JSS HOSPITAL Vs. PANKAJRANI

JUDGEMENT

(1.) This revision petition has been filed by the Medical Superintendent/M/s. JSS Hospital and two other doctors (hereinafter referred to as 'Petitioners') being aggrieved by the order of the State Consumer Disputes Redressal Commission, Karnataka (hereinafter referred to as the "State Commission") in Appeal No. 528/2005 in favour of Smt.Pankajarani and others (hereinafter referred to as the 'Respondents').

(2.) The facts leading to the complaint filed by the Respondent No. 1 are that her husband, late S.M. Prasad who was a practising Advocate at Kollegal had developed hoarseness of voice on September, 1999 which got aggravated because of which he approached Petitioner No. 2, Dr. Shiva Kumar, ENT Surgeon at the Petitioner/hospital for diagnosis and treatment. On the advice of Dr. Shiva Kumar, Respondent's husband was admitted in the hospital and a provisional diagnosis was made that it was a case of chronic Laryngitis/nodular lesion over left vocal chord leading to a suspicion of carcinoma of the larynx. The patient was, therefore, advised to undergo micro larynginal examination/biopsy in order to confirm the diagnosis and take further treatment. These procedures were scheduled for 8.00 p.m. on 6.9.2001 but certain complications occurred because of which the operation could not be completed and it was decided to perform Tracheastomy on the patient at 9.30 p.m. for which high risk consent was obtained from the son of the patient as per the case sheet. After the Tracheastomy, the general condition of the patient deteriorated and despite being put on a ventilator, there was no improvement and he was declared dead at 10.30 a.m. on 7.9.2001. According to the medical records, the cause of death was stated to be cardio respiratory failure secondary to MI(?), restrictive lung disease secondary to chronic smoking. According to the Respondent, earlier tests conducted on the patient did not indicate that he was suffering from any lung disease and he was diagnosed with only chronic laryngitis /nodular lesion over the left vocal chord. It, therefore, appears that while conducting the Tracheastomy, there was some negligence resulting in respiratory failure and death was not due to any lung disease or myocardial infraction. Respondents therefore, approached the District Forum on 8.9.2003 i.e. two years after the death of the deceased because the Respondent was hopeful that as promised, the Petitioners/hospital would provide employment to the son of the deceased and they had requested Respondents not to precipitate the matter. However, since Petitioners failed to keep this commitment, Respondents, therefore, filed a complaint before the District Forum on grounds of medical negligence and deficiency in service and requested that Petitioners be directed jointly and severally to pay to the Respondents compensation of Rs. 11,80,000 along with interest @ 9% from the date of complaint till realization of the entire amount for causing the death of her husband on whom the entire family was dependent. Further, this was a justifiable amount because the children of the deceased were not settled and with the death of the deceased, the family was put to great financial hardship.

(3.) Petitioners on the other hand denied that there was any medical negligence which resulted in the death of the Respondent's spouse. According to them, during the direct larynginal examination before performing the surgery, Petitioner could not see the vocal chord and the lesion of the patient and, therefore, the procedure was abandoned without doing either the micro larynginal procedure or the biopsy. Since the patient was expressing some respiratory distress, efforts were made to relieve this condition by inserting an E.T. Tube but the patient could not tolerate the insertion of the Tube and tried to take it out himself. It was only then that a decision was taken to do a Tracheastomy to ease the respiratory distress for which high risk consent was taken as per the normal practice and the procedure was performed. Despite this, the patient's condition did not improve and, therefore, no surgery could be performed. The patient was put on spontaneous breathing and given continuous medicines but his condition deteriorated and despite best efforts of the doctors he could not he revived. His death was attributed to cardio respiratory failure secondary to M1 (Miocardial Infraction) and Restrictive Lung disease secondary to chronic smoking. There was no negligence in dealing with this case and the patient was under the treatment of a specialist ENT surgeon who had done many emergency and elective Tracheastomies both under local and general anaesthesia and on patients whose condition was much worse than that of the patient. Thus, the death occurred despite best medical treatment and care and was attributed to his chronic problems prior to the surgery.