RAJINDER SINGH DOGRA Vs. P N GUPTA

JUDGEMENT

(1.) This appeal against the order dated 27.03.2002 of the Consumer Disputes Redressal Commission, Union Territory, Chandigarh (in short, 'the State Commission') in complaint case no. 6 of 2001 has been filed by the complainant (Rajinder Singh Dogra). By this order, the State Commission dismissed the complaint holding that the complainant had failed to prove his allegations of medical negligence, carelessness and deficiency in service on the part of the opposite party (OP -Dr P.N. Gupta) in the treatment of his wife (Smt. Reeta Dogra). For the sake of convenience, the parties are referred to as per their status before the State Commission.

(2.) The undisputed facts are that the complainant's wife (Reeta) suffered from abdominal pain for some time. On ultrasonography of the abdomen, she was diagnosed with stones in her gallbladder. The complainant and his wife approached the OP at his P.N. Urology and Surgical Centre (hereafter, 'Centre') for consultation on this problem. The OP advised surgery and fixed it for 11.09.2000. Some necessary preliminary tests were also advised. The surgery was conducted on 11.09.2000 as scheduled and the patient was discharged the very next day, i.e., on 12.09.2000 with the advice of follow-up visit to the Centre on 20.09.2000 for removal of stitches (and the drain). The stitches (and the drain) were removed on that date. Thereafter, the patient went to the Centre for consultation with the OP on 25.09.2000, 28.09.2000 and 30.09.2000 with complaints of stomach ache, constipation and vomiting (the last being complained of on 30.09.2000). She was treated symptomatically by prescribing a mild laxative (Isabgol) and an antacid (Ocid). On 02.10.2000 she was again taken to the OP with complaints of serious discomfort and yellow pigmentation of her eyes. The OP then advised ultrasonography and x-ray investigations. After seeing the reports of these tests, the OP admitted her to the Centre on the same day (02.10.2000). On 03.10.2000, the OP drained out about 100 cc of bile-stained fluid from the patient's peritoneal cavity. On 04.10.2000, he conducted another surgery (laparotomy) and placed a tube drain to remove the ascitic (abdominal) fluid. This was followed by ultrasonography and chest x-ray on 10.10.2000. On 12.10.2000, the patient was referred to one Dr. Neeraj Nagpal for Endoscopic Retrograde Cholangio Pancreatography (ERCP) to evaluate the biliary system for leak, residual stones, etc. ERCP could not be conducted fully because of difficulty in cannulating the bile duct and the patient was referred back to the OP. On 13.10.2000, the OP referred the patient to the Department of Hepatology (Liver Clinic) at the Post Graduate Institute of Medical Education and Research (PGI), Chandigarh for further investigations and treatment. A repeat ERCP was done on 16.10.2000 at the PGI which showed a deformed anatomy at D1/ D2, minimal narrowing of the Central Bile Duct (CBD) and a leak in the area of the Cystic Duct. Sphincterotomy of about 7 mm was done and a 7 cm stent was put in place. Post-ERCP, the patient remained well for about 24 hours whereafter she started developing ERCP-induced pancreatitis. Despite intensive treatment at the PGI, she went on to develop sepsis and multi organ failure from which she could not recover and ultimately expired on 04.11.2000.

(3.) The main allegation in the complaint was that though Reeta continued to complain of pain ever since 12.09.2000 and visited the OP on 20.03.2000, 25.09.2000 and 28.09.2000 with the same complaint of persisting stomach pain, the OP did nothing more than prescribing Liquid Cremaffin and Isabgol and, on 30.09.2000, despite her complaint of vomiting, he only prescribed Ocid (an antacid). Thus, during this entire period, the OP made no attempt to advise appropriate investigations to ascertain the cause of persisting stomach pain. As a result of this prolonged neglect of her post-surgery complaints, Reeta developed obstructive jaundice and further complications. Though the OP carried out fluid aspiration on 03.10.2000 and another surgery (laparotomy) on 04.10.2000 to place a drain, he failed to make out the cause and location of bile leakage. ERCP, belatedly recommended and attempted on 12.10.2000 (at a private clinic instead of a tertiary medical care centre) was also unsuccessful. It was only thereafter that the OP thought it fit to refer Reeta to the PGI. The complainant also alleged that the OP knew from the x-ray taken on 03.10.2000 that the patient had developed lung complications but he did nothing about it. According to the complainant, it was the negligence on the part of the OP in not being able to ascertain the location of bile leakage and persisting with his line of treatment from 04.10.2000 in particular that Reeta developed various intractable complications by the time she was referred to the PGI on 13.10.2000.