By: Akanksha
The Delhi State Consumer Disputes Redressal Commission, comprising President Justice Sangita Dhingra Sehgal and Judicial Member Pinki, has held Metro Hospital & Heart Institute in Lajpat Nagar, New Delhi, guilty of deficiency in service under the Consumer Protection Act, 1986. In its judgement dated November 6, the Commission ordered the hospital to pay compensation of Rs. 15 lakh plus litigation costs of Rs. 50,000 to the patient Surest Kumar (through his wife Mrs. Shakuntala) on account of a complaint filed in 2015, because the hospital did not provide an ambulance with life support and a doctor to transfer the critically ill patient after he suffered a stroke following heart valve treatment in November 2013. As a result, the hospital did not meet basic standards of reasonable care and took almost five hours to transfer the patient. The family had to make their own arrangements to transfer the patient.
The case involved Suresh Kumar, a patient diagnosed with rheumatic heart disease, severe mitral stenosis, moderate mitral regurgitation, and several aortic regurgitation. He had undergone dual valve replacement and left atrial appendage litigation surgery at AIIMS on November 25, 2008 and remained under regular follow-up. On November 13, 2013, Kumar developed acute breathing difficulty and was rushed to Metro Hospital Heart Institute.
On an echocardiogram, it was found that there was a block in the aortic prosthesis (mean gradient between 61-66 mmHg), caused by a thrombus. Based on this, Dr. Samanjoy Mukharjee, the treating cardiologist, recommended admission and commenced treatment with streptokinase to break down the clot.
It is claimed that the family was not informed of any risks involved with the treatment, only that they would be receiving an injection. They claimed that they were told by the doctors that everything would be alright within 2-3 days. On November 15, 2013, Kumar suffered a stroke due to a clot travelling to his brain. This resulted in him being paralyzed on his right side and losing the ability to speak. The hospital recommended that Kumar be transferred to a facility which specialized in neurological care. While the family agreed, the hospital did not provide a fully equipped ambulance or doctor to accompany Kumar.
As recorded in the Commission’s judgement, when pressed for arrangements after clearing the bill, the hospital told the attendants that no arrangements can be made as neither the doctor nor the ambulance is available to take the patient to some other hospital.
The family claimed that almost five hours passed before they arranged for an ambulance on their own from Vimhans Hospital. No doctors were present when the patient was being transported. Since his admission in the ICU of Vimhans Hospital and subsequent treatment in Sir Ganga Ram Hospital and AIIMS, Kumar has not improved. He is suffering from speech loss, memory loss, decreased power of mind, and right-sided weakness. He is completely dependent on the family.
He approached the Commission seeking Rs. 35 lakh for medical negligence and mental agony, Rs. 50 lakh for loss of future earnings, and Rs. 50,000 in litigation costs.
Contesting the claims, Metro Hospital and the doctor maintained that treatment followed standard medical protocols and high-risk written consent explaining neurological and bleeding risks was taken before administering streptokinase.
The hospital has said that stroke is a known side effect of thrombolytic therapy and the family refused to move to their Noida unit, 23law reported. The Commission examined expert opinions from G.B. Pant Hospital, the Delhi Medical Council (DMC), and the erstwhile Medical Council of India (MCI). According to the court documents, the G.B. Pant Hospital expert board observed:
“Thrombolytic therapy (Streptokinase) for stuck valve thrombosis is one of the established lines of management which was instituted in this patient. High risk consent for the administration of streptokinase (thrombolytic) was taken from the patient before the administration of streptokinase and all the risks were explained as per the consent page attached in records. Dislodgement of thrombus causing stroke is a known complication of the disease i.e. thrombosis of aortic valve.”
Both the DMC and MCI found no prima facie medical negligence against Dr. Mukherjee. Quoting the bench, ThePrint reported:
“A perusal of the aforesaid medical opinions leaves no room for doubt that the patient was managed successfully using streptokinase as per the standard medical protocol,” the bench said, adding that “prima facie, no medical negligence can be carved out” against the doctor.”
While clearing the doctor, the Commission held that the hospital “miserably failed” to discharge its elementary responsibility regarding patient transportation. Referring to the Supreme Court ruling in Balram Prasad v. Kunak Saha, the bench said that a patient coming to a premier hospital with high charges has a reasonable expectation of receiving treatment of similar quality. The bench said:
“A hospital is not merely a commercial establishment providing medical facilities for consideration; it is an institution entrusted with the onerous responsibility of safeguarding human life... The provision of basic emergency facilities, including an appropriately equipped ambulance and qualified medical personnel for patient transfer, cannot be treated as an optional or dispensable service.”
The bench was surprised to find that the hospital did not give any valid reason for not arranging the transport. Quoting the order, ThePrint reported:
“In the present case, the record unequivocally reflects that the hospital failed to make adequate arrangements for the transportation of the patient, thereby resulting in the wastage of precious and critical time at a juncture when the patient was in an extremely vulnerable condition and required immediate medical intervention.”
Emphasizing that patients and attendants cannot be expected to independently arrange emergency infrastructure, the Commission stated:
“The duty of a hospital does not come to an end merely upon providing consultation or administering treatment within its premises.”
It further observed that:
“We further observe that the failure to arrange for an ambulance and appropriate medical supervision during the transportation of a critical patient is not a mere procedural lapse or an inconsequential administrative omission. It represents a failure to adhere to the elementary standards of reasonable care and medical responsibility expected of a hospital.”
Noting that “in matters concerning human life, precious time lost in arranging basic emergency medical facilities may have consequences which cannot subsequently be undone or compensated for,” the bench held that the conduct showed “a serious dereliction of the duty of care.”
As reported by ThePrint, the Commission directed Metro Hospital to pay Rs. 15 lakh as “compensation for the mental agony and distress caused to the patient and the attendants on account of deficient service in failing to provide the life support ambulance and putting the life of the patient at risk,” plus Rs. 50,000 as litigation costs. As noted by 24law, the total amount of Rs. 15.5 lakh must be paid on or before January 6, 2027, failing which it will carry 9% annual interest from the date of filling the complaint until realization.
(Rh/APC)
