Chandra Paul v. Narayana Multi Speciality Hospital

STATE CONSUMER DISPUTES REDRESSAL COMMISSION

WEST BENGAL

11A, Mirza Ghalib Street, Kolkata - 700087 Complaint Case No. CC/248/2015 ( Date of Filing : 07 Jul 2015 )

1. Chandra Paul W/o Late Soumendra Nath Paul, 157/4, Narasingha Dutta Road, P.O. - Howrah - 711 101, P.S. Bantra. ...........Complainant(s) Versus

1. Narayana Multi Speciality Hospital Andul Road, Howrah -711 109, P.S. Andul.

2. Dr. Sanjoy Kumar Saha, West Bank Hospital Andul Road, Howrah - 711 109, P.S.- Andul. ............Opp.Party(s)

BEFORE:

HON'BLE MR. JUSTICE MANOJIT MANDAL PRESIDENT HON'BLE MRS. SAMIKSHA BHATTACHARYA MEMBER HON'BLE MR. SHYAMAL KUMAR GHOSH MEMBER PRESENT:Mr. Utpal Roy Chowdhury , Advocate for the Complainant 1 Mrs. Keka Chakraborty,Ratnadipa Sarkar, Advocate for the Opp. Party 1 Ms. Somali Mukhopadhyay, Ms. Ratnadipa Sarkar, Advocate for the Opp. Party 1 Dated : 06 Oct 2023

Final Order / Judgement

SAMIKSHA BHATTACHARYA, MEMBER

The instant complaint has been filed u/s 17(1)(a)(i) ofCP Act, 1986 by the complainant against the OPs alleging medical negligence. The facts of the case, in brief,are that the husband of the complainant Late SoumendraNath Paul aged about 68 years was admitted in OP No.1 Hospital namely NarayanaMultispeciality Hospital (formerly known as West Bank Hospital) on 30.05.2013 at 1:55 P.M. under the supervision of Dr. Sanjoy Kumar Saha/OP No.2 in ICCU Bed No. ICU-2 with the complaint of Respiratory distress and fever for four days.He was diagnosed as a case of COPD (Chronic Obstructive Pulmonary disease).The patient was examined by OP No.2 and upon examination the following investigations were prescribed:

Routine blood, CReactive protein, Blood Culture, ABG, ECG, Urine routine examination.

The patient was given some medicines and was put in a mechanical ventilator

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inBIPAP mode i.e., Non-Invasive. The urine routine examine showed pus cell 4 to 5/HPF and Micro Organism- BacteriaSancty.Total WBC count was 11400 as against maximum permissible limit of 10,000.C Reactive protein was 8.1 mg where the normal limit is less than 1.0.

Immediately after admission, the condition ofthe patient took a nose dive as revealed from his blood investigation report dated 01.06.2013 onwards and chest x-ray report dated 03.06.2013 revealed Pachy Opacities in left para cardiac region.On 08.06.2013 due to fall in oxygen saturation ET Tube intubation was done and the patient was put on mechanical ventilation.On the same date, Central VenousCatherisation was done at about 12:30 P.M.The sputum culture sensitivity dated 10.06.2013 showed growth of Acenetobacter Baumannii (multi drug resistant). The complainant has alleged that this is hospital acquired i.e., Nasocomial Infection.On 13.06.2013 theprocess of weaning off ventilation was failed as the patient could not tolerate the same.On 17.06.2013 Tracheostomy was done at about 5:50 P.M.Immediately after Tracheostomy, the condition of the patient was kept on deteriorating and he was infected by lot of Nasocomial i.e. hospital acquired infection. On 25.06.2013 Urine Culture Sensitivity report showed growth of Klebsiella Pneumonia (multi drag resistant) and Tracheostomy Tube Suction Culture sensitivity report on the same date showed growth of Pseudomonas Aaeruginosia (multi drag resistant).On 05.07.2013 at about 6 P.M. during the visiting hours, when the patient was in Bed No. ICU-9, the complainant noticed that her husband was gasping rapidly and nobody was attending him and mechanical ventilation was also disconnected.She immediately called nursing staff but none was available and on 06.07.2013 she was informed that her husband died on 05.07.2013 at 9.05 P.M.The complainant has alleged that the mechanical ventilator was disconnected by OP No. 1 Hospital without her knowledge and consent which caused death of her husband.The complainant vide her complaint dated 19.08.2013 sent a letter to the OP No.1 Hospital. The death certificate dated 06.07.2013 indicates the cause of death was cardio respiratory failure in a case of Chronic Obstructive Airway distress with pneumonia and multi organ failure. The complainant has also alleged that OP No.1 hospital was gross negligent in providing adequate food and nutrition to the patient and treated the patient like a garbage which lead to various hospital acquired infections like Aceinetobacter Baumannii, pseudomonas klebsiella which ultimately cause death of the patient on 05.07.2013. The complainant

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was totally mislead and misguided by the OPs about the cause of death of her husband and therefore, she requested the OP No.1 hospital to provide her the treatment sheet in respect of treatment of her late husband in terms of Section 1.3.2 of MCI Rulesvide her letter dated 13.08.2013 and 19.08.2013. OP No. 1 supplied the same and the treatment-sheet revealed that no nursing note with regard to the monitoring of vital signs was available during the tenure of hospitalization of the patient. The OP No.2 has failed to exercise his due skill in diagnosis which resulted the wrong treatment upon the patient/deceased husband of the complainant. The complainant has further stated that no amount of compensation can bring back forlorn happiness in the family of the complainant but the death causes irreparable loss and damages in detriments tothe destitute petitioner caused by deficiency of service by OPs No. 1 & 2 which needs to be compensated in the form of deterrent to eradicate the social evil and malpractice. The untimely of the demise of the husband of the complainant due to rash negligent act on the part of OPs No. 1 & 2 jointly severally. Due to untimely demise of her husband, the complainant was suffering from trauma. Therefore, the complainant has filed the instant complaint praying for direction upon OPs to pay jointly and severally total compensation amount of Rs.29,87,946.83/- only to the complainant as mentioned in the paragraph No.25 including pecuniary and non-pecuniary damages, legal expense, punitive damage etc.

Upon receiving the notice the OP No.1 appeared through their Ld. Advocate and filed their written version.In their written version, OP No.1 has stated that no ground exists nor have any ground hasbeen made out in the complaint petition in support of the claim against the OP No. 1.There is no deficiency in service on the part of the OP No. 1nor any medical negligence on their part. The OP No.1 hospital is a multi speciality hospital and it has all necessary medical equipment and instruments for carrying out all kind of tests.The hospital has a fully equipped laboratory for conducting tests.The hospital has acquired a good reputation because of its high standard of medical treatment. The complainant has not disclosed any ground on the instance of deficiency in service on the part of the hospital. The OP No.1 has taken all necessary measures at all material time to redress the issues raised by the complainant regarding the treatment of her husband since deceased.The OP No.1 has taken all necessary precautions in accordance with rules and regulations relating to medical treatment.Despite best effort of the hospital authority and the renowned doctors attached to the hospital, the condition of the patient was worsening on 24/25.06.2013 due to the best efforts and cooperation of OP)

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No.1 the patient was responding positively.However, the condition of the patient was deteriorated on 04.07.2013 and despite the best efforts of the OPs, the patient expired on 05.07.2013.The patient having been admitted with severe lung condition survived for more than 35 days.At the time of discharge of the dead body of the patient on 06.07.2013, the complainant did not raise any allegation regarding deficiency in service on the part of the OPs.Subsequently, on 19.08.2013 the complainant sent a letter requesting the OP No.1 to provide certain documents which was necessary to lodge mediclaim from NIC and ESIC.Therefore, it is evident that complainant has not raised any contemporaneous grievance regarding the quality of service rendered by OP No.1 in the treatment of her deceased husband.Therefore, the complaint is nothing but an afterthought with an mala fide intention of unlawful gain.

The OP No.1 has also stated in their written version that the alleged cause of action, if at all, arose on 05.07.2013 but the present complaint has been filed on 07.07.2015 which is beyond the period of statutory limitation.The complainant has not disclosed the reason for delay and has not prayed for condonation of delay in filing the complaint and as such the complaint be dismissed at the outset without going into the merit.

OP No. 1 has also denied that the complainant is a victim of medical negligence in rendering service towards the husband of the complainant due to rash and negligent act or dereliction of duty on the part of the OP No. 1. All the allegations made in the complaint petition are denied by OP No. 1 The complainant is not entitled with the cost of treatment amounting to Rs.2,57,966.83 or any delay or other amount claimed by the complainant. The complainant is not a 'consumer' under Section 2 (1)(d) of the CP Act, 1986. The allegations contained in the complaint petition are vague, vexatious, frivolous, and without any merit. The instant complaintprocedure is speculative and has been filed for mala fide intention and for unlawful gain. The complaint is liable to be forthwith dismissed with cost. Upon receiving the notice of OP No. 2 did not appear before this Commission and the case was fixed ex parte against OP No. 2 vide order No. 15 dated 03.04.2018 passed by this Commission. Challenging this order, OP No. 2 filed a petition before the Hon'ble National Commission being First Appeal No. 1223 of 2018 whereby the Hon'ble National Commission has been pleased to allow the OP No. 2 to file written version before this Commission

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subject to payment of cost of Rs.25,000/- to be paid to the complainant within four weeks. OP No. 2 paid such cost and accordingly the ex parte order against the OP No. 2 was vacated vide order No. 20 dated 24.04.2019. Ultimately, the OP No. 2 filed written version on 29.05.2019. In his written version, OP No. 2 also denied all material allegations inter alia stated that no ground exists nor have any ground been made out in the petition of complaint in support of the claim made therein against the OP No. 2. There is no deficiency in service provided by the Hospital nor any medical negligence on its part of OP No. 2 or of any Doctor, Directors, Officers or staff by reason whereof the complainant is entitled to any monetary compensation as alleged at all. The OP No. 2 has admitted that late SoumendraNath Pal, husband of the complainant was admitted under him on 30.05.2013 under very serious condition with advance COPD in a drowsy state with respiratory failure. The condition of the patient was further aggravated due to Pneumonia. The patient put on non-invasive ventilator. As per standard practice,immediately upon admission, various tests were conducted on the patient. The report of such tests were available with the Hospital on 31^st May, 2013 and 1^stJune, 2013. Upon receiving the report, the doctor treated him. Despite his best efforts and efforts of the hospital authorities and the renowned doctorsattached to the hospital, the condition of the patient was worsening on 24/25^thJune, 2013. For the best effort given by the OP No. 1 and OP No. 2 the patient was responding positively. However, the condition of the patient again deteriorated on 4^thJuly, 2013 and despite the best efforts given by OP No. 2, the patient expired on 5^thJuly, 2013. The patient was admitted with severe lung infection and survived for more than 35 days. The OP No. 2 has also stated that the complaint is barred by limitation since the husband of the complainant died on 05.07.2013 and the present complaint petition was filed on 07.07.2013. The OP No. 2 has also statedthat the blood investigation report dated 01.06.2013 reveals that the tests were conducted on 30.05.2013 when the patient was admitted and depicted the condition of the patient before he was admitted. The patient was admitted with severe lung infection and the OP NO. 2 as an attending doctor had to make empirical change in antibiotics on 07.06.2013 despite the best efforts the patient was intubated and subsequently ventilated on 08.06.2013.

The patient on a central intravenous line with dopamine for inotropic support and blood transmission for his on-going care. The patient had a local seizure which was treated with levicetaram on 09.06.2013. The condition of the patient was improved on 11.06.2013 with the help of said treatment and

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the life support was withdrawn. However, after being intubated for many days, the patient was ventilated through tracheostomy tube which is implanted and such fact was communicated to the family members of the patient and the consent was obtained. The patient was also attended by an ENT consultant on 15^thJune, 2013 and an operation was performed on 17^th June, 2013 with the consent of the family members. Over the next few days, the patient remained on ventilator requiring less oxygen. However, again on 24.06.2013 the condition of the patient worsening and the patient started running high fever. In course of treatment in the hospital, the patient not only required oxygen support but required blood transfusion and the patient was put on high protein diet with calorie supplement, enternal and parenteral fluid administration, sodium and potassium supplement, appropriate medication along with antibiotics. But the patient remained on ventilation largely due to age frailty, poor muscle mass and underlying chronic illness. The patientwas attended by the Doctor as well as the Hospital Authority.However, on July, 5, 2013 the patient unfortunately succumbed to cardio respiratory arrest and was declared dead on 05.07.2013 at 9:05 p.m. The OP NO. 2 has also denied in his written version, that the mechanical ventilation on 05.07.2013 was disconnected as alleged. The purported document dated 19.08.2013 was issued more than one and half month after the death of the patient which is clearly an afterthought and was issued with the malafide intention to institute the instant proceeding. The cause of death mentioned in the death certificate is correct and all allegations are denied. The OP No. 2 has also denied that he failed to exercise in diagnosis that resulted in wrong treatment upon the patient. Despite the proper diagnosis and best treatment provided by him the patient died. All the allegations made in the complaint petition are denied and OP No. 2 has mainly denied that the amount of compensation claimed by the complainant. The complainant is not a consumer under Section 2(1)(d) of the CP Act, 1986. Hence, he has prayed for dismissal of the complaint case since, the allegations in the complaint petition are vague, vexatious, frivolous and want of merit.

In course of argument, Learned Counsel for the complainant has stated that the husband of the complainant was admitted in the OP No. 1 hospital on 25.05.2013 at 1:05 am with the complaint of respiratory distress and fever for four days. The routine tests were advised by the OP No. 2. The patient was in a non-invasive mechanical ventilation. The condition of the patient was elaborately mentioned in the petition of complaint. On 25.06.2013, Urine Culture Sensitivity report shown growth of Acinetobacter Baumannii (Multi

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Drug Resistant) Tracheostomy suction sensitivity report showed growth of pseudomonous Aeruuginosia (multi drug resistant) on 05.07.2013. The patient was gasping rapidly and none was attending the patient and mechanical ventilator was also disconnected. On 06.07.2013 complainant was informed that the patient died on 05.07.2013 at 9:05 pm.

The Ld. Advocate for the complainant has submitted that the case in Supreme Court in (2009) 9 SCC 221 in Malay Kumar Gangully Vs Sukumar Mukherjee and Ors.

The Ld. Advocate for the complainant has also cited the judgment passed by Hon'ble Apex Court passed in the case of SavitaGarg vs. Director, National Heart Institute reported in (2004) 8 Supreme Court Cases 56 where the Hon'ble Court held that "It is the common experience that when a patient goes to a private clinic, he goes by the reputation of the clinic and with the hope that proper care wil be taken by the hospital authorities. It is not possible for the patient to know that which doctor will treat him. When a patient is admitted to a private clinic or hospital it is hospital clinic which engages the doctors for treatment." HHHence, the complainant has prayed for awarding compensation in favour of the complainant by allowing the petition of complaint. The complainant has filed the medical literature on Acinetobacter Baumannii and pseudomonous Aeruuginosia, pneumonia.

Ld. Advocate for the OPshas argued that despite best efforts of the OPs, the condition of the patient was worsening on 24/25^thJune, 2013. Due to best effort provided by the OPs, the patient was responding positively. The condition of the patient again deteriorated during July 4, 2013 and despite best efforts of the OPs, the patient expired on 05.07.2013. The patient was survived more than 35 days since the effective steps were taken and the treatmentwas provided by the OPs. After taking the dead body of the patient on 06.07.2013 the complainant did not raise any allegation regarding the deficiency in service on the part of the OPs. The complainant is nothing but an afterthought with mala fide intention of unlawful gain. The next course of argument on behalf of the OPs is that the case is barred by limitation. Since, the cause of action arose on 05.07.2013 when the husband of the complainant expired. But the presentcase was filed on 07.07.2013 which is beyond the statutory period of limitation. The complainant has not disclosed any reason for delay any and also not filed any petition for condonation of delay in filing the complaint. In such circumstances, the said complaint liable to be dismissed at the outset and without going into the merit. In this

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connection, the Ld. Counsel for the OP No. 1 has cited the judgment passed in Himkash Sales Depot Nurpurvs Manager, State Bank of Patiala passed by Hon'ble National Commission on 10^thOctober, 2012 where the Hon'ble National Commission has been pleased to hold, inter alia, if no cogent reasons shown to condone delay in filing the complaint, the complaint must be rejected.

The OP No. 1 has further stated that the complainant has not filed any single document to prove that there was any negligenceon the part of the opposite parties. On the other hand, all the medical documents of the deceased patient such as clinical assessment form, copy of admission form, copy of liquid diet chart, copies of test reports, copies of daily observation chart, copies of intake/output and irrigation chart and prescription chart are submitted before this Commission which prove beyond doubt that the deceased patient was given the best possible treatment and OPs tried their best to save the life of the patient.

The Ld. Advocate for the OPs has stated the following judgments passed by Hon'ble Apex Court in Indian Medical Association vs. V.P Shanta & Ors (1996 IR SC 550) where the Hon'ble Apex Court held that "The skill of a medical practitioner differs from doctor to doctor and it is incumbent upon the Complainant to prove that a doctor was negligent in the line of treatment. Therefore, a doctor is guilty only when it is proved that he has fallen short of the standard of reasonable medical care."

The Ld. Advocate for the OPs has cited another decision of the Hon'ble Apex Court in the case of Jacob Mathew vs. State of Punjab, III (2005) CPJ 9 (SC), where the Hon'ble Court observed that "the higher the acuteness in emergency and the higher the complication, the more are the chances of error of judgment. The Hon'ble Court further observed as under:

At times, the professional is confronted with making a choice between the devil and the deep sea and he has to choose the lesser evil. 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. Which course is more appropriate to follow, would depend on the facts and circumstances of a given case. The Hon'ble Supreme Court in case of Martin D'Souza V. Mohd. Ishfaque 1

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(2009) CPJ 32 SC has observed that : "When a patient dies or suffers some mishap, there is a tendency to blame the doctor for this. Things have gone wrong and, therefore, somebody must be punished for it. However, it is well known that even the best professionals, what to say of the average professional, sometimes have failures. A lawyer cannot win every case in his professional career but surely he cannot be penalized for losing a case provided he appeared in it and made his submissions." The OPs have submitted that all allegations contained in the complaint petition are vague, vexatious, frivolous and no reference can be placed thereupon. Hence, the Ld. Advocate for OPs has prayed for dismissal of the complaint with cost.

The Ld. Counsel for the OPs has further stated that the patient was admitted in OP No. 1 hospital under the treatment of O No. 2 doctor. There is no negligence on the part of the OP No. 2. Despite best efforts of the OPs on BIPAP, the deceased patient needed to be intubated and ventilated on 08.06.2013 and Antigungal Agent was started because of his underlying illness. The use of steroids and frailty which would contribute towards the immune suppressed state. The deceased patient needed a central intravenous line with Dopamine for inotropic support and blood transfusion for his ongoing care. He had focal seizure which was treated with levicetaram on 09.06.2013. Despite best efforts, the condition of the patient was worsening on 24/25^thJune, 2021 and ultimately, the patient died on 5^thJuly, 2013. All the effective steps were taken by both the OPs. Hence, the OPshave prayed for dismissal of the complaint petition with cost.

Both the OPs have cited the judgment passed by the Hon'ble Apex Court in Dr. Harish Kumar Khurana versus Joginder Singh and others [(2021)10 Supreme Court cases291].

On careful perusal of the record we observed that the authorised signatory of the OP No. 1 has admitted, it appears that both the OPs have stated in their written version that the alleged cause of action if at all arose on 05^thJuly, 2012 when the husband of the complainant expired and the present complaint has been heard on 07^thJuly, 2015 which is beyond the statutory period but the careful perusal of the record we have observed it appears to us that the complainant has sent a letter dated 19^thAugust, 2013 alleging deficiency in service against the OP No. 1. But OP No. 1 remain silent therefore, the cause of action also arose on 19^thAugust, 2013. We know that that the cause of

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action is bundle of facts therefore, the case is not barred by limitation. Both the parties filed their respective evidence on affidavit, questionnaire and reply.

Upon hearing the parties and on perusal of the materials on record it is admitted fact that Late Soumendra Nath Pal aged about 68 years, the husband of the complainant was admitted in OP No. 1 Hospital on 30.05.2013 at about 1:55 pm in ICCU bed No. ICU2 under the supervision of OP No. 2 doctor with the complaint of respiratory distress and fever for four days. He was diagnosed as a case of COPD. Routine blood test,C-Reactive protein, blood culture, ABG, ECG, urine routine tests were advised by OP No. 2. It is also admitted fact that the patient was put on non-invasive mechanical ventilation. The chest ex-ray report dated 30.06.2013 revealed that patchy opacities in left paracardiac region. On 08.06.2013 the oxygen saturation failed. As a result, the patient was put on mechanical ventilation and on the same date central venous catheterisation was done at about 12:30 pm. Sputum culture and sensitivity report dated 10.06.2013 showed growth of Acinetobacter Baumannii, which is Nosocomial infection. On 17.06.2013 tracheostomy tube was implanted at about 5:50 pm. On 25.06.2013 urine culture sensitivity report showed growth of Klebsiella pneumonia and culture sensitivity tracheostomy suction culture sensitivity report showed growth of pseudomonas Aeruginosa.

On 05.07.2013, the complainant noticed that patient was gasping rapidly. On 06.07.2013, the complainant was informed that on 05.07.2013 at about 9:05 pm the patient expired. The Death certificate shows the cause of death as sepsis pneumonia. Now the question is whether there is any deficiency in service on the part of the OP No. 1/ hospital and on the part of the OP No. 2 / doctor. There is no denial that the husband of the complainant was admitted with complaint of respiratory distress and fever for four days. As per central protocol the OP No. 2 advised some investigations and he prescribed medicine as per investigation reports. The allegation of the complainant is that the patient suffered from infections Acinetobacter Baumanni, Klebsiella pneumonia and pseudomonas Aeruginosia which are multi drug resistant. These infections are caused due to hospital borne infection. The complainant has not alleged anything against the procedure of treatment provided by OP No. 2 / doctor. The complainant has alleged only that the patient died due to sepsis pneumonia. Before suffering from sepsis pneumonia the patient was

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infected with Acinetobacter Baumannii which is multi drug resistant. The complainant has annexed the medical literature on Acinetobacter Baumannii infection. From the literature, we come to know that Acinetobacter Baumannii is one kind of Gram negative aerobic bacillus. that has emerged from an organism of questionable pathogenicity to an infectious agent of importance to hospitals worldwide. Gram-negative bacteria (GNB) are among the world's most significant public health problems due to their high resistance to antibiotics. An opportunistic patheogen, Acinetobacter Baumannii has a high incidence among immuno compromised individuals, particularly those who have experienced a prolonged hospital stay. The organism has the ability to accumulate diverse mechanisms of resistance, leading to the emergence of strains that are resistant to all commercially available antibiotics. The microbiology, pathogenesis, epidemiology, and disease associations of Acinotobacter infection will be reviewed here. The treatment and prevention of Acinetobacter infection are discussed separately.

Infections with Acinetobacter Baumanii to occur in debilitated patients in ICUs (among both children and adults) and among residents of long-term care facilities (particularly facilities caring for ventilator-dependent patients). Additional risk factors include recent surgery, central vascular catheterization, tracheostomy, mechanical ventilation, enteral feeding, and treatment with third generation among neonates include low birth weight, total parenteral nutrition, and central associated Acinetobacter infections is based on data from outbreak investigations.

Acinetobacter outbreaks have also been traced to common-source contamination (particularly contaminated respiratory and ventilator equipment), and to cross-infection by the hands of health care workers caring for colonized or infected patients. Once Acinetobacter is introduced into a hospital, serial or overlapping outbreaks caused by various multidrug-resistant strains are frequently observed. Subsequently, endemicity of multiple strains is established, with a single endemic strain predominating at any one time. Prolonged colonization may contribute to the endemicity of Acinetobacter Baumannii after an outbreak; in one study, colonization persisted for up to 42 months and affected 17 per cent of patients.

In this connection, we can rely upon the judgment passed by the Hon'ble Apex Court in (2009) 9 SCC 221 in Malay Kumar Gangully Vs Sukumar Mukherjee and Ors inter alia stated in Para 93-95 "Failure to prevent

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Nosocomial infection i.e., disease originating in hospitals - held it is the responsibility of the hospital to prevent such infection specially where patient has high risk infection due to nature and disease suffered……"

We can also rely upon in the judgment passed by the Hon'ble National Commission in the "Applo Emergency Hospital vs. Dr. Bommakanti Sai Krishna & Anr where the Hon'ble National Commission held that

"The possibility of infection occurring is not denied and is, in fact admitted in the revision petition, though very indirectly. Neither the revision petition nor the counsel point to any evidence placed before the for a below and ignored by them which could have shown that the cause/source of the infection lay not in the treatment in the OP Hospital, but elsewhere. Therefore, we reject this contention of the revision petitioner.

It is also alleged that there is no direct evidence against hospital to show that the infection was acquired at the hospital.

As already observed, the infection occurred during the stay of the Complainant at the hospital. On the other hand, there is nothing to show that the source of infection law outside the hospital. Thus, there is preponderance of possibilities of the infection having been acquired in the hospital itself. We, therefore, do not accept the contention that it was necessary for the Complainant to produce expert evidence to prove negligence on the part of the concerned doctors in the hospital."

In the instant case also the patient was infected with the infection Acinetobacter Baumannii while staying in the hospital for his treatment. The conditions of the patient was critical and therefore, the hospital authority should take more precautions such that the patient should not be infected with such hospital borne, specially ICU borne infection. These type of infections are a result of staying in a hospital or a health care servility, but secondary to the patient's original condition. Infections are considered nosocomial if they first appear within 48 hours or more after hospital admission or within 30 days after discharge. Thus, it becomes the liability of the hospital to prevent such infection specially in the cases where the patient has high risk of infection due to the nature of disease suffered.

The OP No. 1 has claimed that the OP No. 1 is a multi-speciality hospital which provides high degree of care. In such a big health care institutionlike

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OP No.1, the patient was infected with nosocomial infections which originate in a hospital. The nosocomial infections, also referred to as health care associated infections, are infection(s) acquired during the process of receiving health care that was not present during the time of admission. This very incident happened in the case of the patient / husband of the complainant. The plea taken by the OPs is that there is no Expert opinion. Expert opinion is advisory in nature and not binding on court. Moreover, in the case in hand, the complainant has alleged that her husband expired due to hospital borne infection. The complainant has not alleged against the line of treatment provided by OP No. 2/doctor.

The complainant also has not alleged any fault in the procedure of treatment by OP No. 2 that 'what ought to have been done was not done' by the OP No. 2 / doctor. Here, at the time of staying in the hospital, the patient was infected with Acinetobacter Baumannii which is one kind of gram negative and drug resistant bacteria and is transmitted from hospital due to improper sterilization of the ICU and other equipments. Acinetobacter Baumannii is an opportunistic pathogen or colonizer of hospitalized patients, especially severally unwell patients on intensive care units and its most common way of transmission is contact, mainly from hands of hospital staff. The patient has been admitted in a big hospital and the patient died due to hospital borne infection clearly proves that there is negligence on the part of the hospital. The negligence is on the face of record and the relevant documents are already annexed with the petition of complaint.

The complainant has filed this complaint for death of her husband in the OP No. 1/ hospital. It is not the case that the patient expired suffering from the disease for which he got admitted but for the ICU borne infection which caused his death. The OPs have not denied that the patient was infected with multi drug resistant infections which are hospital borne infections. These infections lead to cardio-respiratory failure, pneumonia and sepsis which are mentioned in the Death certificate of the patient. Therefore, the reason of death is infection due to Acinetobacter Baumannii, Klebsiella pneumonia and pseudomonas Aeruginosa, which are hospital borne infections. OP No. 2 also gave reply against question no. 11 put forward by the complainant that "the wording nosocomial infections are meant for only health care related infections."The complainant has paid Rs.2,37,000/- towards hospital bill which went in vain.

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