Thursday, March 23, 2023

Brief notes of argument in consumer case of medical negligence

 

BEFORE THE HON’BLE CONSUMER DISPUTES REDESSAL COMMISSION, WEST BENGAL, AT KRETA SURAKKA BHAWAN, PREMISES NO. 11A, MIRZA GALIB STREET, GROUND FLOOR, KOLKATA – 700087

 

Consumer Complaint No. CC/195/2013

 

In the matter of :

Jyoti Prokash Chakraborty,

                                                                                      APPELLANT

                                                                   VERSUS

The Institute of Child Health Trust, and Others,

RESPONDENTS

 

BRIEF NOTES OF ARGUMENT ON BEHALF OF THE APPLICANT;

 

Facts;

1.   19th day of April’ 2009, the petitioner with his minor child Joydipto Chakraborty, visited the Institute of Child Health Trust, at about 11 am, since the petitioner’s child suffering from cold, cough and fever. The child suffering was not to take food (light or heavy) and after having little water also, vomiting tendency raised. Earlier, in the month of December’ 2008, petitioner visited with his child for different sufferings of toilet problems and that time the child was admitted for three days, and cured. Such being cause of good belief tends the petitioner to visit on the occasion.

 

2.   The Doctors conducted X-Ray of Chest and after gone through the report, informed about the cause of “Nemonia” and suggested for admission of the child for further treatment. The child was admitted in the Institute of Child Health Trust.

 

3.   On admission of the child, the name of three visiting Doctors were given (a) Dr. Joydeep Roy, (b) Dr. (Miss) Manjuri Mitra, and (c) Dr. P.G. Khanedlwal. The treatment started with providing saline water and oxygen through mask on face of the child. At about 1 pm one doctor attended the child and prescribed some medicine, and administered the same.

 

4.   On 20th day of April’ 2009 (Monday), Saline and Oxygen continued. At about 11 am to 12 am, Dr. Joydeep Roy, and Manjuri Mitra, attending the child but did not say anything. At about 12:30 pm Dr. A.K. Basu, attended the child, and suggested to move the child to ventilation, as the child was suffering from respiratory problems. Dr. A.K. Basu also suggested that the Child was suffering from hernia problems and required permanent solutions through operation. Prescribed so many medicine and suggested for X-Ray. After visiting hours in evening, the child has been shifted to the HDU-2 Bed at 1st floor from the Bed no. S-97 at 1st floor, where saline continued but oxygen opened up. The child was then suffering from high fever and the whole part of his body became very hot, the attending nurses said that nothing to worried as the same is a cause of reaction of medicine administered to the child.

 

5.   On 21st day of April’ 2009 (Tuesday), the saline continued and oxygen again started. At about 12 pm Dr. M. Mitra and Dr. J. Roy attended the child on their visit and suggested for Harnia Operation. The petitioner asked them about the necessity of such operation, but they did not say anything. They prescribed medicine. The petitioner meet with Dr. Apurba Ghosh, Director of the said Institution, who said there is no Harnia case, the operation is not required. The child case is of a medicine case and only medicine can cure.

 

6.   At about 1:30 pm Dr. A.K. Basu attended the child and shouting that “I don’t have any time, and asking your petitioner’s wife to agree for operation by tomorrow, and suggested her wife to consult with your husband immediately” . on such provocation wife of the petitioner assailed into depression as the said dialogue and throwing in unexpected manners were not desirable. The staff nurses said about the said Doctor as renowned pediatric Doctor in the City.

 

7.   In visiting hours while the petitioner came into knowledge of such incident from his wife, who was with the child, decided to consult with the other Doctors about the operation, which desired by the said Doctor A.K. Basu. At about 7 pm the junior Doctors forcibly taken the signature of the petitioner without explaining the content and purports of those printed forms and the necessity of such operation, and given the prescription being lists of medicine, and requisition for blood in pursuance to conduct operation.

 

8.   The child condition was very poor his fever was very high, the saline water and oxygen continued with the administration of medicines, prescribed. At about 9:30 pm one Dr. Birendra Rai attended the child and prescribed medicine.

 

9.   On 22nd day of April’ 2009 (Wednesday), early in the morning one Junior Dr. Sarsang Pradip attended the child and give medicine. The child fever was 102’ degree, the whole body was very hot. The nurses were coming and going and attending little bit to the child. The care by the staff nurses were not good. The petitioner’s wife Priyanka Chakraborty, was much worried about the child only due to conduct of the staff nurses and the Doctors at the said Institute.

 

10.                At about 12:30 pm, the staff nurses taken the child for the operation, while he was suffering from high fever, and more particularly, while the petitioner’s wife did not consent for such operation of the child. Forcible child was taken to the operation room.

 

11.                 While the operation room was closed, the petitioner and his wife standing outside the said operation room. Assuming well that operation is going on; But after an hour Dr. A.K.Basu leave the O.T. and did not say anything to the petitioner. After 15 minutes the O.T. door opened and the ward boy has taken the child in his lap rushed here and there, junior doctors also under some anxiety and rushed here and there and called continuously to someone. After 20 minutes Dr. A.K. Basu came again in O.T. and child was taken in O.T. again. The Petitioner astonished to saw the happenings during the operation of the child.

 

12.                After half an hour Dr. A.K. Basu came out from O.T. though the junior Doctors requested him not to leave the O.T. The Petitioner asked Dr. A.K. Basu, about their child conditions, then he said that the child conditions was not good. Thereafter a ward boy taken the child in his lap from the said O.T. room at 3rd floor at Bed no. HDU-2, without saline and oxygen, and at about 4:30 pm ventilation system given to the child.

 

13.                About 6:30 pm only the Petitioner’s wife allowed to see the child, Dr. Mitra and others were using ice on head of the child. It has been very carefully observed that the child did not move a little bit nor open his eyes for a bit, and the whole of his body under high temperature.

 

14.                It is pertinent to say that during such happenings of the operation and post operation of the child, one X-ray has been done, though nothing informed to the petitioner. The Doctors prescribed several medicine during the operation and post operation. On post operation medicine consist “morphin” injection of 2mg, and the said morphine has been administered to the child.

 

15.                On 23rd day of April’ 2009 (Thursday), early in the morning at about 5:30 am, it has been reported by the staff nurses that the ventilation was not working. One technical person asked by them, who reached at 7 am. The child conditions deteriorated and temperature of body did not low by means used by the doctors and staff nurses.

 

16.                At about 10 am Dr. Mitras and Dr. J. Roy attended the child but did not inform anything. Thereafter at about 11:45 am Dr. A.K. Basu, attended the child and informed the Petitioner that his child was not in a good condition; But he did not say the reasons as to why child’s condition was not good.

 

17.                Thereafter, the Petitioner meet with Dr. J. Roy, to discuss about the condition of the child, then the said Doctor said that he cannot say anything about the research job of Dr. A. K. Basu, on your Child.

 

18.                At about 3 pm one X-ray of the child has been done; but did not inform about to the petitioner. Thereafter in evening at about 5:30 pm Smt. Purnima, recognized herself wife of Dr. A.K. Basu, attended the child and used ice on head and chilled water on whole body. Thereafter 7:30 pm she prescribe morphine and administered. While the petitioner purchased such morphoine the medical store guys informed that this quantity of moprphine should not be administered on child of 7 years older, and asked to take the signature of the petitioner.

 

19.                On 24th April’ 2009 (Friday) at about 12 pm Dr. Basu attended the child and thereafter at about 1 pm some junior Doctors attended the child and done some nosal therapy on child and asked for X-ray of the child.

 

20.                At about 5:30 pm the wife of the DR. Basu, attended the child; but no development has been seen in the child. The child did not open his eyes, no movement, and the temperature remained, as it was.

 

21.                At about 10:30 pm (night) Dr. A.K. Basu, attended the child and asked the petitioner for the arrangement of Rs. 4,00,000/- ( Four Lakhs) only, which the petitioner arranged. Dr. Basu informed that the child conditions was very serious need to transfer to CMRI as soon as possible as the same is equipped for better treatment of the child. Thereafter at about 11:15 pm (night), the child was arranged to shift to CMRI.

 

22.                While the child was taken in the ambulance for CMRI, there was no saline, oxygen or any service to the child has been provided, which normally assume to be given in emergency. At the time of leaving the persons of the institute taken signature of the petitioner on white blank paper.

 

23.                At about 12:15 am the child reached at CMRI. Dr. Saugata Acharya attended the child and admitted in CMRI; but did not inform anything about the condition of the child.

 

24.                On 25th April’ 2009 (Saturday), the child condition has not been informed nor any information given about his treatment.

 

25.                On 26th April’ 2009 (Sunday), at visiting hour, Dr. Saugata Acharya, informed the Petitioner, that the child conditions was not good, and the same as it was.

 

26.                On 27th April’ 2009 (Monday) in morning Dr. Saugata Acharya attended the child and asked for Brain MRI. At about 2 pm in afternoon the petitioner asked for the permission of hair cutting of the child, without saying that why the hair cutting was required. However, the petitioner given consent for hair cutting of the child.

 

27.                In the evening Dr. Saugata Acharya informed the petitioner that Blood Clotting at the back side of the child has been seen; but did not answer on hair cutting and MRI report, whatsoever.

 

28.                On 28th April’ 2009 (Tuesday), Dr. Saugata Acharya, was not available. The staff burses did not say about any development in the condition of the child.

 

29.                On 29th April’ 2009 (Wednesday), at about 12:30 pm very dramatically, DR. A.K. Basu and Dr. Saugata Acharya, asked the petitioner to meet with them at conference room of the CMRI. While the Petitioner meet with them, DR. A.K. Basu shows one X-ray and informed the petitioner that the Operation of the Child was successful. Thereafter Dr. Saugata Acharya, shows the MRI report about Blood Clotting at the back side of the child , and said that the Brain Death has been occurred to the Child and for that both of them sugested for neuro treatment and referred to one Dr. Avijit Chattopadhyay, who done EEG of brain and informed that there was no hope.

 

30.                On 30th April’ 2009 (Thursday), there was no report or information.

 

31.                On 01-05-2009 (Friday), “bed shole” problems has been reported by the staff nurses, and no Doctor attended the child.

 

32.                 On 02-05-2009 (Saturday), there was no report or information.

 

33.                On 03-05-2009 (Sunday), there was no report or information.

 

34.                On 04-05-2009 (Monday), at about 9 am declared expired by CMRI and no Doctor came forward to said that how the death occurred.

 

35.                On 05-05-2009 (Tuesday), the Post Mortem of the Child’s body, assailed.

 

36.                On 6th July’ 2009, the Petitioner visited ACMOH (Medico – Legal) department at Alipore, Kolkata – 700027, and meet with Doctor Uma Prassana Ghosal (PM Doctor), who informed the following;

 

a)    Blood Clotting at the Back Side of the head;

b)   Three Sharp cutting mark (may be of the operation), at the upper side of stomach, of which no cutting mark adjoined together;

c)    One cutting spot at both the wrist;

d)   Two cutting spot at back side of the spinal cord;

e)    One cutting spot at both the leg mid joint;

 

37.                The petitioner approached the Alipore Police Station with his Complaint against Doctors and the Hospital, which has not been registered by the Police, on plea that the complaint relates to the Doctors.

 

38.                On 31-12-2009, the Learned Chief Judicial Magistrate, Alipore, South 24 Parganas, directed the O/C, Alipore Police Station for FIR and investigation, into the matter of complaint of the Petitioner. The Police registered FIR being no. 04 of 2010, dated 06-01-2010, under Section 304A, 366, 337, 338, 352, 166, 167, 168, & 34 IPC, against the two Hospitals and the Doctors.

 

39.                The 161 statement of Dr. U.P. Ghoshal, dated 17-02-2010, shows as “ Death appears to be due to lack of Oxygenation of the brain tissue causing irreversible damage to the brain – Anti Mortem in nature”, “ I could not give the final opinion as some reports are still awaiting”, “ I did not receive the following documents 1) 1st Chest Xray plate, 2) MRI Plate of the deceased made at CMRI, 3) EEG tracing – prepared at CMRI, and 4) FSL Report.”, “As the victim child was suffering from right side diaphragmatic Harnia but during P.M. Examination it has been noted that the operation was done on the Left Side”.

 

40.                The following acts and omissions of the respondents establish their negligent and breach of duty :

 

1.   The circumstances has never been described as on 20th day of April’ 2009, Dr. A.K. Basu, formed his opinion that the child of your petitioner was from “Harnia”, whereas on 19th day of April’2009, the Doctors of the Institute of Child Health Trust, admitted the child of your petitioneron forming opinion of suffering from “Neumonia”.

 

2.   The Doctors did not describe anything about “Harnia” Symptom and Diagnostics to your Petitioner.

 

3.   The Operation of the Child of your petitioner, has been done in a very forcible manner, and without consent of your petitioner.

 

4.   The Doctors were behaving in a very rude manner, to your petitioner.

 

5.   The causes has never been described by the Doctors as to why a long and prolong period has been occurred for the operation of the child of your petitioner.

 

 

6.   The Doctors causes Drug Abuses to the Child of your petitioner by prescribed MORPHINE medicine on two occasions in a big quantity.

 

7.   The Wrong Operation has been caused by the Doctors of the Institute of Child Health Trust, at the Left Side of the Child of your petitioner, while as allegedly the child of your petitioner was suffering with hernia at right side.

 

8.   The M.R.I. of Brain of the Child, has been caused by Dr. Saugata Acharya of the Calcutta Medical Research Institute, though no report has ever been communicated and or described to your petitioner.

 

9.   That at the death of the Child the followings are found on the body of the child :

 

a.    Blood clotting at the Back side of the head,

b.   Three sharp cutting mark, at the upper side of Stomach, of which no cutting mark adjoining together,

c.    One cutting spot at both the wrist of the child’s body.

d.   Two cutting spot at back side of the spinal cord,

e.    One cutting spot at both the leg mid joint.

 

10.                That on no stretch of imagination it can be said that at the hernia operation by the doctors, those cutting marks at leg, at wrist, at spinal cord, and three cutting marks at stomach can be held to be logical and required under the medical profession as to treatment and have operation of the harnia of a child of six years old.

 

11.                That the Wrong operation, without consent and in breach of duty, well established the negligent acts and omission of the Doctors and or the Respondents.

 

41.                Due to purported activities of the respondents / opposite Parties, your petitioner’s child’s life ended at the age of six years, and whereas, your petitioner was compelled to incurred expenses of Rs. 2,95,912.95 ( Rupees Two Lakhs and Ninety five thousand and Nine hundred twelve and paise ninety five ) only, in a circumstances, compelled by the respondents / opposite parties, while your petitioner is a poor man and having a poor earning, he used to borrow money from his relatives and friends to meet such big expenses.

 

42.                Your petitioner loss his only son, at instances and more particularly at the acts and omission of the Doctors / respondents / opposite parties, and frustrated as such he will not be in a position to get his son return at his hand rather your petitioner remains with love and affection of the memories of his only son.

 

43.                If the respondents took the care with due diligence his son will not left his life forever, and whereas now only and only due to the purported acts as described, your petitioner is without his only lovely child.

 

44.                Due to the purported acts of the doctors / respondents / opposite parties, your petitioner is denied to his child. that by no stretch of imagination or any story, anyone can fulfill the presence of the child of your petitioner,   and whereas it is very pathetic to lose the child of your petitioner, thus the petitioner hearts and mind always full with tears and agony

 

During the Proceeding;

 

1.           On receipt of notice, the respondent no. 1, 2, 3, 4, 5, 9, and 10, appeared, and submitted their Written Version, Evidence on Affidavit, Questionnaire, and Reply. Participate in trial of the present Consumer Proceeding.

 

2.           The Respondent no. 12, appeared in the present Consumer proceeding; But did not submit any written Version, and subsequently did not participate in trial of the present Consumer Proceeding. The Respondent no. 12, is a Post Mortem Doctor, who cause post mortem of the child.

 

3.           Regarding the Respondent no. 8, the respondent nos. 1, 2, 3, and said that the said Doctor is not associated with them. However, the Respondent no. 8, did not appear in the present consumer proceeding.

 

4.           It is pertinent to states that the stated respondents did not appear at the first threshold on receipt of the notice, therefore the notice by way of paper publication has been served by the petitioner under due direction of the Hon’ble State Commission. Therefore the services of notice has well complied on all the respondents.

 

At the First threshold ;

The Respondent no. 5, Dr. Ashok Kumar Basu, submitted an application for NOT MAINTAINABILITY OF THE CASE, which has been registered as M.A. 245 of 2015, in the present Consumer Proceeding. The Petitioner submitted his Objection to the said Not maintainability application of the case. The said application has been duly heard and the Hon’ble State Commission, was pleased to pass necessary order on 17/06/2016, in the followings;

The Learned Counsel for the Misc. Applicant has submitted that the complaint case is barred by limitation.  It is contended that the baby died on 04/05/09 and the complaint case was filed on 19/08/13.  It is submitted that the Complainant filed criminal case against the doctors and the said case ended in FRT.  It is contended that there is no law that after the end of the criminal trial the complaint case has to be filed.  It is submitted that no petition for condonation of delay was filed by the Complainant and, as such, the complaint case is liable to be dismissed. 

 

The Learned Counsel for the Complainant has submitted that the baby died on 04/05/09, but prior to 16/10/12 the Complainant was unaware of the negligence of the OPs.  It is contended that from the statement of Dr. U.P. Ghosal, the Autopsy Surgeon, the Complainant came to learn that the Operating Surgeon committed mistake in surgery.  It is submitted that without consent of the Complainant party the child was operated upon and against the submission of FRT the Ld. C.J.M. has been pleased to direct further investigation.  It is contended that from the papers received from the criminal case on submission of FRT, the Complainant came to know about the negligence on the part of the OPs.

We have heard the submission made by both sides and perused the papers on record.  On the point of limitation it has been stated in the objection against the Miscellaneous Application that on 16/10/12 the Complainant received the final report, copy of the P.M. report, the statement u/s 161 Cr.P.C. of Dr. U.P. Ghosal and expert opinion from which the Complainant came to know that there was negligence on the part of the OPs.  On the other hand, the contention of the Misc. Applicant is that the cause of action arose from the date of death of the baby, that is, on 04/05/09 and the complaint was filed after the expiry of two years from that date.  In view of the specific pleading of the Complainant that from the papers of the criminal case supplied to him after the submission of FRT on 16/10/12 he came to learn about the negligence on the part of OPs, we are of the considered view that the cause of action arose from 16/10/12 and the complaint has been filed within the period of limitation.  The contention of the Learned Counsel for the Misc. Applicant is, therefore, not acceptable. 

          MA 245 of 2015 is dismissed.  Fix 29/06/16 for filing W.V.

 

Written Version of the Respondents assessed at a glance;

{ Annexed } – Page number – 17 to 24

 

Questionnaire and Reply of the Respondents; Relevant one;

{ Annexed }  - Page number – 25 to 45

 

 

 

 

Judicial References ;

 

(1)  The Apex Court defined “informed Consent” in the context of doctor patient relationship, in a verdict delivered on the Samir Kohli – Versus – Dr. Prabha Manchanda case, it ruled that a doctor had to secure the consent of a patient before commencing a treatment, including surgery. Whereas your petitioner ward is minor and not even upto the age of 12 years, as per Section 90 of the Indian Penal Code to obtain consent from the ward of your petitioner, as such your petitioner can only give consent, which he did not given for the said purported operation of his ward, and the doctors of the said institution did not expressed and informed in details about the necessity of the operation of your petitioner ward. The said operation has been conducted forcibly and without the consent of your petitioner.

 

(2)  In the case of Dr. Laxman Balkrishna Joshi Vs. Dr. Trimbark Babu Godbole and Anr., AIR 1969 SC 128 and A.S. Mittal Vs. State of U.P., A.I.R. 1989 SC 1570, it was laid down that when a doctor is consulted by a patient, the doctor owes to his patient certain duties which are : (a) duty of care in deciding whether to undertake the case, (b) duty of care in deciding what treatment to give, and (c) duty of care in the administration of that treatment. A breach of any of the above duties may give a cause of action for negligence and the patient may on that basis recover damages from his doctors.

 

(3)  In the case of the Indian Medical Association Vs. V.P. Shanta and Ors. III ( 1995 ) CPJ 1 ( SC ), the Supreme Court finally decided on the issue of coverage of medical profession within the ambit of the Consumer Protection Act’ 1986, so that all ambiguity on the subject was cleared.

 

(4)  The National Commission in the case of Dr. Ravishankar Vs. Jery K. Thomas and Anr. II ( 2006 ) CPJ 138 ( NC ), held that based on the facts and circumstances, the obvious deduction is that the appellant doctor is responsible for leaving behind ribbon guaze resulting in complication. Medical Negligence was proved, and such cases is very similar to the present case matter, as such this present cases is related to the facts and circumstances of Wrong Operation and also without the consent of your petitioner, and thus this is the case well established medical negligence.

 

(5)  In the case of Prashanth S. Dhakanka Vs. Nizam Institute of Medical Science and Ors. ( 1999 ) CPJ 43 ( NC ), the National Commission deliberated on important issue such as what constitute medical negligence, the duty of a hospital to engage a specialist when a specialist is available, vicarious liability of a hospital for omission and commissions of doctors and staff, and compensation for mental and physical torture.

 

(6)  The facts and circumstances as described herein above are well settled medical negligence of the Doctors and hospitals, and in such event as described in the Indian Medical Association Vs. V.P. Shanta and Ors. III ( 1995 ) CPJ 1 ( SC ), no expert opinion is required, as such it is well seen that the wrong operation has been done by the Doctors at the Left side of the child, while he was suffering with the Right side Harnia, problems, as alleged by the Doctors.

 

(7)  In the case of Bolam Vs. Frien Hospital Management Committee, ( 1957 ) 2 All ER 118, McNair, J. summed up the law as the following : “ the test is the standard of the ordinary skilled man exercising and professing to have that special skill. A man need not possess the highest expert skill : It is well established law that it is sufficient if he exercise the ordinary skill of an ordinary competent man exercising that particular art. In the case of a medical man, negligence means failure to act in accordance with the standards of reasonably competent medical men at the time. There may be one or more perfectly proper standards, and if he confirms with one of these proper standards, then he is not negligent”, and whereas in the present facts and circumstances, the acts and omissions well constitute the negligent act of the doctors.

 

(8)  In the case of the State of Haryana and Ors. Vs. Smt. Santra, I ( 2000 ) CPJ 53 (SC ) ( by S. Saghir Ahmed and D.P. Wadhwa, J.J. ), the Supreme Court hold as “ Claim for damages was based on the principle that if a person has committed civil wrong, he must pay compensation by way of damages to the person wronged”.

 

(9)  In the All India Medical Council Cases ( Supra ), it has been held by the Hon’ble Supreme Court of India, as some of the negligent acts as in the present application, submitted by the petitioner before the Hon’ble Commission, does not require any expert opinion, as such the negligent acts are at the prima facie established and clearly understand.

 

Conclusion;

 

The Petitioner is well entitled to get relief/s in terms of his prayer, in the given facts and circumstances, in the interest of administration of Justice.

 

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Total number of Pages 45 (Forty Five).

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