M. Rajavadivelu v. Janamma Hospital
Date
of Judgment 4.3.2013 by National Consumer Disputes Redressal Commission, New
Delhi.
Facts: In his complaint to the State Commission, Appellant had
contended that his late wife Mrs. Vijayalakshmi had been admitted to Respondent
No.1/ Hospital on 2-1-1998 for undergoing Hysterectomy, which was done on
3-1-1998 by Respondent No.2 under general anaesthesia administered by
Respondent No.3. It was informed that surgery was successful and the patient
would recover within one hour.
However,
at 9.45 a.m. Appellant was told by the Respondents that the Patient had
developed breathing problems and would need to be shifted to the nearby Chennai
Kaliappa Hosp. for ventilator support. Ambulance was sent from that Hospital.
Shifting the Patient to ambulance took about 10 minutes, no doctor accompanied
the Patient in the ambulance and only a nurse was present. During the transit
period in ambulance Patient was again deprived of oxygen since the oxygen was
not pumped to the Patient through an ambu bag. This delay proved to be fatal.
In the
admission sheet of Chennai Kaliappa Hospital it was found - Patient was not
conscious and the pulse rate and heart sounds were not heard. She was shifted
to ICCU and connected to the ventilator with a diagnosis of Hypoxic
Encephalopathy due to lack of oxygen to the brain. Tracheotomy was done on 4-1-1998.
Patient shifted to Ramachandran Medical College Hosp However, Patient passed
away on 3-4-1998.
It was
contended that Patient expired due to medical negligence and deficiency in
service. After the surgery was over when there was breathing problem,
life-saving equipments like a ventilator were not available in the Respondent
No.1/Hospital. If Patient had been put on a ventilator and sufficient oxygen to
the brain had been ensured she would not have suffered Hypoxic Encephalopathy,
which caused her death. Time taken to shift the Patient to the Chennai Kaliappa
Hospital took about an hour, which proved fatal.
Order of State Commission: “There is nothing on record to show that the opposite parties had
committed anything wrong in the performance of the surgery and administration
of anesthesia. Opposite party-3 deposed that the patient regained consciousness
after surgery and that there was no Hypoxia during surgery and there was no
reintubation after surgery. Oxygen cylinder was available in the ambulance
which carried the patient to Chennai Kaliappa Hospital. A well trained nurse
accompanied the patient. No medical code expects that the patient must be accompanied
by the surgeon and anaesthetist when she is being shifted to another hospital.
The first charge relating to negligence falls to
the ground.
As regards the allegation regarding the non-pre-
assessment tests before administering anaesthesia, the witness examined by the
complainant viz., P.W.II expert has clearly admitted that he had no occasion to
peruse the discharge summary as well as pre-assessment chart.
There are no allegations with regard to the
administration of the anaesthesia by the complainants. It is not the case of
the complainants that the death occurred due to administration of anaesthesia.
The patient died only after a period of three months. The expert P.W.II has not
been able to give the cause for the death. His evidence is an interested one.
The opposite party-3 is a Senior Anesthetist and
having rich experience for several decades. There is no legal evidence to prove
the negligence on the part of the opposite parties.”
National Commission Held: It is admitted by the Respondents
that soon after the surgery the Patient developed breathing problems, that
there was no ventilator facility in the Respondent No.1/Hospital, which
necessitated Patient being shifted to a nearby Hospital.
Had
a ventilator been available and the required oxygen administered to the Patient
by Respondents, she would not have suffered from Hypoxic Encephalopathy which
led to her death some weeks later.
It
is medically well established that Hypoxic Encephalopathy occurs when the brain
does not receive enough supply of oxygen which can be fatal because as little
as within 5 minutes of oxygen deprivation, brain cells can begin dying. In the
instant case, Respondents have themselves admitted that they took 10 to 15
minutes to transfer the Patient to the ambulance and thereafter some more time
to the Hospital, which was undoubtedly fatal in this case.
The
Respondents should not have conducted a major surgery like Hysterectomy under
general anaesthesia without ensuring that such life saving facilities were
available in their Hospital. Further, they should have ensured that oxygen
through ambu bag was available in the ambulance because a Patient with
breathing problems cannot breathe the required oxygen through the oxygen
tube/catheter attached to the oxygen cylinder.
Medical negligence and deficiency in service is
established. Respondents are jointly and severally directed to pay the
Appellant 3 lakhs within a period of 3 months, failing which it will carry
interest @ 9% per annum for the period of default. 
