MP consumer court clears hospital, cardiologist in post-angioplasty death case

Bhopal: The State Consumer Disputes Redressal Commission (SCDRC), Madhya Pradesh, recently exonerated Bhopal Memorial Hospital and Research Centre and its cardiologist from allegations of medical negligence in the treatment of a patient who died following cardiac complications.

The history of the case goes back to 2003, when the complainant's wife, suffering from chest pain, was being provided treatment by the concerned cardiologist. To assess her actual condition, she was advised to undergo angiography, for which an ambulance was arranged by the treating doctor.

It was alleged that while being shifted from the ambulance, the treating hospital dropped the patient, leading to the development of pulmonary edema. The complainant alleged that no investigation was done for 2 days, and on 11.6.2003, angiography and angioplasty were performed by the treating doctor. Two stents were implanted and on 16.06.2003, the complainant was administered with a 'A negative' blood group, even though her blood group was 'A positive'.

Due to said blood transfusion, the condition of the patient deteriorated, alleged the complainant. On 17.06.2003, the patient again complained of chest pain, as angioplasty failed, but the Cath Lab of the treating hospital was not functioning, and on 23.06.2003, the patient developed acute septicemia and was kept on dialysis. On 25.06.2003, she was diagnosed with renal failure. The patient's condition was continuously deteriorating, and she eventually died on 27.06.2003.

The complainant further alleged that the treating hospital and doctor also showed resistance in providing medical documents, as they realized that the patient's death was due to their negligence. Therefore, alleging a deficiency in service on the part of treating hospital and doctor, he approached the District Commission, seeking relief.

On the other hand, the treating doctor and hospital submitted before the District Commission that the patient's condition was not good when she was brought to Bhopal. It was also submitted that the transfusion of blood was not responsible for the patient's health condition. They also argued that the prescriptions were not provided to the complainants since the bill amount was pending, and after the bills were cleared, the necessary papers were provided to them. They denied any claims of negligence or deficiency in service.

When the complaint was dismissed by the District Consumer Court, an appeal was made before the State Consumer Commission. The counsel for the complainants reiterated the case details and argued that even though the patient's condition was deteriorating continuously, the service of the senior doctors was not called, and the patient was not referred to any higher centre. Ultimately, the patient developed renal failure and was put on dialysis, but despite that, she could not be revived.

Meanwhile, supporting the District Commission's order, the hospital's counsel argued that the patient was treated well during her entire stay in the hospital. Whatever was required to be done was done, but despite the best of efforts, her life could not be saved, which is, however, not a ground to hold the opposite parties negligent in the instant matter, submitted the counsel for the hospital and doctor.

While considering the matter, the Commission noted that the patient's cardiac case sheet showed the date of admission that a provisional diagnosis was made for 'acute extensive anterior wall ST elevation, MI, acute pulmonary edema with cardiogenic shock NIDDM/obesity'.

The detailed history in the said document revealed that the patient had pulmonary edema, before being shifted to the hospital.

"Therefore, the allegations of the complainants that she suffered pulmonary edema after fall from stretcher is found to be incorrect," noted the Commission.

"As regards allegations that under guidance of opposite party No.2/doctor the patient was being treated at Hoshangabad and therefore he was responsible for her poor health condition, when she was brought to Bhopal, the District Commission has rightly observed that she was under direct observation of Dr. *** and he himself should have judged medication and dosages looking at her condition," it further noted.

The Commission further noted that consent for angiography was obtained from the patient's relative, even though the complainants alleged that no prior consent for angioplasty was obtained.

"Therefore, considering the circumstances and in the light of above, we find that the District Commission has rightly observed that no separate consent for angioplasty was required. It is admitted by the complainants that after the procedure the patient was able to sit and consume food through mouth, which shows that her condition had stabilized after the aforesaid procedure," observed the Commission.

Further, the State Consumer Court refused to accept the allegations that the patient was wrongly administered A Negative blood, whereas the blood group of the patient was A Positive, since as per medical literature, A Negative blood can be administered to an A Positive blood group patient.

"Also, the allegations that the blood which was administered was nearing expiry and was not safe to be administered, do not hold any relevance, as admittedly the blood which was transfused had not yet expired. Therefore, it was safe to administer such blood," observed the Consumer Court.

The Commission noted that admittedly, after the procedure, the patient suffered another myocardial infarction, and the same cannot be attributed to negligence on the treating hospital and doctor's part.

"The complainants have alleged that the Cath Lab of the opposite party No.1/Hospital was out of order at that point of time and therefore, the opposite parties could have referred the patient to another centre. To this, the opposite parties have categorically replied stating that at that point of time the only Cath Lab available in the entire city was that of the opposite party No.1/Hospital and angioplasties were not done anywhere. Also, it was not possible to shift her safely, since general condition of the patient was not good. Therefore, the best possible treatment available at that point of time was provided by opposite party No.1/Hospital by thrombolyisng her without delay. Case sheets available on record suggest that the patient was being monitored and managed with due care but since her general condition was not good, despite efforts, she could not be saved. The complications, which developed in the case cannot be held to be arisen because of opposite parties," it opined.

The Commission referred to the Supreme Court order in the case of Jacob Mathew Vs State of Punjab & Anr III and Martin F D’Souza Vs Mohd. Ishaq I and Harish Kumar Khurana (Dr.) Vs Joginder Singh & Ors. II. In Jacob Mathew's case, the Apex Court had held that true test for establishing medical negligence in diagnosis or treatment on the part of a doctor is whether he has been proved to be guilty of such failure as no doctor of ordinary skill would be guilty of, if acting with ordinary care.

In Martin F D'Souza's case, the Apex Court held that sometimes, despite best efforts, the treatment of a doctor fails and the same does not mean that the doctor or the surgeon must be held guilty of medical negligence unless there is some strong evidence to suggest that the doctor is negligent.

Referring to these judgments, the Commission observed, "Therefore, we are of the view that the District Commission has rightly reached a conclusion that the complainants have not been able to establish any deficiency in service in the instant matter against the opposite parties. The District Commission has thus, rightly passed the impugned order and has committed no illegality or infirmity while passing the same."

To view the order, click on the link below:

https://medicaldialogues.in/pdf_upload/mp-scdrc-no-med-negligence-321998.pdf

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