Delay in Conducting H1N1 test: Delhi Hospital told to pay Rs 25 lakh to patient
New Delhi: The State Consumer Disputes Redressal Commission has directed a city-based Hospital to pay a compensation amount of Rs 25 lakh on account of delay in conducting the H1N1 test during the days on a patient who later succumbed to the disease of swine flu.
The case concerned a patient suffering from high-grade fever, cough with symptoms of vomiting and repertory problems who was admitted to Ayushmann hospital. The patient was diagnosed with “Acute Bronchitis”. The condition of the patient deteriorated, and his father alleged that he asked to get the HINI (Swine Flu) test done as a precautionary measure since in those days swine flu had spread. However, the test was not conducted by the hospital despite the insistence.
The man turned adamant and demanded to conduct the test. The hospital then revealed that they do not have the laboratory available for conducting the Swine Flu test. In the process, three crucial days were wasted making the condition of the patient from bad to worst. Thereafter, the hospital sent the sample for H1N1 test to a laboratory, where it was found positive for H1N1 virus.
On receiving the reports, the hospital referred the patient to some other hospital stating that do not have resources to impart treatment for the ailment. The patient was rushed to the RML Hospital wherein the hospital declined to admit the patient after preliminary examination.
The patient condition kept deteriorating while he was taken to AIIMS, Safdarjung Hospital, Deen Dayal Hospital, but was not admitted in either hospital due to non-availability of Ventilator. Subsequently, the patient succumbed to the ailment on December 15 in Hindu Rao Hospital. The patient's family approached the commission demanding compensation. However, the hospital denied negligence on their part and responded that it was the complainant who delayed in the matter of approaching the hospital for treatment.
Delhi Medical Council (DMC) observed in their report that it was the system failure leading to the death of the patient. At the same time, in the report of the Medical Council no specific observation has been made against the OPs for keeping the patient in their hospital virtually with no treatment inasmuch as HINI Test was not conducted for three days. Infact it appears they have not gone into question of negligence against OPs with objectivity, the forum noted.
Commission observed whether the allegation of the negligence as against the hospital survives in the facts and circumstances of the case. The court stated that there may be cases of apparent deficiency/negligence in service by the doctors. Such cases of negligence can be broadly categorised as under:
- The doctor does not give immediate treatment when required.
- The doctor does not take precaution as per the medical jurisprudence of giving the test dose of medicines which are likely to be fatal in some cases or may cause allergy.
- Post-Operative treatment is not given properly.
- The surgical wound is caused at a different place than required.
- After Operation, septicaemia or gangrene takes place.
- Improper prescription of drugs. In case of fever, without knowing the cause of fever, combination of tablets and injections for malaria, thypoid etc are freely used on trial and error basis.
- Medical instruments are left in the body.
- Mal-practice by the doctors, such as uncalled for pathological reports or investigations prescribed.
The court noted
The present case is not a case of complicated surgery or a case of transplant of limbs and organs in human body. It is allegedly a case of improper and unconventional method of treatment and delay done in attending to the patient and affording him treatment. This means the subject matter have to be examined on, the principles of Res ipsa loquitur to reach to a conclusion. Res ipsa loquitur is a rule of evidence which in reality belongs to the law of torts where things speak for themselves. Firstly the OPs admitted the child knowing it fully well that they do not have proper faculties to treat the patient and secondly they delayed conducting the HINI Test vital for the purpose. Inference as to negligence can be drawn from proved circumstances by applying the rule if no reasonable explanation as to the cause is coming forth from the defendant.
Quoting previous judgements, the court observed
The purpose of holding a professional liable for his act or omission, if negligent, is to make the life safer and to eliminate the possibility of recurrence of negligence in future. Human body and medical science both are too complex to be easily understood. To hold in favour of existence of negligence, associated with the action or inaction of a medical professional, requires an in-depth understanding of the working of a professional as also the nature of the job and of errors committed by chance, which do not necessarily involve the element of culpability.
Examining the present case, the court stated that despite all the symptoms and the fact that in the year swine flu had spread in the city in all the corners, no test of HINI was undertaken. Commission member Anil Srivastava held;
"The hospital admitted the child knowing it fully well that they do not have proper faculties to treat the patient and secondly they delayed conducting the HINI Test vital for the purpose."
The court further added;
"Their guilt is further aggravated as the hospital admittedly had no laboratory to conduct the test. If the hospital was handicapped in conducting the test or inadequate to attend to the patient they should have either not admitted the patient or in the alternate they should have made all possible arrangements to make up for the deficit. On the contrary, the hospital admitted the patient and kept him there for 3 to 4 days with virtually no treatment of the ailment and the complainant was also kept in dark leading to the deteoriation of the patient. This is per se negligence of the hospital."
Subsequently, the commission ordered to pay a sum of Rs 2500000 to the complainant for the suffering, mental pain and agony caused.
