Case Law: Compensation Of Rs. 5 Lakhs To Be Given By The Doctor And The Hospital Not For Negligence But For Lack Of Consent

HARISH KUMAR CHADHA V. INDRAPRASTHA APOLLO HOSPITALS & ORS. (FIRST APPEAL NO. 623/2011)

ORDER DATED: 9.04.2018

The State Consumer Disputes Redressal Commission has ordered Indraprastha Apollo Hospitals, Sarita Vihar to pay compensation of Rs. 5 lakhs to the family of a deceased patient.

The hospital has been accused of transfusing blood to the patient when the patient didn’t need it and also it was alleged by the Petitioner that the hospital authorities did the procedure only to make money.

Brief Facts:

The patient named Anupama who was suffering from diarrhoea, was taken to a family doctor for medical treatment. However, even after a treatment of four days, the patient felt no relief, hence on 22.07.2004 was admitted in Indraprastha Apollo hospital in Sarita Vihar. There she was diagnosed as a case of Systemic Lupus Erythematosus (SLE). Haemoglobin levels were found low in Anupama’s body and hence she underwent the blood transfusion. However, soon after the procedure, she got a psychosis attack.

Contention Of The Complainant:

• The complainant, Harish Kumar Chadha, Anupama’s father, contended that one of the doctor examined the patient and declared her fit for discharge but later, he was told that the patient is not fit for discharge
• Thereafter two units of blood were transfused and double dose of steroid was given, which rocked the brain of the patient. He alleged that the blood transfusion was prohibited in case of fever and chills despite that the patient was transfused blood
• On 30.07.2004, the patient was shifted to ICU and was put on a ventilator
• The Complainant alleged that the patient was not discharged only in order to grab money as the ICU charges were Rs. 70,000/- per day. On 2.08.2004, he was asked to deposit Rs. 1 lakh and when he expressed his incapacity to pay the same, the ventilator, oxygen and other facilities were withdrawn by the hospital administration
• There was contradiction in the death summary and the doctor’s report
• It was alleged that the death of the patient was concealed initially and only informed to the attendants the next day.

Defense Of The Doctor:

• The hospital and the doctors clearly denied all the allegations. They informed that the patient was admitted to Hospital on 22.07.2004 complaining of vomiting 5-6 times daily for the last 10-12 days and also had loose stools, 6-8 days a day
• The patient was having fever for the last 10 days. She disclosed the history of Reynauds Phenomenon in winter
• Towards past history, it was also informed that at the age of 13 years, she had developed skin rashes along with fever and ulceration. The same was resolved with treatment but no records were available
• Thereafter the patient had recurring episodes of skin disorder, Bullous Lesions which were associated with generalized Lymphadenopathy. These episodes occurred 2-3 times a year and resolved with treatment
• Doctors submitted that the patient was diagnosed as suffering from Systemic Lupus Erythematous with Coomb’s positive haemolytic anemia. They contended that it was a complicated disease and could not have an on spot diagnosis without referring to a stringent battery of tests. Patient had multiple Lymphnodes (cervical) of the size from 0.5 to 2 cms in neck. There was no contra indication to blood transfusion
• Deceased had presented with low haemoglobin. Her condition warranted life saving measures. Steroids needed to be given. Fever was not a contraindication in such a situation. Cause of fever could be infective or non-infective due to an auto-immune disease like SLP. In non-infective fever as in auto-immune disease, there was no contraindication to steroids. Steroids were given in a standard dose
• On 3.08.2004, she developed bradycardia followed by unrecordable pulse and BP. Cardio Pulmonary Resuscitatk was continued but eventually even after the best efforts she succumbed to her illness at 4.20 p.m. on 3.08.2004.

Court Held:

• The case was earlier presented in front of the District Forum which relied upon the Experts’ opinion dated 23.05.2006 given by Medical Council of Delhi and hence awarded Compensation of Rs. 25,000 on the ground of mental agony suffered by the family on account of “deficiency in service’ as there was communication gap between the family of the patient and the treating doctor
• The matter was then challenged before the State Commission.
• The State Commission observed that there is no document on record suggesting that either of the doctor was of the opinion that the patient was fit for discharge at any point of time during her admission
• Contradiction in the death summary and the case sheet is minor in nature as episodes of vomiting and diarrhoea are noticed in case sheets on certain occasions
• Complainant failed to indicate the case sheet showing the transfusion having been done with fever/chills
• Complainant has not placed on record any medical literature showing that the standard protocol warranted not to administer two doses of methylprednisolone
• Hence the Complainant failed to establish that the experts opinion was wrong
• However, as there is no “informed consent” or any such disclosure in black and white in the whole of the record before the Commission. There is no consent obtained while transfusing blood, or while transfusing plasma and the experts while giving opinion have held the Hospital guilty on that count
• The Court held, “compensation to the tune of Rs. 5 lac would meet the ends of justice. The appeal is accordingly partly allowed. OP-1 Hospital and the treating doctor are directed to pay an amount of Rs. 5 lakhs jointly and severally to the Complainant within a period of 30 days from today failing which it shall carry interest @ 12% per annum.”