The National Consumer Disputes Redressal Commission (NCDRC), New Delhi, has upheld the Punjab State Commission’s order holding Max Super Specialty Hospital, Mohali, and its consultant Dr Sudheer Saxena guilty of medical negligence and deficiency in service in a case related to the death of Pinjore resident Rishi Gupta, 43.Gupta died in 2013, four days after a pacemaker was implanted under a package costing around Rs 5.5 lakh. The national commission dismissed Max Hospital’s appeal, stating that the state commission’s order finding the interventional cardiologist and the hospital liable was based on a “correct appreciation of evidence and law and does not suffer from any infirmity warranting our interference”. Accordingly, the appeal was dismissed and the state commission’s order was upheld.Case backgroundAccording to complainant Pooja Gupta, her husband Rishi Gupta, 43, was admitted to the ICU of Max Super Specialty Hospital, Mohali, on September 17, 2013, with a history of prolonged chest pain. He had a severe pre-existing heart condition and had undergone a Coronary Artery Bypass Graft (CABG) at the age of 27. He was under the care of Dr Sudheer Saxena, who advised a pacemaker. A four-day package costing around Rs 5.5 lakh was discussed.The complainant alleged that the surgery was not performed until the fourth day. On September 20, after she deposited Rs 3 lakh, the patient was taken for surgery. It was alleged that the doctor, without a complete kit, implanted a cheap ‘double chamber’ pacemaker costing Rs 45,000, as per the bill. The surgery remained incomplete as the doctor cited the unavailability of the third wire. On September 22, the doctor performed another surgery and implanted the actual biventricular pacemaker costing Rs 4,47,869. The complainant alleged this was done to replace the wrong pacemaker. The patient was discharged on September 24 in a hasty manner, despite being in pain.On September 27, the patient suffered a severe heart attack, was brought back to the hospital, and died. A DDR was registered and a postmortem examination was conducted.Alleging gross medical negligence, cheating and unfair trade practice, the complainant sought total compensation of Rs 84,73,036.State commission and appealOn May 4, 2017, the state commission held Dr Sudheer Saxena guilty of medical negligence and Max Super Specialty Hospital vicariously liable. It directed them to pay Rs 32,94,000 jointly and severally to the complainant, along with interest @9 per cent per annum in case of delay.The appellant doctors and the hospital challenged the state commission’s order. They claimed the state commission erred in holding them liable without proper appreciation of the complex medical procedure.“The procedure was carried out in two stages due to the patient’s fragile condition, which is standard protocol. No second pacemaker was implanted; only the third lead was placed in the second stage. The state commission ignored the expert report from the medical board of PGIMER, Chandigarh, which concluded that the procedure was carried out as per protocol,” the appellants contended. They added that the complainant’s statement regarding a cheap double chamber pacemaker was incorrect as even the cheapest such device costs much more. The mention of ‘double chamber pacemaker’ in the bill was a typographical error in the hospital’s billing software and referred to surgical/procedure charges, not the cost of the device.NCDRC orderThe national commission agreed with the state commission and the high court that “the appellants have failed to provide a cogent and consistent explanation for the contradictions in the medical records and the bill. The expert opinion of PGIMER does not resolve these specific factual inconsistencies. The appellants have, therefore, failed to prove that there was no negligence or deficiency in service on their part,” the order stated.