PREM KISHORE Vs. SUDHIR KHANNA

JUDGEMENT

(1.) Smt. Urmila Devi (since deceased, for short, the 'patient') consulted Dr. Sudhir Khanna (Opposite Party No. 1) at Sir Ganga Ram Hospital (for short, the 'SGRH') - Opposite Party No. 6, who diagnosed her condition as 'Retroperitoneal Fibrosis with Bilateral Hydroureteronephrosis'. On 24/4/2013, "Bilateral Double J Stenting" - a minor procedure was performed in SGRH and she was discharged on the next day. For permanent relief, the Opposite Party No. 1 suggested the "Robotic Ureterolysis" surgery and gave estimation of Rs.1,50,000.00 as charges. The surgery was scheduled for the last week of June, 2013. As the patient was anaemic -Hb 8.9gm %, the physician Dr. Anurag Gupta treated the patient from 18/6/2013 till 26/8/2013. The Hb % improved to 9.9 gm % and the date of surgery was fixed on 4/9/2013. The Opposite Party No. 1 did not inform about the need of blood transfusion for surgery.

(2.) On 4/9/2013 the patient was taken to Operation Theatre (OT) at 7.00 a.m. for the surgery. It was alleged that during the procedure, Dr. Khanna negligently cut the external iliac artery, which resulted into heavy blood loss. He instead of repairing the cut of iliac artery, continued with the surgery for further three hours by applying haem clips only. He did not call the vascular surgeon for artery repair. Later on, when the situation became out of control and complicated, the Opposite Party No. 1 obtained the consent of the patient's husband for open surgery. He had not disclosed about injury of iliac artery. Dr. V. S. Bedi, the Vascular Surgeon (Opposite Party No. 4) was called to repair the iliac artery, but it was too late (3 hours of the injury). It was alleged that the patient suffered heavy blood loss about more than 3 litres, which further led to Acute Renal Failure (ARF). It was further alleged that the Opposite Party No. 1 was performing this Robotic surgery for the first time and he was not qualified and had no experience in the said procedure. This fact was concealed by the Opposite Parties from the patient and her family members. Due to careless and negligent act, the external iliac artery was cut. Thus it was gross negligence. Even after knowing the cut, he applied haemo clips on the main vessel and continued the operation. Dr. V.S. Bedi, with his team, performed Polytetrafluoroethylene (PTFE) bypass grafting to the damaged artery which caused further blood loss. Within two days, the patient was given 15 units of packed RBCs (PRBC), 14 units of Fresh Frozen Plasma (FFP) and few units of other blood components. After the operation, the patient was shifted to ICU, the doctors gave fake assurance that the patient's condition was stable. Thereafter, Dr. Sudhir Khanna went abroad, leaving behind the patient in the hands of other doctors. It was alleged that the Opposite Party No. 1 and his team was aware about Haemophilia Carrier state of the patient, but the doctors failed to administer anti-Haemophilic Factor VIII or Cryoprecipitate prior to and / or after surgery. Thus, it led to continuous blood loss and ultimately, the death. Thereafter, the patient was kept on dialysis and ventilator from 5/9/2013. It was followed by Continuous Renal Replacement Therapy (CRRT). Thereafter, on 6/9/2013, the patient suffered cardiac arrests twice, he was revived. Again he suffered, 3rd cardiac arrest, but despite meticulous CPR efforts, the patient expired and declared dead at 3.40pm. He further alleged that he was compelled to pay Rs.4,16,000.00 against the agreed cost of Rs.1,50,000.00, however after long arguments, the hospital came to know mistake on their part and therefore, the amount was settled to Rs.3.67 lakh. It clearly amounts to alleged manipulative strategy of the Hospital to hide their mistake. Being aggrieved, the Complainant registered an FIR at Rajender Nagar Police Station under Sec. 304A of IPC. He also filed a complaint before the Medical Council of India and filed this instant Consumer Complaint under u/s 21(a)(i) of the Act 1986 and prayed compensation of Rs.1,92,51,000.00 with 18% interest. Defense:

(3.) The Opposite Parties filed the common reply and denied any negligence on their part. It was submitted that the patient was referred by Dr. S. N. Wadhwa, a senior renowned Urologist at SGRH to the Opposite Party No. 1 for renal ailments. After a detailed check-up by both the doctors, it was diagnosed it as a rare Retroperitoneal Fibrosis (RPF) with Bilateral Hydroureteronephrosis (HDN) with Acute on Chronic Kidney Disease (CKD). Accordingly, the patient and her family members were explained about the nature of RPF as a rare disease having serious consequences, if left untreated. It was also explained that the treatment will be done in two steps because of the compromised kidney functions on account of back pressure on both ureters. The first step was to relieve the obstruction of the ureters temporarily by placing Bilateral DJ stent. After improvement in the kidney functions, the definitive surgery for bilateral Ureterolysis would be performed for RPF. The informed consent was taken after explaining the patient and her family members about the nature, benefits and risks of the operation and the hospital stay with expenses. It was also explained with linear diagrams and pictures. It was pertinently submitted that on 25/4/2013, the Complainant consulted several doctors in the city, including Safdarjung Hospital before coming to the Opposite Party No. 6 hospital. The patient and her husband was also informed about the Robotic surgery, its advantages and limitations as well as the option of conversion to conventional open surgery. After discussions among themselves, the Complainant opted for surgery at SGRH -Opposite Party No. 6.