Holding two doctors, including one cardiologist, from Kolkata-based Ramakrishna Mission Seva Pratishthan, responsible for medical negligence in treating the patient who died of cardiac arrest, the national consumer disputes redressal commission (NCDRC) directed these two doctors to pay Rs10 lakh to the family of the deceased patient.
In
an order last month, the NCDRC bench of Binoy Kumar (presiding member), says, "For not attending to the patient in such a critical state and knowing fully well that he is the only competent doctor to treat such a patient available in the hospital, it is a clear case of deficiency of service on the part of Dr M Lodha, the cardiologist. Dr Ankit Roy, a post-graduate trainee is responsible for deficiencies like not recording the medical report correctly and for making wrong entries and not informing and summoning the cardiologist within time."
"It is an unfortunate incident in which the patient died of acute myocardial infarction, which could be serious in nature and to this extent, expecting Dr Ankit Roy to have provided the required treatment with his level of knowledge and experience would be to expect much. I am constrained to consider only a token compensation to be paid by Dr Ankit Roy in the circumstances of the case," the bench says.
NCDRC directed Dr Lodha to pay Rs7 lakh and Dr Roy Rs3 lakh to the family of the deceased patient within six weeks.
The case is related to Tushar Ganguly from Kolkata, who was taken to Ramakrishna Mission Seva Pratishthan after complaining of pain in the chest and upper portion of both arms. His wife, Ratna Ganguly and her brother, in the complaint, alleged that Mr Ganguly did not receive proper treatment for nearly two hours at the hospital and died due to a heart attack in the emergency ward at Ramakrishna Mission Seva Pratishthan.
Alleging medical negligence resulting in the untimely death of Mr Ganguly, his wife and his father, Dipak Kumar Ganguly, filed a consumer complaint praying for the compensation of Rs2.77 crore with interest of 12%(pa) per annum with the cost of litigation on account of deficiency of service and medical negligence from Ramakrishna Mission Seva Pratishthan, Dr Anup Roy, Dr Lodha and Dr Ankit Roy.
In their reply, the hospital and the doctors contended that when Mr Ganguly arrived at the emergency room, the attendants were immediately informed of the likelihood of this case of heart attack and the non-availability of beds in its cardiac care unit (CCU).
The counsel says, "Mr Ganguly and the attendants were repeatedly informed about the critical situation of collapsing at any moment, with the patients of acute myocardial infarction (AMI), may arise at any moment advising to take the patient to some other hospital due (to) unavailability of the beds in CCU in their hospital. When the patient was seen collapsing, gasping for breaths, and no pulse or blood pressure (BP) was recordable, despite limited facilities in the general medicine ward, necessary steps were taken to revive the patient, but eventually, the patient expired at 10.55pm. The patient and the attendants wasted their valuable time by not going to some other hospital, even after knowing that there were no vacant CCU beds in their hospital."
The counsel for the Gangulys submitted that Dr Anup Roy and Dr Ankit Roy are doctors in the Ramakrishna Mission Seva Pratishthan hospital responsible for medical negligence and manipulation of records. "There was a delay in conducting the troponin (Trop)-T test (which detects damage to the heart muscle) and not administering the life-saving drugs when Mr Ganguly had evidently suffered a cardiac arrest and further the cardiologist was also not informed on time. This is a clear case of medical negligence as the patient died of cardiac arrest while being under treatment with the hospital and the doctors."
Further, the counsel for the hospital and the doctors submitted that the complaint was not maintainable as the service provided by the hospital and the doctors to Mr Ganguly was free of charge.
He says, "The hospital in question is not a super speciality hospital, and there was no bed in the ICU at the time Mr Ganguly was brought in. Further, the attendants of the patient were told to take him to a super speciality hospital as the hospital is a charitable one with limited facilities. However, all care was taken, and there was no medical negligence on the part of the hospital or the doctors."
The NCDRC bench of Mr Kumar, while deciding whether the complaint was maintainable, observed that though the hospital is a charitable institution, the fact is that the Gangulys had to make payment for the drugs and the other disposables as ordered by the doctors for which they had submitted the bills. "So, I consider the complaint to be maintainable as payment has been made to the hospital for the drugs and disposables."
Talking about the allegations of manipulation of records by the treating doctors, the bench noted that there is variation in what has been stated in the written version of Ramakrishna Mission Seva Pratishthan, Dr Anup Roy and Dr M Lodha for having administered Trop-T test and administration of ecosprin and clopidogrel.
"As per the evidence produced by the Gangulys, Trop-T test kit was purchased at 9.39pm from the hospital, whereas, in the written statement, it has been stated that the same was administered at 8.45pm. It has also been recorded in the hospital record. On careful perusal, it appears to have been an interpolation, as no sufficient spacing is seen. To this extent again, I am in agreement with the counsel for the Gangulys that the hospital record has been manipulated," the bench says.
Mr Kumar from NCDRC further noted that "Dr Lodha, the cardiologist on the role was informed about the critical condition of Mr Ganguly only at 10.30pm, if I go by the deposition made by him before the West Bengal Medical Council (WBMC) and 8.45pm, if I go by the written statement filed by the hospital and the doctors. When the Trop–T test, as given in the statement of the hospital and the doctors, was conducted at 8.45pm and assuming it to be true, then the hospital and the doctors and in particular, Dr Ankit Roy, should have informed the cardiologist (Dr Lodha) at that time itself. So the delay from 8.45pm to 10.30pm is not properly explained by the hospital and the doctors. Taking the ground in such circumstances that the hospital is ill-equipped makes no sense when there is a proper specialist cardiologist available with the hospital. This is again another reason for holding the hospital and the doctors deficient in service of medical negligence."
Considering the issue of compensation, NCDRC noted that as far as the hospital is concerned, being a charitable institution and not directly involved with the treatment of the patient, attributing medical negligence would not be appropriate, considering also that they already had a cardiologist on roll. Insofar as Dr Anup Roy is concerned, he was only the first responder who immediately had referred the patient to Dr Ankit Roy and, hence, attributing any medical negligence on him would be out of the question, the bench says.
The bench noted that as per the written version of the hospital and the doctors, Dr Lodha was informed about Mr Ganguly, but it is not known from the record available and even from the submissions made by the counsel for the hospital and the doctors what advice he gave to Dr Ankit Roy or any other doctor in the hospital considering that the Trop-T test was positive, indicating some kind of cardiac arrest. "If the doctors were aware of the gravity of the situation at 8.45pm, based on the TROP-T test and the ECG report, in such a situation, the cardiologist (Dr Lodha) should have come to the hospital to attend to Mr Ganguly."
NCDRC observed that Mr Ganguly, the deceased patient, was 40 years old and the sole earning member in the family of four members and was employed with a public sector company, earning around Rs40,000 per month.
"It is also to be noted that Dr Ankit Roy is a post-graduate trainee and therefore, cannot be asked to pay the compensation as demanded by the Gangulys. It is an unfortunate incident in which the patient died of acute myocardial infarction which could be serious in nature and to this extent expecting Dr Ankit Roy to have provided the required treatment with his level of knowledge and experience would be to expect much. I am constrained to consider only a token compensation to be paid by Dr Ankit Roy in the circumstances of the case," the bench says.
(Consumer Case No1544 of 2018 Date: 12 June 2024)
