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--------------- Print Magazine --------------
 
  May 2016
 
  April 2016
 
 
 
 
CASE STUDY - by Anoop K. Kaushal

ADMINISTRATIVE ANOMALIES AND PROFESSIONAL NEGLIGENCE

Rajat Jain v. M/s D.R. Nursing Home

First Appeal  No.199 of 2007, decided by the National Consumer Disputes Redressal Commission New Delhi on 1-8-2012.

Facts:   Mother of the Appellants had contacted Respondent No. 2, Dr. P.N. Gupta at D.R. Nursing Home  for treatment of Hernia and after examining her, she was advised operation to be conducted on 8-6-1994 by a senior surgeon in the hospital, Dr. Rajindra Kumar Murtika, for which she was admitted on 7-6-1994. The three doctors who were nominated to conduct the surgery were not surgeons and Dr. Murtika was not even present during the surgery conducted on 8-6-1994.  During the course of the surgery, in the Operation Theatre itself, the patient went into a coma which was not disclosed to the relatives, there was no oxygen cylinder at the time of operation and it was only when her condition rapidly deteriorated that an oxygen cylinder was brought from the second floor.  Thereafter the patient was hurriedly shifted to Sunder Lal Jain Hospital.  The patient unfortunately expired in that hospital.  A post-mortem conducted thereafter indicated that the patient died of Hypoxia consequent to administration of anaesthesia.  The Report also mentioned that only the outer skin of the patient's abdomen had been stitched up following the surgery and peritoneum and muscles layer were left open.  A complaint was filed before the State Commission because due care was not taken during the operation and while administering anaesthesia which resulted in Hypoxia and subsequent death of the patient and also conducting the surgery in an ill-equipped operation theatre where even an oxygen cylinder was not readily available.

  Defence: It was stated that Dr. Murtika, the surgeon, conducted the operation and the other Respondents/doctors were a part of the operating team. It was denied that the condition of the deceased deteriorated in the operation theatre itself due to the negligence of the Respondents/doctors and lack of immediate oxygen facilities, that cardiac arrest occurred following the administration of the drug vercuronium, the patient was successfully revived.  The said drug is routinely used but unfortunately reaction and side-effects can occur in some cases as happened in the instant case. Even when she was admitted to Sunder Lal Jain Hospital, she was not in a critical condition and was breathing on her own, responding to painful stimulation. Respondents categorically denied that the oxygen cylinder was not available at the time of operation and also that only the outer skin of the body was stitched. 

  Expert Opinion: A Medical Board constituted by the Director of Health Services, Government of Delhi on investigation concluded that Respondent No.1 was a well-equipped hospital staffed by qualified doctors who conducted the surgery and no case of medical negligence was established in this inquiry. 

  Findings: The State Commission concluded that only Respondent No.1 along with Respondent No.2 can be held guilty of medical negligence, firstly, for not having arranged the oxygen cylinder immediately at the time of operation and secondly, because of non-availability of doctors who were competent to handle the patient,  and also took note of the observations of the Medical Board constituted by the Director of Health Services, Government of Delhi which concluded that the patient developed progressive bradycardia leading to cardiac arrest as a result of the drugs used during anaesthesia but no evidence of any negligence on the part of team of doctors managing the case could be detected, hence  directed that a lump sum compensation of ` 1 lakh be paid jointly and severally.

  Held: During the course of the surgery following reaction to one of the drugs, the patient suffered cardiac arrest because of which at the insistence of the relatives, she was transferred to Sunder Lal Jain Hospital where admittedly she survived for 7 days.  The State Commission as a first court of fact has noted that while there was no medical negligence per se on the part of Respondents, there were clear administrative deficiencies which had an adverse impact on the patient's critical health condition .   We see no reason to disagree with these findings of the State Commission based on evidence filed before it.  The Respondents' denial that the operated area was not properly stitched up is not borne out by facts on record and is confirmed in the post-mortem report.  The State Commission in its order has not given any reasons for awarding the  amount but it appears that it did not take into account the fact that the deceased was well-educated and gainfully employed and that her death had, at a young age, deprived the Appellants of a mother, which is an irreparable loss but also there was monetary and financial loss which could be quantified, keeping in view, her monetary contribution to the family's income. While we agree with the order of the State Commission that medical negligence could not be established on the part of all the Respondents/doctors and that only Respondents No.1 and 2 can be held guilty for deficiency in service in the instant case,  we direct that the compensation to be paid by Respondents No.1 and 2, jointly and severally be enhanced from ` 1 lakh to ` 7 lakhs  with interest @ 6% per annum to the Appellants from the date of filing the complaint till realization along with litigation cost of ` 10,000. 

 
 
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