{"id":161677,"date":"2008-05-22T00:00:00","date_gmt":"2008-05-21T18:30:00","guid":{"rendered":"https:\/\/www.legalindia.com\/judgments\/dr-v-k-ghodekar-m-b-b-s-vs-smt-sumitra-pralhad-korgaonkar-on-22-may-2008"},"modified":"2015-07-29T01:08:28","modified_gmt":"2015-07-28T19:38:28","slug":"dr-v-k-ghodekar-m-b-b-s-vs-smt-sumitra-pralhad-korgaonkar-on-22-may-2008","status":"publish","type":"post","link":"https:\/\/www.legalindia.com\/judgments\/dr-v-k-ghodekar-m-b-b-s-vs-smt-sumitra-pralhad-korgaonkar-on-22-may-2008","title":{"rendered":"Dr.V.K.Ghodekar (M.B.B.S.) vs Smt. Sumitra Pralhad Korgaonkar on 22 May, 2008"},"content":{"rendered":"
National Consumer Disputes Redressal<\/div>\n
Dr.V.K.Ghodekar (M.B.B.S.) vs Smt. Sumitra Pralhad Korgaonkar on 22 May, 2008<\/div>\n
  \n \n \n \n \n \n NATIONAL CONSUMER DISPUTES REDRESSAL COMMISSION\n\n\n\n\n\n \n\n \n\n\n\n NATIONAL CONSUMER DISPUTES\nREDRESSAL COMMISSION \n\n NEW DELHI \n\n \n\n \u00a0\n\n REVISION PETITION NO. 1727\nOF 2002 \n\n \n\n(From the\norder dated 1.7.2002 in F.A.No.76\/2000 of the State Commission, Goa) \n\n \n\n \u00a0\n\n Dr.V.K.Ghodekar (M.B.B.S.)   Petitioner\n\n \n\n \n\n Versus\n\n \n\n \u00a0\n\n \n\nSmt. Sumitra Pralhad Korgaonkar  \nRespondent \n\n \n\n \u00a0\n\n \n\n BEFORE: \n\n \n\n \u00a0\n\n \n\n HONBLE\nMR. JUSTICE M.B. SHAH, PRESIDENT \n\n \n\n HONBLE\nMRS. RAJYALAKSMI RAO, MEMBER \n\n \n\n HONBLE\nDR. P.D. SHENOY, MEMBER \n\n  \u00a0\n\n \n\nFor the Petitioner  : Mr. M.N. Krishnamani, Sr. Adv., \n\n \n\nWith Ms. A. Subhashini & Mr.A.V.Rangam,\nAdvocates\n\n \n\n \u00a0\n\n \n\nFor the Respondent : Dr. Sanjay P. Korgaonkar, Auth.Rep. \n\n \n\n \u00a0\n\n \n\n \u00a0\n\n \n\n 22-5-2008 \n\n  \u00a0\n\n O R D E R \n<\/pre>\n
  \u00a0<\/p>\n
  \u00a0<\/p>\n
 MRS. RAJYALAKSHMI RAO, MEMBER <\/p>\n
 The questions which
\nrequire consideration in this revision petition are:\n<\/p>\n
(a) Whether
\na medical practioner before prescribing a drug, which has side effects, should
\nbe careful or not in informing the patient about its side effects such as
\nhypoglycemia etc.?\n<\/p>\n
(b) Whether,
\na doctor should give treatment for diabetes to a person who is alcoholic,
\nstraightway on the basis of urine test report, without confirming by proper
\npathological test that the patient is suffering from diabetes and thereafter
\nwithout informing the patient that the medicine should be taken before food and
\nalcohol should be avoided?\n<\/p>\n
 In our view, it is the
\nduty of the doctor, before prescribing diabetic drug, to inform the patient
\nabout the side effects of a drug, particularly to an alcoholic person and he
\nshould be informed that alcohol may increase sugar level and that diabetic drug
\nshould be taken before food.\n<\/p>\n
 If is not done it will be
\na deficiency in service.\n<\/p>\n
 \u00a0<\/p>\n
This Revision Petition arises from the order dt.1-7-2002 passed by the
\nState Consumer Disputes Redressal Commission, Goa, in Appeal No.76 of 2000,
\nreversing the order dt.22-2-2000 of the District Forum, Panaji in Complaint
\nNo.310 of 1993.\n<\/p>\n
 The facts of the case are
\nas follows :\n<\/p>\n
The complainant Smt. Sumitra Pralhad Korgaonkar filed a petition before
\nthe District Forum stating that her husband Pralhad Korgaonkar, aged about 45
\nyears was taken to the opposite party
\nDr. V.K.Ghodekar, Medical Practitioner at village Aldona on 23-2-1993,
\nas he was having chronic cough and cold. Dr. V.K.Ghodekar, the opposite party,
\ngave some medicines and asked him to come back on 26th February,
\n1993 with a sample of urine for test. Accordingly on 26-2-93, Shri Korgaonkar,
\npresented himself before the opposite party with the urine sample. The opposite
\nparty who tested the urine mentioned that the urine sample showed sugar, which
\nis indicative of diabetes and prescribed one tablet of 5 mg. of Euglucon per
\nday for five days.\n<\/p>\n
 The Complainant stated
\nthat after taking Euglucon tablet, for 3 days, Shri Korgaonkar, in the early
\nmorning hours of 3-3-1993 at about 2.00 A.M., began sweating very much and had
\nconvulsions and became unconscious. He
\nhad to be rushed to the government hospital at Mapusa at 4.00 A.M., on 3rd
\nMarch,1993. At the hospital, soon after admission, he went into coma for about
\n4 days and thereafter recovered consciousness, but remained in the hospital for
\n40 days and was discharged on 10th April, 1993. He was advised to
\ntake the treatment at home. He was again admitted in the hospital on 22-5-1993
\nfor a few days. However, on 5-8-1993, Shri Korgaonkar passed away.\n<\/p>\n
 The complainant Sumitra
\nKorgaonkar, who is the wife of the deceased Korgaonkar, alleged that the
\nopposite party prescribed the tablet Euglucon  a specific drug for diabetes
\nwithout ascertaining properly whether the patient was infact suffering from
\ndiabetes. Medical literature was produced to show that Euglucon is a very
\nsensitive drug and needs to be administered with care and the dosage is to be
\nregulated carefully depending on the level of blood sugar. It is alleged that Shri Korgaonkar went into
\ncoma due to hypoglycemia and that subsequent treatment in the government
\nhospital did not really help him to recover and that his death is directly
\nattributable to rash administration of Euglucon tablets by the opposite party.\n<\/p>\n
 The District forum which
\nheard the matter dismissed the complaint on the ground that no negligence has
\nbeen proved. In Appeal, however, the decision was reversed holding that ;\n<\/p>\n
(a) In
\nthe first instance the opposite party did not even ascertain whether the
\npatient was suffering from diabetes at all ;\n<\/p>\n
(b) Without
\nso ascertaining, a specific and very sensitive anti-diabetic drug, dosage of
\nwhich has to be regulated with care, has been administered ;\n<\/p>\n
(c) The
\ntablets were prescribed in a routine manner without advising the patient who is
\nan alcoholic that he should not consume alcohol and that the drug should be
\ntaken only after the food ;\n<\/p>\n
(d) That
\nthe patient developed Coma because of the adverse effect of Euglucon.\n<\/p>\n
(e) The
\nopposite party was directed to pay the complainant an amount of Rs.1,09,000\/-
\nalongwith interest at 18% and he was also to bear a cost of Rs.5,000\/-.\n<\/p>\n
 The
\npresent appeal is filed by the doctor against the said order.\n<\/p>\n
 We heard both the
\nparties and carefully perused the evidence on record. The arguments of the
\npetitioner i.e., opposite party are: (a) that testing of urine sugar is one of
\nthe first steps used by general practitioners like him in detecting
\ndiabetes; (b) that sugar in the
\nurine indicates that the patient had diabetes; (c) that the dosage of Euglucon
\nprescribed was the minimum; (d) that
\nno evidence has been produced as to when and how the deceased consumed the
\ntablets of Euglucon; (e) that there is no evidence produced to link the
\ndevelopment of Coma on 3-3-1993 with the prescription of Euglucon given on 26th
\nFeb 1993; (f) that the patient in fact never came back to the opposite party
\nafter taking prescription on 26-2-1993; (g) that no medical record of the
\nGovernment Hospital, Mapusa was produced to show as to what had transpired in
\nthe hospital ; (h) that one of the random blood tests at the Govt. Hospital on
\n3-3-1993 showed that blood sugar as 185 mg confirms that the patient is a diabetic; (i) that the test which
\ntook-place in August-1993 can be of no stretch of imagination be said to have
\nbeen caused by consumption of three Euglucon tablets of 5 mg each in February,
\n1993; (j) and that the decision of the District Forum was correct; and urged
\nthat the order of the State Commission should be set aside.\n<\/p>\n
 The
\npetitioners son who is himself a doctor argued the case for the respondent
\ni.e. for Smt. Sumitra Pralhad Korgaonkar. He submitted ; (i) that for testing
\nwhether a person is diabetic or not, testing urine for the same is not a
\ndefinite test to establish diabetes; (ii) that the urine test can be positive
\nfor sugar under various other conditions including alcoholism; (iii) that the
\nopposite party, the doctor, knew that late Shri Korgaonkar was an alcoholic and
\nurine test can be false positive; (iv) that he was not suffering from any
\nserious disease other than chronic cough and cold when he went to the doctor;\n<\/p>\n
(v) that there was no reason for him to go into a Coma soon within 4 to 5 days
\nafter seeing the petitioner doctor; (vi) and that the development of Coma can
\nonly be attributed to the consumption of tablets prescribed by the petitioner
\ndoctor.\n<\/p>\n
 It is also argued that
\nwhile unfortunately no record of the government hospital, Mapusa, could be
\nproduced because they were inadvertently destroyed or misplaced by the hospital
\nauthorities, evidence of the attending doctors who also submitted themselves to
\ncross-examination is very much on record and it can be relied upon.\n<\/p>\n
 We heard both the parties
\nat length and after careful consideration of evidence on record we are of the
\nopinion that the petitioner (the opposite party) was totally negligent in discharge
\nof his duties and that there is a clear deficiency in service provided by him
\nfor the following reasons :\n<\/p>\n
 The first question that
\narises is as to why the petitioner doctor (opposite party) wanted to test the
\nurine of late Korgaonkar when he was brought in with the complaint of chronic
\ncough and cold. The petitioner himself answered this by saying that Korgaonkar
\nwas smelling alcohol and was in a drunken state and he had suspected him to be
\nan alcoholic. He argued that this is what prompted him to ask the patient to
\nbring his urine for test after four days for possible diabetes.\n<\/p>\n
 The medical
\nliterature produced on record shows that Euglucon is a drug belonging to
\nSulfonyl Ureas. This is a specific anti-diabetic drug, which is required to
\nbe administered after testing blood sugar levels. As a matter of fact, when
\ndiet, exercise and weight reduction do not lower the blood sugar, then the
\npatient is put on drug therapy, with drugs like Euglucon and even then the
\ndosage needs to be adjusted periodically depending on the blood sugar levels.
\nThe literature further shows that Severe Hypoglycemia(lowering blood sugar
\nlevels) can be induced by Sulfonyl Ureas. These drugs increase release of
\ninsulin. Therefore, these drugs like Euglucon are required to be administered
\nimmediately after intake of food. Literature further shows that intolerance of
\nalcohol may occur in patient treated with Sulfonyl Ureas. Therefore the
\npatients are strictly advised to avoid alcohol while taking the drug. We find
\nthat none of the precautions were given to the patient and the opposite party
\nmerely prescribed Euglucon 5 Mg. for five days.\n<\/p>\n
Secondly, the record of admission of the patient to the Asilo Government
\nHospital on 3-3-1993 clearly shows that he was admitted at 4.00 A.M. on complaint
\nof convulsions. The patients relatives told the attending doctor, Dr. S.S.
\nGovekar, that the patient was not talking since 2.00 A.M., that he had
\nconvulsions and frothing at the mouth, and that he had a similar convulsions at
\n8.00 P.M. on the previous night. They told the doctor that the patient had
\ntaken one tablet of 5 mg. Euglucon for the previous 4 days. Dr. Govekar
\nconfirmed these facts in his cross-examination, and stated that his diagnosis
\nwas that of Hypoglycemia (fall in blood sugar level) due to consumption of
\nEuglucon, with chronic bronchitis. Dr. Govekar stated that he had taken a blood
\nsample to find out random blood sugar level, and thereafter administered 2
\nampules of 24% glucose to restore the blood sugar level. This record at the time
\nof admission in the hospital is a contemporaneous record and has to be relied
\nupon.\n<\/p>\n
 It is clear from the
\nabove that in the very first instance when the patient was brought to the
\nhospital in a comatose condition, the attending doctor felt that it is a case
\nof Hypoglycemia resulting from the administration of 4 tablets of Euglucon over
\nthe past 4 days. This tentative diagnosis has been confirmed by the very first
\nblood sugar test taken on 3-3-1993 soon after admission of the patient in the
\nAsilo hospital, which showed the Random blood sugar at less than 50 mg. It is
\nclear that the culprit is Euglucon administered to a non-diabetic patient.\n<\/p>\n
The third issue to be considered is whether the opposite party was right
\nin coming to the conclusion that the patient was having diabetes on the basis
\nof urine test conducted by him. The State Commission in its speaking order
\nquoted extensively from medical literature to show that the opposite party was
\nwrong to come to such conclusion.\n<\/p>\n
Dr. Stephen Fajan and Dr. Robert Williams, MD, Professor of medicine,
\nUniversity of Washington, in their book  Methods and Criteria for Diagnosis of
\nDiabetes Mellitus stated as follows:\n<\/p>\n
The
\npresence of Glycosuria never establishes the diagnosis, and blood sugar
\ndetermination must be made to confirm or eleminate the diagnosis of diabetes.
\nRenal and alimentary Glycosuria must be differentiated from diabetic Glycosuria
\nas discussed later. Other Meliturias and non sugar reducing substances in urine
\nwhich may give false positive reactions for glucose also must be considered.\n<\/p>\n
 \u00a0<\/p>\n
In Davidsons Principle and Practice of Medicine, 15th
\nEdition, 1987, on page 467, it is stated ;\n<\/p>\n
Glycosuria. the most serious disadvantage in
\nthe use of urine test diagnostically arises from individual variations in renal
\nthreshold, so that on the one hand some undoubtedly diabetic people have a
\nnegative urine test for glucose due to raised renal threshold, and on the other
\nthose with a low renal threshold give a false positive test. In order to
\ndistinguish cases of this type from patients with mild diabetes, suitable tests
\nof carbohydrate tolerance is required.\n<\/p>\n
 \u00a0<\/p>\n
A perusal of the above authorities on the subject show a unanimity of
\nopinion that blood sugar estimation and glucose tolerance test are mandatory
\nbefore confirming diagnosis. Further, the opposite party himself in his
\naffidavit-in-reply has admitted, the patient was suffering from chronic
\nalcoholism and all types of complications. He further admitted in his cross
\nexamination that, sometimes the urine shows positive sugar test even though
\nthere is no sugar. However, it is in certain cases like pregnancy and chronic
\nalcoholism etc. <\/p>\n
Both the statements clearly show that the opposite party is aware that
\nthe patient being alcoholic, urine test could show a false positive. The
\nopposite party clearly ignored standard medical practice and was further
\nnegligent in discharge of his duty to the patient.\n<\/p>\n
The last issue to be considered is whether administration of the
\nprescribed dosage of Euglucon can cause the damage that the patient suffered in
\nthis case.\n<\/p>\n
Dr. Dulari Pandodkar, who attended to the patient in the Asilo Hospital
\nhas stated in her examination in chief;  at the time of discharge of the
\npatient he had behaved abnormalities due to prior irreversible, neurological
\ndamage suffered by the patient following drug induced hypoglycemic coma; In
\ncross; I say that one tablet of Euglucon per day given to a normal person can
\ncause hypoglycemia causing lack of supply of glucose to the brain resulting in
\nirreversible damage to the brain. This can also occur in patients taking normal
\ndiet.\n<\/p>\n
Similarly, Dr. M.R.Pendekar, Senior Physician at the Asilo Hospital
\nissued a certificate dt.25-8-1993 stating that Pralhad was diagnosed as a case
\nof chronic alcoholism with drug induced Euglucon hypoglycemic coma with
\nirreversible neurological damage. This opinion remained unshaken and
\nunrebutted in cross-examination. The deposition of the two doctors as well as
\nthe initial diagnosis of Hypoglycemia by Dr. Govekar, discloses a unanimous
\nopinion that the patients hypoglycemic coma was induced by the drug Euglucon.\n<\/p>\n
In view of the findings we fully
\nendorse the well-reasoned order of the State Commission and dismiss the
\nrevision petition.  There shall be no order as to costs.\n<\/p>\n
 \u00a0<\/p>\n
 ..J <\/p>\n
 (
\nM.B. SHAH) <\/p>\n
 PRESIDENT <\/p>\n
 \u00a0<\/p>\n
..\n<\/p>\n
(RAJYALAKSHMI RAO) <\/p>\n
MEMBER <\/p>\n
 \u00a0<\/p>\n
.\n<\/p>\n
(P.D. SHENOY) <\/p>\n
MEMBER <\/p>\n
 \u00a0<\/p>\n
rk.<\/p>\n","protected":false},"excerpt":{"rendered":"
National Consumer Disputes Redressal Dr.V.K.Ghodekar (M.B.B.S.) vs Smt. Sumitra Pralhad Korgaonkar on 22 May, 2008 NATIONAL CONSUMER DISPUTES REDRESSAL COMMISSION NATIONAL CONSUMER DISPUTES REDRESSAL COMMISSION NEW DELHI \u00a0 REVISION PETITION NO. 1727 OF 2002 (From the order dated 1.7.2002 in F.A.No.76\/2000 of the State Commission, Goa) \u00a0 Dr.V.K.Ghodekar (M.B.B.S.) Petitioner Versus \u00a0 Smt. Sumitra Pralhad […]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_lmt_disableupdate":"","_lmt_disable":"","_jetpack_memberships_contains_paid_content":false,"footnotes":""},"categories":[1],"tags":[],"class_list":["post-161677","post","type-post","status-publish","format-standard","hentry","category-judgements"],"yoast_head":"\nDr.V.K.Ghodekar (M.B.B.S.) vs Smt. 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