Professional Documents
Culture Documents
C. C. NO. 03 / 2024
VERSUS
INDEX
PLACE: -
DATE: - / /2023
C. C. NO. 03 / 2024
VERSUS
The answering OP most respectfully begs to submit their reply to the complaint filed by complainant as under: -
1.
Before submitting the reply in detail, the answering OP is required to introduce their qualification and experience as Neuro Surgeon before Hon’ble
a. OP No.2 had completed his M.B.B.S. from KGMC Lucknow University in the year of 1992 and after that, completed his MS from GSVM
Medical college Kanpur university in the year of 1996 and MCh Neuro Surgery From IMS BHU in the year of 2000.
b. OP No.3 had completed his M.B.B.S. from MUHS, Nashik University in the year of 2010 and after that, completed his Ms (Gen Surg)
from MUHS, Nashik university in the year of 2016 and MCh Neuro Surgery From NIMHANS Bengaluru in the year of 2020.
2.
The Answering OP is having an excellent academic career. The OP also has attended various local, regional level, State level, National level and
international level conferences organized by various societies for updating their knowledge and surgical skills. A few of such awards and achievements
3. EXPERIENCE: -
PRELIMINARY OBJECTIONS: -
OP raises following preliminary objection and requests Hon’ble Commission to dismiss the complaint summarily by giving priority to preliminary objections
4.
That the present Complaint is wholly misconceived, groundless, frivolous, vexatious and scurrilous which is unsustainable in the eyes of law and
has been filed without any justified reason/cause against the OPPOSITE PARTY NO.123just to harass, defame and extort illegal sum of money from the
5.
That no specific, scientific and justified allegations in regard to negligence or deficiency in providing services has been made by the complainant
against the OPPOSITE PARTY NO.123and the complainant has totally failed to explain “as to how he is involved and the OPPOSITE PARTY NO.123were
negligent”, hence the Complaint is miserably failing to explain the cause of action against the OPPOSITE PARTY NO.123. Hence is liable to be dismissed
outright.
6.
That the complainant has filed this Complaint with false allegations of negligence to the Hon’ble Commission by claiming exorbitant amounts
without any basis, just to waste the valuable time, harass and defame the OPPOSITE PARTY NO.123. Although it is a fact that the OPPOSITE PARTY
NO.123has not committed any negligence in this case, while providing the said treatment, hence Complaint is liable to be dismissed.
7.
That as such no cause of action arose against OPPOSITE PARTY NO.123in this case, no negligence or deficiency in services in services has been
made/provided by OPPOSITE PARTY NO.123to the patient while providing the said services in question, and hence this Complaint is not maintainable in
8.
That the complaint has not approached the Hon’ble Commission with clean hands as the complaint intentionally, deliberately and willfully has not
submitted true facts about the actuality and chronology of diseases/treatment and further he has suppressed the true material facts in regards. Further the
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complaints intentionally, deliberately have not submitted all the treatment records, which are expected to be available with him. Hence the complaint is liable to
be dismissed.
9.
That the present complaint is baseless and flagrant abuse of process of law which has been made intentionally to harass and blackmail the answering
respondent and had been filed by the complainant after a big thought, merely because minimal court fee needs to be paid for lodging a complaint before the
consumer court and the complainant want to misuse the provisions of the CPA 2019.
10.
That, “res ipsa loquitor” cannot be applied in this case since the opposite party has explained factual medical issues as well as its legal implications
in detail in a very reasoned manner. Hence, the Commission should not apply the principle of “res ipsa loquitor” because OP has explained in detail each and
every baseless allegation hurled by complainant. Without putting a questionnaire and answennaire the hon’ble commission should not apply and pass an order
11.
The hon’ble commission should get medical literature related to the subject matters, otherwise put suitable questionnaires and answennaire to
answering Op as well as complainant in lieu of evidence, without that the commission should not pass any order against answering OP.
12.
The hon’ble commission should get expert witness related to the subject matters, otherwise put suitable questionnaire and answennaire to answering
Op as well as complainant in lieu of evidence, without that the commission should not pass any order against answering OP.
13.
The hon’ble commission should get eyewitness related to the subject matters, otherwise put suitable questionnaires and answennaire to answering
Op as well as complainant in lieu of evidence, without that the commission should not pass any order against answering OP.
14.
The hon’ble commission should not pass any order for Cost, for interest on the compensation, any contribution to consumer welfare fund, ex-gratia
payment to complainant without putting questionnaire and answennaire in lieu of evidence, the commission should not pass any order against answering OP.
15.
That the complainant, with deliberate intent, has refrained from disclosing the pertinent facts to this esteemed Court. Not only have the correct facts
been willfully concealed, but the complainant has also intentionally abstained from producing the relevant records, thereby impeding the process of just and fair
adjudication. In light of such actions, it is pertinent to invoke the esteemed legal maxim "suppressioveri, suggestiofalsi" which means "suppression of the
truth is the suggestion of the false." Given the aforesaid circumstances, it is evident that the complainant's intention has been to mislead the Court by
concealing the true facts and suggesting false implications. In view of the above, it is most respectfully prayed that this Hon'ble Court may be pleased to consider
the complainant's deliberate acts as an attempt to defeat the ends of justice. Therefore, it is just and proper that this case be dismissed forthwith, upholding the
sanctity of justice.
COMPENSATION CULTURE: -
16.
As per Karnataka High Court judgment in Dr Ganesh Nayak v. V Shamanna, (Karnataka), 2023(1) KCCR 808, Writ Petition No.21688 of
2009 (GM-RES). D/d. 14.01.2023 which states that 'compensation culture' - Medical negligence - Cases launched recklessly - Medical professionals
should be protected from legal action just like public servants are protected against bonafide errors in their action.
a.
It does not need research to show that more often than not, the cases of medical negligence are launched recklessly by the patients and their
relatives; 'compensation culture' which obtains in other jurisdictions is gradually gaining entry to the field of medical services in our
society affecting a healthy relationship of doctor & patient; it is tritely said "faith heals and not the medicine"; faith here means the one
reposed in the treating doctor; courts have been nowadays observing that an unscrupulous section of the people are prone to use the
slightest opportunity to sue the doctors and hospitals, in the hope of making fast buck; the motivation of people bringing actions for
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medical negligence are more complicated: some sue for money; others sue for getting an acceptance of guilt; some others do it to ensure
that errors would not be repeated; but a large chunk of cases does not involve bona fide claims, cannot be much disputed; the 'compensation
culture' be it truth or a myth in varying degrees, has given rise to risk aversion; medical professionals having a complaint made against
them gather an impression that there is an unjustifiable attack on their professional integrity and reputation; this may lead to a defensive
response of the medicos ultimately resulting into enormous cost escalation in medical services; if the public servants can be legally
protected for the bona fide errors in their action, there is no reason to extend for not extending such a protection to the medical
professionals.
b.
It is said the realm of medicine is an ever growing branch of uncertain knowledge; William Osler (1849-1919), a Canadian Physician, more
than a century ago had said that "medicine is a science of uncertainty and an art of probability", a host of un-assessable factors entering the
fray of diagnosis & treatment; the advancement of science & technology has to some extent reduced the level of such uncertainty and
enhanced the degree of probability, is also true; however, it cannot be disputed that the medical field is still in a fluid state;
c.
A great Indian sage Ramakrishna Paramahamsa had said: "God laughs on two occasions. He laughs when the physician says to the patient's
mother, 'Don't be afraid...; I shall certainly cure your boy.' God again laughs, saying to Himself, 'I am going to take his life, and this man
says, he will save it!..." Even if it is shown that a drug or a procedure did cause an injury, it is difficult to ascertain whether this is because
of the drug or the procedure; for example, it might be that the drug or the procedure is not defective if it provides a cure for the vast
majority of people, although it has undesirable consequences for a small number of people; if a patient is of the unlucky few, there will be
difficulty in concluding that the drug or the procedure was actionably defective; this is only to highlight the uncertain causation obtaining in
the realm of medical liability; this aspect ought to have animated the decision making process that culminated into the impugned order of
penalty; however, that having not happened, the impugned order suffers from another legal infirmity. Before parting with this case, it needs
to be observed that: medical and paramedical professionals are inevitable for a healthy society; Vedic literature lauds medical practitioner
and medicine as 'vaidyonaaraayanoharihi', nearly meaning that a true doctor as a healer is God and that a true medicine is like the sacred
17.
What is that conduct that signals the termination and ending of an established Doctor-patient relationship? - Once the duty of care under Doctor-
patient relationship has arisen, it continues till the happening of any of the following contingencies:
b. Refusal by the patient to allow implementation of the diagnostic, therapeutic and screening tests plan
c. The patient conduct shows that patient is not following advice and instructions given by doctor
18.
That this complaint is bad for non-arraignment and mis-arraignment of parties.
a.
At the time of cause of action and Currently, opposite party no.1 was insured with “National Insurance Company Ltd”, through its Professional
Indemnity Policy No. 240400492210000090 effective from 25-Mar-2023 to 24-Mar-2024 (Copy of insurance policy is being annexed as “Annexure R-
1”).
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b.
Currently, opposite party no.2 was insured with “National Insurance Company Ltd”, through its Professional Indemnity Policy No.
240400492210000090 effective from 25-Mar-2023 to 24-Mar-2024 (Copy of insurance policy is being annexed as “Annexure R-1”). At the time of cause of
action opposite party no.2 is insured with “ICICI Lombard General Insurance Company Limited”, through its Professional Indemnity Policy No.
4021/A/257525125/00/000effective from 31-Aug-2022 to 30-Aug-2023 (Copy of insurance policy is being annexed as “Annexure R-2”).
c.
Currently, opposite party no.3 was insured with “National Insurance Company Ltd”, through its Professional Indemnity Policy No.
4021/A/317830090/00/000effective from 27-Oct-2023 to 26-Oct-2024 (Copy of insurance policy is being annexed as “Annexure R-1”). At the time of cause of action
opposite party no.2 is insured with “ICICI Lombard General Insurance Company Limited”, through its Professional Indemnity Policy No.
4021/A/269186352/00/000effective from 27-Oct-2022 to 26-Oct-2023 (Copy of insurance policy is being annexed as “Annexure R-3”). Patient is the
beneficiary of indemnity insurance policy under CPA 2019 since indemnity insurance is bought for litigant patients (third party), there is no benefit to the doctor
if litigation is not launched by the patient party. This indemnity insurance is designed primarily for patients who might pursue litigation. However, the doctor
doesn't gain any advantage unless the patient initiates legal action. The privity of contract exists as doctors are making payment for litigant patients (third party)
in anticipation of litigation which may occur during the course of professional medical practice. Essentially, doctors pay for this insurance to get protection from
potential lawsuits from patients, expecting that litigation might arise during their medical practice. Should a doctor lose a case and compensation is decreed
against them, the indemnity insurance provider will cover the compensation based on the policy's terms. Hence insurance company is necessary and proper party
to be arrayed by the complainant and the details of the insurance company is given here-in-above.
19.
Patient Mr. Shankar Ghosh was admitted on 22.04.2023 in emergency after suffering severe head injury causing life-threatening, dying-dying dead
condition with Right frontotemporo parietal with acute SDH with Low general condition with life-threatening, dying-dying dead Comatose state (GCS: E1-V1-
M2). Emergency treatment was done by Dr. Amitabh Mishra & Dr. Vishram Sagar Pandey (MS, Mch, Neurosurgeon). CT scan of brain showed – life-
threatening Large right frontotemporo parietal acute subdural hematoma (SDH) with mass effect. Extremely serious, critical, life-threatening condition was
discussed with the patient relatives in detail and Surgery was advised with very high risk associated with Head injury in such a morbid patient during per
operative period and in post-operative period as well as risk of re-bleed, risk of infection due to low immunity, residual neurological deficit and Persistent coma
was explained to patient relatives in details. After taking very high-risk consent for such a moribund patient with the risks discussed with patient party, consent
was taken. Moribund patient was operated on 22.04.2023 as a last-ditch effort to save him from the impact of severe head injury. Emergency lifesaving as per
standard protocol was followed for such severe head injury patient in the Post operative period. Such a moribund patient with such high-risk surgery in post
operative period was treated with standard protocol and with relevant blood investigation and other investigations on day-to-day basis depending upon the
seriousness of the patient and treated accordingly, since patient was battling between life and death since admission. This critical patient was also seen by Dr. A.
K. Adhikary (MD, Physician) for life-saving suggestions because patient was dying-dying dead and life-threatening. Patient relatives were told about the life-
threatening and further deteriorating condition of the patient daily by the treating doctors - Dr. Amitabh Mishra (MS, Mch, Neurosurgeon), Dr. Vishram Sagar
Pandey (MS, Mch, Neurosurgeon), Dr. A. K. Adhikary (MD, Physician) and Dr. Nirman Chatterjee (MBBS, Intensive care specialist), as well as bad prognosis
twice daily, as well as other time if enquired by the patient relatives. Patient was also seen by Dr. A. Debnath (Nephrologist) for the kidney Condition, and Dr. P.
Mandal (Cardiologist) for heart Condtition. Patient developed rashes which was treated by Dr. A. K. Adhikary (MD, Physician) and Dr. S Adhikary (MD,
Physician), Dr. A. Mishra (MS, Mch, Neurosurgeon) / Dr. V. S. Pandey (MS, MCh, Neurosurgeon) and Opinion of Dr. Arup Dey Sarkar (MD, Dermatologist)
was taken. Despite our life-saving, emergency, timely efforts treatments surgeries and references to the appropriate specialties, patient expired on 28.05.2023,
due to severe head injury caused by original trauma. Whatever serious, severe, life-threatening, moribund is reflected in Post-mortem report, Remarks by Civil
surgeon. Post-mortem does not show any deficiency of service, medical negligence, unfair trade practice on the part of treating doctors. The death was due to the
original trauma causing head injury which made patient extremely sick, serious, moribund, dying-dying dead, life-threatening situation. The doctors team tried to
attempt each and every aspects by impact of serious severe head injury diligently prudently with due care and caution by providing standard protocol based
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treatment and standard protocol based surgery. Death has nothing to do with the surgery. Everything was done diligently prudently with due care and caution and
there was no negligence, deficiency of service in treating this comatose patient with severe head injury caused due to the negligence of the patient himself by
20.
GUARANTEE AND WARRANTY WITH RESPECT TO THE END RESULTS OF TREATMENT:Law does not require professionals to
give guarantee or warranty with respect to the end results of the services rendered by them. What law requires is that the services rendered must not be sub-
standard or below par. And the services rendered must be without any shortcomings. The end results are immaterial. The Supreme Court held in Jacob Mathew
vs. State of Punjab (2005) 6 SSC 1], that, “A physician would not assure the patient of full recovery in every case. A surgeon cannot and does not guarantee
that the result of surgery would invariably be beneficial, much less to the extent of 100% for the person operated on. The only assurance which such a
professional can give or can be understood to have given by implication is that he is possessed of the requisite skill in that branch of profession which he is
practicing and while undertaking the performance of the task entrusted to him, he would be exercising his skill with reasonable competence. This is all what the
person approaching the professional can expect. Judged by this standard, the professional may be held liable for negligence on one of 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 profession. It is not possible for every professional to possess the highest level of expertise or skills in that branch which
he practices. A highly skilled professional may be possessed of better qualities, but that cannot be made the basis or the yardstick for judging the performance of
the professional proceeded against on indictment of negligence”. In the instant case OP provided the services to the patient diligently with due care and skill.
There was no complication of the treatment given to the patient. Thus, there was no negligence or deficiency in services provided by OP to the patient.
21.
That the present Complaint is NOT supported by any EXPERT MEDICAL WITNESS on behalf of the complainant. It is most humbly
submitted that the National Consumer Disputes Redressal Commission has clearly envisaged in its judgment in Dr. Harkanwaljit Singh Saini v. Gurbax Singh
and Anr. 2003;(I) CPJ 153 (NC) that, “The Commission cannot constitute itself into an expert body and contradict the statement of the doctor unless there is
something contrary on the record by way of an expert opinion or there is any medical treatise on which reliance could be based. ” The present complaint is not a
simple and straightforward case as it involves highly technical knowledge to understand it. That the Complainant has approached the Hon’ble Commission
without support of any scientific evidence and has leveled bald allegations without support of any relevant medical literature in support of his contentions, hence
PARAWISE REPLY
22.
OPPOSITE PARTY NO.123 states that, each and every word of each and every allegation, mentioned in each and every sentence and paragraphs in
the whole complaint, against OPPOSITE PARTY NO.123, except those admitted specifically and expressly in this reply, stand specifically and vehemently
denied. There are so many facts which are twisted and written out of context just to make them appear as if the complainant is correct, but actually is misguiding
the hon’ble court. Such twisted and written out of context statements are totally denied, if they do not fall in conformity statements made here-in-below with
scientific explanations and supporting evidence. The narration of the complainant is based on a laymen view without any scientific basis. The factaprobanda
(the facts required to be proved i.e. material facts) should factaprobantia (the facts by means of which they are proved i.e. particulars or evidence). It is
settled law that pleadings must contain only factaprobanda and not factaprobantia. The material facts on which the party relies for his claim are called
factaprobanda and they must be stated in the pleadings. But the facts or facts by means of which factaprobanda (material facts) are proved and which are in the
nature of factaprobantia (particulars or evidence) need not be set out in the pleadings. This is mentioned in the Supreme Court of India, 2 judge bench
23.
With reference to the contents of the Para no. 1 is abuse of process of law since a law-abiding peaceful citizen do not indulge in unnecessarily
litigation.
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24.
With reference to the contents of the Para no.2 is a matter of the record.
25.
With reference to the contents of the Para no.3, it was sheer negligence on the part of family members who allowed their senior citizen father to
climb on a ladder which led fall. Anyone from the younger family member would have climbed the ladder instead of him to avoid this fall. The patient suffered
fall due to original trauma due to his own and family member’s negligence, carelessness.
26.
With reference to the contents of the Para no. 4, 5 is a matter of the record. Patient Shankar Ghosh, aged 58 years was admitted on 22.04.2023, as a
case of Head injury following fall on 22.04.2023, and seen by Dr. Amitabh Mishra (MS, Mch, Neuro Surgeon),in the emergency room. His general condition
was very low and patient was in deep coma. (Glasgow Coma scale), GCS was E1V1M2 =(4/15). CT scan showed right fronto temporo parietal acute SDH with
mass effect Patient relatives were explained regarding the seriousness of the head injury and urgent requirement of surgery of the brain. Patient relatives were
explained regarding poor prognosis. Following complications were explained related to surgery. Rebleed infection, Residual Neurological deficit, sepsis,
prolonged need for the ventilator and Tracheostomy in the post operative period, risk of drug allergies, high risk of intra operative and post operative death.
27.
With reference to the contents of the Para no.6, 7 is matter of record. However, any hint of any allegation directly indirectly or remotely hurled to
OP no.123 is wrong and vehemently denied. Investigation at the time of admission showed WBC 18300 which may be because of patient having infection at the
28.
With reference to the contents of the Para no.8 is wrong and denied and true facts are that patient was operated under GA on 22.04.2023, Right
fronto temporo parietal decompressive craniectomy with evacuation of SDH and Duroplasty.
29.
With reference to the contents of the Para no.9, 10, 11, 12, 13, 14 is wrong and denied and true facts are that in the post-operative period patient was
treated as per standard protocol with ventilator supports, antibiotics, anti-epileptics, anti-oedema drugs and IV fluids and other supportive measures along with
relevant investigation time to time as per desired on day to day basis. Since the patient was battling for his life since admission. He was also seen by Dr. Amit
Kumar Adhikary (MD, General Medicine, Physician), for life-saving advise. Patient relatives were told about the life threatening and poor condition of the
patient daily by the treating doctors. Dr. Amitabh Mishra (MS, MCh, Neuro Surgeon), Dr. Vishram Sagar Pandey (MS, Mch, Neuro Surgeon), Dr.Amit Kumar
Adhikary (MD, Physician) / Dr. Subhojyoti Adhikary (MD, Physician), and Dr. Nirman Chatterjee (MBBS, FCCS, USA) intensive care (Physician), twice daily
as well as other time if enquired. Patient was also seen by Dr. Abhinaba Debnath (DM, Nephrologist), for the kidney condition and Dr.Priyankar Mandal (DM,
30.
With reference to the contents of the Para no.15, 16, 17, 18, 20 is wrong and denied and (Para no.19 already defined in para no. 29) true facts are
that patient developed rashes on 19.05.2023, and after consultation with treating doctors, advise was followed which included anti-allergic drugs, I.V fluids and
stoppage of probable offending drug (Phenytoin), patient was evaluated further by Dr. Subhojyoti Adhikary (MD, General medicine- Physician) Dr Amit Kumar
Adhikary(MD, General Medicine, Physician), Dr. Amitabh Mishra (MS, Mch, Neuro Surgeon), and Dr. Vishram Sagar Pandey (MS,Mch, Neuro Surgeon), and
Opinion of Dr. Arup Dey Sarkar (MD, Dermatologist), was taken. Despite our whole hearted, timely efforts, treatments, surgeries and references to the
appropriate specialties, patient expired on 28.05.2023, due to severe head injury caused by the original trauma.
31.
With reference to the contents of the Para no.21, 22, 23 is wrong and denied and true facts are that ante mortem injuries necessitating surgical
operation is also reflected as the cause of death in post - mortem report, cause of death didn’t mentioned any infection or skin disease. Remarks by Civil surgeon
in the post mortem report does not show any deficiency of service, medical negligence, unfair trade practice on the part of treating doctors. The death was due to
the original life-threatening head injury which made patient extremely sick, serious and moribund.
32.
With reference to the contents of the Para no.24, 25, 26, 27, 28 is wrong and denied and true facts are that the team of doctors treated this serious
severe head injury patient diligently prudently with due care and caution by providing standard protocol based treatment and timely intervention with surgery.
Death had nothing to do with the surgery. There was no negligence, deficiency of service in treating this comatose patient with severe head injury.
33.
With reference to the contents of the Para no.29, 30, 31 is abuse of process of criminal law as well as civil law. No police authority took any action
34.
With reference to the contents of the Para no.32, 33, 34, 35, 36, 37, 38 is abuse of process of law and consumer protection act since it is uncalled
for, and litigation was indulged for no rhyme or reason to harass the opposite party. And yet this uncalled-for consumer case filed against OPPOSITE PARTY
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NO.123. All these allegations and demand of complainant is not acceptable to OP no.123, Since, everything was done diligently, prudently, with utmost due care
and caution. There is no negligence, deficiency of service or unfair trade practice on the part of the OPPOSITE PARTY NO.123. Hence, not liable to pay
anything to the complainant.Complainant is playing the legal rhetoric usually appended at the end of each consumer case to get a favorable order by alleging
baseless, untenable, unscientific, wrong and out of context narrations. Thus, wasting the valuable time of himself, respondents and legal machinery.
35.
With reference to the contents of the para no.38, prayer clause is based on mere allegations without any admissible evidence under the Indian
Evidence Act. This is highly inflated claim asking Rs 10,00,000/- for which complainant claims that he has sought medical treatment by paying Rs. 353500 /-
only and trying to make a fortune by making the CPA a fishing expedition to earn windfall fortune of money by alleging negligence. Section 34 (1) of CPA 2019
clearly states that the complainant has right to claim only what actually paid for goods or services excluding mental and physical trauma, which are notional and
cannot be quantified in terms of money. As such, as described above, there is no negligence, deceptive practice, deficiency of service or unfair trade practice on
the part of the OPPOSITE PARTY NO.123. Therefore, not liable to pay anything to the patient party. The complainant is not entitled to get any alleged amount
of compensation in view of the facts and circumstances of the case. Therefore, it is prayed that the complaint may kindly be dismissed with cost in the interest of
natural justice.
a.
Ramesh Kumar v. Dr. Akhil Saxena &Ors. Civil Appeal No. 7984 of 2016, the Hon'ble Supreme Court upheld the dismissal of Consumer Complaint
No. 351/2012 - as inflated claim observed by this Commission for 6 crores 30 lakhs- remanded back- bench hunting not allowed
b.
Chanchali Narendra v. Continental Hospitals, (NCDRC)- Consumer Case No.2447 of 2019. D/d. 18.6.2020, consent form mention of only pain as
side effects, but CT Cisternography test patient party’s assumption that there was a leak at the site of lumber puncture was not acceptable to the top court,
Complaint is vague, apart from being grossly inflated amount of 3 Crores, dismissed.
c.
Indian Trading Corporation through Kewal Kishan, Registered Partner vs. State Bank of India - 2003 (2) CPC 561 observed Complainant cannot
claim an inflated and hypothetical figure without any actual casual linkage with the purported cause of action. "If an amount is claimed which has no relevance to
the true facts of the case voluminous evidence will have to be unnecessary laid and great deal of time spent which otherwise could be utilized for looking into the
d.
Neeraj Kumar Gupta and Ors. vs. Panchtatva Promoters (P) Ltd. And Ors.National Commission observed - It seems that the inflated compensation
has been demanded to claim and justify the pecuniary jurisdiction of this Commission."
36.
As per a latest Supreme Court Judgment decided on 7-09-2021 in the matter of “Harish Kumar Khurana v. Joginder Singh, 2021 SCC OnLine SC
673, the Supreme Court held that merely the treatment was unsuccessful or the patient dies during the surgery cannot be presumed to be the medical negligence
37.
As per three judge bench judgment of Supreme Court in Indian Medical Association VS V.P SHANTHA, (1995) 6 SCC 657 which confines the
application of Consumer Act to certain defined negligence such as “………….There may be cases which do not raise such complicated questions and the
deficiency in service may be due to obvious faults which can be easily established such as removal of the wrong limb or the performance of an operation on the
wrong patient or giving injection of a drug to which the patient is allergic without looking into the out patient card containing the warning [as in Chinkeow v.
Government of Malaysia, (1967) 1 WLR 813 P.C.] or use of wrong gas during the course of an anesthetic or leaving inside the patient swabs or other items of
operating equipment after surgery. One often reads about such incidents in the newspapers. The issues arising in the complaints in such cases can be speedily
disposed of by the procedure that is being followed by the Consumer Disputes Redressal Agencies and there is no reason why complaints regarding deficiency in
service in such cases should not be adjudicated by the Agencies under the Act. In complaints involving complicated issues requiring recording of evidence of
experts, the complainant can be asked to approach the civil court for appropriate relief………..”
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38.
In Sanjay Gupta v. Ajit Maurya, (NCDRC) (New Delhi), Consumer Case No. 228 Of 2013. D/d. 23.04.2019. Onus was upon the complainants to
prove that the opposite parties were negligent in the treatment - Opposite parties, on the other hand, have demonstrated by producing medical literature
showing it to be not a case of medical evidence - No expert evidence has been led by the complainants to prove any medical negligence on the part of the
opposite parties in the procedure - Complaint dismissed. Patient had Elective L.S.C.S. on 02.12.2012. It is further stated that the operation was successful and
there were no complications during the procedure. It is also claimed that the required amount of oxygen was administered to her during the procedure and all
other parameters were looked-after. It is further alleged in the written version that when she was being transferred to the stretcher for being taken to the ward, she
had a sudden AFE casing cardiac arrest for which immediately cardiopulmonary Resuscitation was given. She was resuscitated and shifted to ICU. She was
taken to Sanjay Gandhi Post Graduate Institute of Medical Science, Lucknow by her husband against medical advice and at that time all her vitals were normal.
39.
Two judge Supreme Court judgment in Martin F. D'Souza v. Mohd. Ishfaq, (2009) 3 SCC 1 says in paragraph number 35 that “……………Before
dealing with these principles two things have to be kept in mind : (1) Judges are not experts in medical science, rather they are lay men. This itself often makes it
somewhat difficult for them to decide cases relating to medical negligence. Moreover, Judges have usually to rely on testimonies of other doctors which may not
necessarily in all cases be objective, since like in all professions and services, doctors too sometimes have a tendency to support their own colleagues who are
charged with medical negligence. The testimony may also be difficult to understand, particularly in complicated medical matters, for a layman in medical
matters like a Judge; and (2) A balance has to be struck in such cases. While doctors who cause death or agony due to medical negligence should certainly be
penalized, it must also be remembered that like all professionals doctors too can make errors of judgment but if they are punished for this no doctor can practice
his vocation with equanimity. Indiscriminate proceedings and decisions against doctors are counter productive and serve society no good. They inhibit the free
40.
Three bench Supreme Court judgment in Jacob Mathew v. State of Punjab, (2005) 6 SCC 1 says in one of the paragraph that “………….No sensible
professional would intentionally commit an act or omission which would result in loss or injury to the patient as the professional reputation of the person is at
stake. A single failure may cost him dear in his career. Even in civil jurisdiction, the rule of res ipsa loquitur is not of universal application and has to be applied
with extreme care and caution to the cases of professional negligence and in particular that of the doctors. Else it would be counter productive. Simply because a
patient has not favourably responded to a treatment given by a physician or a surgery has failed, the doctor cannot be held liable per se by applying the doctrine
Res ipsa loquitur is a rule of evidence which in reality belongs to the law of torts. Inference as to negligence may be drawn from proved circumstances by
applying the rule if the cause of the accident is unknown and no reasonable explanation as to the cause is coming forth from the defendant. In criminal
proceedings, the burden of proving negligence as an essential ingredient of the offence lies on the prosecution. Such ingredient cannot be said to have been
proved or made out by resorting to the said rule (See Syad Kabar v. State of Karnataka (1980) 1 SCC 30). Incidentally, it may be noted that in Krishnan and
Anr. v. State of Kerala (1996) 10 SCC 508 the Court has observed that there may be a case where the proved facts would themselves speak of sharing of common
intention and while making such observation one of the learned judges constituting the Bench has in his concurring opinion merely stated "res ipsa loquitur'.
Nowhere it has been stated that the rule has applicability in a criminal case and an inference as to an essential ingredient of an offence can be found proved by
resorting to the said rule. In our opinion, a case under Section 304A IPC cannot be decided solely by applying the rule of res ipsa loquitur………..”
41.
Two bench Supreme Court judgment in Ins. Malhotra (Ms) Vs. Dr. A Kriplani & others 2009(4) SCC 705 says in paragraph number 9 that,
“………………..The record produced before the Commission would show that in the operation theatre, the patient was jointly examined by Dr. A. Kriplani and
Dr. S.R. Gupte, Hon. Anaesthesiologist and they had taken conscious decision that the laparoscopy was not contra-indicated in any way. Dr. Pratima Prasad felt
that an attempt to conduct laparoscopy had to be abandoned and it became necessary to perform the laparotomy to get tissue for biopsy which was the main and
only objective of the investigation. In the process, the perforations caused during laparoscopy were duly sutured. On opening the abdomen, it was noticed that
the patient had active military tuberculosis. Peritoneum and all the abdominal structures were adhered together. It was also noticed that the intestines were
perforated due to introduction of laparoscopy trocar and cannula. It was stated by Dr. Pratima Prasad that Dr. Vasant V. Sheth performed the peritoneal biopsy
9
and sutured six intestinal perforations. The laparotomy was performed with complete success and did not create any complication to the patient. Dr. Pratima
Prasad also submitted in her statement that it was conclusively proved by the post-mortem examination that the sutured intestines had healed and had not
developed any leak…………………” This shows that complications can occur in any surgery, and if they heal then they cannot be attributed as negligent act.
42.
Supreme Court three bench judgment in State of Punjab vs. Shiv Ram &Ors. [AIR 2005 SC 3280] says in one of the paragraphs that “…………
Dealing with the topic of complications and sequelae of sterilization, the textbook states: "Failure rate of sterilization varies from 0.4% in Pomeroy's technique,
0.3-0.6% by laparoscopic method to 7% by Madlener method. Pregnancy occurs either because of faulty technique or due to spontaneous recanalization." In
'The Essentials of Contraceptive Technology', written by four doctors and published by Center for Communication Programs, The Johns Hopkins School of
Public Health in July, 1997, certain questions and answers are stated. Questions 5 and 6 and their answers, which are relevant for our purpose, read as
under…….” This means that, this judgment is applicable to every medical procedure like tubal ligation and all such procedures, which have (A) Chances of
failure, (B) Chances of recurrence (C) Chances of complications (D) Chances of consequences due to failure or recurrence, hence without restricting the
43.
On 24-03-2023 two bench judgment of National Consumer Commission has stated in Smt. Devarakonda Surya Sesha Mani Versus Care
Hospitals Institute of Medical Sciences & 2 Others vide Consumer Case No.339 of 2014 that the human body is like a highly complex machine and a doctor
could not assure full recovery of a patient. The only assurance that such a professional can give or can be understood to have given by implication is that he
possessed the requisite skill in that branch of the profession which they are practicing and while undertaking the performance of the task entrusted to them, they
would be exercising their skill with reasonable competence, Apex Consumer Court further added.
44.
On April 30, 2017 Rs.2.5 Cr. Case was dismissed - Suman Taneja v/s. Metro Hospital as Doctors shouldn't be dragged to the Court unnecessarily,
as it's in the interest of the patient. National Commission observed while dismissing the Complaint for damages of Rs.2.5 Crores as it prevents Doctors from
discharging their duty to a suffering person who needs their assistance utmost. The Complainant, widow of a deceased patient, claimed damages to the tune of
Rs. Two & half Crores on the ground that her husband who was diagnosed as Inferior Wall Myocardial Infarction (IWMI) did not receive the emergency
treatment in Golden Hours. The Doctor refused to do initial stenting initially on the ground that he was not to leave for holiday & thus Doctors violated the
Hippocratic Oath. The Cardiologist could not do stenting properly. The National Commission, after going through the entire record and medical literature, held
that there is no Medical Negligence. The primary (Percutaneous Coronary Intervention) PCI was not done due to non-availability of cardiologist, with explained
consent and patient was referred to higher center. It should be borne in mind that every cardiologist is not capable or experienced to the extent of performing
PCI. The record shows the proper treatment given to the patient. It further held, "Referring a patient to Higher Center is not Medical Negligence". National
Commission observed while dismissing the Complaint for damages of Rs.2.5 Crores as it prevents Doctors from discharging their duty to a suffering person who
45.
The Hon'ble Supreme Court of India in Kusum Sharma and Another Vs Batra Hospital and Medical Research Centre and Others (2010) 3
SCC 480 has laid down certain principles which should be kept in view while dealing with cases of Medical Negligence. Applying the principles laid down it is
submitted that no case of medical negligence is made out against the answering Opposite Parties and the present complaint is liable to be dismissed.
a.
Negligence is the breach of a duty exercised by omission to do something which a reasonable man, guided by those considerations which ordinarily
regulate the conduct of human affairs, would do, or doing something which a prudent and reasonable man would not do.
b.
Negligence is an essential ingredient of the offence. The negligence to be established by the prosecution must be culpable or gross and not the
c.
The medical professional is expected to bring a reasonable degree of skill and knowledge and must exercise a reasonable degree of care. Neither
the very highest nor a very low degree of care and competence judged in the light of the particular circumstances of each case is what the law requires.
d.
A medical practitioner would be liable only where his conduct fell below that of the standards of a reasonably competent practitioner in his field.
e.
In the realm of diagnosis and treatment there is scope for genuine difference of opinion and one professional doctor is clearly not negligent merely
f.
The medical professional is often called upon to adopt a procedure which involves higher element of risk, but which he honestly believes as
providing greater chances of success for the patient rather than a procedure involving lesser risk but higher chances of failure. Just because a professional
looking to the gravity of illness has taken higher element of risk to redeem the patient out of his/her suffering which did not yield the desired result may not
amount to negligence.
g.
Negligence cannot be attributed to a doctor so long as he performs his duties with reasonable skill and competence. Merely because the doctor
chooses one course of action in preference to the other one available, he would not be liable if the course of action chosen by him was acceptable to the medical
profession.
h.
It would not be conducive to the efficiency of the medical profession if no Doctor could administer medicine without a halter round his neck.
i.
It is our bounden duty and obligation of the civil society to ensure that the medical professionals are not unnecessary harassed or humiliated so that
they can perform their professional duties without fear and apprehension.
j.
The medical practitioners at times also have to be saved from such a class of complainants who use criminal process as a tool for pressurising the
medical professionals/hospitals particularly private hospitals or clinics for extracting uncalled for compensation. Such malicious proceedings deserve to be
k.
The medical professionals are entitled to get protection so long as they perform their duties with reasonable skill and competence and in the interest
of the patients. The interest and welfare of the patients have to be paramount for the medical professionals.
46.
That CPA 2019, section 38 and sub-section (7) states that every complaint before District Commission shall be disposed of as expeditiously as
possible and endeavor shall be made to decide the complaint within a period of three months from the date of receipt of notice by opposite party where the
complaint does not require analysis or testing of commodities and within five months if it requires analysis or testing of commodities, hence as per section 38 (7)
if any compensation is granted against OP No.2, he shall not be liable to pay any interest beyond the period of three months for the procedure and laxity in the
47.
That, three judges’ bench of Supreme Court under article 141 of constitution of India in Dr. J.J. Merchant &Ors. v Shrinath Chaturvedi (2002) 6
SCC 635 have also observed that, “The National Commission or the State Commission is empowered to follow the said procedure. From the aforesaid Section it
is apparent that on receipt of the complaint, the opposite party is required to be given notice directing him to give his version of the case within a period of 30-
days or such extended period not exceeding 15 days as may be granted by the District Forum or the Commission. For having speedy trial, this legislative
mandate of not giving more than 45 days in submitting the written statement or the version of the case is required to be adhered. If this is not adhered, the
legislative mandate of disposing of the cases within three or five months would be defeated.”
“From the wording of the aforesaid Section, it is apparent that there is legislative mandate to the District Forum or the Commissions to dispose of the
complaints as far as possible within prescribed time of three months by adhering strictly to the procedure prescribed under the Act. The opposite party has to
submit its version within 30 days from the date of the receipt of the complaint by him and Commission can give at the most further 15 days for some unavoidable
Hence, as per section 38 (7) as well as above mentioned supreme court judgment, this case should be disposed off, within 90 days. For any delay, on the part of
the District Commission / State Commission the opposite party should not be penalized for paying interest also on any compensation awarded, if negligence is
THROUGH COUNSEL
VERIFICATION
11
Verified at ……………………… on this ___ day of _________, 2023 that the contents of the OPPOSITE PARTY NO.123 affidavit are true and correct to the
best of the OPPOSITE PARTY NO.123 knowledge. No part of it is false and nothing material has been concealed therefrom.
C. C. NO. 03 / 2024
VERSUS
I, Dr Amitabh Mishra and Dr Vishram Sagar Pandey , Indian inhabitant, having address at Sanjeevani & Mutli Speciality Hospital, West Ashrampara, Sevok
Road Siliguri West Bengal - 734001 the above-named OPPOSITE PARTY NO.123, do hereby solemnly affirm and declare as under:
1. That the OPPOSITE PARTY NO.123 in the above noted complaint case and that the OPPOSITE PARTY NO.123 is well conversant with the facts
2. That the accompanying written statement on behalf of the OPPOSITE PARTY NO.123 to the complaint has been drafted by our counsel under the
OPPOSITE PARTY NO.123 instructions and I have gone through the same and the contents of the same are true and correct and the same may be treated as part
and parcel of this affidavit and the same is not being repeated herein for the sake of brevity.
VERIFICATION
Verified at ………………… on this ___ day of _________, 2023 that the contents of the OPPOSITE PARTY NO.123 affidavits are true and correct to the best
of the OPPOSITE PARTY NO.123 knowledge. No part of it is false and nothing material has been concealed therefrom.
C. C. NO. 03 / 2024
VERSUS
APPLICATION ON BEHALF OF OPPOSITE PARTY NO.123 TO IMPLEAD THE INSURANCE COMPANY AS ONE OF THE OPPOSITE
1. That this is the case of alleged medical negligence against OPPOSITE PARTY NO.123, for being one of the treated doctors.
2. That the applicant opposite party has mention in the written statement that,
a.
At the time of cause of action and Currently, opposite party no.1 was insured with “National Insurance Company Ltd”, through its Professional
Indemnity Policy No. 240400492210000090 effective from 25-Mar-2023 to 24-Mar-2024 (Copy of insurance policy is being annexed as “Annexure R-
1”).
b.
Currently, opposite party no.2 was insured with “National Insurance Company Ltd”, through its Professional Indemnity Policy No.
240400492210000090 effective from 25-Mar-2023 to 24-Mar-2024 (Copy of insurance policy is being annexed as “Annexure R-1”). At the time of cause of
action opposite party no.2 is insured with “ICICI Lombard General Insurance Company Limited”, through its Professional Indemnity Policy No.
4021/A/257525125/00/000effective from 31-Aug-2022 to 30-Aug-2023 (Copy of insurance policy is being annexed as “Annexure R-2”).
C. Currently, opposite party no.3 was insured with “National Insurance Company Ltd”, through its Professional Indemnity Policy No.
4021/A/317830090/00/000effective from 27-Oct-2023 to 26-Oct-2024 (Copy of insurance policy is being annexed as “Annexure R-3”). At the time of cause of
action opposite party no.2 is insured with “ICICI Lombard General Insurance Company Limited”, through its Professional Indemnity Policy No.
4021/A/269186352/00/000effective from 27-Oct-2022 to 26-Oct-2023 (Copy of insurance policy is being annexed as “Annexure R-3”). That
professional doctor covers the risk of liability, if any, which may arise if they are held liable for medical negligence by any Competent Court/Commission
etc, by taking the Professional Indemnity Insurance Policy from the insurer companies.
3. That the Insurer Company, through their independent advocate, also contests the case filed against the doctor insured with them. In case any
liability comes on the doctor on account of medical negligence and insurance company is not made a party, then the doctor faces problems in getting
the indemnity from the insurer company to the extent of insured amount.
4. That a Three Judges Bench of Hon’ble Commission in “Dr. C.C. Choubal Vs. Pankaj Srivastava (IV (2003) CPJ 111(NC)” In a case of medical
negligence against the petitioner-doctor, an application was filed by him to implead the Insurance Company as co-respondent. This application was dismissed by
the District Commission and appeal against that by petitioner was also dismissed by State Commission. Insurance Company may not be a necessary party, but it
is certainly a proper party inasmuch as claim against the Doctor would be covered if there is any medical negligence found against him. It would be more
appropriate if Insurance Company is made, a co-respondent. Subsequently the orders against the Doctor, if any, are passed there would be no difficulty for the
complainant to get the amount of compensation to the extent of amount of the policy from the Insurance Company. Thus “the Insurance Company may not be a
necessary party, but it is certainly a proper party in as much as claim against the Doctor would be covered, if there is any medical negligence found against him.
It would be more appropriate if Insurance Company is made a co-respondent….” (Copy of the Order is annexed hereto and is marked as Annexure –B).
PRAYER
13
In view of the above, it is most humbly prayed that this Hon’ble Commission may graciously be pleased to implead “National Insurance Company
Ltd”&“ICICI Lombard General Insurance Company Limited”, The insurer of OPPOSITE PARTY NO.123 in the array of respondents in this present
(DR. )
PLACE: -
DATE: - / /2023
THROUGH COUNCEL
C. C. NO. 03 / 2024
VERSUS
AFFIDAVIT
I, Dr. Amitabh Mishra S/o Sh. Jagat Narayan Mishra Indian inhabitant, having address at Sanjeevani & Mutli Speciality Hospital, West Ashrampara, Sevok Road
Siliguri West Bengal – 734001 the above-named OPPOSITE PARTY NO.1, do hereby solemnly affirm and declare as under–
1. That I am the opposite party and such being aware of the facts and circumstance of the present case I am competent to swear this affidavit.
2. That the accompanying application for impleading Insurance Company has been drafted by my counsel under my instructions and I have gone
through the contents of the same and the same are true and correct and be read as part and parcel of this affidavit, as the same are not being repeated herein for
DEPONENT
VERIFICATION
Verified at on this day of ______, 2023 that the contents of my above affidavit are true and correct to the best of my knowledge and nothing
DEPONENT
C. C. NO. 03 / 2024
VERSUS
AFFIDAVIT
I, Dr. Amitabh Mishra S/o Sh. Jagat Narayan Mishra Indian inhabitant, having address at Sanjeevani & Mutli Speciality Hospital, West Ashrampara, Sevok Road
Siliguri West Bengal – 734001 the above-named OPPOSITE PARTY NO.2, do hereby solemnly affirm and declare as under–
1. That I am the opposite party and such being aware of the facts and circumstance of the present case I am competent to swear this affidavit.
2. That the accompanying application for impleading Insurance Company has been drafted by my counsel under my instructions and I have gone
through the contents of the same and the same are true and correct and be read as part and parcel of this affidavit, as the same are not being repeated herein for
DEPONENT
VERIFICATION
Verified at on this day of ______, 2023 that the contents of my above affidavit are true and correct to the best of my knowledge and nothing
DEPONENT
C. C. NO. 03 / 2024
VERSUS
AFFIDAVIT
15
I, Dr. Vishram Sagar Pandey S/o Sh. Ramudresh Pandey Indian inhabitant, having address at Sanjeevani & Mutli Speciality Hospital, West Ashrampara, Sevok
Road Siliguri West Bengal – 734001 the above-named OPPOSITE PARTY NO.3, do hereby solemnly affirm and declare as under–
1. That I am the opposite party and such being aware of the facts and circumstance of the present case I am competent to swear this affidavit.
2. That the accompanying application for impleading Insurance Company has been drafted by my counsel under my instructions and I have gone
through the contents of the same and the same are true and correct and be read as part and parcel of this affidavit, as the same are not being repeated herein for
DEPONENT
VERIFICATION
Verified at on this day of ______, 2023 that the contents of my above affidavit are true and correct to the best of my knowledge and nothing
DEPONENT