Doctors Has Treated The Patient As Per Reasonable Standards And Care; No Negligence Or Deficiency On Their Part; NCDRC

The bench stated that, the team of doctors at hospital has treated the patient as per the reasonable standards and care. There was neither medical negligence nor deficiency during treatment from the Opposite Parties.

In this case, the appellant (Patient) had symptoms of pain in the upper end of Rt. Tibia. He was admitted in the Army Hospital Research and Referral Delhi Cantt (Opposite Party). The CECT chest revealed a nodule in right lung lower lobe. The Opposite Party did not perform biopsy/Fine Needle Aspiration Cytology of lung nodule to confirm Tuberculosis. Patient was detained in Hospital for 34 days without any treatment. After investigations and MRI, he got admitted in Joint Replacement Centre Ward at AHRR for removal of the right tibial bone and some part of the knee joint. The patient was operated without conducting proper medical tests and 7 inches of long bone with knee joint was removed. The patient was ill-advised by the treating doctors for removal of affected 7 inches by cancer and its replacement. Besides that, he was given extra-large size knee prosthesis. So, the prosthesis got infected since its fitting. Later, at Apollo Hospital, the pus discharge was diagnosed as due to tuberculosis. Due to negligence of the Opposite Parties, Patient suffered permanent disability attributable to the doctors in the AHRR.

Being aggrieved due to the gross negligence of the Doctors and Hospital, the Patient filed Consumer Complaint before the State Commission, Delhi. The State Commission dismissed the Complaint.

Aggrieved by the decision of State Commission Delhi the Patient filed an appeal before the National Commission under Section 19 of the Consumer Protection Act, 1986.

Before the National Commission, the appellant (Patient) submitted that the Respondents wrongly diagnosed cancer and kept him under wrong treatment for more than six months. It was submitted that after 6 cycles of therapies, the Knee Replacement surgery was performed without carrying out prior investigations. It was argued that there was no cancer, unnecessary excessive doses of the Chemo & Radio radiotherapies were given. Therefore, due to negligence of Respondents, he became crippled for life (on crutches) and thus only possible treatment for him remained was above knee amputation of the leg. It was submitted that more than 17 years, he is under such pathetic condition.

The respondents (­­­­­­­­­Hospital and Doctors) reiterated the treatment given to the Appellant by the team of doctors as per standard protocol. It was submitted that there was no negligence or deficiency on their part.

The issue for consideration before the National Commission was whether the Opposite Parties are liable for the loss suffered by the Appellant or not.

The bench found that, at AHRR surgery for excision of proximal right tibia and replacement with tumour prosthesis was performed. The surgery was not done forcibly, but it was done after obtaining the informed consent of the Appellant.

Commission opined that, the limb salvage surgery was performed in the interest of patient. It was the due diligence of team treating doctors at AHRR, which avoided amputation of Rt. Leg. The Patient, thereafter, could walk on his own feet rather than with an artificial Rt. foot.

Commission stated that after span of years, the development of TB can't be attributed to the diagnosis/ treatment of cancer. It is known that after cancer treatment by chemo/radiotherapy, due to immunosuppression, the patient may develop several infections even TB also. It was neither negligence nor deficiency in service of the Opposite Parties.

Commission relied upon the case of Achutrao Haribhau Khodwa and Ors. v. State of Maharashtra and Ors, where the SC held that, "in the very nature of medical profession, skills differ from doctor to doctor and more than one alternative course of treatment are available, all admissible."

Commission observed that, during proceedings before the State Commission, it took an expert medical board opinion from Maulana Azad Medical College (MAMC), which ruled out negligence. The HPE diagnosis of true cut biopsy as NHL/Small cell tumour was correct. The treatment by six cycles of Chemotherapy and radiotherapy was responded well. Pulmonary nodule disappeared after the 4 cycles of chemotherapy. It was the specialized surgery, available at AHRR and very few advanced Centers in India. The affected diseased bone was removed and replaced with an imported customized HMRS Titanium Prosthesis. The treatment was totally done by AHRR as voluntarily in nature.

The bench stated that, the team of doctors at AHRR has treated the patient as per the reasonable standards and care. There was neither medical negligence nor deficiency during treatment from the Opposite Parties.

National Commission dismissed the appeal.

Case Name: SGT Chaman Lal & Anr. v. Union Of India & Ors.

Case No.: FIRST APPEAL NO. 48 OF 2014

Corum: Justice R.K. Agrawal, President and Dr. S.M. Kantikar, Member

Decided on: 23^rd June, 2022

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