Kidney, Lung Specialist Not Available: Max Hospital to pay Rs 10 Lakh

Bhatinda: Holding the hospital guilty for not giving adequate treatment to a patient for a speciality in which they did not have a specialist available, the Punjab Consumer Disputes Redressal Commission has directed Max Hospital to pay Rs 10 lakh to the patient’s kin.

The case relates to one 69-year-old Raj Kumari who was admitted to the Max hospital on 31.12.2014 under the care of Sharad Gupta, Medical Officer having ailment pertaining to Kidney and Lungs. The patient was treated at the hospital for the next 15 days and was discharged at the request of her husband on 15.01.2016, as the condition of the patient had deteriorated. She was then taken to some other hospital including DMCH, Ludhiana but the patient did not respond to the treatment and died on 7.2.2015.

Alleging deficiency in services and medical negligence against the hospital, the complainant/the deceased's husband filed a case with the consumer forum, claiming that the hospital was not having any specialist to give the treatment of kidney or lungs.

The Laboratory examination report submitted to the bench to show that the hospital had not given any treatment of kidney and lungs. The body of the patient was retaining the water to a great extent for which no treatment was given to the patient, which ultimately led to her death, the complainant alleged.

The cause of death has been mentioned as under:-

“Septicaemic Shock

Acute Respiratory Distress Syndrome

Multi Organ Dysfunction Syndrome

Acute Kidney Injury

Lower Respiratory Tract Infection (Cause H1N1)

Chronic Obstructive Pulmonary Disease”

Upon notice, the hospital authorities appeared and filed their written reply taking preliminary objections as under:

“The complainant is not covered under the definition of the consumer, therefore, he has no locus standi to file this complaint; there are no specific allegations with regard to any medical negligence on the part of Ops; the complaint is abuse of process of this Commission and has given a distorted version in order to pressurize and harass the Op; it is on the record that the patient left LAMA on 12.1.2015 and expired on 7.2.2015, therefore, the complaint is liable to be dismissed”

The hospital authorities markedly stated that there is no specific evidence with regard to any medical negligence on their part. Through their written statement, the hospital stated that it is 200 bedded healthcare facility offer services in medial disciplines like Neurosciences, Orthopedics, Cardiac Sciences, Cancer Care, Medical Care, Diabetic Unit, Obstetrics and Gynecology, Minimal Access and Metabolic and Bariatric Surgery

Informing the bench about the condition of the patient when approached the hospital, the hospital stated,

 “The patient aged about 69 years was admitted in Emergency condition with Op Hospital suffering from Bradycardia, Dyspnoea. At the time of admission, her pulse was feeble, BP was not recordable, the patient was feeling drowsiness, breathlessness, complaint of C/o D.O.E. – 5 days. The patient was seen by the critical care team Dr. Parag Kumar, Anesthesia, Dr. Vitual Gupta, Internal Medicine, Dr. Sharad Gupta, Cardio and various other Doctors. ECHO of the patient was done on 31.12.2014, which revealed right heart failure with moderate tricuspid regurgitation.Everyday condition of the patient was explained and treatment was discussed with patient’s attendant.

The hospital added that on 11.12.2014, Jagga (patient's husband) made a request that the patient is suffering from kidney and lungs problem and that the hospital was not having any Specialist and then they had called Dr Jagdeep from outside.

“Op do not know the condition of the patient after 12.1.2015 to 7.2.2015 and what type of treatment was given to the patient,” the counsel of the hospital averred.

On hearing both sides, the bench presided by Justice Gurcharan Singh Saran and Judicial Member, Rajinder Kumar Goyal observed,

“It has been argued by the counsel for the complainant that mainly the Op had given treatment with regard to the heart treatment but along with heart problem the complainant was facing problem with regard to the kidney and lungs for which no proper treatment has been given, which is clear from the test report of Urea Serum and Creatinine Serum in the investigation report. The creatinine test and ultrasound abdomen as referred and the discharge summary showing the hospital course shows mainly the treatment given with regard to the heart problem. The patient was intubated and on improving the condition of the heart, he was extubated. With regard to the Creatinine, blood test is done to check the function of the kidney and high level creatinine may indicate that your kidney is damaged and not working properly and ultrasound abdomen shows fluid in the abdomen/pelvis. In case it is not properly treated, it may further aggravate the disease in the patient, which amounts to deficiency in service/medical negligence.”

Taking note of the unavailability of specialists in the hospital, that the court stated,

“No expert with regard to the kidney problem was available with the Op. Op in their written statement has specifically stated that they offered services in medial disciplines like Neurosciences, Orthopedics, Cardiac Sciences, Cancer Care, Medical Care, Diabetic Unit, Obstetrics and Gynecology, Minimal Access and Metabolic and Bariatric Surgery but kidney specialty is not there with the Op Hospital. Instead of giving proper management to the patient, the Op continued with the treatment of their own without calling for any Specialist in kidney treatment. Mere dialysis is not the treatment of kidney disease.”

“They called Dr. Jagdeep from outside but no date is mentioned on which date the said Doctor was called and what treatment he had given is not reflected in the discharge summary and counsel for the Op has also not referred to any other treatment document during the course of arguments. Once the proper treatment was not given at the initial stage, the problem aggravated and ultimately the patient died,” the court observed.

The bench ultimately held,

“For not giving treatment to kidney and lungs problem, had deteriorated the condition of the patient, which ultimately led to her death, therefore, we are of the considered opinion that there is medical negligence or deficiency in service on the part of Op for not giving the treatment to kidney and lungs problem of the patient which deteriorated the condition of the patient and ultimate death of the patient. For medical negligence or deficiency in service on the part of Op, Op is directed to pay Rs. 10 Lacs as lumpsum amount to the complainant, which includes compensation and litigation expenses. The amount is ordered to be paid within 45 days of the receipt of the copy of the order, failing which it will carry interest @ 8% p.a. from the date of filing the complaint till payment.”

Attached is the judgment