Routh Raheswari vs Uppalapati Venugopala Rao

THE present revision petition has been filed by one Routh Raheswari (herein after referred to as Petitioner), who was aggrieved by the order of the Andhra Pradesh State Consumer Disputes Redressal Commission, Hyderabad, which had dismissed the appeal alleging medical negligence on the part of Dr U Venugopala Rao (hereinafter referred to as Respondent).

THE Petitioner who was the original complainant before the District Forum has stated that she had been suffering from stomach pain for the past one year and she used to go to the Respondents Nursing Home for treatment. In March 2003, she was advised that she required a hysterectomy operation to cure the pain. After charging Rs.3000/- from the Petitioner she was admitted to the Respondents Nursing Home where without proper diagnosis, clinical examination and procedure she underwent surgery on 21.03.2003, which is a major operation. On 25.03.2003 she developed vaginal and lung infection. When her condition deteriorated, a day later she was shifted to the Nagarjuna Hospital which being a multi-specialty hospital had better medical facilities. THE Respondent assured that he would bear all the expenses of her treatment as the present complication arose due to his fault. THE Respondent however, did not come forward for her treatment, for which the Petitioner was charged Rs.30,000/-. Once the Petitioners condition stabilized she was advised to get readmitted in the Respondents Nursing Home for recuperation, but the Respondent refused to re-admit her and therefore, she took admission in another hospital. THE Petitioner has further stated that because of medical negligence on the part of the Respondent, she has been suffering both financially and physically and she still continues to have serious physical disabilities. In view of this, the Petitioner approached the Additional District and Sessions Judge who referred her complaint to the District Forum, where she sought compensation of Rs.1,50,000/-. The Respondent denied the above allegations and stated that it was only after proper diagnosis and clinical investigation including blood and urine test that the hysterectomy was performed. The operation theatre was properly equipped and the operation was conducted by qualified doctors including an anesthesist. Despite best possible medical care the Petitioner did develop vaginal and lung infection and the Respondent personally took her and admitted her to Nagarjuna multi-specialty Hospital for treatment. Respondent also got her 30% concession on the charges from that Hospital. It is incorrect to state that the Respondent refused to readmit her in his Nursing Home. In fact, the Petitioner never came back to the Respondent after her discharge from the Multi-specialty hospital.

The District Forum after hearing both the parties gave a divided ruling. The President and one Member of the District Forum held that there is deficiency in service on the part of the Respondent and directed the Respondent to pay Rs.1.00 lakh including medical expenses with interest @ 9% from the date of complaint till realization together with cost of Rs.1000/- The lady Member of the District Forum gave a dissenting order holding that there was no deficiency in service and dismissed the complaint.

AGGRIEVED by the majority order of the District Forum, the Petitioner filed an appeal before the State Commission. The State Commission after considering the evidence on record, notably the evidence of Dr Madhusudhana Rao who was the medical expert in the multi-specialty Nagarjuna hospital concluded that there was no evidence produced to suggest medical negligence on the part of the Respondent. The relevant part of the State Commissions order reads as follows: The Respondent has not proved by tangible evidence that there is deficiency of service on the part of the appellant in conducting the operation. He had concluded all investigations prior to the surgery and also post operatively when suspected infection the appellant has treated the Respondent with anti-biotic and when chest infection was noticed, he shifted the Respondent to Nagarjuna Hospital, Vijayawada which had better facilities and accompanied the Respondent taking reasonable skill and care in the absence of any expert evidence on behalf of the Respondent as to what exactly is the defect in the operation conducted by the appellant, we cannot come to the conclusion that there is negligence or deficiency in service against the appellant. In 1 (1998) CPJ 110 (NC) in Sethuram Subrahmanyam vs Triveni Nursing Home the National Commission held that the complainant has not given any expert evidence in support of the allegation. For establishing medical negligence on the part of the doctor, there must be sufficient evidence that the doctor or the Hospital has not taken reasonable care while treating the patient. Therefore, we are of the opinion that the appellant doctor followed the standard methods and exercised professional skills.

AGGRIEVED by the order of the State Commission, the Petitioner has filed the present revision petition. Learned Counsel for both parties made oral submissions. Learned Counsel for the Petitioner has reiterated that it was because of lack of proper diagnosis and clinical care that the Petitioner developed infections and this fact was rightly appreciated by the District Forum. The Respondent even after the operation was callous and refused to bear the cost of the treatment at the multi-specialty hospital after promising to do so. Had due care been taken both before and after the surgery by the Respondent and the Nursing Home, Petitioner would not have required referral to another hospital. In fact, the Medical consultant at that hospital has confirmed that she was suffering from infections including lung infection. This clearly proves medical negligence on the part of Respondent. The learned Counsel for the Respondent drew our attention to the affidavit of Dr Madhusudhana Rao the medical consultant of the Nagarjuna Hospital (who treated the Petitioner on her referral to that Hospital) wherein he has clearly stated that as per the case sheet which he saw at the time of admission of the Petitioner, necessary precautions were taken before the surgery and the hysterectomy was done without any unwanted incidence. The patient was found to have round worms infestation and it is possible that this was the cause of her lung infection. The medical Consultant has stated that post operatively 5% to 10% of patients do develop some complications even in the best hospitals in the world and out of these nearly half of them are due to infections and that infections can occur even without the fault or negligence on the part of the doctor. He has further stated in his affidavit that he gave the Petitioner concession on fees on the request of the Respondent and that the Respondent had accompanied the Petitioner to the hospital and monitored all her vital functions through oxygen mask, pulse-oximeter en-route. Even during her stay in the hospital the Respondent had been verifying the condition and well being of the Petitioner over phone. In view of these facts, the learned Counsel for the Respondent has stated that this is conclusive evidence that there was no medical negligence or dereliction of duty/ deficiency of service on the part of the Respondent.

WE have heard the learned Counsel for both the parties at length and have carefully considered the relevant evidence on record. It is clear from the evidence produced before the District Forum that there was no deficiency in the surgery conducted in the Respondents Nursing Home. It was done by qualified doctors and this has been confirmed by the Medical Consultant Dr Madhusudhana Rao of the Nagarjuna multi-specialty Hospital, where the patient was referred when her condition deteriorated. The medical consultant in his affidavit has opined that neither the vaginal or lung infection was the result of hysterectomy; and the latter infection was perhaps caused because the Petitioner had round worm infestation. He has further stated in his affidavit that as per the case history of the Petitioner seen by him, all precautions were taken before the Surgery by the Respondent including necessary anesthesia, blood and urine check-up. The Petitioner did not require any re-surgery and she was cured in a matter of few days by conservative treatment i.e. through medicines. The Medical Consultant has also opined that post operative even in the best hospitals, a patient can get infection. In fact 5-10% patient can develop complications and this does not necessarily imply any fault or negligence on the part of the doctor. In the instant case, there is thus independent evidence by a medical expert to corroborate the Respondents contention that there was no lack of skill, sincerity or diligence on his part in dealing with the Petitioner. A doctor can be held guilty of medical negligence only, if he fails to attend to a patient promptly and professionally and if the patient is treated by doctors who do not have the required skill, knowledge and expertise. This was clearly not so in the instant case and the Petitioner had also not produced any credible evidence to prove the allegations of medical negligence on the part of the Respondent.

TAKING into consideration the above facts we, see no reason to interfere with the well-reasoned order of the State Commission which rightly dismissed the Appeal. The majority order of the District Forum is set aside and the order of the State Commission is upheld with no order as to cost.