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HindustanTimes Sat,30 Aug 2014

PGI, CTU told to pay Rs. 10 lakh to Anupama's parents

HT Live Correspondent, Hindustan Times  Chandigarh, April 02, 2013
First Published: 22:22 IST(2/4/2013) | Last Updated: 22:29 IST(2/4/2013)

The state consumer disputes redressal commission, Chandigarh, has ordered Post Graduate Institute of Medical Education and Research and Chandigarh Transport Undertaking to pay Rs. 7 lakh and Rs. 3 lakh, respectively, to the parents of 16-year-old girl Anupama Sarkar who died at the premier institute in July 2012.

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While the premier institute was held guilty of “negligence in the treatment” of Anupama, CTU was held “deficient in services” since the girl's leg was crushed under a CTU bus on July 17, 2012, after which she was taken to PGI where she had breathed her last.

“PGIMER was negligent of not treating the patient with due care and skill,” observed the state consumer disputes redressal commission while asked the PGI to pay compensation to Anupama's parents Amit Sarkar and Konika Sarkar.

The commission asked CTU to pay compensation for “deficiency in services”, which would be paid by the UT administration. The commission also directed the PGI and CTU to pay Rs. 25,000 as cost of litigation.

“Anupama died due to “per se” negligence of the treating doctors of PGIMER by not treating the patient with due care and skill. Had the doctors concerned exercised due care and skill, they would have followed the requisite protocol by performing the operation on the crushed leg of the patient on the very day of her admission, as a result whereof, development of gangrene and septicemia would have been avoided and her life would have been saved,” ruled the commission.

“From the facts and circumstances of the case, as also from the enquiry reports, it is apparent that there was considerable delay in properly treating the patient. But due to non-availability of the proper medical treatment, in time, the condition of the patient deteriorated badly and her life could not be saved,” it added.

The leg of Anupama, a student of Government Model Senior Secondary School in Sector 18 and a resident of Mauli Jagran complex, was crushed under a CTU bus on July 17. Her family had alleged that delay in the treatment led to the amputation of her leg. The delay in the surgery resulted in the spread of the infection to her entire body and it developed into gas gangrene, they claimed. The condition led to sepsis and her death on July 24, 2012.
 
Complainant's case

Pankaj Chandgothia, counsel for the complainants, submitted before the commission that due to inadequate medical care and treatment, gangrene and septicemia developed in the left leg of the complainant, which was crushed in the accident on July 17, 2012. Had the PGIMER provided the medical assistance properly, promptly and immediately after her admission, she could have been saved, the counsel contended.

Chandgothia pointed out that due to delay in surgery, the complainants could not save the life of their only daughter.

PGI's submissions

The PGI denied all allegations leveled by the complainants and submitted that due care was taken after the girl's admission. The patient was planned for surgery, at the time of her admission, and all the arrangements were made. The patient was even transfused blood but due to heavy rush of patients, the same could not be conducted, the premier institute's counsel argued.

The defendant institute further submitted that the patient was taken for surgery on the night of July 19, 2012, since 80-90 patients were admitted in the Advance Trauma Centre on an average during those days as against the availability of 17 beds. As many as eight similar serious open fracture surgeries were pending, the PGI counsel said. Anupama could not be given preference over these eight as it would have amounted to sacrificing the interests of the aforesaid patients'.

The counsel contended that she was found unfit for anesthesia and was shifted back to the operation theatre recovery room. The patient was anemic and her blood pressure was 85/50. The PGI submitted that the patient was given due medical attention, and  the gangrene and sepsis could also set in following severe wound contamination due to the mechanism of injury (crushing) and place of injury (roadside accident).

Anupama was intubated and put on a ventilator with triple inotropes due to persistent low blood pressure.

CTU deficient for allowing bus to ply without insurance

CTU was held guilty of deficiency in services because the bus involved in the accident had no insurance and was plied in violation of the Motor Vehicles Act.

The commission held that since the CTU was one of the departments of the Chandigarh administration and working under its control, Rs. 3 lakh to be paid by the UT administration could be said to be adequate compensation on behalf of the former.

Probe panel report helped nail PGI

Following the death, the PGIMER had marked an inquiry by external experts. The committee headed by Dr SS Gill, vice chancellor of Baba Farid University of Health Sciences, Faridkot, found that the incident happened due to “systemic flaws”.

The report by the enquiry panel of five doctors led by Prof SS Gill categorically mentioned that it would have been appropriate for the team of treating doctors to periodically reassess all the patients and reprioritise the operation theatre schedule according to the seriousness of the case vis-à-vis other cases.

The committee ruled that the mechanism of injury of Anupama should have raised a high index of suspicion that the patient had sustained crush injury of the thigh and was likely to develop serious complications. However, the panel said, the medical team decided to stick to its previous waiting list and hence the patient could not be taken for surgery till July 19, 2012.

The said committee further mentioned that though the orthopaedic team insisted that there were serious cases, which could not have been delayed, the panel felt that priority should have been rearranged for Anupama.

It was found that all the doctors who deposed before the probe committee accepted that there was a delay which was due to heavy rush of many serious patients. However, the committee opined that Anupama should have been given due priory over other cases.

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