Judgment:
Oral Order (As per Sri R.Lakshminarasimha Rao, Honble Member)
1. The complainants are the appellants. The first complainants wife after becoming pregnant approached the opposite party no.1 hospital pertaining to the opposite party no.2 and she had undergone blood test, urine test, ultrasound scan prescribed by the opposite party no.2. She was admitted to the opposite partyno.1 hospital for delivery on 24.9.2006. The opposite party no.2 performed caesarean section on the first complainants wife on 25.9.2006. The second complainant was born and she and her mother were discharged from the opposite party no.1 hospital on 2.10.2006. The first complainants wife approached the opposite party no.1 hospital on 4.10.2006 with abdominal pain and urinary problems. The second opposite party after conducting tests such as blood test, urine test etc., declared that the patient was suffering from jaundice and dysfunctioniong of kidneys. The patient was shifted to Yashoda Hospital, Malakpet Hyderabad where she was diagnosed with urosepsis, severe sepsis with multiorgan failure, ARF, ARDS and Hepatitis. The complainant no.1 stated to have incurred an amount of `1,40,000/- at Yashoda Hospital. The patient was shifted to Osmania General Hospital on 9.10.2006 and she expired on 12.10.2006 due to sepsis with multi organ dysfunction.
2. The case of the complainants is that within a gap of one day between the date of discharge and readmission of the patient in opposite party no.1 hospital of the patient on 4.10.2006, the tests conducted blood urea, serum creatine, total bilrubin were found with abnormal values and in such circumstances, the opposite party no.2 had discharged the patient in casual manner and it is submitted that while the patient was undergoing treatment in opposite party no.1 hospital, the opposite party no.2 left for Badrachalam for about four days without providing proper treatment to her.
3. The opposite parties resisted the claim contending that the opposite party no.1 hospital is well equipped and render service by trained staff in all eventualities. It is submitted that the first complainants wife suffered sudden severe bleeding which necessitated an emergency caesarean operation that was conducted on 25.9.2006. At the time of discharge of patient on 2.10.2006 certain medicines were prescribed and the condition of the patient and the baby was good. The patient was readmitted on 4.10.2006 at 5 p.m. with a complaint of upper abdominal pain. The opposite party no.2 observed development of jaundice and suspected malfunction of kidney. After conducting the tests, the patient was diagnosed with jaundice and malfunction of kidneys. After the patient was shifted to Yashoda Hospital, the subsequent events were not within the knowledge of the opposite parties. The patient was suffering from ineffective hepatitis which might be due to incubation period and as such it could not be detected at initial stage of examination, before performing caesarean section and until her discharge from opposite partyno.1 hospital.
4. On behalf of the complainants, PWs 1 and 2 have been examined. Exs.A1 to A19 were marked. On the side of the opposite parties Dr.Balamba was examined as RW1 and the husband of the opposite party no.2 was examined as RW2. Ex.B1 case sheet was marked.
5. The District Forum has dismissed the complaint holding that there was no medical negligence on the part of the opposite parties.
6. Feeling aggrieved by the order of the District Forum, the complainant have preferred the appeal contending that the opposite parties failed to diagnose jaundice when the patient was discharged on 2.10.2006 and the opposite party no.2 had left for Badrachalam without entrusting the patient to any other doctor. The opposite parties have not conducted any tests at the time of discharging the patient.
7. The point for consideration is whether there was any medical negligence on the part of the opposite partyno.2 and the other doctors of the opposite party no.1 hospital and if so to what relief?
8. The first complainants wife used to approach the opposite party no.1 hospital during her pregnancy period for periodical check up and she was admitted to the opposite party no.1 hospital on 24.9.2006 for delivery. On 25.9.2006 caesarean section was performed. The complainant no.2 was born. On 2.10.2006 the second complainant and her mother were discharged from the opposite partyno.1 hospital. On 4.10.2006 the first complainants wife admitted to the opposite party no.1 hospital on 4.10.2006 with abdomen pain and urinary problems and on the same day pathological tests were conducted which revealed the patient suffering from jaundice and malfunctioning of the kidneys.
9. The opposite party no.2 has not filed affidavit nor got examined herself. The husband of the opposite party no.2 who is also a doctor in the opposite party no.1 hospital deposed that there were no symptoms and signs suggestive of urinary tract infection during the stay of patient in opposite partyno.1 hospital or at the time of her discharge therefrom. In his cross examination he has deposed that the wife of the complainant no.1 was diagnosed with the infection only after making investigations in the hospital. The contention of the complainants is that the opposite parties had not detected the jaundice and malfunction of kidneys during the patients stay at opposite party no.1 hospital or after her discharge therefrom. Each time the patient was admitted to opposite partyno.1 hospital, tests were conducted. PW2 has stated that the initial report had shown rising of serum bilrubin and raise in alkaline phosptise, PT, there was rising blood urea, serum creatine.
10. Recently the Honble Supreme Court in V. Kishan Rao Vs. Nikhil Super Specialty Hospital in Civil Appeal No. 2641/ 2010 after considering the entire case law and where the principles of res ipsa loquitor have been made applicable in the case of medical negligence held :
 âIn a case where negligence is evident, the principle of res ipsa loquitur operates and the complainant does not have to prove anything as the thing (res) proves itself. In such a case it is for the respondent to prove that he has taken care and done his duty to repel the charge of negligence.â
11. The Honble Supreme Court in Savita Garg (Smt) v. Director, National Heard Institute reported in 2004 CTJ 1009 (SC)(CP) â (2004) 8 S.C.C. 56 in which it is held as follows:
â Once a claim petition is filed and the claimant has successfully discharged the initial burden that the hospital was negligent and that as a result of such negligence the patient died, then in the case the burden lies on the hospital and the doctor concerned who treated that patient, to show that there was no negligence involved in the treatment. Since the burden is on the hospital, they can discharge the same by producing the doctor who treated the patient in defence to substantiate their allegation that there was no negligence. It is the hospital which engages the treating doctor, thereafter it is their responsibility. The burden is greater on the institution/hospital than that on the claimant. In any case, the hospital is in a better position to disclose what care was taken or what medicine was administered to the patient. It is the duty of the hospital to satisfy that there was no lack of care or diligence. The institution is a private body and it is responsible to provide efficient service and if in discharge of its efficient service there are a couple of weak links which have caused damage to the patient, then it is the hospital which is to justify the same and it is not possible for the claimant to implead all of them as parties.â
12. In Jacob Mathew v. State of Punjab reported in III (2005) CPJ 9 (SC), the Apex Court has held in para 48(3) as follows:
â A professional may be held liable for negligence on one of the two findings; either he was not possessed of the requisite skill which he professed to have possessed, or, he did not exercise, with reasonable competence in the given case, the skill which he did possess. The standard to be applied for judging, whether the person charged has been negligent or not, would be that of an ordinary competent person exercising ordinary skill in that professionâ.
13. Though line of the treatment opted by the opposite parties no.1 and 2 cannot be faulted with yet it can be said that in the light of the evidence of the PW2 the opposite parties had not shown due care nor exercised diligence required in diagnosing when they came to know about the abnormal values of serum creatine etc. It is pertinent to note that the opposite party no.2 had not examined herself as she is the doctor who treated the patient and there was severe criticism that she left for Bhadrachalam without attending on the patient though such allegations was no made in the complaint, it is the obligation of the opposite party no.2 to substantiate her case by examining herself as a witness. However, failure of the opposite party no.2 or the other doctors of the oppose party no. 2 to diagnose the problem in proper perspective by itself cannot be a ground to award compensation.
14. For the aforementioned reasons and in the light of the decisions of the Supreme Court we are of the considered view that this duty in tort or reasonable care as per standard medical parlance was not exercised.
Therefore in the circumstances of the case we are of the view that a sum of `50,000/- will be reasonable amount if awarded as compensation to the complainant on all counts.
In the result the appeal is partly allowed. Order of the District Forum is set aside. The opposite parties no.1 and 2 directed to deposit `50,000/- before the District Forum and on receipt of such amount the District Forum shall deposit the amount in the name of the complainant no.2 with a nationalised bank. The complainant no.1 is entitled to receive interest accrued on the amount of `50,000/- till the complainant no.2 attains majority. No costs.