National Consumer Disputes Redressal Commission: While considering the appeals arising from order passed by State Consumer Disputes Redressal Commission (‘SCDRC’), Kerala holding the opposite parties negligent to pay compensation of Rs. 7 lakhs, Kantikar (Presiding Member) reversed the decision and held that negligence could not be attributed to the hospital and doctors while dismissing the instant appeals and complaint before SCDRC.
A patient aged 37 years underwent a laparoscopic sterilization operation at Deen Hospital on 25-09-2006. Regular course of explanation was done by the medical staff regarding modality of sterilization process, its pros and cons, chances of failure, risk of anesthesia as well. After the surgery, the patient was stable and oxygen saturation was satisfactory but after few minutes the patient developed breathlessness. She showed signs of pulmonary edema (lung congestion). Some required steroids were given to her in repeated intervals. Initially, her condition was stable, but oxygen levels remained between 75% to 80%. Therefore, the patient was transferred to one Hospital and then another, where she was pronounced dead. The SCDRC held the hospital and Doctors liable to jointly pay compensation of Rs 7 lakhs for medical negligence.
The Commission considered the question of whether the death was due to spinal anesthesia (‘SA’), if so administered.
The Commission pointed that the track of the injection mark was found entering the spinal cord in the Postmortem report ,the possibility of SA was ruled out as the injection mark itself is not conclusive as it can be done for diagnostic or therapeutic purpose.
The Commission relied on the PM report which stated that death was caused due to the combined effect of brain hypoxia (reduction in oxygen supply to the brain tissue) and Adult Respiratory Distress Syndrome (‘ARDS’) (low oxygen in blood leading to lung injury). It noted that these were rare complications which could occur after the General Anesthesia (‘GA’) and once the patient was under GA there was no necessity to administer SA.
The Commission also referred to the text book named Robbins Textbook “Pathologic Basis of Disease” to support its findings regarding respiratory distress in the instant matter. It also went through ‘Postmortem technique hand book’ for understanding the mark above natal cleft.
The Commission said that puncture over the Dura (outer skin) could not be commented because the Spinal cord was retrieved by cutting the vertebral column and in such a scenario it was not possible to appreciate the pin-point puncture mark. Therefore, the findings of the PM report were not convincing to prove administration of SA.
The Commission clarified the settled notion that “every death of a patient cannot, on the face of it, be considered as death due to medical negligence, unless there is material on record to suggest to that effect”. The Commission gave weightage to the said statement through Jacob Mathew v. State of Punjab, (2005) 6 SCC 1 and Bombay Hospital & Medical Research Centre v. Asha Jaiswal, 2021 SCC OnLine SC 1149.
The Commission said that in the instant case, the doctors had effectively managed the complications in the operation theatre and timely referred the patient to the other Hospital for ventilator support.
The Commission held the findings in PM erroneous and the whole approach of SCDRC unsustainable in law. Thus, the Commission dismissed the instant appeal and complaint filed before the SCDRC.
Even after coming clean in the instant case of medical negligence, the hospital on humanitarian grounds and on its own volition decided to pay the amount of Rs. 7 lakhs and which has already been deposited with SCDRC to the complainants. The Commission clarified that such an instance shall not be construed as a precedent.
[Philips Thomas v. Deen Hospital, 2023 SCC OnLine NCDRC 194, Order Dated: 6-06-2023]
Advocates who appeared in this case :
For the Petitioner: Advocate Saju Jacob, Advocate Arush Gangal, Advocate Tessy Varghese;
For the Respondents: Advocate Raghenth Basant, Advocate Ajay Krishna.