New Delhi: In a medical negligence case, the National Consumer Disputes Redressal Commission (NCDRC) has upheld an earlier order of UP State Consumer Disputes Redressal Commission of awarding Rs 15.65 lakh compensation to the family of a woman who died due to wrong medication.
“It is important when administering any potentially harmful medication that contraindications have been reviewed and don’t exist. Therefore, a hospital that fails to follow, or has an employee breach, the recommended standards of care set out by the drug formulation faces increased chances for being held liable by a court. The patient who suffered has the greatest chance of succeeding on a claim for negligence,” read the NCDRC order dated January 30, 2017.
The court of presiding member Dr B C Gupta and member Dr S M Kantikar was adjudicating over two cases — an appeal by Sitaram Srivastava who sought enhanced compensation for the death of his wife in 1998, and the second by the Sanjay Gandhi Post Graduate Institute of Medical Sciences (SGPGI), Lucknow, to quash the case.
The complainant Sitaram Srivastava’s wife, Krishna Devi, was suffering from vitiligo skin disease. In January 1998, she approached a skin specialist in Kanpur, Dr S C Aggarwal, who treated her with the drug ‘Levamisole 150 mg’. “It is alleged that the said drug was not meant for treatment of Vitiligo and overdose of the said medicine developed nausea, vomiting, pain in abdomen etc,” said the order.
In February 1998, the patient discontinued the treatment and consulted heart specialist Dr A K Trivedi, who told her that she should not have been prescribed Levamisole. He then referred the patient to Dr R N Dwivedi, senior physician and professor of medicine at GSVM Medical College, Kanpur, who, in turn, suggested immediate shifting of the patient to SGPGI, Lucknow.
Krishna Devi was admitted to SGPGI on February 27 morning and continued with the treatment till March 8, when she was administered ‘Vancomycin injection’ in a single bolus dose without any IV drip. She died within 10 minutes of being administered the drug.
The court observed, “‘Vancomycin’ injection should have been administered slowly through the drip intravenously for more than one hour through the Burette Set.”
The patient’s husband, Sitaram Srivastava, then filed a complaint before the UP State Consumer Disputes Redressal Commission, Lucknow for alleged medical negligence causing death of his wife. The state commission granted a compensation of Rs 15,65,000 to be paid by the hospital (SGPGI, Lucknow) “within two months, failing which, it shall be liable to pay interest at 10% per annum from the date of order till its realisation”.
Dissatisfied by the state commission order, both the parties filed cross appeals — the hospital for dismissal of complaint, and the complainant for enhancement of compensation — before the national commission.
Somiran Sharma, the counsel for the hospital, argued before the national commission that when the patient was admitted to SGPGI, she was diagnosed as suffering from drug-induced Agranulocytosis due to Levamisole prescribed by Dr S C Agrawal and that it led to suppression of bone marrow and caused ‘Aplastic Anaemia’. Blaming Dr Agrawal, the counsel added if he had taken slight care, the patient could have been saved from developing Agranulocytosis.
The SGPGI counsel vehemently denied that the injection ‘Vancomycin’ was given as a bolus dose. He argued that the nursing staff had given another injection Factum directly through IV (intravenous) whereas ‘Vancomycin’ was given through drip after dilution. Nurse Ajay Kumar too had denied injecting Vancomycin as bolus in his statement to the state commission, but the commission had ignored the evidence of Kumar as “the nursing sheet showed overwriting/interpolation on 8.3.1998, regarding the timings of injection as ‘2 or 4 or 9’.”
As per the hospital’s medical record, the patient died at 4.35 PM due to sudden cardiac arrest, but the national commission observed, “We are rather surprised that the medical record is devoid of clinical findings pertaining to cardiac arrest and which resuscitation steps were taken by attending or resident doctors.”
On Srivastava’s appeal the NCDRC order said, “We do not find any reason to enhance the compensation because the state commission passed the well-reasoned order and awarded just and proper compensation to the complainant.”
The national commission’s order concluded by saying, “We are of the considered view that the opposing party (SGPGI) is liable for medical negligence in this case. The OP had tried to hush up the matter, failed to maintain medical record properly as per standard of practice. Therefore, we are not inclined to interfere in the impugned order of the state commission. Accordingly, both the appeals are dismissed. The parties are left to bear their own costs.”
by Anju Sneh