Heart patient ‘back in ICU’ in 12 hours, Mumbai hospital told to pay Rs 3 lakh payout

Before the state commission, the patient sought enhancement of the award, whereas the hospital challenged the finding of deficiency in service and sought dismissal of the complaint.

“The opposite party/Hospital has claimed that the complainant developed respiratory infection after being discharged, but there is no evidence in the discharge summary to corroborate the same…We conclude that the District Commission has not committed any error or illegality by holding the opposite party/Hospital deficient in service,” the commission said on July 17.

Dr Yadav had undergone a bypass on July 27, 2019 and was discharged on August 7, 2019, after spending two weeks in the hospital. On August 8, however, he developed severe breathing difficulties, his oxygen saturation allegedly dropped below 50 per cent, and he had to be rushed again to the same hospital’s ICU. Claiming that he had been discharged prematurely despite his condition and that he was subjected to negligent treatment and over-billing, he approached the district consumer commission.

The complainant alleged that he is a resident of Damoh in Madhya Pradesh, and had  undergone angiography in Jabalpur, where doctors detected blockages in all three coronary arteries. He was advised to undergo coronary artery bypass graft (CABG) surgery and he chose the Mumbai-based hospital.

Case

The man alleged that although he was informed the surgery package would cost around Rs 9 lakh, the hospital eventually charged him about Rs 14.85 lakh for the first admission. He further claimed that after surgery he experienced severe pain and swelling in his right hand and that despite repeated complaints, the surgeon did not attend to him. A venous “Doppler” examination allegedly revealed damage to blood vessels in the hand, he added.

It was further alleged that despite objections raised by him and his family over his deteriorating condition, he was discharged on August 7, 2019. Within hours, he reportedly suffered acute breathlessness and was readmitted to the ICU, and the second admission resulted in an additional bill of Rs 1.46 lakh, prompting him to allege deficiency in service before the consumer commission.

The hospital contested the allegations and maintained that the patient had long-standing diabetes, hypertension, weak kidneys and a history of smoking, making him a high-risk patient. It argued that although the treatment package covered a seven-day stay, Dr Yadu remained admitted for 14 days because of respiratory complications, which explained the higher bill.

The hospital further contended that after discharge he developed bronchospasm and respiratory infection due to chronic obstructive pulmonary disease (COPD), necessitating readmission. It maintained that all treatment was provided according to established medical protocol and there was no negligence.

Hospital’s records

• After examining both discharge summaries, the state commission found that the hospital’s own records weakened its defence.
• The first discharge summary showed the patient’s diagnosis as ischemic heart disease, triple vessel coronary artery disease, hypertension and diabetes mellitus.
• However, it consistently recorded that no abnormality was detected in the respiratory system.
• The commission also noted that there was no mention of any respiratory infection during the first admission and none of the 21 medicines prescribed included antibiotics.
• The second discharge summary similarly did not record any previous history of COPD or chronic pulmonary disease.
• Although the hospital later claimed that the patient’s emergency was triggered by a pre-existing lung condition, the commission found no such history reflected in its own medical documents.
• Even during the second admission, the systemic examination again stated that no abnormality was detected in the respiratory system.
• The commission also observed that while the hospital repeatedly argued that the patient developed respiratory infection after discharge, the discharge summary contained no evidence supporting that claim.
• Instead, an HRCT chest scan suggested pulmonary interstitial oedema. It held that the hospital was attempting to attribute the patient’s condition to causes that were not borne out by the contemporaneous medical records.

The state commission agreed with the district commission that the patient should have remained under observation for a longer period before discharge. However, it refused to increase the compensation, holding that the award already granted was adequate.

Significance

The ruling underscores that hospitals can be held liable for deficiency in service if a patient is discharged prematurely, especially when their own medical records fail to support the reasons later offered to justify the discharge.

Consumers facing similar grievances may contact the consumer helpline in their respective states (Madhya Pradesh: 0755-2559778, 0755-2559993) or dial the National Consumer Helpline at 1915 for assistance.