T RAMA RAO Vs. VIJAYA HOSPITAL

JUDGEMENT

(1.) The case of the complainant T. Rama Rao is that his wife late Dr. Vijaya Lakshmi was a Medical Officer at the Primary Health Centre, Vanapalli. She had undergone an operation for Mitral Stenosis in the Institute of Cardio Vascular Diseases sponsored by Madras Medical Mission (Opposite Party No.2) with Dr. K. M. Cherian as the Chief Surgeon. The operation was successful and the complainant's wife meticulously followed the medical advice and she was declared to be doing well. While so on 13.7.91 she lost control of her left side limbs and she was immediately admitted in the 1st Opposite Party Hospital on 14.7.91. She was allotted room No.103 and the 2nd Opposite Party Madras Medical Mission was nominated as the consultant by the 1st Opposite Party. The complainant paid the necessary charges to the 1st Opposite Party. Next day, i. e. , on 15.7.91, the patient was referred to Dr. Deepak, Neuron Physician and he conducted C. T. Scanning test. After the test. Dr. K. M. Cherian of the 2nd Opposite Party declared that it was a medi cal case and not a surgical one, and that the patient would be alright within a week under the treatment of the Neuron Physician. But either Dr. K. M. Cherian nor anybody else of the 2nd Opposite Party arranged for the services of a Neuron Physician till 24.7.91. When the condition of the complainant's wife became very serious Dr. Deepak attended on her only on 24.7.91 but could not do anything, and the complainant's wife died on 26.7.91 at 6 a. m. Thus the doctor patient died for want of proper medical treatment from 16.7.91 to 23.7.91. The death could have been averted had the patient been placed under the treatment of a Neuron Physician. Thus the Opposite Parties were guilty of gross negligence in their duties in failing to arrange for proper treatment under a Neuron Physician. At least on 15.7.91 the 1st Opposite Party should have nominated a Neuron Physician as consultant and the 2nd Opposite Party ought to have referred back the patient to the 1st Opposite Party for nominating by it a Neuron Physician. Thus the Opposite Parties 1 and 2 jointly and severally are liable for the negligence. When the complainant's father in law and the Consumer Action Group, Madras demanded from the Opposite Parties for copies of the case sheets pertaining to the complainant's deceased wife, the Opposite Par ties declined. The further case of the complainant is that the deceased Dr. Vijayalakshmi was draw ing a salary of Rs.3,600/ p. m. + other benefits and perks before her death and she was aged only 38 years; when she died she had yet to serve 20 years more. Therefore, the loss of income to the complainant in the death of his wife would be about Rs.10,00,000/. On these grounds, the complaint has been filed for directing the Opposite Parties to pay the said sum of Rs.10 lakhs to the complainant.

(2.) The 1st Opposite party Vijaya Hospital in its written version contends that Dr. Vijayalakshmi was under the entire treatment provided by the 2nd Opposite Party which is an independent body consisting of its own special ists, assistants, etc. , and the 1st Opposite Party was not responsible for the treatment. The 1st Opposite Party only provides nursing services including all medical facilities in the hospital and it does not treat the patient. The 2nd Opposite Party is not an employee of the 1st Opposite Party. The complainant's wife Dr. Vijayalakshmi died as early as 26.7.91 and this complaint has been filed belatedly and hence the complaint is the result of an after thought. A band of well qualified specialists and consultants is provided with consultation rooms for attending on the patients. The patients are taken care of and attended to by the specialists, consultants who are not employees of this Opposite Party and they are paying charges to this Opposite Party for providing them with the consultation rooms and other facilities. This Opposite Party pro vides nursing facilities including all medical facilities such as laboratory services to those consultants. The consultants pay for the consult ing rooms used by them in the hospital. As regards the treatment given to the patients, the consultants are alone responsible. The patients and the attendants are fully made aware of this position. The 2nd Opposite Party is an autonomous body which operates independently and there is not remotest master servant relationship or principal agent relationship between this Opposite Party and the 2nd Opposite Party. The deceased Dr. Vijayalakshmi had been treated earlier by Dr. K. M. Cherian at the Railway Hospital in the year 1976 77 and by the 2nd Opposite Party on 10.8.87. When the patient Dr. Vijayalakshmi was brought to the main reception of this Opposite Party at 10 p. m. on 14.7.91 the Receptionist on duty might have found from the records available with the patient that the patient had been treated earlier by the 2nd Opposite Party and, therefore, had referred her to the 2nd Opposite Party. Thus the complaint against this Opposite Party is liable to be dismissed.

(3.) The case of the 2nd Opposite Party in its written version is that the patient had her faculties fully alive till her death and she did not complain of any deficiency in service. This complaint has been filed belatedly after two years and, therefore, the 2nd Opposite party is handicapped to defend itself because it will be difficult to make available all the relevant papers. Dr. Vijayalakshmi had Mitral valve replacement done by Dr. K. M. Cherian on 10.8.87. She had a closed heart operation for her blocked valves by Dr. K. M. Cherian in 1976 77 when he was a Cardiac Surgeon for the Indian Railways in the Southern Railway Hospital, Perambur. The Mitral valve replacement was then a high risk surgery as most other open heart surgeries. Dr. Vijayalakshmi did well and was discharged with a particular advice to come for the first check up three months after discharge to regulate her anti coagulation. She had prosthetic valve replacement which necessitated absolute control over the blood clotting parameters. As in line with the hospital's usual practice, a booklet containing all information about the post operative care was given to her in spite of the fact that she herself was a medical professional. She came for the first check up after three years on 12.4.90 and it is not known whether she had conducted her medical test regularly. When she came for the check up on 12.4.90 Dr. Vijayalakshmi specifically told Dr. K. M. Cherian about her unhappy married life. Dr. Vijayalakshmi was admitted on 14.7.91 with a history of sudden stroke which developed 24 hours before her admission. At that time, when Dr. K. M. Cherian enquired about the anti coagu lation status she specifically told him that she had stopped taking medicines. A C. T. Scan was taken. Dr. Deepak Arjundas-Consultant Neuron Physician was called in on 15.7.91 who pre scribed her some treatment and the treatment was given as per his instructions only and the patient got all the treatment prescribed by him and he had seen the patient on many occasions. She developed breathing difficulty and lowurnary output on 25.7.91 for which Dr. George Abraham, Consultant Nephrologist was consulted and necessary treatment was instituted. She was shifted to the Intensive Care Unit at 11 a. m. In spite of all endeavours and best treatment she was progressively becoming worse, and on 25.7.91 she became comatose. Obviously the brain lesion was progressing and she died of major embolic episode due to improper anti coagulation or rather absence of anti coagula tion. It is further contended by this Opposite Party that it is not unusual for patients who have undergone surgery, not following after discharge the post operative guidelines meticulously or take necessary care required of by them either owing to complacency or other extraneous reasons and in some cardiac surgery cases, even if patients take meticulous care after operation, complications do set in after some months or years leading to disastrous consequences for which there can be no explanation nor can any one be blamed. As such there was no deficiency in service on the part of this Opposite Party. Hence the complaint cannot be maintained.