FIRST APPEAL NO. 2135 OF 2018
J.J. CLINIC & NURSING HOME & ANR.Versus
KUMARI RICHA SINGH
Decided by the Hon’ble NCDRC on 30.04.2024.
FACTS: Appellant No. 1 is a fully equipped medical center with doctors of different specialties as visiting Consultants and Appellant No. 2 is a qualified Consultant Physician and Cardiologist. On 11.10.2011 the Respondent, who was aged 1 1/2 years was admitted to the Appellant 1 hospital with a history of high grade fever and was under treatment of Appellant No. 2 who prescribed medicines including intravenous injections. The Respondent was discharged on 13.10.2011. As per the Discharge Card of the Appellant No.1 (Hospital), the Respondent had been prescribed medicines and syrup but no injection. There was no mention of any bandage on the left leg. According to the Respondent, the treatment had included wrapping of a tight bandage on the left leg due to which she developed gangrene and after a few days of discharge from the appellant no.1 hospital was required to be admitted to the Sunder Lal Hospital, Banaras Hindu University (BHU) on 15.10.2001. However, she was discharged from this hospital on 20.10.2001 and was admitted to KEM Hospital, Mumbai on 23.10.2001 from where she was discharged on 27.10.2001. The left leg of the Respondent was amputated below the knee on 29.10.2001 at the KEM Hospital, Mumbai in view of the need to prevent the spread of gangrene. Subsequently, she received treatment at the All India Institute of Physical Medicine & Rehabilitation, Mumbai for artificial limb implantation in November, 2004. It was contended that it was evident from the prescription dated 13.10.2001 that though Appellant No. 2 diagnosed Febrile Convulsion and prescribed IntraMuscular Fortum 250 mg and IntraMuscular Mikacin 100 mg BD (Antibiotic), the treatment rendered on 11.10.2001 and 12.10.2001 was without any pathological test to ascertain the disease.
The Discharge Record of SS Hospital, BHU, Varanasi indicated the Respondent was suffering from Meningitis Fever. Hence, the Appellants did not try to confirm the cause of illness through any tests. The diagnosis of gangrene of the left leg by S Hospital, BHU and KEM Hospital, Mumbai indicates that the cause of gangrene developing in the left leg was due to the mistake and negligence of the Appellants during treatment due to tying of tight bandage which was not removed at the time of discharge. The treatment by a non-qualified professional/quack is strongly denied and the cause of the gangrene is attributed to the un-professional treatment and negligence of the Appellants. It was submitted that gangrene could not have developed within a span of a day and that since in infants intravenous drips are administered through the leg after fastening it with a bandage to prevent disturbance, the tying of the tight bandage was clearly attributable to the negligence of the Appellants.
OBSERVATIONS: The averment of the Respondent in the case on hand is that the Appellant No. 2 failed to provide the standard of care by bandaging the left leg so tightly that it resulted in gangrene on account of preventing flow of arterial blood to the lower portion of the leg and that the Appellant No. 1 (hospital) deliberately did not provide the medical records of treatment for the period 11.10.2001 till 13.10.2001 as required under the Medical Council of India’s Regulations since there had been a failure to detect Meningitis Fever through a pathological test. From the record it is evident that Appellant No. 2 is a Physician and Cardiologist and there is no allegation of any lack of medical skill on his part. The Discharge Summary from the Appellant No. 1 hospital and the prescription mentions the intra vascular injections and medication that the Respondent had been placed on while admitted for Febrile Convulsion. As regards the Respondent’s averment is that a bandage was tied tightly to the lower part of the left leg while the Respondent was on IV drip, neither the Discharge Summary of the Appellant 1 Hospital nor the records of SS Hospital, BHU, Varanasi record that such a tight bandage was advised or tied to the leg of the Respondent either at the time of discharge or admission in these hospitals. It has also not been pleaded that the medication prescribed at the Appellant 1 hospital with regard to IV medication was continued after 13.10.2001. It is also not Respondent’s case that the medication prescribed by Appellant No. 2 was responsible for the gangrene. The only averment with regard to treatment is that the doctor failed to prescribe the test for Meningitis. Respondent relied upon this Commission’s judgment on Vidya Devi (Deceased) through LRs and Ors vs R Mehindru (Dr) in RP No 2348 of 2003 decided on 07.04.2008, II (2008) CPJ 232 (NC), wherein it was held that if normal and obvious tests were not conducted before arriving at a diagnosis and the course of abruptly deciding on diagnosis and commencing treatment would not normally be followed by a professional man of ordinary skill. Hence, Appellant 2 was liable since he commenced treatment without ascertaining cause of fever through tests. Appellant 1 erred in not maintaining records.
HELD: The issue of whether treatment was based on incorrect diagnosis is not the primary issue here. It is whether the bandage that was tied so tightly caused gangrene. There is no evidence on record as to why the bandage was used when whether the treatment prescribed by Appellant 2 was carried on or not after discharge has not been urged in pleadings. It is also not brought on record whether the tight bandage was, in fact, prescribed by Appellant no.2. The contention of the Respondent can therefore not be considered. Therefore, attribution of gangrene to the treatment at Appellant 1 hospital under Appellant 2 has not been established through evidence by the Respondent. Admittedly, gangrene could not have developed within a day. The respondent has not brought any evidence on record to conclusively establish whether the advice for a tight bandage was prescribed by appellant no.2. In view of the above, the finding of the State Commission that “gangrene in the lower left leg of the complainant has developed because of the negligence of the OPs in the treatment, in taking care of the complainant during her treatment” is not substantiated by any evidence on record.This finding is also contrary to the evidence on record as per the discharge summary. In the instant case, it has also not been established with evidence that the cause of gangrene was either medication prescribed by Appellant No. 2 or that he was responsible for the tying of a tight bandage which prevented blood circulation in the lower left leg of the Respondent. The finding of the State Commission in this regard cannot, therefore, be countenanced and must be set aside.The appeal is found to have merits and is accordingly allowed. Order of the State Commission is set aside. FA No. 2309 of 2018 filed by the Respondent No. 1 is also accordingly dismissed as without merits.
