Medical Negligence – Angiography – aorta dissection – sever pain – right leg runs down – no pulse sensation – resulted in another Hospital an anigography and angio palsty – drives the complainant for mental and physical agony and financial loss – state consumer forum allowed the petiton – on appeal National consumer forum dismissed the complainant – Apex court held that There is sufficient material to come to the conclusion that the complainant was
found stable after third day of angiography and till the date of discharge on September 8, 1999. The only allegation of the complainant is of abdominal pain during the process of angiography. There is no dispute that she was aged about 55 years and suffering from hypertension when the angiography procedure was conducted on her. It is probable that due to such associated causes the passage of the catheter through aortic space was not smooth.
There is no material to infer that Dr. Chawla had undertaken any adventurous step.
There is nothing on record which points out that Dr.Chawla used any brutal force to push the catheter. In our opinion, mere completion of the angiography does not rule out aorta dissection during the procedure. We find that the complainant did not had a serious aorta dissection but was having sub-acute aorta dissection and this is the reason that the complainant was subjected to clinical management and, in fact, her condition became stable without any surgical interference. It is nobody’s case that Dr. Chawla is not a competent coronary expert or he lacked adequate knowledge in the field of coronary surgery. He is duly qualified and has good academic credentials. We have not found his conduct to be below the normal standard of a reasonably competent practitioner in his field. We are in agreement with the reasoning and the conclusion arrived at by the National Commission that the complainant has not been able to prove medical negligence on the part of Dr. Chawla. In the result, we do not find any merit in the appeal and it is dismissed without any order as to costs.=
whether it was
the direct result of any negligent or rash act committed by Dr. Chawla
while conducting the angiography.
Dr. Chawla examined the complainant clinically
on September 1, 1999 and conducted Echo test. Dr. Chawla noticed that
there was possibility of blockages which needed appropriate confirmation
and medical treatment and accordingly he advised for admission of the
complainant in the Research Centre for conducting angiography. =
Dr. Chawla with the consent of the complainant’s son, a
medical practitioner, decided to conduct angiography on September 2, 1999.=
The complainant has alleged
that during the angiography procedure, she felt severe pain in the abdomen
and brought the said fact to the notice of Dr. Chawla but he ignored the
same and continued with the procedure. =
On
September 3, 1999, according to the complainant, Dr. Chawla alongwith
another consultant namely Dr. Suri examined her who found pulse of her
right leg practically absent and as such he reprimanded Dr. Chawla=
Dr. Trehan of the Escorts Heart Institute, Delhi and
was admitted in the said Institute on September 13, 1999. Another
angiography was conducted at the Escorts Heart Institute through radial
artery of the right arm and on that basis, according to the complainant,
Dr. Trehan opined that aorta dissection has taken place during the
angiography procedure done by Dr. Chawla at Tagore Heart Care and Research
Centre, Mahavir Nagar, Jalandhar, Punjab and that was iatrogenic in nature.
Ultimately, she had undergone angioplasty on October 18, 1999 and was
discharged after ten days.=
The complainant alleged medical negligence on the part of Dr. Chawla
and the Research Centre while conducting the angiography on September 2,
1999 resulting into dissection of aorta.
She has alleged that she had to
obtain further treatment and due to the sheer negligent act of Dr. Chawla
incurred heavy expenditure in undergoing angioplasty and angiography at
Escorts Heart Institute.
Alleging the aforesaid, the complainant filed
petition before State Commission, interalia, praying compensation of Rupees
Eleven lacs from Dr. Chawla-Respondent No.2 and the Research Centre-
Respondent No.1.=
State Commission held in this regard:
“….It is true that hypertension is one of the factors of causing
aorta dissection but in the present case, the aortic dissection had taken
place when respondent no.2 was passing the catheter through iliac artery
travelling through aorta blood vessel reaching inside the arteries
adjoining the heart.
The dissection of aorta had taken place because
respondent no.2 was negligent.
In fact, it is case of res ipsa loquitur
i.e. the facts speak themselves and point out that it has taken place due
to negligence of respondent no. 2.If he taken due care and caution, then
this dissection of aorta would not have taken place because it is a very
rare phenomenon.
Hence, we hold that the respondent had not taken due care
and caution and had acted negligently in passing the catheter through iliac
artery by performing angiography and this led to severe pain in her abdomen
and she even complained but unmindful with the pain of complainant, he
continued with the process and completed the same.
This again suggests
that he was insensitive to the pain and agony of the complainant.”
In this regard, the National Commission has observed as follows:
“18. We are of the opinion that the State Commission committed
an error while reaching a finding that the doctrine of Res ipsa loquitur is
applicable to the fact situation of the present case. In fact, we do not
find any basis to support such finding, particularly, when the medical
record shows that complainant – Smt. Kanta was stable when she was
discharged on 8.9.1999 from the hospital and could later on travel to Delhi
for the purpose of coronary surgery. We think it proper to hold that there
was no negligence committed by the appellants while conducting the
angiography procedure.”
In this regard, the National Commission has observed as follows:
“18. We are of the opinion that the State Commission committed
an error while reaching a finding that the doctrine of Res ipsa loquitur is
applicable to the fact situation of the present case.
In fact, we do not
find any basis to support such finding, particularly, when the medical
record shows that complainant – Smt. Kanta was stable when she was
discharged on 8.9.1999 from the hospital and could later on travel to Delhi
for the purpose of coronary surgery.
We think it proper to hold that there
was no negligence committed by the appellants while conducting the
angiography procedure.”=
Apex court held that
From the entries made in the discharge
summary, we do not find that there was any emergency to treat the aortic
dissection.
Aortic dissection came to be noticed beyond all reasonable
doubt on September 3, 1999.
She was not operated upon.
It may be
mentioned here that in case of acute aortic dissection, emergency open
heart surgery is required.
However, in case of sub-acute aortic
dissection, treatment with medication may be sufficient.
There is
sufficient material to come to the conclusion that the complainant was
found stable after third day of angiography and till the date of discharge
on September 8, 1999.
The only allegation of the complainant is of
abdominal pain during the process of angiography.
There is no dispute that
she was aged about 55 years and suffering from hypertension when the
angiography procedure was conducted on her.
It is probable that due to
such associated causes the passage of the catheter through aortic space was
not smooth.
There is no material to infer that Dr. Chawla had undertaken
any adventurous step.
There is nothing on record which points out that Dr.Chawla used any brutal force to push the catheter.
In our opinion, mere
completion of the angiography does not rule out aorta dissection during the
procedure.
We find that the complainant did not had a serious aorta
dissection but was having sub-acute aorta dissection and this is the reason
that the complainant was subjected to clinical management and, in fact, her
condition became stable without any surgical interference.
It is nobody’s
case that Dr. Chawla is not a competent coronary expert or he lacked
adequate knowledge in the field of coronary surgery.
He is duly qualified
and has good academic credentials.
We have not found his conduct to be
below the normal standard of a reasonably competent practitioner in his
field.
We are in agreement with the reasoning and the conclusion arrived
at by the National Commission that the complainant has not been able to
prove medical negligence on the part of Dr. Chawla.
In the result, we do not find any merit in the appeal and it is
dismissed without any order as to costs.
advocatemmmohan 
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