Observing that the treating doctor failed to diagnose and treat severe coronary artery disease and further tried to fabricate false reports for saving his skin, Punjab State Consumer Court has directed the doctor to pay Rs 10 lakh as compensation to the patient.

The case goes back to 2018 when the patient felt uneasiness and pain in her chest on April 11. After consulting a local physician, she was taken to the treating hospital in Chandigarh, where the treating doctor, who is also the sole proprietor of the Hospital, examined the patient. Several tests including ECG, Echo, and Angiography were done.

It was submitted by the patient (complainant) that on the basis of the tests, which declared that the patient was suffering from acute heart blockage, the treating doctor insisted on immediate surgery and warned that delay in surgery might cost the life of the patient.

Under such circumstances, the husband of the patient claimed that the complainant was operated on by the treating doctor. During that time, the treating doctor informed the husband of the patient about implanting a stent in the blocked arteries and assured that post-surgery there was no blockage in the heart. However, a few days later the patient felt severe pain in the chest again. First, the treating doctor told them that it was due to surgery and the second time the complainant was asked to take some medicines and come back for a follow-up check-up on June 5.

Meanwhile, unsatisfied with the treatment, the patient opted for a second opinion and consulted a doctor at another Hospital. The second doctor prescribed some tests and after examining the reports informed the complainant that there was 95% blockage in the same artery.

When the second doctor asked for the barcode sticker of the previous stent along with the CD of the angiography, the complainant realized that the treating doctor at the first hospital didn't provide them with the same. In fact, the second doctor allegedly further observed that the stenting at the first hospital was not properly done and there was negligence on the part of the doctor, even though he denied giving that in writing.

However, the operation was conducted once again at Fortis hospital and after discharge and follow-up treatment, the husband of the complainant approached the treating doctor at the first hospital and demanded a barcode, make brandand expiry date of the stent and asked to supply CD of angiography. This demand, however, was not fulfilled.

Alleging malafide intention, concealing the facts of still existence of blockage in the same artery despite check-up and treatment, the complainant approached the State Commission and filed a complaint and demanded a full refund of the money spent by them at the first hospital, the cost of treatment and follow-up treatment at the second hospital, costs of litigation, and also another Rs 25 lakhs on account of compensation for causing mental tension, harassment and mental agony to the patient.

The treating doctor at the first hospital, on the other hand, denied all the allegations and further charged the complainant for concealing facts. The doctor further claimed that the first blockage found on 14 April and the second one on May 31 were at different places. Although the blockage was in the same artery (Left Anterior Descending Artery), but the second one was at a totally different place. So, no question of wrong stenting arises, as the two blockages were at two different positions.

When the second hospital (Fortis) was called for hearing, it reiterated the facts stated by the complainant and admitted that the blockage was found in the same artery where the first treating doctor had operated on.

After perusing the documents relevant to the case, the State Commission noted that the treating doctor at the first hospital, in order to save his fault, prepared a false report dated 31.05.2018. The report showing a diagnosis of Double Vessel Disease (DVD) and advising PTCA+Stent to LAD/CABG, was never supplied to the patient. On the other hand, the coronary angiography report dated 31.05.2018 showed normal condition of the artery. "Two different reports of similar test are not possible," noted the Commission.

"Thus, the first hospital has committed willful and intentional forgery and fabrication in the medical record, in order to save his skin," the Commission observed.

Further, the consumer court took note of the fact that the treating doctor at the first hospital couldn't reply to the interrogatory questions properly and he was not competent enough to perform the surgery as he was not having requisite enrolment as per the Medical Council of India. In fact, there was no evidence to show that the doctor was enrolled under Punjab Medical Council.

The Commission declared at this outset: "Doctor at the first hospital cooked up the false story with regard to the new blockage at the ostial region of LAD and produced a false report in that regard. The medical negligence and deficiency in service on the part of first hospital has been clearly proved on record and, hence, the patient is entitled to all the reliefs, as claimed in the complaint."` "The perusal of the medical record of O.P. No.1 (first hospital) and O.P. No.3 (Fortis Hospital) reveals that O.P. No.1discharged the patient with blockage of LAD ostial 95% undiagnosed or intentional," further mentioned the order.

Further referring to the contentions of the treating doctor that the check angiography report on 31.05.2018 revealed that stenting point was different than the second blockage point, the consumer court noted that this fact was not mentioned by the doctor in the prescription slip.

The commission also referred to the diagnosis mentioned as DVD and mentioned, "Once the procedure for LAD proximal has been performed, then the disease cannot be stated as DVD, because after stenting of the proximal LAD, blockage at ostial location shall be called as SVD (single vessel disease)."

Thus, after considering the facts related to the case, the State Commission noted: "Coronary Artery Disease progresses over the years. It cannot occur within few days. No patient will conceal her reports from the other doctor, when she goes for second opinion and is aware that her life is at risk. It is common that the doctor many a time does not supply complete records to conceal his deficiency. This has happened in this case."

"Thus, negligence at issue in this case is failure to diagnose and treat severe coronary artery disease and thus breached the standard of care prescribed for cardiologist in diagnosis and treatment of the patient, who presents with symptoms of chest pain even after deploy of stent. Otherwise, it is a life-threatening issue." Holding the treating doctor at the first hospital guilty of medical negligence, the Commission directed the doctor, having sole proprietorship of the hospital, to pay lump-sum compensation of Rs 10,00,000/- (Rupees Ten Lac only),along with interest at the rate of 8% per annum from the date of filing of the complaint till realization to the complainant, on account of deficiency in service and medical negligence on the part of the O.P. No.1 and resultant loss, mental agony, harassment, unavoidable pain, sufferings caused to patient, including aforesaid medical expenses. Further, the doctor was asked to pay Rs 22,000 as litigation costs within 45 days of the receipt of the order.

Source: https://medicaldialogues.in/news/health/medico-legal/stent-of-stunt-doctor-slapped-rs-10-lakh-compensation-for-false-angio-report-failure-to-treat-cad-81631