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Judgment
THE complainant No. 1-Shri Jaspal Singh and Amandeep Singh (minor) son of Shri Jaspal Singh, complainant No. 2 of Ludhiana District filed this complaint on 24.2.1997 alleging that on 30.3.1996 wife of complainant No. 1-Smt. Harjit Kaur suffered burn injuries accidentally from a stove. At the time of accident, her injury was to the extent of 50%. She died on 2.7.1997 due to alleged negligence on the part of the Doctors/staff at P.G.I., Chandigarh for mis-matching of blood.
ON 30.3.1996, at about 6.15 p.m., wife of complainant No. 1 Harjit Kaur received burn injuries from a stove at Samrala. At the time of accident, her injuries were to the extent of 50%. ON the same day, Smt. Harjit Kaur was admitted in Daya Nand Medical College, Ludhiana (DMC) and there was recovery. She remained in the D.M.C. Ludhiana upto 19.4.1996. The complainant incurred an expenditure of more than Rs. 50,000/- there upto 19.4.1996. She was later on shifted to PGI, Chandigargh on 19.4.1996 itself because the treatment was very costly at Ludhiana in a private hospital. Here in PGI she died and a claim of Rs. 9.00 lacs has been made in the complaint. Respondent No. 1, i.e. Post Graduate Institute (PGI), Chandigarh did not choose to file separate reply and adopted the reply filed by respondent No. 2, i.e. Dr. Varun. In his reply, respondent No. 2 has raised certain preliminary objections regarding the maintainability of the complaint in view of the complicated questions of fact which required elaborate evidence to sift truth out of the records and the records require testimony of several witnesses. It has also been objected that since the cause of death of the patient is septicemia and not mis-matched blood transfusion, the complaint is misconceived. On merits, it has been averred that as per DMC record, exact details of the mishap have not been mentioned. Respondent No. 2 has averred in his reply that he has not transfused wrong blood to the complainant''s wife which alleged to have caused her death. He has also averred that he neither called for bottle of blood nor did he give blood transfusion. Junior Resident had been giving the blood transfusion and proper grouping and cross matching is done by the blood bank and not by transfusing doctor. The Senior Resident, who remains on duty for 24 hours is also unaware of any such thing. The blood stain urine was never shown to respondent No. 2. It has been further stated that the costly medicines were provided by the PGI and her file was made "Poor free" only because Jaspal Singh was unable to purchase medicines. 5. At the PGI, there was an improvement in her recovery, but respondent No. 2, Dr. Varun, Senior Resident, Department of Plastic Surgery, PGI told the complainant that the blood is not sufficient and she requires the surgery of one leg. She, therefore, required one bottle of blood. The blood group of Mrs. Harjit Kaur was A+. But the patient was transfused B+ group blood on 20.5.1996 in the afternoon. At that time the blood of the patient was 11 Hb and within two minutes of the transfusion of blood, she developed chest pain. Respondent No. 2 was immediately consulted who stopped the blood transfusion. The blood transfusion was re-started after about a few minutes. On the night 20th May, 1996, the urine of the patient was redish like blood and it was shown to the Nurse on duty. On the next day, respondent No. 2 was also informed of the redish urine but he did not give any medicine. On 21.5.1996, respondent No. 2 again called for one one bottle B+ group blood and transfused the same in the patient. She again discharged the redish urine which was again shown to respondent No. 2 on 21.5.1996. The condition of Mrs. Harjit Kaur, patient became more serious. Her blood fell down to 5 Hb and she became very weak. The other doctors opined that it was due to wrong transfusion of blood that the kidney has been damaged. The complainant has alleged that the patient was of A+ blood group, whereas she was transfused B+. The complainant gave a written complaint against the wrong transfusion of the blood to the Head of the Department of Plastic Surgery who marked the enquiry to another Senior Doctor and wrong transfusion of blood to the patient was found. The condition of the patient became very serious. Her urea was 94 mg. whereas permissible limit is 40 mg. percentage as per the report of the urine dated 30.5.1996 (Annexure C/5). The condition of the patient started deteriorating day by day and the complainant spent more than Rs. 10,000/- on the costly medicines which were prescribed by the Doctors. The Doctors again asked the complainant to determine the blood group of the patient from outside and the sample was, therefore, sent by the Doctors to the Blood Disease Hospital, Opposite Cricket Pavilion, Sector 16, Chandigarh and it was found that the blood group of Harjit Kaur was A+ (C/6). The condition of Harjit Kaur deteriorated and she ultimately died on 1.7.1996 at 7.00 a.m. Her Death Summary was prepared by Senior Resident of Plastic Surgery Department, in which it was mentioned that due to the wrong transfusion of blood (from a different blood group) she expired (Annexure C/7). 6. The death summary also clearly mentioned that she recovered from blood transfusion. During the cross-examination of respondent No. 2, Dr. Varun Kulshrestha now practising at 1201-C, Sector 32, Chandigarh, it has been brought out by him that the correct blood group A+ was transfused to the patient on 15.5.1996. However, in his further cross-examination he was admitted that on the intervening night of 20/21.5.1996, though he was not on duty, but B+ blood was transfused to the patient. He further deposed that the mis-matched blood affects the kidney of a patient and in this case blood urea reached 100 gm. which was brought down to normal on 12.6.1996. The relevant portion from the cross-examination of Dr. Varun Kulshrestha is reproduced below : "...It is however, correct that B+ blood was transfused to this patient. On the intervening night of 20/21.5.1996 I was not on duty nor I was requisitioned. In the morning also urine contained red blood was not shown to me. It is correct that on 21.5.1996 also B+ blood was transfused to this patient. I have seen page 11 of the record of PGI and it is incorrect to suggest that blood O II was recorded having been transfused whereas B+ blood was transfused. The proceedings ''A'' - ''A'' of course bears my signatures."
It would also be relevant to reproduce the Death Summary (Annexure C/7) for the proper adjudication of this case which reads as under : "Alleged H/o accidental burns while making tea on stove on 30.3.1996 at about 6.15 p.m. She was treated at Civil Hospital, Samrala and DMC, Ludhiana and finally came to PGI on 19.4.1996. At the time of admission she was taking orally and passing urine. She sustained 50% TBSA III burns involving both upper limbs, part of trunk and most of both lower limbs. 75% of eschar removed by 1.5.1996 and all eschar removed by 8.6.1996. Had fever from 21.4.1996. Blood culture was sterile. Wound swab 4.5.1996 showed pseudomonan and injection Sefazoltine injection Imikaline were given. A+ve blood transfused on 14.5.1996. Mis-matched B+ve given on 20.5.1996 and 21.5.1996. Two units of packed O+ve given on 29.5.1996 for anaemia. Liver function was slightly deranged. One unit of O+ve packed cells given on 2.6.1996. Nephrology was harmotology consultation taken. Recovered from mis-matched transfusion....6/96 blood culture shows staff auereus but no picture of septicaemia. Subsequent culture on 15.6.1996-MBC and 18.6.1996 sterile. Fungal serology negative. Since 28.6.1996 she started deteriorating and died at 7.30 a.m. on 1.7.1996 inspite of supportive measures. (Emphasis supplied) Sd/- Sr. Resident 1.7.1996."
After hearing the learned Counsel for the parties and perusing the relevant records with their assistance including evidence of the parties and other documents on record, this Commission has come to the conclusion that there has been serious deficiency and negligence on the part of the PGI and its attending doctor(s)/staff for transfusing wrong blood group to the patient which caused death of the wife of complainant No. 1. Mis-matching of blood has been confirmed by the Senior Resident in the Death Summary also (Annexure C/7). Once the patient is brought to the PGI or any other Institute of Health Care, the background/history, if any, for example that the patient was maltreated by the husband, does not absolve the hospital from its professional obligations. The Post Graduate Institute, (PGI), Chandigarh is, therefore, liable to pay a sum of Rs. 2.00 lacs to the complainants out of which 3/4th shall be put in the fixed deposit in favour of minor Amandeep Singh son of Jaspal Singh, complainant No. 2, and th be paid to the complainant No. 1 (husband) a Government employee. The PGI shall also pay costs of Rs. 5,000/- to the complainants. It is, however, upto the PGI Authorities to recover this amount from the erring doctor(s)/staff. Complaint allowed.