PASUMARTHY NARAYANA vs APOLLO HOSPITAL ENTERPRISES LTD.

THE complainant Shri Pasumarthy Narayana filed this original complaint alleging deficiency in service and medical negligence on the part of the opposite parties. THE relevant facts in brief are as follows:

THE son of the complainant, Anil Kumar, a youth aged 18 studying B.E. (Electronics) at Visakhapatnam approached respondent No. 1, the Apollo Cancer Hospital at Chennai on 30.9.1996 with complaints of Gingival swelling with bleeding for about three months followed by low grade fever for about a month along with general weakness, with history of rashes all over the body. He was admitted on the same day and the admission card, in addition to mentioning the above facts about his illness, also mentioned that he was investigated locally and sent to the Apollo Hospital for further management. The illness is diagnosed as Acute Myeloid Leukemia (M4) in common language blood cancer. In the hospital he was given two phases chemotherapy treatment and after being treated for 60 days, he was discharged on 28.11.1996. In the discharge certificate, there is a mention that he was advised to come after 15 days for Bone Marrow Transplantation (BMT). The complainant states that after discharge Anil Kumar came to Visakhapatnam and attended to his day-to-day work. However, the boy again fell ill and approached the Apollo Cancer Hospital once again on 3.6.1997 and was admitted as an in-patient. This time he was treated in the hospital for 46 days but ultimately he expired on 20.7.1997.

The complainant''s main case is that at the time of admission of Anil Kumar in the hospital in the first instance on 30.9.1996 the opposite parties did not disclose the details of treatment necessary for complete recovery from blood cancer. It is alleged that the opposite parties failed to explain that the treatment would be complete only after Bone Marrow Transplantation. Even though the opposite parties at the time of discharge advised the patient to come after 15 days for BMT, they failed to stress and disclose the importance of BMT for survival of the patient.

IN addition to his main allegation, they have also added other grievances to the effect that the timing of starting chemotherapy and the quantum of dose of chemotherapy were not proper and no proper care was taken as is evident from the fact that he was not put in the INtensive Care Unit. They also alleged that the aim of the doctors was only to extract money and that in all he paid Rs. 5,51,557/-. As a relief they claimed a total amount of Rs. 33,47,612/- which includes return of the money paid with interest, compensation for loss of life, compensation for mental agony and torture, expenses towards conveyance, lodging and boarding and cost for litigation. The case of the respondents is that the boy was suffering from advanced stage of blood cancer and that after two phases of chemotherapy given during the first admission, there was remission in the cancer as revealed by the pathological tests. The patient was advised to come within 15 days for Bone Marrow Transplantation and the matter was also discussed with the father of the patient and that the father however neglected the whole matter and brought the child only after six months after there was serious relapse of the cancer. Their argument is that there was total negligence on the part of the father that the treatment given by them is according to the standard practice that every possible care has been taken, but unfortunately, the boy could not be saved because there was a clear delay of six months in getting medical treatment.

WE have gone through the case record very carefully. The crucial issue for decision is whether the doctors properly advised the patient to come back for further treatment at the proper time. The hospital discharge certificate dated 28.11.1996 which is on record reads as follows: "Since patient needs BMT, the necessity of BMT was discussed with father and HLA typing was sent (report awaited) and which patient is discharged with the advice to come after 2 weeks prepared for further management till then continue. Tab. Folic acid 1 tab. twice daily. Tab. Becosules 1 cap. once daily. Tab. Dexorange 1 cap. once daily. Rantac 1 tab. twice daily. Sd/- Dr. N. Ramesh ConsultantMedical Oncologist" The above would indicate the following: (1) The patient needs Bone Marrow Transplantation; (2) The necessity of BMT was discussed with the father; (3) The patient was discharged with the advice to come after two weeks; (4) He was advised to come prepared for further management; (5) Some pathological reports, for which samples were sent, were still awaited; (6) Certain treatments were advised to continue.

The authenticity of the discharge certificate has not been challenged. In addition to the above, the respondents have brought on record the fact that at the time of discharge on 28.11.1996, Dr. Ramesh had given a quotation (cost estimate) for BMT to enable the complainant to seek necessary sanction from his employer, the State Bank of India. The boy''s father (complainant) is a fairly senior officer with the SBI and is well educated. He cannot say that he did not understand the implications of blood cancer or the contents of the discharge certificate or about the need to continue the treatment properly. In spite of such clear-cut instructions, the boy was brought back to the respondent''s Hospital on 3.6.1997 i.e., exactly after 6 months with complaints of fever for two weeks, vomiting, and rashes all over the body and with enlarged liver and spleen. He was immediately admitted and Bone Marrow treatment was done the very next day which confined him to be relapse. The respondents had brought on record that they started salvage chemotherapy on the next day i.e., 5.6.1997 and continued with proper medical treatment for the remaining days. As his immunity was falling he was put in the Immune Intensive Care Unit. However, in spit of the best treatment given, the patient died since timely medical aid was not sought. For chemotherapy treatment it has been pointed out that it was planned according to the standard practice after taking into consideration the height, weight, body surface, etc. It is pointed out that induction of chemotherapy varies from patient to patient and there cannot be any specific time-frame for the same. On the contrary it is contended that opposite parties have taken proper care and precaution by administering chemotherapy. It is further pointed out that complainants were negligent in not bringing their son for further treatment, as advised. In our view, the aforesaid contention requires to be accepted and it will be difficult to arrive at the conclusion that there was any deficiency in service on the part of opposite parties in giving treatment to the deceased.

THOUGH we have sympathy that a young boy met with an untimely death, we see no merit in the complaint. The complaint stands dismissed. Complaint dismissed.