SARASWATHI Vs. VIMALA HOSPITAL P LTD

JUDGEMENT

(1.) This complaint is filed by Mrs. Saraswati, aged 24 years, widow of the deceased M. Murugaraj, and the minor children. The case of the complainant is that her husband (the deceased) was admitted in the 1st opposite party hospital on 24.9.1995 with history of persistent vomiting. After several tests and scans, the case was diagnosed as chronic duodenal ulcer with obstruction and the husband of the complainant was advised to undergo a surgery by the 2nd opposite party. The surgery was done and he was discharged on 8.10.1995. The deceased returned to his native place. After 10 days, he had the same continuous vomiting, and so he rushed to the 1st opposite party hospital where he was treated by the 2nd opposite party. After a week, he was discharged. Once again, he approached the 2nd opposite party on 14.12.1995. On 14.12.1995, without assigning any reason, the 1st opposite party directed the deceased to see a hematologist at Rajaji Hospital, Madurai. On 21.12.1995, the deceased rushed to Madurai Rajaji Hospital where he was informed that he had serious renal problem and was not properly diagnosed and treated by the 1st opposite party and advised to get the discharge summary from the 1st opposite party hospital. The 2nd opposite party reluctantly gave a discharge summary. After producing the discharge report to doctors at Madurai hospital, the deceased was shifted to Government Hospital, Madras, and was admitted there on 12.1.1996. The doctors were shocked to see the discharge summary given by the 2nd opposite party as the blood urea test was not reflected in the report, in spite of urine albumin being (+ + +) and blood pressure was also not recorded. The complainant further submitted that in the report, Barium meal test finding were not mentioned and endoscopy was not done. The complainant submitted that the haemoglobin value was only 7.6 gms. at the time of surgery and surgery must have been recommended only when the haemoglobin was 10 gms. The following treatment was also not done properly and once again wrongly diagnosed as auto immune hemolytic anenmia. After conducting several tests and knowing the facts of the case, the opposite party never approached a nephrologist for consultation or referred the patient to a nephrologist to seek his opinion. The opposite party failed to diagnose the renal problem of the deceased. Due to the deficiency in service of the opposite parties, the deceased was put to untold agony and hardship. The deceased was a businessman owning an eating house near Dindigul and earning Rs.7,500/- per month. The complainant prayed for a compensation of Rs.10,00,000/- for loss of income for the near future, loss of companionship and consortium, mental agony and including hospital expenses.

(2.) The opposite party in its version denied all the allegations of the complainant and contended that Mr. Murugaraj visited Vimala Hospital (P) Ltd. with a history of persistent vomiting for the past three months. The opposite party, on examination, found that Mr. Murugaraj's abdomen was distended and was tender on palpation. Pulse rate and temperature were increased. He was in impending shock and was infused Ringer Lactate (1.5 litres) and Dextrose Saline 1.5 lts. for 24 hours alongwith potassium chloride. Nasogastric aspiration drained 3400 ml within the first 12 hours of admission which was a clear indication of gastric outlet obstruction. This was later on confirmed by Barium Meal X-rays which showed delayed emptying of Barium into small bowel. This again was also a clear indication of gastric outlet obstruction due to duodenal ulceration. This needed an immediate surgery. As Mr. Murugaraj's haemoglobin level was low, he was administered blood transfusion. After transfusion, his haemoglobin count increased appreciably. After this, the anaesthetist certified that he was fit for operation. The opposite party performed a gastro jejunostomy on Mr. Murugaraj by which the feed substances were directed from the stomach to bypass to the jejunum bypassing the ulcerated part of the duodenum. As there was oedema around the ulcer, the opposite party did not perform vagotomy and there were a lot of adhesions from the stomach to the liver which was probably due to old perforation. After surgery, Mr. Murugaraj's condition improved and he was stable. His vomiting stopped and he was feeling much better. Mr. Murugaraj came on 20.10.1995 for medical examination. His haemoglobin level was low. The opposite party suspected that he might be suffering from auto immune haemolytic anaemia. He was given intravenous fluids followed by small dose of steroid, H2 receptor blockers to reduce his haemolytic anaemia and gastric acid respectively. He was also put on Decadron 4 mgs. twice a day and ondansetrone to decrease his vomiting. Mr. Murugaraj reacted well to this treatment and he was discharged on 30.10.1995. He was advised to come for a check-up after a week. On 7.11.1995, Mr. Murugaraj reported for a check-up. He had no recurrence of vomiting and his appetite was good. As the opposite party was not available, he was examined by the opposite party's assistant and was advised to continue iron tablets and protein nutrient powder. Again, Mr. Murugaraj reported on 23.11.1995, and complained of giddiness and loss of appetite. He was given appropriate treatment and was also put on ciplacitin to increase his appetite and advised to come after a week for a check-up. He did not turn up but was taking treatment with other quacks around Dindigul. This could have been the real cause for further deterioration of his condition. On 18.12.1995, Mr. Murugaraj again reported for a check-up. He complained of loss of appetite and mild chest pain. As his haemoglobin level which had been stable earlier had fallen, he was referred to a haemotologist, Elskene Hospital, Madurai. The opposite party denied the allegation that he threatened and abused the relatives of Mr. Murugaraj and gave an incomplete discharge summary to them. The opposite party submitted that the summary was complete in all respects except the details relating to blood urea, creatinine and bilirubin which could not be entered on account of certain limitations in the computer used by the opposite party. There is no suppression of facts at any point of time. As the patient was reacting positively to the treatment, the need for a nephrologist was not felt. The opposite party further stated that the fee collected from the complainant was only normal charges. The opposite parties are not guilty of any acts of negligence and are not bound to compensate the complainant in any manner. The opposite party prayed that the complaint may be dismissed with costs.

(3.) The points for determination are : (1) whether there was any negligence or deficiency of service on the part of the opposite party (2) If so, the amount of compensation the complainant is entitled to