DR. SVSS PRASAD Vs. N. SHASHANK REDDY

JUDGEMENT

(1.) This Appeal filed against the Order dated 30.01.2013 in CC No. 28 of 2010 by A.P. State Consumer Disputes Redressal Commission, Hyderabad, wherein the Complaint was partly allowed holding medical negligence during the treatment and directed the Appellants to pay Rs. 7 lakh plus Rs. 10,000/- towards cost.

(2.) Brief facts that the Complainant N. Shashank Reddy's mother Kamala about 54 years (since deceased, hereinafter referred to as the 'patient') on 22.09.2009 consulted Dr.Rajesh Reddy and Dr. Alok Ranjan at Apollo (the Opposite Party No. 3). The MRI revealed high grade Glioma of brain. The PET scan advised by Dr. Vijayanand Reddy, the Opposite Party No. 2 revealed small activity in the lymph nodes near lungs, however the lymph node biopsy ruled out any malignant deposits and it was suspected as tuberculosis (TB) lymph node. On 01.10.2009 biopsy from the brain lesion confirmed the diagnosis of Primary Central Nervous System lymphoma (PCNSL). The Opposite Party No. 1- the medical Oncologist Dr. SVSS Prasad the treating medical Oncologist decided to adopt DeAngelis protocol for treatment which gives less neurocognitive impairment and increase the chances of survival about 24 to 36 months. As requested by the Complainant the Opposite Party No. 1 had telephonic discussion and emails exchange with the patient's relative Dr. Praveen Reddy (Hematologist and Oncologist) based at USA. The Opposite Party No. 1 assured the facility to treat the patient with DeAngelis protocol was available at Apollo Hospital (Opposite Party No. 3). Therefore, on such assurance from the Opposite Party No. 1 the Complainant dropped to take his mother to USA for treatment.

(3.) On 06.10.2009 the patient got admitted in the Opposite Party No. 3 -hospital and her bone marrow biopsy was performed. The 1stcycle of chemotherapy was started on 08.10.2009 by infusing 2700mg High Dose of Methotrexate (HDMTX). It was alleged that for next two days the MTX level was not monitored to rule out MTX toxicity. As per protocol to minimize the MTX toxicity and complications 'Leucovorin' rescue was to be started at 24 hours after HDMTX administration. It was alleged that the Opposite Party No. 1delayed it for 48 hours and did not monitor daily the Urine pH, serum creatinine, blood urea nitrogen and electrolytes. The patient was discharged on 11.10.2009. Thereafter, patient developed dizziness and drowsiness and again admitted on 19.10.2009 to the Opposite Party No. 3 Hospital. It was diagnosed as Hyponatremia(low blood Sodium), it was 107 mEq/lit (Normal134-145). The hospital took 9 days to correct Sodium level which usually takes 3 to 4 days. On 28.10.2009 the Opposite Party No. 1 started 2nd cycle of chemotherapy with administration of 4600 mg of HDMTX, but the urine pH level was not tested or confirmed. It was alleged that during 1st and 2nd chemotherapy cycle the Opposite Party No.1 did not follow the DeAngelis protocol i.e. did not monitor Urine pH, serum creatinine, blood urea nitrogen and electrolytes. At the time of discharge, the Opposite Party No. 1 prescribed two Neupogen shots at home instead of the recommended dose of 5 to 7 shots. The patient was again admitted on 03.11.2009 due to MTX toxicity which caused bone marrow suppression and low blood counts. The kidneys got affected badly and dialysis was done on 09.11.2009, however the patient developed renal failure and septicemic shock. On 10.11.2009, she suffered minor cardiac arrest and she was put on ventilator, but her condition did not improve and the patient died on 12.11.2009.