SRIKANT Vs. WOCKHARDT HOSPITAL AND HEART INSTITUTE

JUDGEMENT

(1.) THE complainant had gone to OP Hospital on 20.1.2001 for medical check -up as he felt little uneasiness during his morning walk. He was subjected to various Tests on 21.1.2001. He was also subjected to Coronary and Peripheral Angiogram which revealed certain disorders and he underwent left internal carotid stenting and CABG subsequently. It is contended that surgery and other treatment also followed. Complainant contends that during the entire course of treatment including pre and post hospitalization, the doctors at OP Hospital did not reveal the adverse effects of the treatment. The complainant contends that after he was subjected to left internal carotid Angioplasty with stenting, he developed confusion and weakness in right upper limb resulting in paralysis of the upper limb and loss of speech by the time he was discharged. The complainant contends that this has rendered him bed -ridden since the date of discharge in spite of undergoing physiotherapy at high cost. The complainant contends that he requires atleast two assistants to attend to him round the clock. He also contends that this has made him unable to attend to his routine as a Member of the Legislative Council. He contends that the doctors and the staff in the OP Hospital have given treatment to him without proper precautions and therefore the OP is liable to pay him compensation of Rs. 20.00 lakh.

(2.) OP filed a version admitting the fact of having given treatment to the complainant. It is contended on behalf of the OP that the complainant's history showed that he had diabetes and hypertension and complaints of fatigue or exertion on talking. He also had history of Idiopathic Thrombocytopenic Purpura (ITP) and was treated for the same with the steroids resulting in the patient gaining weight. OP contends that the patient also gave his history suggestive of Transient Ischemic Attacks (TIA) which signified transient reduction of blood supply to the brain rendering the patient to high risk of stroke or brain infraction. It is further contended that on examination the patient was conscious; had blood pleasure 150/90 mm Hg, his cardiovascular system was compromised and he had carotid bruit on the left side of the neck. Diagnosis also revealed, (a) Angina Pecrotis Class -II to III [Positive Treadmill test], (b) Hypertension, (c) Diabetes Mellitus, (d) TIA in the left carotid territory. The result of Tread Mill Test was strongly positive. Coronary and Carotid Angiogram revealed 70% long stenosis proximally, 60% Astrial Stenosis, mild irregularities in right Carotid, 80% Astenosis at the ostium of left internal Carotid artery. The OP denies that such a man was hale and hearty as contended by the complainant. OP contends that after review of the history, report of Angiogram and detailed evaluation and discussions with Dr. Vivek Jawali, the case was put up for Carotid Angioplasty. 5% risk was explained to the patient and his wife before their consent was taken and Angioplasty was carried out on 22.1.2001 through right fenoral artery. Attempt was made to place an Angioguard filter to provide protection system distal to the stenosis, but could not be negotiated across the stenosis and therefore it was decided to avoid further manipulations. OP contends that during the procedure, the patient became transiently drowsy and confused, but recovered fully and was obeying, and was started on small dose of Dopamine infusion. It is contended that report of Angiogram was also discussed with Dr. Vivek Jawali. In view of severe Carotid stenosis, the patient was considered to be a high risk patient for stroke during bypass surgery and therefore Carotid Angioplasty and Stent followed by CABG operation was suggested. The plan of action was discussed with the patient and his wife; 5% risk of stoke was also discussed with the patient's wife. Carotid artery Angioplasty and stent were carried out on 22.1.2001. At about 12.30 p.m. on the same day, further deterioration in the level of consciousness was observed and the patient developed slurring of speech associated with right upper and lower limb. Carotid Doppler and C.T. Scan were done on urgent basis which revealed good distal flow. Supportive Therapy was instituted. Blood pressure was stabilized. The fenoral sheet was removed; patient was managed in the ICU and Ward with the standard accepted and supportive medical and physiotherapy for a hemiparasis secondary to embolic episode. There was gradual improvement in the level of sensorium and patient was discharged in a haemodynamically stable state with the advice to continue medicines and to have physical and speech therapy.

(3.) THE OP contends that the patient had symptoms of transient Ischemic Attacks i.e., slurry of speech and difficulty in speech intermittently. OP has denied that there was negligence or deficiency of service on the part of its doctor or staff.