New Delhi : The National Consumer Disputes Redressal Commission on Friday upheld the order of Delhi State Commission awarding Rs. 10 Lakhs compensation to a diabetes patient whose fingers were amputated after the hospital tied her to a bed overnight. The Presiding Member of the Commissioner Dr. S.M. Kantikar passed the order noting that, “there was failure of duty of care from the ICU staff in the OP hospital. The Order of the State Commission is reasoned and awarded just and adequate compensation to the Complainant. I do not find any reason to enhance the compensation”.
The factual matrix of the case reveals that the complainant/patient, who suffered from vomiting and general malaise, had been admitted to Mata Chanan Devi Hospital on March 28, 2001. The complainant alleged that she had informed the Dr. Jain who examined her in the emergency ward, about her diabetic status since 4 to 5 years.However, he advised to put the patient on glucose drip instead of saline. Her condition deteriorated further and she became restless and was feeling breathless.It is alleged that when the blood glucose level shot up to 465 mg%, and patient became pale, the OP did not make any attempt to reduce the blood sugar. After an hour, the patient was shifted to ICCU. The X-Ray that was taken an hour after that showed that the patient had developed broncho-pneumonia. She suffered a respiratory arrest two hours after that, and was intubated and put on an old and noisy ventilator. When another doctor visited the patient in ICU, he advised Dr. Jain to tie both the hands of the patient with the bandage to the fence of the bed to avoid pulling of urinary tube.
The complainant alleged that her hands had been tied to the bed from 2.00 pm till next early morning, which led to swelling and impaired circulation in hands, and cause gangrene of the left hand. She alleged that the doctors delayed examination of her cyanosed left hand, and she became weak, drowsy and semi-conscious. Her husband was informed that there were no super specialists available in the hospital, nor were there anyone from outside ready to examine her.
The patient was thereafter taken to Apollo Hospital on 30th March 2001. At Apollo Hospital, it was mentioned in the clinical notes that there was gangrene of the left hand up to left wrist possibly as a result of long-term compression of blood flow, because of venous edema. She was advised to undergo 10 days treatment of gangrene by hyperbaric oxygen therapy, which was very expensive, and finally, the fingers on her left hand were amputated. On being aggrieved by the same, the Complaint was filed before the State Commission. The Hospital had, however, denied the allegations, and maintained that the patient had come in a very critical stage and stayed in the hospital for less than 24 hours, without giving reasonable time for the treatment. However, they pointed out that the complainant had stayed in Apollo Hospital for 2 weeks and amputation was done after 20 days of her leaving the OP hospital. The State Commission allowed the complaint and passed the award.
The Hospital, on being aggrieved by the order of the State Commission filed the appeal before NCDRC. Another appeal was also filed by the complainant seeking enhancement of compensation to Rs. 50 lakhs. The NCDRC noted that in the instant case, the husband of the complainant patient had lost confidence on OP hospital and had taken her to Apollo Hospital after staying in the former for less than 24 hours. The NCDRC took note of the affidavit by the complainant’s husband that at the time of discharge, Dr. Sudhir Chhabra at OP hospital did not disclose that the patient was suffering from gangrene because of wrong instructions i.e. tying of hand. He pointed out that even the Medical Superintendent was reluctant to allow the patient to go to Apollo Hospital as it would have exposed their wrong treatment and gross negligence. This evidence was not rebutted by the OP hospital.The NCDRC also observed that it was admitted that the Complainant took LAMA discharge and admitted his wife in Apollo Hospital, however, the doctors of OP Hospital did not issue the discharge certificate at the time of referring to the Apollo Hospital, which had been a deficiency on their part. The NCDRC noted that on a bare perusal of the findings of Apollo Hospital, it could be inferred that the gangrene developed due to tight tying of the hands, which went unnoticed and unmonitored throughout the night by the ICU staff, and thus amounts to failure of duty of care.
“The higher duty of care was expected from the ICU staff as such the instant patient was critical”, it was observed. The NCDRC also refused to accept contention of the Complainant that the doctors had not taken steps to reduce the blood sugar of the patient. “From the medical record, it is evident that proper doses of insulin were given and the doctors efficiently managed the critical condition of the patient. However, she developed gangrene of fingers in left hand during her ICU stay. The possibility of such gangrene was due to compromised state of the patient (diabetic, ketones and generalized infection – septicemia). But the evidence of patient’s husband about tying the hands cannot be brushed aside. It was the onus upon the OP to explain the cause of gangrene, but failed to prove”, it found.
It therefore found failure of duty of care from the ICU staff in the OP Hospital. It thus held that the compensation awarded by the State Commission was just and adequate, and did not find any reason to enhance the same. The Appeals were thus dismissed.