In Focus

Doctor’s neglect kills patient, kin get Rs 15 lakh payout

Yogesh Kumar, a CRPF constable attached to the Customs department of the government of India at Jaipur, developed kidney problems and was in critical condition due to renal failure.

He was admitted to Bombay Hospital under Dr Ashok Kripalani, consultant nephrologist and in-charge of the hospital’s artificial kidney unit. He was advised renal transplant, for which the required advance of Rs 1,48,000 was deposited by the authorities under the Central Government Health Scheme (CGHS). The kidney donor was also kept ready. Meanwhile, Yogesh was repeatedly admitted and discharged from the hospital, being advised haemodialysis each time. The last discharge was given on December 31, 1997, after a nurse’s complaint that Yogesh had slapped her.

The discharge card had no advice and merely prescribed certain medications. Yogesh’s parents repeatedly requested that the doctor continue treatment, as his condition was critical and discharging him, would be against medical ethics. When their pleas fell on deaf ears, they took him to Delhi. He could not get admitted to AIIMS, but was admitted to Sir Ganga Ram Hospital,
where he was put on dialysis.

After discharge, he returned to Jaipur, where he was admitted to Santokba Durlabhji Hospital, where he died on February 8, 1998. The medical certificate of death stated that he died of “cardiac arrest due to ESRD—septicaemia— Hepatitis B positive case of chronic renal failure”.

Yogesh’s parents filed a consumer complaint alleging that their son had died due to the negligence of Bombay Hospital and its doctors who forcibly discharged him. Dr Kripalani contested the case, contending that the complaint was time-barred, that it was not maintainable as no fees had been paid to him and objected to Yogesh’s wife not being joined in the proceedings.

On merits, Dr Kripalani said that Yogesh was suffering from end-stage renal disease, for which he was put on dialysis and was advised kidney transplant.

Meanwhile, Yogesh was admitted on four occasions when he was treated as per standard protocol. The government of Maharashtra had granted permission for a kidney transplant on August 8,1997, which was valid for 90 days, until November 7,1997, but Yogesh did not approach him along with a kidney donor during this period. The fee which had been deposited was partly refunded since the transplant could not be carried out in the sanctioned period.

Yogesh was of sound mind, yet he slapped the nurse merely because she had woken him up to check his vital parameters such temperature, blood pressure on her routine round. Such behaviour was unacceptable, and hence Yogesh was discharged. What happened thereafter was not the concern of the hospital or its doctors, and they could not be held liable for his death.

Yogesh’s parents pointed out that it was the hospital which had applied for sanction of the kidney transplant. The permission granted by the Maharashtra government was not communicated to them either by the hospital or its doctors. They learnt of the permission after it had lapsed when they brought Yogesh in for a routine admission. So, even though there was a ready donor, the transplant could not be carried out because of non-communication of the permission.

The commission found that the hospital billing Yogesh and Dr Kripalani was remunerated by the hospital on the basis of a tie-up, his services were not free and the commission concluded that Yogesh was a consumer and held the complaint to be maintainable. Both, the doctor and the hospital could not produce evidence to show that the patient had been told of the nod for the kidney transplant. As Yogesh did not know of this, the sanction lapsed after 90 days and no transplant could be done, leading to his death.

The failure to inform the patient about the sanction was held to be a deficiency in service. There was no police complaint, internal inquiry report, or other evidence to substantiate that Yogesh had slapped or misbehaved with the nurse. Yet, he was mercilessly discharged without any follow-up advice, even though a follow-up was required after he had undergone an AV fistula procedure just a day prior to the forceful discharge. This too was held as a deficiency in service.