Consumer forum slaps Rs 31.2 lakh compensation on private hospital for not referring patient to liver, kidney specialists

The district consumer body led by its president Raghupatruni Chiranjeevi and member Ch Shanmukha Rao observed that the two doctors and Hospital failed in their duty of care, and it was not a reasonable standard of practice, thus all the opposite parties (the hospital, the RMO of the Hospital, the Director of the Hospital and the Psychiatric Doctor) were negligent.

The bench clarified that it was the duty of the opposite parties’ doctors to refer the patient to Specialists in Liver and Kidney Organs for further treatment instead of being treated by a Psychiatrist and General Medicine Doctors, but this was not done.

The case involved the complainant, who alleged negligence in following Standard Operating Procedure (SOP) and sought Rs 75 lakh compensation for gross negligence and deficiency of service from Great Eastern Medical School & Hospital (GEMS Hospital) in Ragolu, Srikakulam. The complainant's husband was admitted to the hospital in April 2021 due to fever and abdominal pain but reportedly faced inadequate medical examination and treatment procedures. The complaint cited the administration of excessive anesthesia and medications, leading to her husband's deteriorating health and eventual demise while under hospital care. Despite complaints and lack of improvement in the patient's condition, the hospital allegedly continued ineffective treatment.

The complaint highlighted an incident on April 5, 2021, where the patient was observed in a critical state, struggling for oxygen, yet lacked immediate medical attention. The complaint further emphasized that the deceased suffered collateral damages due to medical negligence, resulting in his unfortunate passing on April 16, 2021.

The complainant sought relief, indicating that subsequent checks with medical specialists confirmed the improper execution of standard operating procedures by the hospital, leading to irreversible damages. The complaint mentioned significant expenses incurred for the deceased's treatment and highlighted the family's dependence on the deceased's income, now shattered due to the loss.

Additionally, the complaint referenced a legal notice issued to the hospital for amicable resolution, which allegedly received an unsatisfactory response, leading to threats and intimidation from the hospital's associates. The complaint concluded by asserting that the hospital's conduct amounted to gross medical negligence and service deficiency, necessitating the filing of the complaint before the Commission for redressal.

However, the hospital management denied the allegations, claiming the patient's chronic alcoholism caused severe damage to vital organs. The counter filed by the Resident Medical Officer (RMO) of the hospital presented a detailed response to the complaint made by Katam Aruna against GEMS Hospital. The filing denied several allegations mentioned in the complaint. It emphasized the hospital's reputable standing, asserting that it was recognized by the government and had a good track record in Srikakulam district.

The RMO's submission stated that before being admitted to GEMS Hospital, Her late husband, the patient, had been treated in Srikakulam due to alcohol-related health issues. The filing alleged that despite prior treatments, there was no improvement in Suresh's condition until he was advised by a doctor named K Raju to seek treatment at GEMS Hospital. The hospital purportedly provided outpatient care to the patient before diagnosing him with a chronic disease and advising inpatient treatment. The filing claimed that the hospital staff regularly monitored his condition, administered medications, and provided care as required. It further contended that his health initially improved but later deteriorated, prompting intensive care and eventually resulting in his passing on April 16, 2021.

Regarding the complainant's request for medical records, the RMO stated that copies of the records were provided solely for insurance purposes. It alleged that after receiving insurance compensation, Aruna attempted to extract additional unlawful gains by issuing a legal notice to the hospital, prompting a reply from the hospital's side.

The RMO disputed the allegations of medical negligence and contended that during the patient's hospitalization, neither the complainant nor her family members raised complaints against the hospital staff or the treatment provided. It refuted the claim that the patient's passing was due to drug overdose and challenged the lack of evidence supporting her claims of spending a significant amount on medical expenses during the treatment.

The filing asserted that the complainant's demand for compensation of Rs 70,00,000 is excessive and beyond the jurisdiction of the district forum. It accused the complainant of creating a false case to damage the hospital's reputation and attempts to blackmail for financial gain. It claimed that the complainant did not follow proper procedures for complaint resolution and raises concerns about mental agony caused to the hospital due to these accusations.

The psychiatric doctor's counter submission reiterated several points made by the RMO and denied allegations of medical negligence. It contended that the patient's condition was due to chronic alcoholism and other health issues, refuting claims of deficient treatment.

In response to the evidence presented by the complainant, the hospital presented affidavits from relevant staff members to counter her claims. The evidence included documents supporting their assertions about Suresh's treatment and the hospital's standard procedures during his care.

After hearing the parties, the Commission highlighted a few key points of determination that included- Whether there was a breach of duty by the Opposite Parties and if they are guilty of medical negligence?; If negligence is proven, whether there was a deficiency in service as claimed in the complaint?; If proven, whether the complainant is entitled to the claimed reliefs?; and What relief should be granted, if applicable.?

The Opposite Parties (No. 4 ie. the psychiatric doctor and No. 3 ie. the Director of the Hospital) presented written versions and extensive documentation, contesting the complaint's maintainability under the law. They cited the Indian Medical Association vs. V.P. Shantha case, establishing that medical services fall under the Consumer Protection Act, allowing the Consumer Disputes Redressal Agencies to entertain medical negligence cases.

It was noted by the Commission that the RMO admitted the patient, stating chronic disease and critical condition, which led to hospitalization. They provided detailed medical treatment information and mentioned the patient's deteriorating health due to prescribed medications.

The discussion delved into defining medical negligence, citing legal precedents and criteria for establishing medical negligence. It highlighted the duties owed by medical practitioners to patients and provides examples of medical negligence such as misdiagnosis and delayed diagnosis.

The case analyzed whether the Opposite Parties were negligent in their treatment. It scrutinized the actions of the psychiatric doctor (Opposite Party No. 4) who initially treated the deceased, raising questions about their qualifications to diagnose and treat severe liver and kidney disease. The Commission examined the medical evidence provided, revealing discrepancies in dates and treating doctors, and questions the suppression of certain facts by the Opposite Parties.

In conclusion, the Commission emphasizes the need for sufficient medical evidence to ascertain if the death resulted from medical negligence. The case highlighted various legal principles, medical procedures, and discrepancies in the treatment timeline, aiming to establish whether the Opposite Parties were indeed negligent in their care of the deceased patient.

Subsequently, the commission, concluded that the hospital's failure to refer the patient to specialist doctors for liver and kidney treatment was a clear case of negligence.

In Commission's view;

"It was the duty of the opposite parties’ doctors to refer the deceased to Specialists in Liver and Kidney Organs for further treatment instead of treating by Psychiatrist and General Medicine Doctors, but it was not done. Moreover they didn't conclude that the exact decease caused to lead the death of the deceased in Medical Terminology. It was clear negligence on the part of the opposite parties and may be leads to death of the Husband of the complainant. Moreover, the opposite parties did not confirm/conclude that the deceased is having particular disease mentioned in Medical Terminology and which leads to the death of the deceased as not curable disease."

It explained;

"It is true that the deceased had been suffering severe illness to his both the organs Liver & Kidneys, the RW-1 & RW-2 also categorically admitted the same but this commission concluded that after careful verification of entire record placed before this commission that there was no Proper advice given by the opposite parties to the Complainant or family members of the deceased. In fact, after conclusions made by the Hospital Authorities, they did not choose to refer the patient/deceased to appropriate specialists in Liver and Kidneys and they have to take opinion from the complainant and family members of the complainant for Transplantation of Liver and kidneys, at least for dialysis of Kidneys if necessary. When a medical professional fails to diagnose what condition a patient is suffering from, then it may result in misdiagnosis. If a patient is not treated properly due to any mistake in diagnosis, the doctor can be made liable for any further injury or damages caused as a result of the misdiagnosis."

The Commission further went through the Article relating to the “A systemic review of Clinical Management of Alcohol withdrawal" which was published in the year 2013 in Industrial Psychiatry Journal, and noted that;

"No cogent and adequate evidence to show that the relevancy to this case and authenticate to support the contentions made in the written versions of the opposite parties. Moreover on perusal of the entire record in the instant case, it is revealed that the opposite party No.4 is a Psychiatric doctor and she treated to the deceased for six days and later One Dr XYZ who is Doctor in General Medicine treated to the deceased for about eight days till the date of death of the deceased. In fact at the initial stage when the deceased admitted into the opposite partie's Hospital, opposite party No.4 was deputed by the opposite party No.2 for treating to the deceased. The opposite parties have to adduce the evidence of the Dr XYZ who is the Key Witness in this case as he was treated doctor at the time of the death of the deceased but the opposite parties failed to adduced and even they didn’t choose to mention die same in their written version and as well as in their evidence affidavits. The actions and inactions of opposite parties clearly shows that the breach of duty by Opposite parties and are guilty of medical negligence jointly and severally."

The Commission expressed that;

"In negligence cases, one must prove that there was a duty, that duty was breached, and the breach of that duty caused damages. In the present case, the two treated doctors and Hospital failed in their duty of care, and it was not a reasonable standard of practice, thus all the opposite parties were negligent. Hence, in Commission’s opinion, the medical negligence was attributed to the doctor and hospital, and the Complainant deserved the compensation."

It added;

"This Commission further relied on the Judgment of National Consumer Disputes Redressal Commission in F.A.No.559/2019 of Vishnu Priya Giri vs. G.M. Modi Hospital Research Centre for Medical Sciences, dated 13-05-2022 held that the surgeon was liable for medical negligence; as well, the hospital was vicariously liable. The hospital needed qualitative change and systemic improvement also. Therefore, on the basis of the foregoing discussion, OP 1 (The Chairman/MD of the Hospital) & OP 2(RMO of the Hospital) shall pay total compensation of Rs 20 lakhs with interest of 6 %pa and cost of litigation shall remain at Rs. I lakh only."

Eventually, the ruling mandated a compensation of Rs 31.2 lakh to the complainant for the hospital's negligence and causing mental distress to the family, along with additional legal expenses of Rs 10,000. It held;

"In the result, this complaint is allowed partly by directing the opposite parties No.l to 4 jointly and severally to pay a sum of Rs.31,20,000/- (Rupees thirty one lakh and twenty thousand only) towards compensation to the complainant for gross negligence, mental agony, loss of consortium and deficiency of service committed towards the complainant by the opposite parties, and further directing to pay Rs. 10,000/- (Rupees ten thousand only) towards litigation expenses including Advocate Fee within 45 days from the date of this Judgement."

To view the original order, click on the link below: