Medical negligence 

“The Hospital was saddled with Rs. 24,56,000 as it conducted the Neurosurgery in absence of facility of CT Scan/ NCCT, but the Doctors were absolved” – Delhi State Commission.
http://cms.nic.in/ncdrcusersWeb/GetJudgement.do?method=GetJudgement&caseidin=8%2F0%2FCC%2F161%2F2003&dtofhearing=2017-04-18
B.R. Saini & ors. V/s. Lions Hospital & Research Centre & ors. Complaint No. 161/2003, decided on 18/04/2017.
Facts in short :

1. The deceased Shri. Trilok Singh, 37 years, was admitted to Lions Hospital on 19.11.2001 with the symptoms of headache for five months, occasional vomiting and urinary incontinence for ten days.

2. (Late) Dr. Braham Prakash with all test reports advised surgery of the brain & accordingly the patient was operated upon on 20.11.2001. However After the surgery, patient became drowsy and his condition deteriorated and went in Coma and finally took his last breath on 25.11.2001.

3. The Father of the deceased filed the complaint on various grounds. 

4. It was alleged that It is mandatory for a neurosurgical center conducting operation of head/meningioma to have CT Scan facility and this fact was confirmed under RTI and further the Expert Committee also poined that at the first sign of deterioration, immediate NCCT of Head should have been done for an appropriate management which was not done in the case.

5.It was further alleged that no proper informed consent was taken. As the deceased left him behind his mother, widow, daughter and son and was earning per month Rs.6000/-, considering total life expectancy of 60 years, the complainant claimed compensation to the tune of Rs., 24,56,000/-
Defense of Hospitals and Doctors.

1. The defense of the hospital was that the patient was diagnosed as suffering from right frontal meningioma & Operation was conducted by 2 consultant neurosurgeons. The cerebral oedema is a post operation complication associated with neurosurgery. Further it submitted that Hospital was not liable for the actions of a consultant doctor.

2.In response to the allegation of lack of CT Scan facility, Hospital submitted that the complainant was well aware of the same and so did the Doctors.  

3.Dr. Brahm Prakash, one of the neurosurgeons expired during the pendency of the compliant and hence he was absolved from the allegations.

4. The another Neurosurgeon Dr. Ashish Srivastava challenged the complaint as barred by law of limitation as same ought to have been within 2 years, whereas he was added as a party to the case on 24.05.2006 when the surgery was conducted on the patient on 20.11.2001. Thus the complaint against the Doctor was dismissed. No specific negligence or deficiency in service is imputed against Dr. Ashsih, observed the Commission further.
Held :

1. The Commission allowed the complaint and granted Rs.24,56,000 to the family of the deceased, considering the dependants of the deceased and his age of 37 years.

2. It rejected the arguments of the Hospital that in the year 2001, the facility of CT Scan was not common as the expert opinion clearly said that without such facility such operations should not have been conducted. 

3.The hospital cannot be allowed to wriggle out of its responsibility of entertaining only those patients for whom he had requisite equipments

4.RML Hospital New Delhi at another place while giving information under RTI Act in response to an RTI application, also opined that neurosurgical centre should have all the required facilities including CT scan for diagnosis as well as follow up.

5.It relied upon many judgments and most importantly the judgment of National Commission In the case of M. Rajavadivelin v. Janamma Hospital, 2013(2)CPJ622 (NC), wherein the hospital was held guilty of negligence when there was no ventilator facility. It was held that the doctor should not have conducted a major surgery without ensuring availability of life saving facility.
This judgment though delivered in the year 2017, the facts are of the year 2001. In 16 years, technology has become more advanced, but it may not be affordable to all the Hospitals. Technology and cost of treatment has converse ratio. Isn’t it ? Still, there are many Hospitals which don’t have all the state of the Art equipments and they refer the patient to higher center and which is the correct mode and further ti has been held in many judgments that referring a patient to higher center is not a negligence. 
Thanks and Regards
Adv. Rohit Erande

Pune.©

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