D. BEEMESWARA RAO vs SECRETARY, HYDERABAD RACE CLUB

LATE Subrahmanyeswara Rao, hereinafter called ''the deceased'' is the brother of the complainant and was working as Assistant Superintendent in Hyderabad Race Club. He approached the dispensary of the first opposite party for nail prick in toe of his right leg on 27.12.1996, whereupon the O.P.-1 administered a T.T. injection. However by 28.12.1996 he presented before the first opposite party dispensary with severe pain and swelling at the site of injection of the left hand. The doctor gave him two tablets to subside the pain, but pain did not subside and during the night of 29.12.1996 the deceased complained of breathlessness and sleeplessness and got himself admitted in the second opposite party nursing home at about 2.00 a.m. on 30.12.1996. The duty doctor prescribed some medicines and the deceased was kept in the nursing home till 6.00 p.m. on that day. At that time the resident doctor advised the patient to go to speciality hospital. Accordingly, the patient was admitted in the third opposite party super speciality hospital at 7.00 p.m. and he died at 7.45 p.m. on 31.12.1996. However the thrid opposite party issued a death summary stating that the problem was diagnosed as Cellulities DM, UGI, bleed, Uraemia with septic shock.

THE complainant and his brothers approached the opposite parties for details as to the complaint, treatment given and cause of death, but they were denied of such information. Hence the complainant has issued a legal notice to the opposite parties. THE first opposite party issued a reply stating that the widow of the deceased informed them not to furnish any information. The second opposite party refused the notice while no reply was given by the thrid opposite party. Another notice was given to the second opposite paty which also could not be served on him. This complaint is, therefore, filed claiming a sum of Rs. 15,36,000/- alleging that the opposite parties failed to correctly diagnose the disease as well as the timely treatment due to which the complainant''s brother died a premature death.

In the written version filed by the first opposite party it is denied that the death was due to injection administered by the doctor of the club. The deceased might have taken the injection on his own accord and his death was only due to ill-health and high blood pressure and blood sugar. The complaint is not maintainable without impleading the widow of the deceased. In fact she gave a letter stating that she has not complained with regard to the medical aid given by the first opposite party.

IN the written version filed by the second opposite party, it is stated that the deceased was admitted at 11.30 p.m. on 28.12.1996 and was discharged at 7.00 a.m. on 30.12.1996 since the surgeon had opined that the patient may be referred to any INstitutional Hospital as the patient was in septicemic shock. That apart the patient was a chronic diabetic and except administering medicines and I.V. fluids nothing was done on the patient and as the progrerssion was bad he was referred to an INstitutional Hospital. No notice was issued to this opposite paty. It is denied that the patient died due to administering Tetquak injection. Further the allegation that I/B Abscess was done in the hospital is not true. In the counter filed by the third opposite party, it is stated that the patient was brought to their hospital on 30.12.1996 at 9.20 p.m. in a serious condition. Even after giving emergency treatment, there was no response from the patient. The doctors have explained the condition of the patient to the complainant. In spite of resuscitation measures, the patient expired. There is no deficiency in service on their part.

THE complainant examined himself as P.W. 1 besides filing Exs. A-1 to A-4. THE second opposite party examined its Proprietor Dr. K. Goverdhan Reddy as R.W. 1 while the third opposite party examined its Medical Superintendent as R.W. 2. THEy also filed Exs. B-1 to B-5. The point, therefore, that arises for consideration is whether there is any deficiency in service on the part of the opposite parties, and if so to what relief the complainant is entitled to? The complainant''s brother late Subrahmanyeswara Rao took an injection from the dispensary run by the first opposite party being its employee for a nail prick in the toe of his right leg on 27.12.1996. He complained of severe pain with swelling at the site of injection and also pain in the left hand. But the doctor gave two tablets for pain relief, but there was no improvement. On the nigth of 29.12.1996, he complained of restlessness and sleeplessness. Therefore, he was admitted in the second opposite party nursing home. However the first opposite party denies administering any injection but states that the deceased might have taken injection on his own accord. There is no proof that any injection was administered by the first opposite party. Further the complainant also does not press his claim against the first opposite party.

HOWEVER, it is the case of the complainant that the patient was taken to the second opposite party nursing home at 2.00 a.m. on 30.12.1996. The duty doctor admitted him and administered medicines worth Rs. 73/- which were purchased from outside shop. He was inpatient in the hospital till 6.00 p.m. on 31.12.1996 at which time the resident doctor advised that the patient should be shifted to a super speciality hospital for treatment. Accordingly, the patient was shifted to thrid opposite party hospital at 7.00 p.m. and the patient died at 7.45 p.m. on 31.12.1996 in the third opposite party hospital. HOWEVER, the second opposite paty contends that the patient was brought to the nursing home at 11.30 p.m. on 29.12.1996 and discharged at 7.00 a.m. on 30.12.1996. Which version is true is the question.

IF really the patient was discharged only at 7.00 a.m. on 30.12.1996, the second opposite party has to explain the treatment given to the patient during that period. The complainant gave a notice on 20.4.1998 marked Ex. A-1. The second opposite party refused the said notice. A fresh notice was given on 29.6.1998 under Ex. A-2 to the second opposite party but the same could not be served as the second opposite party was continuously absent. Either the refusal of the notice under Ex. A-1 or the endorsement of continuous absent for service of Ex. A-2 are enough to show that the second opposite party is not interested in receiving the notice, otherwise it should have made arrangements to receive the notices on its behalf as the nursing home with sufficient staff cannot be said to be without proper authorisation to receive the letters addressed to the second opposite party. Hence we are inclined to hold that the second opposite party is aware of the contents of the notices and refused to receive them. In those notices, it is clearly stated that the patient was in the nursing home of the second opposite party till 6.00 p.m. on 30.12.1996. Further the patient was admitted in the third opposite party hospital after discharge from the second opposite party nursing home at 9.20 p.m. on 30.12.1996. The distance between the two hospitals is only 200 to 300 yards. Therefore, we are inclined to hold that the patient was under the treatment of second opposite party till 7.00 p.m. on 30.12.1996 and not till 7.00 a.m. on that day as contended by the second opposite party. The second opposite party denied having done anything except giving some medicines and injection. But the death summary issued by the third opposite party hospital clearly shows that the patient was admitted with swelling of (LT) side of neck and (LT) arm in dyspnole and shock stage. Swelling followed by rupture of an injection abscess which was 3 days old. It was further noted that the patient was admitted in Sushrutha Nursing Home where I/D of abscess was done.

In the case sheet Ex. B-5, the third opposite party recorded under the history of present illness "3 days back he had an abscess, one of his friends squeezed the swelling, after that, he developed swelling left shoulder extending to neck. Patient went to low B.P. in the morning. No. HTN or DM. Swelling of left shoulder gradually extending to neck". From this it is clear that the patient had an abscess 3 days back and his friend squeezed swelling at the site of injection, thereafter complications arose as the swelling extended to neck. The second opposite party appears to have done incision drainage for abscess. It is for the second opposite party to explain the procedure done and the condition of the patient at the time as well as the subsequent developments before the patient was referred to an institute or hospital. But the second opposite party does not come out with forth right statement of what has happened in its nursing home. The case sheet filed by them under Ex. B-3 merely shows that the patient having taken T.T. injection came for treatment complaining of pain. On examination cellulities of the left arm was the diagnosis made and the patient was found to be in septicemic shock. Merely some tablets and injections were noted. The case sheet does not show the doctor or doctors who treated the patient. Even the incision drainage done for the abscess is not noted in the case sheet. All these are defects, which clearly show deficiency in service on the part of the second opposite party. But at the same time we do not have sufficient material that it is due to the incorrect procedure or inappropriate treatment given by the second opposite party alone the patient died. In fact, the widow of the patient does not join in the complaint. Even the other brothers of the deceased also do not join as parties to the complaint. All these clearly show that they were not sure about the deficiency in service on the part of the second opposite party. As we have already held that not disclosing the treatment or the procedure done to the patient in the case sheet and also not disclosing the names of the doctors who treated the patient and the treatment given by them is deficiency in service, but as the widow and the complainant''s other brothers are not parties to the complaint, we are of the opinion that the complainant can only seek nominal damages for the said deficiency. Accordingly we award a sum of Rs. 30,000/- payable by the second opposite party with interest at 12 per cent per annum from the date of filing of the complaint till realisation.

SO far as the first opposite party is concerned as the complainant does not press his claim against it, the complaint against the O.P No. 1 is dismissed. So far as the third opposite party is concerned, no specific allegation is made against the said opposite party. The case sheet marked Ex. B-4 shows the treatment given to the patient during his stay. By the time the patient was discharged from the second opposite party nursing home, the patient was in a critical condition. The condition of the patient was explained to the complainant and his consent was taken. As the death summary Ex. A-4 issued by the thrid opposite party disclosed that the diagnosis is cellulities, DM, UGI bleed, Uraemia with septic shock and in view of this condition there was no response to the treatment given by the thrid opposite party, we cannot, therefore, find fault with this opposite party.

FOR all the above reasons, the complaint is allowed in part against the second opposite party and the second opposite party is directed to pay a sum of Rs. 30,000/- to the complainant with interest at 12 per cent per annum from the date of filing of the complaint till realisation with costs of Rs. 5,000/-. The complaint against the opposite parties 1 and 3 is dismissed. Time for payment 6 weeks. Complaint allowed in part.