Doctor had Casual approach towards Minor Patient: Consumer Court holds Paediatrician guilty of medical negligence
New Delhi: Upholding the order of the State consumer court, Maharashtra, the National Consumer Disputes Redressal Commission (NCDRC) has held a Thane-based Paediatrician guilty of medical negligence while treating a minor patient of two and half years of age.
The child, suffering from pneumonia expired and the treating paediatrician was held guilty by the Maharashtra State Commission. While the doctor challenged the order, the NCDRC bench observed that the doctor had a casual approach towards the patient.
Holding that the doctor failed in his duty of care and also observing that the medical record was not consistent with the treatment given, or maintained properly, the NCDRC bench noted, "The child was deprived of proper treatment at OP’s hospital. Thus it was the act of omission, accordingly we hold liable for negligence."
With this observation, the top consumer court upheld the order issued by the State Consumer Court and dismissed the appeal by the doctor.
The history of the case goes back to 2003 when the minor daughter of the complainant had developed body rashes and was suffering from high-grade fever. Consequently, the two-and-half-years old patient got admitted to the hospital of treating paediatrician Dr. Ramesh Iyer.
After being treated for five days, it was alleged that the condition of the patient deteriorated further and due to lack of ICU and emergency treatment facilities, the Complainant was compelled to take the child to another hospital Even though the child was taken to another hospital, unfortunately, the child expired.
Following this, the Complainant lodged a Police Complaint alleging that the medical negligence had caused the death of her baby. The matter was referred by the Police to the Directorate of Health Services, Maharashtra for opinion and the Committee of doctors found that the treating paediatrician Dr Iyer had not properly recorded the medical treatment given to the child and the Committee held that the case prepared might be an afterthought. The committee had also held that the doctor had not followed normal procedure.
On the other hand, Dr Iyer denied any negligence in treatment and submitted that the baby was treated as per the accepted norms. After considering the matter, the State Commission partly allowed the complaint and awarded Rs 10 lakh compensation to the complainant along with interest of 6% per annum.
The State Commission had held that there was negligence in medical treatment due to casualness of approach by the doctor, want of necessary care and precautions. "Dr. Iyer is answerable to the Mother and close relatives of patient Baby Shaivi Bhat aged only 2½ years for causing her serious medical condition to develop which led to her untimely death and Dr. Ramesh Iyer, must therefore compensate for loss the complainant justly and reasonably," the State Commission held.
Aggrieved by the State Commission order, the doctor approached the NCDRC bench and relied upon one alleged voluntary endorsement given by the Complainant that stated- "I am very grateful to Dr. Iyer and staff for taking care of my child and for kind cooperation." Further, it was submitted that the baby had been shifted from the hospital against medical advice, though her condition was not fit for discharge.
The top consumer court observed that Dr. Iyer had mentioned in the clinical notes, “No cyanosis, No RDS, Breath rate 22/min and pulse 70/min, No respiratory distress and about medicines ct. all. Patient was stable”.
However, the specialist doctor, Dr. Arole, who had examined the child had mentioned pneumonitis and air in the cavity. Therefore, the doctor had advised for ICD insertion, but it was allegedly note done by Dr. Iyer.
Referring to this, the NCDRC bench observed,
"It is evident that Dr. Arole made her observations on separate sheet. She did not mention the time of examination. Her clinical notes revealed Rub on right side of the chest and she advised ICD insertion under General Anaesthesia (GA). However, in the case sheet, it was noted that the mother took her child for X-ray on her own responsibility at 2.00 pm, but at the same time, X-ray report was mentioned in the case sheet. Dr. Arole has not mentioned about the extent of pneumothorax, though she was Specialist and expected not to write cryptic notes."
Taking note of the fact that the baby became serious and was taken suddenly to another hospital, the top consumer court noted,
"Thus, we agree with the findings of the Committee, which held that the OP was casual in his approach. Moreover, the Committee of JJ Hospital found that notes made by Dr. Iyer were inconsistent as to changes made in prescriptions of medicines, X ray examination was required twice. The temperature was not recorded properly."
The Commission also noted that initially Naupada Police Station had sent the medical record for opinion to Civil Surgeon at Thane, who had given clean chit to Dr. Iyer. The Complainant, thereafter had taken second opinion from J.J. Hospital, Mumbai and had held that negligence was committed by the treating doctor and it also mentioned about the treatment should have been given to the deceased child.
"The OP nursing home did not possess mandatory facilities as required under the Bombay Nursing Act. The junior doctors were not available throughout the day and adequate Oxygen therapy was not available," noted the Commission.
At this outset, the top consumer court also referred to the Supreme Court order in the case of Spring Meadows Hospital v Harjyot Ahluwalia, where the Apex court had discussed about what constitutes medical negligence.
Upholding the State Commission order, the NCDRC bench noted,
"In the instant case, in our considered view, it was not bonafide mistake of OP-1, but was a casual approach towards the patient. The OP doctor failed in his duty of care despite the advice of the Specialist – Dr. Sunita Arole did not insert ICD. The medical record is not consistent with the treatment given and it was not maintained properly. It should be borne in mind that “good medical record is good defense, poor medical record is poor defense”. The child was deprived of proper treatment at OP’s hospital. Thus it was the act of omission, accordingly we hold liable for negligence."
To view the order, click on the link below:
https://medicaldialogues.in/pdf_upload/ncdrc-order-207152.pdf
