Negligence: AP Doctor directed to pay Rs 5 Lakh to family of 25 year old who died of Septicemia

The case concerns a patient who was admitted to Sri Veerabrahmendra Nursing Home run by the doctor in August 2010 for treating an ulcerous growth on the lower part of her right leg. However, she was later diagnosed to be suffering from septicemia and encephalopathy at Vishwabharathi Super Speciality Hospital. Also, complicated malaria and metabolic encephalopathy was suspected. However, for the treatment of serious complications, patient was advised to go to higher centre at Hyderabad. She was taken to Yashoda hospital for better treatment, where she died a few days later.

Thereafter, alleging medical negligence in the diagnosis and treatment from the doctor at Sri Veerabrahmendra Nursing Home for causing the death of the patient, the deceased patient's husband (complainant in the case) moved the district consumer forum. The complainant also initiated criminal proceedings against OP under Section 304-A IPC.

Before the District Forum, the doctor had denied all the allegations maintaining that the patient was not admitted in its hospital/nursing home and he had not performed any operation. He submitted that there was no ulcerous growth on the right leg of the patient but the patient gave a history of suffering from an ulcer over right leg for one month. The ulcer about 1 ½" X 2" was noted on the lateral aspect of the lower part of the right leg. He had cleaned the wound and put dressing with Atramen-C. The doctor then advised few blood tests and prescribed antibiotics, vitamins along with other medicines. The blood parameters were normal. (Urine Albumin-2+). The patient was treated as an out-patient on that day, he added.

The patient expressed her inconvenience to come daily for dressing. Therefore, on 20.08.2010 she requested for admission to the hospital, thus she was admitted till 26.08.2010. Every day cleaning and dressing was done. On 23.08.2010, she developed fever of 100 degrees. Blood test for malaria was negative; the dose of antipyretic was increased. On 25.08.2010 after dressing of wound she attended at Koilakheta court and returned in the evening. In the morning of 26.08.2010, the patient showed symptoms of jaundice. Her blood tests revealed a viral jaundice and as for the treatment of jaundice doctor's daily supervision was not needed, therefore patient was discharged on 26.08.2010 and called after five days for follow up. The patient was advised not to take native medicine at her village. The Vishwabharathi hospital suspected malarial encephalopathy, but could not give a definite diagnosis of septicemia till 3 days into the treatment.The opinion of doctors at Yashoda Hospital about septicemia was not definite but it was the suspected cause of death.

The District Forum, on hearing both the parties, had held that the complainant failed to establish negligence from the doctor and dismissed the complaint. However, later when he moved the state consumer commission, his plea was accepted and the commission had directed the doctor to pay Rs 1.5 lakh as compensation.

Being aggrieved by the order of the State Commission and challenging it before the NCDRC, the doctor filed a Revision Petition for dismissal of the complaint and the complainant filed a counter Revision Petition for enhancement of the compensation.

After perusing all the medical records in the case, the bench of Justices Dr SM Kantikar as Presiding Member and Dinesh Singh as Member observed that the LFT done at the doctor's hospital showed very high values of enzymes and patient was severally jaundiced at the time of discharge. Hence, discharging patient in such condition was not justified. Thus, the doctor failed in its duty of care at the time of discharge.

The bench further observed that the doctor had failed at taking care of the patient in the initial stage of the treatment.

We gave our thoughtful consideration to the arguments from both the sides. It is pertinent to note that the patient was treated at OP Hospital from 18.08.2010 to 26.08.2010. At the time of discharge, she was suffering with severe jaundice. The LFT done at OP's hospital showed very high values of enzymes and patient was severally jaundiced. In our view, discharging patient in such condition was not justified. Thus, the OP failed in its duty of care at the time of discharge. It is pertinent to note that in the written version, OP stated that on 25.08.2010, the patient left the hospital to attend the Court case at Koilkunda and returned in the evening. However, as per the prescription dated 25.08.2010 the patient was given IV fluids at 11 am in the OP's nursing home. After the discharge on 26.08.2010, the patient further developed complications in her village. She was taken to Vishwabharati Hospital on 28.08.2010 and thereafter to Yashoda Hospital on 29.08.2010. In our view, considering the entirety, the OP doctor at initial stage failed to take proper care of the patient. 

In its verdict, the NCDRC judges rejected his petition and enhanced the compensation amount to Rs 5 lakh along with interest.