B SHYAMSUNDER RAJ Vs. M PANDARINATH

JUDGEMENT

(1.) -AGGRIEVED by the order in C. D. No. 82/2001 on the file of District Forum, Ranga Reddy District, opposite party No. 1 preferred this appeal.

(2.) THE brief facts as set out in the complaint are that the complainants' daughter, Ms. Kavita, consulted Dr. Sudheer Goje of Bodhan on 7. 4. 2000 with a complaint of chest pain. After examining the patient, he gave some medicines and advised to undergo some tests but as the patient did not respond to the treatment and on his advice approached Dr. Shyam Sunder of Medwin Hospital, Hyderabad i. e. opposite party No. 1. Opposite party No. 1 treated her as out-patient on 17. 4. 2000 and as initial diagnosis observed that there are no cervical glands and lungs were normal and advised to use medicines for one week as per O. P. card and come for review after four days without prescribing air-bronchogramme. Blood examination was done on 17. 4. 2000 at opposite party No. 3 diagnostic centre revealed that ESR level was on higher side, on 18. 4. 2000 bronchoscope test was conducted at opposite party No. 1 hospital and it was diagnosed as Hyperemia post-set of RVL. On the same day pathological test i. e. cytology for any fluid was done and it was observed no significant inflammation or evidence of malignancy. AFB stain test was done and the report revealed 'negative' for fungal evidence. On 20. 4. 2000 CT Scan for chest (Plain study) was conducted and the report revealed "mild Spleenomegalae" and suggested for clinical correction. The patient was prescribed some medicines but when there was no relief, she approached opposite party No. 1 on 22. 5. 2000 with a complaint of vomitings, and pain in the abdomen. The complainant submitted that the problem was diagnosed as 'drug induced Hepatitis' and advised to stop ATT and prescribed to use some more medicines and advised blood test, liver function test for serum electrolytes. The blood report once again revealed that ESR level was very high and Liver function test suggested for clinical correlation and opposite party No. 1 referred the patient to opposite party No. 2 hospital for admission and treatment. The patient was subjected to CBP test on 22. 5. 2000 for investigation of blood for HIV 1 and 2 and HBs Ag and the report dated 23. 5. 2000 was negative. The report dated 26. 5. 2000 showed that SGPT and alkaline phosphates were high. Opposite party No. 2 doctor referred to opposite party No. 4 diagnostic centre stating that clinical findings as drug induced Hepatitis and investigations were required like US scan of abdomen and x-ray chest PA view. The ultra sound scan of whole abdomen was done on 29. 5. 2000 at opposite party No. 4 hospital and the impression revealed "mild Hrepato meagerly-Hepatitis, mild spleeonomegaly and bilateral pleural effusion for correlation/follow up. X-ray chest PA view impression was "right Upper lobe opacity "koch's for correlation follow up". The complainants submitted that their daughter was in opposite party No. 2 hospital from 22. 5. 2000 and treated for Pulmonary Koch's and drug induced for gastritis, hepatitis and dermatitis and was going in for GR-1 hepatic encephalopathy and was discharged with an advice to go to Medwin Hospital for further management on 30. 5. 2000. Since there was no relief, the patient was admitted in opposite party No. 5 hospital and was again subjected to CBP (for RH-D) type), Haematology, Biochemistry and CBU examination, serology, complete blood picture, bio chemistry for blood urea, ultra sound scan-whole abdomen (female) Bio chemistry for potassium, Bio chemistry for "random blood sugar on 30. 5. 2000. The complainant submitted that there was no proper diagnosis or treatment extended by opposite parties 1 and 2 at any stage and their daughter, Ms. Kavita, finally expired on 3. 6. 2000 at opposite party No. 5 hospital. Hence the complaint for a direction to all the opposite parties to pay the complainants a sum of Rs. 4,80,000 with interest as the Forum deems fit together with costs.

(3.) OPPOSITE party No. 1 denied the allegations made in the complaint and stated that there was no negligence or deficiency of service in treating the patient. He submitted that the patient discontinued her treatment with him much prior to her demise and that he was not aware of the treatment taken by her at Remedy Hospital and submitted that the patient and her parents did not follow the advice given by him. He submitted that the negligence is on the part of the complainants in not taking proper follow up treatment for their daughter which resulted in her death. He admitted that the patient was referred to him by Dr. Sudheer Goje of Bodhan and submitted that the patient approached him with complaint of cough pain in the chest, blood vomitings and was weak and anemic. He submitted that extensive investigations did not reveal any uncommon disease and therefore it was a common disease with unusual symptoms and presentation and small investigations could not identify the problem and hence tests like Pneumonia, T. B. , PTE, cancer and tumor tests such as Bronchoscope, C. T. scan of the chest and nuclear tests were done and P. T. E. , cancer and tumors were excluded and as the ESR level was high, it was an indication for Kochi apart from patchy opacity in lung and on examination of CT scan of chest, bronchial hyperemia, bronchial wash for AFB was negative which can be expected 60% even if the disease is existing. He further stated that he prescribed 4 drugs and ATT for two weeks/one month and asked to come for review if there is any problem but the deceased did not turn up for review and after one month her brother sought advice over telephone for vomitings and pain and submitted that he did not prescribe any medicines and insisted to bring the patient. He submitted that the patient was brought to him on 22. 5. 2000 and on seeing her the doctor noticed the side effects of the drugs and she was diagnosed as suffering from ATT induced hepatitis which is common to occur in 5 to 10% of patient and he immediately advised her to stop ATT and get admitted in Medwin Hospital for check up and intensive care to know the extent of damage to the liver due to side effects. Opposite party No. 1 submitted that due to financial constrains the patient and her brother refused the offer and requested for a small hospital and he submitted that had the patient been brought immediately the damage would have been minimum and under control. He submitted that the patient was admitted in opposite party No. 2 hospital and her condition deteriorated further in spite of giving hepatic protection to liver and the patient developed gastritis and dermatitis as endorsed by Specialist in Gastro Entamologist, Dr. Panduranga Rao. He submitted that when the condition of the patient further deteriorated with Hepatic encephalopathy, the patient's attendants were asked to shift the patient to Medwin but they refused and absconded from opposite party No. 2 hospital and got the patient admitted in opposite party No. 5 hospital where the patient died. He further submitted that he is a post graduate i. e. M. D. from Osmania Medical College in 1991 and subsequently worked as Senior Registrar in Respiratory Medicine at NIMS from 1991 to 1993 and later did his super specialty in pulmonary medicine at P. G. I. , Chandigarh from 1993 to 1995 and is one of the foremost persons in South India with highest qualifications and done diploma in National Boards in Respiratory Medicine in 1992 and working from 1995 till date in Medwin Hospital and got vast experience of 15 years in managing various respiratory diseases and prayed for dismissal of the complaint.