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In a first monthly compensation of Rs.75,000 offered to patient in vegetative state

An additional Rs.51 lakhs slapped on hospital for negligence

Kancheepuram: The District Consumer Dispute Redressal Commission, Kancheepuram, holding the hospital negligent for administering Injection Ceftriaxone which led to the patient into a vegetative state directed the hospital to pay Rs.75,000/- per month to the patient lifetime towards her recurring medical expenses and maintenance charges. In addition, the court directed the hospital to pay a lumpsum compensation of Rs.51,14,431/- to the patient.

The fact of the case is that the complainant took his mother to the said hospital for treating urinary tract infection. The complainant alleged that they had informed the hospital about the allergies of his mother but the hospital rather than conducting tests administered her mother with Injection Ceftriaxone after which she suffered anaphylaxis shock and went into a vegetative state. The complainant contended that the cause of patient urinary tract infection was E-Coli and as per the accepted medical practice antibiotics such as co-trimoxazole (trimethoprim/sulfamethoxazole), nitrofurantoin, ciprofloxacin and ampicillin are prescribed for treating the urinary tract infection. However the hospital rather than administering other antibiotics administered Injection Ceftriaxone, a steroidal antibiotic, that too without administering any test dose. The complainant ridiculed the claim of the hospital that the patient Escherichia coli E-Coli was sensitive and drug resident by asking the hospital as to how did they arrived to the conclusion without any medical/clinical/blood/urine test report and also without trying any empirical treatment. Further the complainant contended that the hospital did not provided them with medical records and bill breakups despite several requests. A one page bill summary was only provided to the complainant it was alleged. The hospital offered the medical records and detailed bill only after the intervention of the Tamil Nadu Medical Council.

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The hospital on the other hand defended its treatment and said that a test dose of Injection Ceftriaxone was administered to the patient to ascertain whether the patient was allergic to Injection Ceftriaxone or not. The treating doctors followed the accepted medical practice by waiting for more than 15 minutes and observed for allergic symptoms in the patient. Since the patient did not show any allergic symptoms for Injection Ceftriaxone, after checking the patients vitals and as they were normal, the patient was administered the remaining quantity of the injection. The hospital contended that as they have followed the accepted medical practice they cannot be held negligent for the present vegetative state of the patient. Also, the hospital denied the allegation of the patient that the bills of the patient was ready but the hospital did not force the complainant to pay the due while the treatment process was going on. The hospital also said that the patient was provided with all the medical records at the time of discharge. Subsequently on the request of the complainant the patient was referred to another hospital of the choice of the complainant along with all relevant medical records. The hospital further said that the complainant did not file any expert evidence which is necessary to prove negligence of the hospital. The hospital concluded that they were negligent or deficient in providing treatment and hence should not be held negligent. The District Consumer forum pointed out that the hospital had handed over one page discharge summary to the complainant at the time of discharge and when the hospital was forced by the Tamil Nadu Medical Council to give complete medical record a different 4 page discharge summary was given. The Consumer forum thus concluded that the medical records were rewritten for the purpose of the case which is nothing but manipulation. Also it proves the complainant contention that they were not given medical records at the time of discharge. The court further agreed with the complainant that it was a case of Res Ipsa Loquitur and the need of expert opinion does not arise as the hospital has to prove they have carried their duty as per standard medical practice. The court pointed out to the urine culture report having date when the patient did not attend the hospital. Also the court pointed out to the time of blood report. In the report the blood sample has been