NCDRC exonerates Apollo Hospital doctors, holds no Negligence in treating patient with Viral Hepatitis E infection,

Published On 2022-04-10 12:24 GMT   |   Update On 2022-04-10 12:24 GMT

New Delhi: The National Consumer Disputes Redressal Commission (NCDRC) recently exonerated the Apollo Hospital Chennai and its doctors from the charges of medical negligence while treating a patient diagnosed with Viral Hepatitis E infection.Such a decision was taken by the top consumer court after it took note of the expert medical board of AIIMS's opinion stating that the doctors had...

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New Delhi: The National Consumer Disputes Redressal Commission (NCDRC) recently exonerated the Apollo Hospital Chennai and its doctors from the charges of medical negligence while treating a patient diagnosed with Viral Hepatitis E infection.

Such a decision was taken by the top consumer court after it took note of the expert medical board of AIIMS's opinion stating that the doctors had managed the patient appropriately.

Dismissing the complaint, NCDRC noted, "it is difficult to attribute medical negligence against the Opposite Parties. The Complainant failed to prove medical negligence."

The history of the case goes back to 2005 when the complainant's son, the patient, had been admitted to the Apollo Hospital in Chennai. After being examined by the Dr. G. Anant Subramaniam, the General Physician, diagnosed it as a case of 'PUO, high Bilirubin and deranged liver function test (LFT)'.

It was alleged that the doctor did not refer the patient to the liver gastro specialists and continued treatment on is own. However the patient did not get any relief and when the condition of the patient worsened he was again taken to the hospital with acute abdominal pain. The next day the patient was referred to Gastroenterologist, Dr. Radha Ram Murthy, who diagnosed it as a case of 'Hepatitis-E infection'. The doctor prescribed Duphalac 30 ml, which was alleged to be responsible for loose motion in the patient.

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Therefore the patient was admitted to the hospital again and consequently the Nephrologist and the Haematologist examined the patient. It was alleged that even though the total WBC count and the platelet count had reduced, the patient was not shifted to CCU till his condition deteriorated.

Apart from this the complainant alleged several other deficiencies in the service of the doctors including unnecessary repeated testing, unavailability of doctors to attend the patient, among others.

The counsel for the Complainant stressed upon the fact that no specific treatment exists for acute Hepatitis -E infection apart from supporting care, but the hospital was treating the patient for commercial illegal gains. The administration of several medicines caused adverse effect and death of his son. Being aggrieved, the Complainant filed the Consumer Complaint and prayed total compensation of about Rs. 5.83 crores.

On the other hand, the Hospital and the doctors submitted before the Consumer Court that at the time of admission the patient was in critical condition as he had been diagnosed with a case of Viral Hepatitis E infection. They pointed out that even though the consultants including Residents and para medical staff were attending him on round the clock duty. 

As the Patient showed symptoms of Liver Failure – Disorientation and Confusion, he was shifted to the Critical Care Unit (CCU) under the care of Critical Care Group. Regarding the other allegations of deficiencies, they further submitted that even though the condition of the patient was being updated to the doctor time and again, the family was in a state of non-acceptance. 

The patient suffered severe acute liver failure having unpredictable outcome. As per the hospital policy, at the beginning, it was clearly explained about the costs involved and available options to transfer out, if they wished. The family members of the patient expressed that financial constraints, but insisted to continue care at Apollo Hospitals, they submitted.
After taking note of the submissions made by both the parties, the top consumer court took note of the fact that the patient was suffering from few health ailments prior to admission to Apollo Hospital, but no one diagnosed it as Acute Hepatitis. The Commission also took note of the fact that after diagnosing the Hepatitis, several specialists at the hospital had attended the patient.
Apart from these, NCDRC had also sought the expert medical board's opinion from AIIMS. The report had mentioned, "The medical board has studied and examined the available medical records and serial charts during the period of hospital stay. The board is of the view that as per available medical records that the diagnosis was Sub Acute Liver Failure and the patient was managed appropriately."
On the other hand, the Commission noted that the Complainant has not produced any expert opinion to support his case. 
At this outset, the Commission observed, "In our considered view, that merely because the patient did not survive after the treatment is not a sufficient ground to hold doctor of hospital for deficiency in service or medical negligence. The treatment was as per the reasonable standard of care, therefore, no fault lies with them. The doctrine of Res-ipsa loquitor is not applicable in the instant case. Even, there were no infrastructural lapses in the hospital. Therefore, no liability to be fastened on any Opposite Party."
Referring to the medical literature relevant in this case, the bench noted that the overall case fatality rate in Acute Hepatic failure is around 0.5 to 3 percent. The Commission also referred to the Supreme Court judgment in the case of Jacob Mathew v State of Punjab and S. K. Jhunjhunwala vs. Dhanwanti Kaur and Another, where it had been clarified that there needs to be direct nexus between negligence and improper performance of surgery to sue a doctor for negligence. 
Taking note of all the facts regarding the case, the NCDRC opined that it was difficult to attribute medical negligence against the doctors.
Dismissing the complaint, the bench noted, "Based on foregoing discussion, it is difficult to attribute medical negligence against the Opposite Parties. The Complainant failed to prove medical negligence."
To read the order, click on the link below.
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