Medical neglience
PRADEEP SHARMA
(Querist) 28 June 2014
This query is : Resolved
It all came to my knowledge when one fine day on 22nd july my son Hardik went to school and at 11.30 am after call from the teacher that he is not feeling well, we brought him home.
He was treated at a hospital. But slowly his left eye black pupil went to the other corner with in a week. I diagnosed it at a good Hospital and found that the nerves coming from brain were tightly filled with blood and this was the reason for it. The concerned doctor referred him to a Neurosurgen .
At this neurosergon Hospital on 23rd July, the doctor admitted him after doing CT scan started the treatment for injury and swelling in his head.
But since there was no relief, on 27th July, I asked him to do CT Scan (Contrast) and it was diagnosed that he had a heavy burden of cysts in his brain and was suffering from Neurocysticerosis of brain with Multiple ring enhancing lesions along with perilesional odema in B/L Cerebral hemisphere & Cerebellar hemisphere. The doctor then started the treatment for the said parasite.
He was continuously having head ache, vomiting with pain in the neck at the region where it joins the head. The following treatment was administered:
Tablet : Albandazole 400 mg – Half tablet BD
Injection : Dexona 2mg iv - BD
Syrup Eption : 1 Tsp – TDS
Tablet : Lasilactone – Half tablet BD
Syrup : Ibugesic Plus – 7.5 ML SOS
And the doctor finally discharged him on 30th July and Inj Dexona too continued BD thereafter.
Again on 13th August, I had to admit him since there was much head ache, vomiting& abdominal pain. The doctor discharged him on 14th August and following treatment continued there after:
Syrup Eptoin – 1 Tsp TDS
Tab: Albandazole 400 Mg – Half tablet BD
Tab: Mepresso 4 mg – Half tablet BD
Stp. Digene – 7.5ml BD
Syp : Meftal Spas – 1Tsp SOS
Again he was admitted on 15th August with Headache, Vomiting, Abdominal pain, Papil Odema. Following treatment was administered by the doctor:
Inj. Dexona – 2mg in – TDS
Inj. Pentex – 20 mg iv – BD
Inj Voveron – Half injection – BD
Inj Laxix – 10mg iv – BD
Neutrol 50cc – iv - TDS
Tablet – Albandazole 400mg – Half tablet – BD
On 16th August, from the morning itself he was weeping a lot and did not eat or drink anything. He was very upset. And at around 2pm he had first Seizure. But there was no foam from the mouth nor did he pass urine during this seizure disorder. This seizure was for around 90 seconds as I remember. He had closed his fists, his leg and fingers were closed too along with his teeth which were tight too. Doctor immediately gave him Inj: Encorate 500mg iv along with Fe-250 mg iv.
Even after seizure disorder, the doctor continued Albandazole tablet which as I have learnt from internet was dangerous and any mental disorder if happened was irreversible.
Anyhow, he continued the following treatment:
Frudus – iv
Tablet – Albandazole – 400 mg – Half tablet – BD
Inj: Encorate – 250mg – iv TDS
Inj : Dexona – 2mg – iv TDS
Inj : Pentex – 20mg – iv TDS
Neutrol – 50 cc – iv BD
Inj Voveron – Half injection – BD
Inj Lasix – 10mg – iv TDS
He was discharged on 20th August and Tablet Albandazole continued till 18th August (21 Days course completed). And following treatment was given at home:
Tab: Mepresso – 8mg - BD
Syp. Valporin – 7.5 ml – BD
Syp: Digene – 2tsp – BD
Syp : Ibugesic Plus – 7.5 ml BD
Again he was admitted on 5th Sept and discharged on 6th Sept with the same symptoms vis head ache, vomiting, abdominal pain etc. Following medication was done:
iv Fluid
Inj Voveron – Half injection – BD
Inj Emset – 2cc iv
Inj Encorate 250mg in 100 mg NS
Inj Dexona 1 mg iv
Master Hardik Sharma was again admitted on 16th September with headache, adema, and vomiting, abdominal pain.
The doctor now again started Tablet Albandazole 400 mg – Half tablet BD saying that it any cyst is alive, that would be killed too. The treatment that continued was as under:
Tablet Albandazole – 400 mg – Half tablet BD
Syp. Valporin – 7.5 ml – BD
Syp: Digene – 2tsp – BD
Tab: Mepresso – 8mg - BD
Syp : Ibugesic Plus – 7.5 ml BD
Tab: Lasilactone – Half tablet - BD
Inj Voveron – Half injection – BD
But again for the second time, Hardik had seizure at around 8.30am. The doctor gave him the following medication:
Inj : Eption 4amp in 100ml NS iv
Inj Fb – 50 ml iv - BD
Inj : Encorate 250mg – iv – BD
Inj : Lasix – 2mg – iv – BD
Inj: Diazepam – 1mg iv – SOS
Inj : Acibe 1 mg – Half amp iv BD
Inj : Voveron – Halg amp iv
Again, he was not feeling well and was admitted on 17th Sept & discharged on 18th Sept as he had a little seizure like feeling, abdominal pain, head ache, neck pain, vomiting etc. Encorate, Dexona, Voveron were given.
The doctor an 17th Sept night said that he is not able to cure him and referred him to AIIMS, Delhi.
On 18th Sept, I took him to AIIMS, Delhi where it was diagnosed that he had two cysts in his left eye also with choroidal lesion. Treatment given at AIIMS was as under:
Inj Dexona 3 mg – 8hrs
Inj Manitol – 60ml 8hrs
Syp Valprin – 7.5ml – BD
Tab: Labozam – 5mg – BD
Tab- Dexona – 2mg (One and a half tablet) – TDS
Tab – PAN 20mg – 01 BBF
On 20th Sept, I took him to PGI, Rohtak, where they continued the same treatment as in AIIMS for 3 days.
On 24th Sept, I took him to Dr. S.K. Bansal former Asstt Professor Neurology, PGIMS, Chandigarh at Sector -8C, Chandigarh. (Prakriti Brain & Nerve Research Centre). He administered the following medicines :
Tab: Diamox – 250mg – Half tablet BD
Syp : Valparin – 7.5ml – BD
Tab: Wysolone 10mg BD -10days
7.5 mg BD – 10 days
5 mg BD – 10 days
Tab: Vitafol (Folic Acid) – 5mg – BD
Till 10th oct, tablet Wysolone is 7.5 mg rest treatment is same. Also, we were giving him Diclomol anti-inflammatory tablet as directed by the doctor when headache & neck ache was unbearable.
On 11th Oct, 2012, he was taken to PGIMER, Chandigarh and they admitted him the same day through emergency.
On 12th Oct, fundus test finding showed chlorodial granuloma in left eye with bilateral papilledema with no evidence of Neurocysticercosis (NCC)
On 15th Oct, NCC Serology test was confirmed negative and Ventriculosomy Peritoneal VP Shunt was placed in his brain the same day.
On 16th Oct, MRS test reported as having a lipid peal, Tuberculoma.
On 19th Oct, CECT chest test found Necrotic Mediastinal nodes with ill-defined random nodules in bilateral lungs s/o ineffective etology tubercular.
Tubecular work up showed positive mantoux and X-Ray S/o B/L pulmonary infiltrates and CECT showing necrotic mediastinal nodes & MRS of cerebellar lesion was reported as having lipid peak S/o. Tuberculoma. CSF was negative for AFB as well as NCC Serology.
Hence within 4 days it was confirmed at PGI, Chd that Hardik Sharma was suffering not suffering from Neurocysticercosis of brain rather he had Disseminated TB (Pulmonary, Mediastinal TB, CNS & chlorodial Tuberculomas along with steroid induced gastritis/ Hirsutism and ATT induced hepatitis.
Had the correct treatment been given & proper diagnosis be done by the doctor who treated him from 22nd July, 2012 to 18th Sept, 2012, VP shunt would not have been placed in his brain.
This is negligence of the said doctor but consumer court lawyers say that they will not win the case because the judges do not listen to the medical negligence of the doctors as per judgment of supreme court.
What should I do??
Having spend around 4-5 lacs on my child. A shunt which is risky to his life placed in his brain which may need revision and the child has become handicapped throughout his life.
Kindly guide me urgently as 2 years will complete on 22nd July, 2014.
What compensation and where should I go for justice. I am very much embarrassed.
Regards,
Pradeep
Sankaranarayanan
(Expert) 28 June 2014
Send a legal notice to the hospital for negligence of services and file a case before appropriate district consumer forum
Kumar Doab
(Expert) 28 June 2014
Discuss it with Lawyer/Law firm specializing in such/Medico Legal cases.
Rajendra K Goyal
(Expert) 28 June 2014
The doctors have done as per the symptoms, even best hospitals may fail sometime to diagnose correctly.
You have liberty to send legal notice and file case in consumer forum, if you feel it was medical negligence.
R.K Nanda
(Expert) 28 June 2014
query too long.
Dr J C Vashista
(Expert) 29 June 2014
Be precise in posting your query, the experts do not have so much time for study of your story, analyse and advise on this social/charitable platform. It would be appropriate to contact, consult and engage a local lawyer.
Send a legal notice to all authorities with the Hospital followed by a consumer complaint.
V.T.Venkataram
(Expert) 29 June 2014
Your statement "This is negligence of the said doctor but consumer court lawyers say that they will not win the case because the judges do not listen to the medical negligence of the doctors as per judgment of supreme court" is misconceived.
If you can prove by producing am expert opinion that (1) that there is a usual and normal practice; (2) that the defendant has not adopted it; and (3) that the course in fact adopted is one no professional man of ordinary skill would have taken had he been acting with ordinary care.", you can win the case
ajay sethi
(Expert) 29 June 2014
be brief and to the point . summarise your query in 2 short paras
T. Kalaiselvan, Advocate
(Expert) 30 June 2014
I go with the experts on this issue, better be brief while posting queries in this portal so that experts understand the issue in a quick reference.
Raj Kumar Makkad
(Expert) 30 June 2014
Unless the opinion of the treating doctors is not found reversed by the superior doctors, consumer fora shall not even entertain such complaint so obtain the expert medical opinion first.
V.T.Venkataram
(Expert) 01 July 2014
As a practicing Advocate who has handled medico legal cases, i differ with what Expert Mr.Raj kumar makkad has stated. The foras are bound to accept the complaints.Expert opinion may not be required if the doctrine of res ipsa loquitur is applicable to the case. In the case of Spring Meadows Hospital v. Harjol Ahluwalia the Supreme Court observed that that gross
Medical mistakes will always result in a finding of negligence. Use of wring drug or wrong gas during the course of anesthetic administration will frequently lead to the imposition of liability and in some situation even the principle of res ipsa loquitur could be applied.
Raj Kumar Makkad
(Expert) 01 July 2014
Respecting the opinion of Shri Venktaram Sir, I do submit that practically consumer fora do refuse to entertain such complaints base upon another verdict of Hon'ble Supreme Court in a similar issue unless the conflicting superior opinion is not enclosed.
V.T.Venkataram
(Expert) 01 July 2014
My dear Mr. Raj kumar makkad ,could you kindly help me by informing tne citation of the Aoex court wshich the Foras are relying to refuse to entertain such complaints base upon another verdict of Hon'ble Supreme unless the conflicting superior opinion is not enclosed
Raj Kumar Makkad
(Expert) 02 July 2014
Indian Medical Association v V.P. Shanta and Others [(1999) 5 SCC 651]
Date of Decision~13/11/1995
A three-Judge Bench of the Apex court considered the important question whether and, if so, in what circumstances, a medical practitioner could be regard d as rendering' service' under section 2( 1)( 0) of the Consumer Protection Act,1986 and whether the services rendered at a hospital/nursing home could also be regarded as 'service.' Relying upon it decision in Lucknow Development Authority v, M.K. Gupta. (1994) 1 SCC 243 (where it was held that the definition of 'service' in the Act was very wide), the Court rejected the argument that only 'occupation' and not 'profession' was covered within the term 'service' and so services rendered by medical practitioners were outside the purview of section 2(1)(o). It also rejected an alternate argument that 'service' contemplated under the Act was of the "institutional type which was really commercial enterprise open available to all who seek to avil thereof"
Referring to section 14(1)(d) and section 2(1)(g), the Bench held that compensation for deficiency in service was to be awarded applying the same test as in an action for damages for negligence. it went on to observe that the standard of care that was required of medical practitioners was laid down in the English decision in Bolaml v Friern Hospital Management Committee 1(1957) 1AI/ ER 118] which had been accepted by the house of Lords and applied in a number of cases. Reference was also made to the Court'. earlier decision in Dr. Laxman Balkrishna Joshi v Dr. Trimbak Bapu Godbole & Another [(1969) 1 CR 206].
The Supreme Court repelled the contention that the Consumer Fora were not equipped to appreciate complex issues which might arise in cases of medical negligence and observed that these Fora were presided over by Judges/retired Judge who were well versed in law and, combined with lay decision making by members with knowledge and experience in various. fields, the constitution of the Fora was adequate to deal with cases of medical negligence. Further, the. safeguard of appeal against the orders of the Fora was available. The Court also did not agree that the summary procedure provided for in the Act was not sufficient to deal with such cases and observed that not every complaint would raise complicated questions. It also observed that in complaint' involving issues requiring recording of expert evidence, the Fora could ask the complainants to approach the civil court. It also noted that very few cases of medical malpractice had been filed till 1985, one of the reasons of which was the court fee payable in an action for damages (before civil courts) but no court fee was required to be paid under the Act,
Holding medical practitioners , government hospitals/ Nursing homes and private hospitals/ nursing homes fell into three categories::
(I) where services are rendered free of charge to everybody;
(ii) where charges are required to be paid by everyone; and
(iii) where charges are required to be paid by persons availing of services but certain categories of persons who could not afford to pay were rendered service free of charge,
The Court laid down the following criteria:
(i) Service rendered to a patient by. a medical practitioner (except where the doctor rendered service free of charge to every patient or under a contract of personal service), by way of consultation, diagnosis and treatment, both medical and surgical, would fall within the ambit of 'service' as defined in section 2(1)(0)
(ii) Merely because medical practitioners belong to medical profession and are subject to the disciplinary control of the
Medical Council of lndia and / or state Medical Councils would not exclude the services rendered by them from the ambit of the Act
(iii) A 'contract of personal service' was to be distinguished from a 'contact for personal services' (as only contract of personal service are expressly excluded from definition of service in section 2(1)(0). In the absence of relationship of master and servant between the patient and the medical practitioner; the service rendered by a medical practitioner to the patient would be under a 'contract for personal services and thus, is not outside section 2(1)(0),
(iv) The expression 'contract of personal service' in section 2.(1)(0) of the Act could not be confined to contract for employment of domestic servants only and the expression would include the employment of a medical officer for the purpose of rendering medical service to the employer. However, such service would be would be outside the purview of section2(1)( 0).
(v) Service rendered free of charge by a medical practitioner attached to a hospital/nursing home or a medical officer
employed in a hospital/nursing home where such service were rendered free of charge to everybody would not be 'service' as defined in section 2(1)(0). The payment of a token amount only for registration purpose at the hospital/nursing home would not alter the position.
(vi) Similarly, service rendered at a non-Government hospital/nursing home where no charge whatsoever was made from any person availing of the service and all patients (rich and poor) were given free service was outside the purview of tile expression 'service.' The payment of a token amount only for registration purpose only at such a hospital/nursing home would not alter the position.
(vii) Service rendered at a non-Government hospital/nursing home where charges were required to be paid by all persons availing of such services fell within the purview of the expression 'service' as defined in section2(1)(o).
(viii) Service rendered at a non-Government hospital/nursing home where charges were required to be paid by persons who were in a position to pay and persons who could not afford to pay were rendered service free of charge would fall within 'service' as defined in section 2(1)(0). Free service rendered to those who could not pay would also would be 'service' and the recipient a 'consumer' under the Act. In arriving at this conclusion, the Court opined that
(a) the protection envisaged under the Act was for consumers as a class;
(b) otherwise, it would mean that the protection of the Act would be available to only those who could afford to pay and not to the poor, although the poor required the protection more; and
(c) Else the standard and quality of service rendered at an the establishment would cease to be uniform.
(ix) Service rendered at a government hospital/health centre/dispensary where no charge whatsoever was made from any person availing of the services and all patients (rich and poor) weregiven free service was outside the purview of the expression 'service' as defined in section 2(1)(0) of the Act The payment of a token amount for registration purpose only at the hospital/nursing home would not alter the position.
Service rendered at a Government hospital/health centre/dispensary where services were rendered to some persons on payment of charges and also rendered free of charge to other persons would fall within 'service' as defined in section 2(1)(0). Free Service to those who could not pay would also be 'service' and the recipient a 'consumer' under the Act. Though Governmental hospitals may not be commercial in the sense of private doctors and hospitals, stin Government hospitals could not be treated differently and in such a case the persons belonging to 'poor class' received free services would be the beneficiaries of the services hired/ availed of by the 'paying class.'
(xi) Service rendered by a medical practitioner or hospital/nursing home could not be regarded a service rendered free of charge if the person availing of the service had taken an insurance policy for medical care where under the charge for consultation, diagnosis and medical treatment were borne by the insurance company. It would fall within 'services" as defined in section 2(1)(0).
(xii) Similarly, where, a a part of the condition of services', the employer bore the expenses of medical treatment of an employee and his family members dependent on him the service rendered to such an employee and his family members by a medical practitioner or a hospital/nursing home would constitute 'service' under the Act.
V.T.Venkataram
(Expert) 03 July 2014
My dear Mr. Raj kumar,
kindly go thru' the latest judgement of the Apex court in Nizam'S Institute Of Medical ... vs Prasanth S.Dhananka & Ors on 14 May, 2009, whereib it is stated as follows _
"We are also cognizant of the fact that in a case involving medical negligence, once the initial burden has been discharged by the complainant by making out a case of negligence on the part of the hospital or the doctor concerned,the onus then shifts on to the hospital or to the attending doctors and it is for the hospital to satisfy the Court that there was no lack of care or diligence. In Savita Garg (Smt.)vs.
Director, National Heart Institute (2004) 8 SCC 56 it has been observed as under:
"Once an allegation is made that the patient was admitted in a particular hospital and evidence is produced to satisfy that he died because of lack of proper care and negligence, then the burden lies on the hospital to justify that there was no negligence on the part of the treating doctor or hospital. Therefore, in any case, the hospital is in a better
position to disclose what care was taken or what medicine was administered to the patient. It is the duty of the hospital to satisfy that there was no lack of care or diligence. The hospitals are institutions, people expect better and efficient service, if the hospital fails to discharge their duties through their doctors, being employed on job basis or employed on contract basis, it is the hospital which has to justify and not impleading a particular doctor will not absolve the hospital of its responsibilities."
Kumar Doab
(Expert) 04 July 2014
The author of this post has mentioned medical negligence in treatment…………
The following recent publications/decisions/judgments may help him, however the author should consult a lawyer well versed in such matters and proceed under expert advise of his lawyer………………….
>>> NATIONAL CONSUMER DISPUTES REDRESSAL COMMISSION
NEW DELHI
FIRST APPEAL No.110 OF 2005
Against the order dated 28.2.2005 in Complaint Case No.39 of 2003 of the Consumer Disputes Redressal Commission, U.T. Chandigarh)
http://164.100.72.12/ncdrcrep/judgement/00140702094955479FA1102005.htm
>>> BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, PANCHKULA.
Consumer Complaint No : 46 of 2011
Date of Institution : 10.03.2011
Date of Decision : 02.07.2014
http://164.100.72.12/ncdrcrep/judgement/97414070309374674SCS.htm
>>> Panchkula pvt hospital told to pay 12 lakh for negligence
Bhartesh Singh Thakur, Hindustan Times Panchkula, July 04, 2014
A board comprising, Dr Rajiv Kapoor, Dr Renu Bhambuand and Dr Rani Singh, declared no medical negligence on the hospital’s part.
But the consumer forum was of the view that court was not bound by expert opinion as they were of advisory in nature and it has to differentiate between “expert witness”and “ordinary witness”.
It ordered Dr Chakrawarty and National Insurance Co Limited, the insurer of the hospital, to pay Rs. 10 lakh to the couple with interest at 9 % since the date of filing of the case and the doctor has to pay an additional Rs. 2 lakh to the couple.
http://www.hindustantimes.com/punjab/chandigarh/panchkula-pvt-hospital-told-to-pay-12-lakh-for-negligence/article1-1236541.aspx
>>> Chandigarh doc asked to pay Rs. 70 lakh for negligent treatment
Press Trust of India, PTI New Delhi, July 03, 2014
The National Consumer Disputes Redressal Commission (NCDRC) has asked a Chandigarh-based doctor to pay Rs 70 lakh to a young man (then a teenager) whose left leg had to be amputated due to the doctor's casual manner of treatment for his fractured leg in July 2003.
The victim Abhishek Ahluwalia's mother Anuradha Ahluwalia had approached the apex consumer commission against the order passed by Chandigarh Consumer Disputes Redressal Commission, which had rejected her plea for compensation.
"It is the respondent no. 1 (Dr Saluja) alone who is to be blamed for such an unfortunate incident.
http://www.hindustantimes.com/punjab/chandigarh/chandigarh-doc-asked-to-pay-rs-70-lakh-for-negligent-treatment/article1-1236451.aspx
Raj Kumar Makkad
(Expert) 04 July 2014
I have never denied the force of law rather have told only about the practical aspects of the consumer forum. The latest judgment told by Doab is no doubt is an ideal judgment these days.
V R SHROFF
(Expert) 04 July 2014
TOO LONG A QUERY..
V.T.Venkataram
(Expert) 04 July 2014
I endorse the practical view expressed by Expert Mr.Raj kumar makkad
Kumar Doab
(Expert) 05 July 2014
Thanks a lot Mr. Makkad for the endorsement.
Expert Mr. Raj Kumar Makkad, Mr.V.T.Venkataram has enriched the forum with their advice and the view taken by court is elaborated by them.
Everyone shall gain from this illustrated thread.
The author must have gained enough confidence from this thread and should approach a lawyer well versed with such matters without any hesitation.
V.T.Venkataram
(Expert) 05 July 2014
Thank you very much for the compliments Mr. Kumar Doab
Kumar Doab
(Expert) 05 July 2014
You are welcome, Mr. V.T.Venkataram.
Kumar Doab
(Expert) 05 July 2014
Author Mr. Pradeep Sharma,
You are concerned about completing 2 years.
Approach a lawyer well versed with such matters with confidence and all docs on record.
If possible discuss with a doctor well known to you and let your doctor download the inputs to your lawyer.
Wish you all the very best.
Kumar Doab
(Expert) 07 July 2014
Mr. Raj Kumar Makkad,
Sir,
You are welcome.
T. Kalaiselvan, Advocate
(Expert) 07 July 2014
Agree with the opinion of Mr. Kumar Doab, that since 2 years limitation is about to be over now, better to contact a lawyer fully conversant in consumer laws and proceed as per his advise.
PRADEEP SHARMA
(Querist) 13 December 2015
I thank all the Learned Experts from the core of my heart for their advice regarding this case.
The case was put up at District level at Consumer court and the medical board gave decision in favour of doctor as he was a visiting doctor at Civil Hospital. But my advocate got it dismissed as there was no Neuro physician or Surgeon at civil Hospital.
New Medical board has been constituted by the court but here too the said doctor has completed his medical studies and had been an Asstt. Professor. One of the clerks took photo of all the docs and sent to the doctor intimating him about the medical board in front of me when I was submitting my docs.
I fear that I may not be able to get justice as he is well known to all here from top to bottom.
What should be my course of action if Medical board again gives decision in the favour of the doctor even when there are all documented evidences that prove that the doctor was guilty.
Deep Regards,
Pradeep Sharma
T. Kalaiselvan, Advocate
(Expert) 13 December 2015
This is regarding further trial proceedings. Your advocate who is fully aware of the entire proceedings as well as the developments in the trial, he will be the better person to give opinion to his further question too.
However based on your contents, the documentary evidences which you have procured should be a strong supportive and substantial evidence, in my opinion.
