Injured patient falls from hospital trolley, dies! NCDRC Upholds Rs 10 Lakh Compensation Against Hospital, Doctor
Medical Negligence
New Delhi: The National Consumer Disputes Redressal Commission (NCDRC) recently upheld the order of the State Commission directing Mission Hospital, Durgapur, West Bengal, and its doctor to pay Rs 10 lakh compensation to the family of the patient, who died while undergoing treatment at the hospital.
Even though the patient had been admitted to the hospital after sustaining severe injuries due to a road accident, while undergoing treatment at the hospital, she fell from the stretcher outside the MRI room, which resulted in fresh injuries.
Taking note of the Expert Committee's report, the NCDRC bench noted that it was clear that there was negligence on the part of the hospital, which could not evade its liability by taking a plea of mechanical fault or product liability in the trolley. As per the Commission, the hospital had the responsibility to ensure that the stretcher was working properly.
The history of the case goes back to 2014 when the complainant's wife, after meeting with a road traffic accident, sustained injuries and was immediately taken to Jeevan Suraksha Hospital, Bankura,; after examining the patient, the hospital authorities referred the patient to higher centre/ B.S.M.C. & H / any State Government Medical College on the same date and the patient was taken to Mission Hospital at Durgapur, where the doctors suggested the patient undergo an operation.
During the treatment at the said hospital, the patient was improving gradually and her physical condition was absolutely normal. However, a few days later, the hospital authorities decided to have an MRI scan of the brain to track the progress or recovery and on the same date, the patient was shifted to the Radiology Department in a stretcher in a semi-conscious state by a nurse and an attendant.
It was alleged that due to 'utter negligence, carelessness and mishandling' of the nurse and the attendant, the patient fell down from the stretcher at the entry point of MRI room and the patient was allegedly left uncared for 4-5 minutes on the floor causing additional injuries on her head resulting in profuse bleeding from the wound and the patient's condition deteriorated further. Unfortunately, she succumbed to such injuries a day later.
As per the complainants, the patient's death occurred due to deliberate and negligent, mishandling by the nurse and the attendant while they were shifting the patient to MRI room. The complainants alleged that the death certificate did not mention anything about subsequent injuries caused due to her falling from the stretcher but only referred the injuries caused due to the Road Traffic Accident though the hospital authorities were vicariously liable for the patient's death.
Therefore, alleging medical negligence on the part of the Hospital, the complainant filed a consumer complaint before the State Commission seeking compensation of Rs 50 lakh for the gross negligence on the part of the hospital along with Rs 20 lakh as penal damages. The Complainant also prayed for a refund of Rs 2,17,849 for the expenses towards the treatment and litigation cost of Rs 25,000.
On the other hand, even though the hospital agreed that the patient had fallen from the stretcher at the hospital premises, it denied that the said incident took place due to deliberate carelessness, negligence, and mishandling of the nurse and the attendant. With this contention, the hospital claimed that there was no negligence on its part and prayed for the dismissal of the complaint.
The State Commission partly allowed the complaint and directed the hospital to pay Rs 10 lakh to the complainants. Challenging the State Commission's order, the hospital and its partner filed an appeal before the NCDRC bench and the complainants also filed a plea seeking an enhancement of compensation.
It was submitted by the hospital's counsel that even though an unfortunate accident occurred due to the mechanical dysfunction of the trolley and the patient fell from the trolley, this incident did not impact the patient's neurological status or contribute to her demise and immediately a team of specialist doctors attended the patient.
The hospital submitted that the Glasgow Coma Scale remained consistent both before and after the incident (E1M2VET) and the patient was immediately shifted back to the surgical ICU for continued care and monitoring. The counsel argued that on 16.07.2024, at about 01.30 a.m., the patient suffered a cardiac arrest, and taking diligent efforts and expert medical attention, the patient unfortunately died.
The hospital's counsel argued that the hospitals and the medical practitioners may be held liable if it can be established that they acted negligently or recklessly while providing services but this case, even though the patient fell from the stretcher she did not receive any injury because of the fall and she succumbed to death due to serious injuries received in the road accident. Therefore, it could not be said that the patient had died due to medical negligence on the part of the hospital as the hospital could not be made liable on the account of loss due to the defect in the trolley.
It was argued that the incident was unfortunate and devoid of negligence or deficiency in service on the hospital's part. The hospital's counsel further argued that the State Commission had wrongly applied the principle of 'Res Ipsa Loquitor' and attributed the patient's death to the fall from the stretcher while there was no proof that the patient died due to the fall from the stretcher.
Meanwhile, the complainants' counsel relied on the inquiry conducted by SEMOH, Durgapur, and Deputy CMOH-1, Burdwan, which had clearly mentioned that there was a gross negligence on the part of the Mission Hospital because video footage clearly showed that the patient had called from the MRI trolley and no immediate action was taken to overcome the situation resulting in profuse bleeding from the nose and head of the patient.
While adjudicating the matter, the Apex Consumer Court took note of the report dated 01.08.2014 of the inquiry committee holding, "Whether it is negligence of the staff concerned of Mission Hospital or the mechanical failure of the MRI trolley, negligence of the hospital authority cannot be overruled. But whether the death was occurred due to the injury at the hospital, it can not be ascertained as because patient was admitted with serious head injury."
The Committee had recommended, "Enquiry committee suggest to take disciplinary action as per CE Act regarding the negligence of Mission Hospital authority and at the same time to form a higher level enquiry team comprising of one neurologist at least."
Further, the Commission also took note of the Expert Committee Report dated 17.12.2014 mentioning that "Considering the inquiry report and the detailed evaluation of Post Mortem report, it is evident that there is infrastructural failure of Mission Hospital, Durgapur, which they have themselves admitted as mechanical fault of the trolley resulting in fall of the patient from trolley and fresh injuries at different sites. Patient expired on that night only. Post mortem report unequivocally shows haemorrhagic shock as the cause of death."
Relying on these reports, the Commission noted that
"It is an admitted fact that the patient had fallen from the trolley and received injuries in her head, nose and other body parts and the bleeding started profusely and her condition deteriorated very first. Apart from this, the inquiry report clearly states that the cause of death was haemorrhagic shock. The death certificate dated 16.07.2014 mentions the cause of death being RTA with severe head injury with right frontotemporal prenatal acute subdural haemorrhage with mildline shift with depressed right frontal bone, fracture with pneumocephalus with frontal conturious."
"Therefore, the contention of the hospital that the patient suffered due to heart attack, resulting in her death, lacks merit and the same is rejected," the Commission held.
After considering the report and detailed evaluation of the post-mortem report, the Commission observed that it was apparent from the report that there was infrastructural failure of Mission Hospital, Durgapur, which they themselves admitted as a mechanical fault of the trolley resulting in the patient's fall from the trolley and fresh injuries at different sites.
Accordingly, holding the Hospital and its employees vicariously liable for medical negligence, the Commission observed,
"Considering the report, it is clear that the patient had received some fresh injuries due to fall. The inquiry report clearly states that after the fall, the patient had profuse bleeding from the nose and there was fresh injuries. In our opinion, it is clear negligence on the part of the hospital and the hospital cannot evade its liability by taking the plea of mechanical fault or the product liability in the trolley. It is the responsibility of the hospital authorities to ensure that the stretcher is working properly. Further, the fact that after the fall, the patient lay unattended on the floor for 4 – 5 minutes bleeding profusely has not been controverted. The apathy and negligence of the employee of the hospital in not ensuring safe transit of a comatose patient for a test is writ large in the event. It is to be noted that there is no allegation of negligence in the treatment against the hospital and/or the doctors. We are of the opinion that the patient had died to the negligent act of the employees of the hospital and the hospital is vicariously liable for the death of the patient."
However, the Apex Consumer Court held that the amount of compensation granted by the State Commission was justified and noted, "Having affirmed the findings recorded by the Commission on the question of medical negligence and deficiency in services rendered by the Hospital, we are required to examine as to whether the amount of compensation awarded by the Commission was just and reasonable. The State Commission awarded compensation of Rs.10 lakh. As on the date of the death, the patient was aged about 69 years. Keeping in view the conspectus of the matter, we are of the opinion that Rs. 10 lakh granted by the State Commission is just and reasonable."
Therefore, holding that the State Commission had passed a well-reasoned order, the NCDRC bench dismissed the complaints.
To view the order, click on the link below:
https://medicaldialogues.in/pdf_upload/mission-hospital-rs-10-l-compensation-271186.pdf
