pains and approached the treating hospital. The hospital authorities referred her to general physician Dr. Khan who after examining the patient, advised her to be admitted to the hospital for complete checkup and necessary tests for proper investigation.

Allegedly, the doctor suspected dengue fever by putting a question mark on the case sheet and advised her to undergo blood and liver function tests. In fact, the discharge summary also indicated that the primary diagnosis was dengue fever with mild thrombocytopenia with hepatopathy. Several tests such as ultrasound for the abdomen, dengue test, platelet count, and WCDC tests were conducted. The ultrasound showed mild hepatomegaly, gallbladder, wall thickening and edematous pancreas, and hypergolic pancreatitis.

As per the discharge summary, the complainant was treated with IV fluids, antibodies, and all supportive medicines and was discharged in hemodynamically stable condition.  As per the reports treatment was given for dengue fever, daily platelet tests were conducted, and it was noticed that platelets were less than the required count. However, at the time of discharge, the platelet count was increased and became almost normal.

The complainant alleged that the treating doctor verified the platelet count at the time of discharge but in spite of constant complaints about stomach aches, no proper treatment or advice was given. Allegedly, she was unable to take a proper diet became weak, and ultimately fainted at her home. Thereafter, she was taken to Apollo Hospital and after conducting the necessary tests, the hospital authorities informed that the patient was suffering from hepatitis E and proper treatment had not been given by a gastroenterologist on the previous occasion.

It was alleged by the patient that even though the ultrasound test report indicated hepatitis-E, the first hospital, and doctor neglected to refer the complainant to a gastroenterologist due to which the infection increased and she had to be kept in ICU for 3 days and the doctors at Apollo could not give confidence of survival of the patient for the initial 48 hours. Finally, after 3 days of aggressive critical treatment, the complainant recovered.

Therefore, alleging medical negligence, the patient filed the consumer complaint and demanded compensation including the cost of treatment i.e. Rs 3,62,379 that she incurred in Apollo Hospital.

On the other hand, the hospital and the doctor submitted that the patient approached them with high-grade fever, chills associated with body pains, nausea, headache, and joint pains for about 4 days duration. Therefore, for provisional primary diagnosis of dengue fever, which was confirmed with laboratory investigation and upon the laboratory report the complainant was given appropriate treatment as per the textbook standards for the symptoms by undertaking requisite investigations.

It was further submitted that at the time of discharge, the condition of the complainant was stable and oral medications were advised. They informed the consumer court that if any complaints developed after discharge, the complainant was advised to report back to the hospital. They further submitted that the complainant did not inform about the difficulty in taking food. They submitted that the ultrasound report indicated mild hepatomegaly gallbladder was thickened, edematous pancreas hypoechoic echo texture this report with symptoms of the complaint of fever, low platelet count, and IgM dengue test positive suggests dengue fever with mild thrombocytopenia with hepatopathy is the correct diagnosis in the clinical setting.

They further argued that general medicine specialists can also treat viral hepatitis E and mostly systematic treatment is given for the same. They pointed out that ultrasound cannot specifically diagnose hepatitis E and hepatitis due to dengue fever also has the same findings as in hepatitis E will be revealed in ultrasound.

Pointing out that treatment for hepatitis due to both hepatitis-E and dengue fever mostly is hydration combined with symptomatic treatment, the hospital and the doctor argued that presumably the complainant's oral intake and hydration was not taken care of at her home resulting in which her condition must have deteriorated at home and the complainant failed to report back for further consultation and treatment. They vehemently denied all the allegations of negligence and prayed for the dismissal of the complaint.

While considering the matter, the consumer court took note of the medical records and also noted that the complainant also filed a complaint against the doctor and the hospital before the DM&HO on the grounds that the alleged Negligence caused irreparable harm, paralysed incompetence and breach of ethics. This was presented before the inquiry committee for detailed inquiry and a report was also submitted.

The expert committee mentioned in the report, "After gone through the available treatment records, opined that there is no medical negligence occurred in the treatment given to the above Hence, the expert committee opined that, there is no medical negligence by opposite party hospital and Doctor in treating the complainant."

Further, the consumer court also referred to an order by NCDRC and another one by the Supreme Court. Last year, the Consumer Court held that merely because the patient did not survive after the treatment is not a sufficient ground to hold the doctor of hospital for deficiency in service or medical negligence.

In the case of Jacob Mathews Vs. State of Punjab, the Supreme Court held that a mere deviation from normal professional practice is not necessarily evidence of negligence.

Referring to these orders, the consumer court exonerated the doctor and hospital and observed,

"Based on above citation, Ex.C1 expert Doctors opinion and available material exhibits, it is difficult to attribute medical negligence against the Opposite Parties. The Complainant failed to prove any medical negligence, hence, the Complaint is liable to be dismissed and the complainant is not entitled for the reliefs prayed and the complaint is liable to be dismissed."

To read the order, click on the link below:

https://medicaldialogues.in/pdf_upload/hyderabad-no-med-negligence-225308.pdf

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