1. Briefly, the claimant being Cardiac patient was advised by Dr M-M-H Noori Cardiologist to get replaced the stent. On evaluation of the complainant's previous history Dr Muhammad Irfan Administrator of the Faisalabad International Hospital Faisalabad, Canal Road Faisalabad, assured the claimant to get replaced the stent and disclosed its total expenses in the sum to Rs. 125000/- including doctors fee, room charges, medicines, laboratory tests and miscellaneous as well as stent expenses. The claimant got admission in the said hospital on deposit of the above said requisite amount as per receipts. Thereafter Dr Mansoor Nasir, Consultant Cardiologist of the defendant's hospital, tried to pass the balloon for stent but he failed due to non availability of specific balloon, hence, Dr Mansoor Nasir referred the claimant to Professor Dr Nadeem Hayyat Malik PIC Lahore. As the defendants have grossly violated the package hence, he visited the office of defendant and demanded the total sum of billing deposited in the hospital alongwith compensation due to his faulty services but he refused. After delivery of legal notice through registered cover envelop AD on 30.12.2008, the claimant has lodged this claim for recovery of an amount of Rs. 125000/- as package amount received by the defendants, compensation and legal expenses in the sum of Rs. 815000/-.
2. The defendant has vehemently contested the claim by filing his statement of defence, interalia, on the ground that the claimant never contacted him for the procedure of Angioplasty as he is a Neuro Surgeon having no personal knowledge of the Heart Ailments of the claimant. In view of the intricate queries of law and facts, involving in this case, it was deemed necessary in the interest of justice to call for evidence of the parties in support of their respective versions.
3. In support of his version claimant Ghulam Murtaza has got recorded his statement as PW through his affidavit as EXPW1/1, whereas, in his documentary evidence he has tendered IPD cash receipt dated 24.11.2008, as EX-P1, hospitalization charges as EX-P2, discharge sheet dated 25.11.2008, as EX-P3, letter dated 13.12.2008, as EX-P4, letter dated 13.12.2008, as EX-P5, fax copies as EX-P6, prescription Dr Nadeem Hayyat Malik EX-P7, cardiac catherization report as EX-P8, prescription slip as EX-P9, Myocardial spect perfusion study as EX-P10, IPD cash receipt as Mark "A", prescription slip as Mark "B", hospital charges Mark "C", discharge slip sheet as Mark "D", application dated 13.12.2008, as Mark "E", application 13.12.2008, as Mark "F", cardiac report as Mark "G", letter Dr Mansoor Nasir as Mark "H", prescription as Mark "J", Myocardial spect study as Mark "K".
4. In rebuttal, Dr Muhammad Irfan, the defendant himself appeared as DW1 through his sworn affidavit as EX-DW1/1. In his documentary evidence, the defendant has adduced the copy of fax as EX-D1, hospital charges as EX-D2, prescription as Mark "A", prescription as Mark "B", discharge sheet as Mark "C", sheet hospital as Mark "D", cheque city bank as Mark "F", Dr monthly IPD as Mark "F/1", application as Mark "G".
5. After conclusion of evidence of the parties, I have heard the learned counsel for the parties at length and perused the record carefully and inestimably.
6. The pivotal point of controversy to be resolved in this case is whether or not the efforts of Dr Mansoor Nasir consultant cardiologist, to pass the balloon for stent, failed due to non availability of specific balloon to be provided to him by the defendant? On stating his case through his affidavit as EXPW1/1, parrot-like, the claimant when subjected to cross examination affected his ignorance whether or not the stenting of his minor capillaries could be done or not and during his cross examination the claimant has avoided to answer the relevant queries put to him from the opposite side.
7. The claimant has himself produced the cardiac cauterization reports as EX-P8, prepared by Dr Mansoor Nasir showing that the claimant Ghulam Murtaza is a known case of ischemic heart disease, previously he had inferior myocardial infection which was treated with SK. Post infarct but he continued to have angina and had angiography which showed severe disease in the proximal, RCA and severe disease in a branch of obtuse marginal. Angioplasty was preformed to the RCA in February 2008. It was directly stented with a bare metal stent with an excellent result. At that stage, Dr Mansoor decided not to intervene on the small branch of the Optus marginal as it was too small and it would not accept any stent. The claimant continued to have chest pains which became more frequent over the last few weeks. Myocardial perfusion scan was requested which showed reversible ischemia in the lateral territory. It was of moderate magi nature. An other look at the angiogram Dr Mansoor Nasir still felt that his branch of obtuse marginal was not large enough but that because of his on going Angina despite atenolol 50 mg * BD, amlodipine 5mg * OD and nicorandial 10mg * BD, repeat angiography was performed. Dr Mansoor Nasir approached the circulation through right femoral artery using a 6F sheath. Angiography of the RCA sured significant in stent stenosis. Angiography of the left system showed severe disease in the branch of optuse marginal. Result of Myocardial perfusion scan in the hind side he went ahead to do angioplasty to the circumflex artery branch. Dr Mansoor used an XB 3.5 guiding catheter and a BMW wire which crossed the lesion with difficulty. During this there was temporary interruption of the blood flow without any discomfort to the patient. After that the doctor tried to cross the lesion with the 2MM balloon which failed as it would not cross the lesion at the proximal end. As mentioned earlier having totally occluded the artery for a long time without causing any discomfort Dr Mansoor decided that it was not the culprit artery. Using an AR1 guiding catheter the same BMW wire was crossed through the in stent stenosis which was then Angiolasted using a 2.75*16 balloon at 14 atmosphere with excellent result. During this balloon inflammation, the claimant did experience discomfort in his chest which were similar to the discomfort which he had been experiencing in the recent past. Having successfully Angioplasty the in stent stenosis Dr Mansoor told the claimant that there was a risk of 10-20% that it might renarrow in future. His current medication included pidogrel 75mg *OD, Aspirin 75*OD, Tenormin 50mg * DD, Amlodipine 10mg * OD and Lipiget 20mg * OD alongwith Ezita 10mg * BD with the plan to review him again with in week. Unfortunately, the claimant continued to experience discomfort in chest therefore, Dr Mansoor has referred him to Dr Nadeem Hayyat Malik. Professor of Cardiology. PIC, Lahore.
8. From the above said report of Dr Mansoor Nasir Associate Professor there is nothing on record to believe that the claimant's process of stenting failed due to non availability of specific balloon rather he has observed that he has done successful Angioplasty in stent but as the claimant continued to experience discomfort in his chest hence he was referred Dr Nadeem Hayyat Malik Professor of Cardiology Lahore.
9. In rebuttal, of claimants such evidence, Dr Muhammad Irfan the defendant has stated that the claimant was admitted to his hospital, that Dr Mansoor Nasir Bajwa Associate Professor of Cardiology conducted the procedure of Angioplasty of the claimant on 24.09.2008, that the claimant never contacted him for the procedure of Angioplasty, that the best available services were provided to the claimant during stenting process, that therefore, the claim in not maintainable.
10. From the above said facts and circumstances, for establishing negligence in treatment on the part of doctor, the test is whether he is to be held guilty as no doctor of ordinary skill could be guilty if acting with reasonable care and skill. In the absence of any expert report or any other evidence showing negligence on the part of the doctor, compensation can not be granted on presumed negligence. There is nothing to show that the claimant was no attended in the defendant's hospital or that the doctor who attended him was in different or negligent in the treatment. All such circumstances are sufficient to show that the claimant is unable to prove his case. Therefore, the claim is hereby dismissed. File be consigned to the record room after its due completions.