Date of Filing      : 25.11.2021

                                                                                                                 Date of Disposal: 13.12.2022

 

DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION

THIRUVALLUR

 

 BEFORE  TMT. Dr.S.M. LATHA MAHESWARI, M.A.,M.L, Ph.D (Law)                                  .…. PRESIDENT

                 THIRU. J.JAYASHANKAR, B.A, B.L.                                                                            ..… MEMBER-I

                 THIRU.P.MURUGAN,M.Com., ICWA(Inter)., B.L.,                                                  ....MEMBER-II

 

CC. No.09/2022

THIS TUESDAY, THE 13th DAY OF DECEMBER 2022

 

Mr.V.Thandavarayan, S/o.Varada Pillai,

No.172, Middle Street, Meesarakandapuram,

Sanurmallavaram, R.K.Pet, Taluk,

Thiruvallur District.                                                                             ……Complainant.

 

                                                                            //Vs//

 

1.Peacock Hospitals Private Limited,

   No.5 Arakonam Road,

   V.K.C.Mahal Opposite, Tiruttani -631 209.

   Thiruvallur District.

 

2.The Manager,

   Peacock Hospitals Private Limited,

   No.5 Arakonam Road,

   V.K.C.Mahal Opposite, Tiruttani -631 209.

   Thiruvallur District.                                        …..opposite parties. 

 

Counsel for the complainant                                                  :   Mr.V.Madhavan, Advocate.

Counsel for the opposite parties                                            : M/s.AAV Partners.

                         

This complaint is coming before us on various dates and finally on 11.11.2022 in the presence of  Mr.V.Madhavan Advocate, counsel for the complainant and M/s.AAV Partners counsel for the opposite parties upon perusing the documents and evidences produced by both parties this Commission delivered the following: 

ORDER

PRONOUNCED BY TMT. Dr.S.M. LATHA MAHESWARI,   PRESIDENT.

 

This complaint has been filed by the complainant u/s 35 of the Consumer Protection Act, 2019 alleging medical negligence in the debridement done to the complainant in the right foot along with a prayer to pay a sum of Rs.10,00,000/- towards compensation for the improper treatment given by the opposite parties for the removal of blister from the right foot of the complainant and to pay a sum of Rs.10,00,000/- towards compensation for the mental agony suffered by the complainant due to the deficiency in service committed by the opposite parties along with cost of the proceedings to the complainant.

Sum and substance of the complaint:-

 

Complaint relates to Medical negligence alleged to have committed by the opposite parties. The complainant allegations was that approached the opposite party on 07.07.2020 with complaints of pain in his right leg. That he was a diabetes mellitus patient and was given treatment for blister formation by the opposite party and was done debridement on 09.07.2020 on the right foot without proper diagnosis and control in the glucose level and was discharged on 11.07.2020.  The discharge advice was followed by the complainant in letter and spirit but due to the negligence committed by the Doctors of the opposite party while performing the debridement for removing the blister from the right foot of the complainant he subsequently developed pain in the area where the debridement was done.  On 15.08.2020 the complainant took subsequent treatment from ESIC hospital, K.K. Nagar, Chennai and due to the improper treatment given by the opposite party his right leg below knee was amputated by ESIC hospital on 02.09.2020.  If the removal of the blister treatment had been done properly there would not have been a chance for amputation of his right leg below knee.  Aggrieved over the act of the opposite parties after issuance of legal notice the present complaint was filed for the following reliefs;

To direct the opposite parties to pay a sum of Rs.10,00,000/- towards compensation for the improper treatment given for the removal of blister from the right foot of the complainant;

To pay a sum of Rs.10,00,000/- towards compensation for the mental agony suffered by the complainant due to the deficiency in service committed by the opposite parties along with cost of the proceedings to the complainant.

Defence of the opposite parties:-

By filing a detailed version the opposite party’s hospital submitted that the 1st opposite party was approached on 07.07.2020 by the complainant with complaints of pain in his right foot who was attended by Dr.Anil Chander.  The complainant had a history of blister formation over his right foot for the past 3 days and the complainant was a known case of diabetes mellitus and had pain under medication for the past two years. On examination of the patient‘s right foot, it was found that he had pain and swelling, maceration of skin and wound discharge.  He had been diagnosed with right foot gangrene/cellulitis. He was further advised to undergo wound debridement of the right foot.  An X-ray was taken and blood investigation had been carried out.  The complainant and his relatives had been explained in detail that wound debridement has to be performed.  The patient had been monitored on a regular basis and after obtaining informed consent from him the complainant had been posted for wound debridement under local anaesthesia.  The procedure was uneventful and post-operatively the complainant did not have any complaint.  The complainant was prescribed necessary antibiotics and wound dressing had been done during his stay in the hospital.  As the complainant’s vitals were stable he had been discharged on 11.07.2020.  At the time of discharge the patient had been advised to continue medications for 7 days and to come back for review after 7 days. After discharge on 11.07.2020 the patient was found to be comfortable and better and he was asked to come back for review after 7 days. On 10.08.2020 the complainant came back to the opposite parties who was advised to undergo wound debridement but the same was refused by the complainant.  Thereafter the complainant never came back to the opposite party’s hospital.  The opposite parties submit that the complainant had suppressed the fact that he had come back to the opposite parties on 10.08.2020 after one month of his discharge from the 1st opposite party hospital after his wound debridement.  It is pertinent to note that from the complaint that the complainant had subsequently undergone wound debridement on various dates at ESI hospital and only on 02.09.2020 he had undergone amputation.  The fact that the complainant had subsequently undergone wound debridement at ESI hospital on various occasions show that the opposite parties had followed the standard protocol for the complainant.  Further it is submitted that the complainant suffered with diabetic ulcers in his right foot who required continuous and treatment did not come to the opposite parties for review as advised but came back only after a month.  The opposite parties are completely unaware as to the medication or dressing done by the complainant post discharge as the complainant had been prescribed medication only for 7 days at the time of discharge.  Thus submitting that there is no deficiency in service and there is no cause of action for the present complaint the opposite parties sought for the dismissal of the complaint.

On the side of complainant proof affidavit was filed and documents Ex.A1 to Ex.A9 were marked on their side.  On the side of opposite parties proof affidavit was filed and document Ex.B1 was marked on their side. 

 Points for consideration:-

 

Whether the allegation pertaining to medical negligence against the opposite parties in the performance of debridement to the complainant’s right foot resulting in amputation of the right leg below knee has been successfully proved by the complainant by admissible evidence?

If so to what relief the complainant is entitled?

Point No.1

On the side of the complainant following documents were filed in support of her allegations; 

Lab reports was marked as Ex.A1;

Discharge of the complainant dated 11.07.2020 was marked as Ex.A2;

Cash bill issued by the opposite parties in the name of complainant dated 10.08.2019 was marked as Ex.A3;

Pharmacy bill dated 10.08.2020 was marked as Ex.A4;

Treatment book given by ESIC hospital, K.K. Nagar, Chennai was marked as Ex.A5;

Legal notice issued by the complainant to the 2nd opposite party dated 27.07.2021 was marked as Ex.A6;

Acknowledgement card for proof of delivery was marked as Ex.A7;

Reply issued by the opposite parties to the complainant dated 03.08.2021was marked as Ex.A8;

Detailed reply notice issued by the 2nd opposite party to the complainant dated 07.09.2021 was marked as Ex.A9;

On the side of the opposite parties following document was filed in support of their defence;

Copy of case sheet was marked as Ex.B1;

Heard both the learned counsel appearing for the complainant and the opposite parties and perused the pleadings and material evidence produced by them.

The crux of the arguments advanced by the complainant is that the treatment given for blister formation over the right foot of the complainant by the opposite parties was performed without proper diagnosis and control of glucose level of the complainant.  It was argued that the debridement done on 09.07.2020 was done negligently and he was discharged on 11.07.2020 and a total sum of Rs.70,000/- was charged from the complainant. As subsequently the complainant developed pain in the area where the debridement was done the complainant approached the ESIC hospital, K.K. Nagar, Chennai on 15.08.2020 and because of the improper treatment given by the 1st opposite party the wound debridement done by the 1st opposite party got deteriorated and due to which the right leg below knee was amputated on 02.09.2020. Thus he argued that the amputation of right leg below knee was caused only due to the improper treatment and negligence committed by the doctor of the 1st opposite party and contending that there is deficiency in service on the opposite parties he sought for the complaint to be allowed as prayed for.

The sum and substance of the arguments by the opposite parties on the other hand is that the complainant was a known case of diabetes mellitus and had been under medication for the past two years.  He was examined by one Dr.Anil Chander, M.B.B.S., M.S. (Ortho) and after inspection debridement was performed after obtaining informed consent from the complainant on 11.07.2020.  The patient was found to be normal when discharged and was advised to take antibiotics and diabetic medicines for 7 days and to come back for review after 7 days but the complainant came back only on 10.08.2020.  The complainant before amputation had undergone debridement on various dates with the ESIC hospital and only on 02.09.2020 amputation was done.  It was argued that the complainant did not come for review as advised after 7 days and if he had come they would had the opportunity of treating him as per the standard protocol.  It was argued that so long as a doctor follows a practice acceptable to the medical profession of that day, merely because a better alternative course or method of treatment was available it cannot be held that the doctor has committed medical negligence.  Thus relying upon the discharge summary of ESIC hospital the opposite parties counsel submitted that they had not committed any medical negligence or deficiency in service and sought for the complaint to be dismissed.

On appreciation of the available pleadings and evidences submitted by both the parties this commission is view of that the complainant had failed to prove the alleged medical negligence againt the opposite parties resulting in deficiency in service for the reason cited below;

As per the Discharge Summary dated 11.07.2020 (Ex.A2) it is seen that it has been clearly given under advice on discharge the tablets to be taken for the complainant for 7 days and for review with FBS with PPBS Report and to come for review after a week in OPD with prior appointment.  In such circumstances it is seen that the medicine has been given only for 7 days and the complainant was asked to come for review after 7 days.  However it is seen that the complainant did not turn up for review and the only the document produced by the complainant in proof for contacting the opposite parties was Ex.A3 and Ex.A4 the cash bill and pharmacy bill dated 10.08.2020 which shows that the complainant contacted the opposite parties only after a period of one month from the date of discharge.  The opposite partie’s contention that if at all the complainant approached for review as advised they would have advised him properly for debridement has to be accepted.

As per records it is shown that the complainant was a known case of diabetic mellitus and even as per the case sheet of the ESIC hospital Ex.A5 dated 31.08.2020 it has been mentioned that the complainant suffers with diabetic foot ulcer with 5th toe amputation and complaint is a debridement patient for past 10 years and he was on insulin and OHA and now the patient is on insulin.  It is evidently made clear from the said observation that the complainant was a highly diabetic patient and was in continued treatment.  The HbA1c with regard to sugar level as on 24.08.2020 is provided in the case sheet of ESIC hospital as 11.08 whereas the normal is only 4-6% and if it is about 8 it refers to poor control.  Even on 08.07.2020 during treatment with the opposite parties the HbA1c was 10.7.  Thus clearly proved that after the debridement was done by the opposite parties the complainant failed to control the blood sugar level by not following the prescription which would have resulted in further complication in foot ulcer and debridement and finally amputation.

The subsequent wound debridements undergone by the complainant with ESIC hospital shows that he has not taken proper care post discharge which resulted in amputation of his leg below knee for which the opposite parties cannot be held liable for the same.

The complainant did not specifically mentioned and pointed out the negligent act committed by the opposite parties while debridement was done and also failed to prove what the opposite parties had omitted to do while debridement is done what they ought to have done leading to further damage to the foot ulcer resulting in the amputation of the leg below knee.  Thus when improper or negligent performance of the surgery (debridement) resulting in any damage by the doctor was not established by the complainant, we could not held that the opposite parties had committed medical negligence in performing the debridement.

When it is the specific allegation by the complainant that due to negligent debridement and negligent treatment the complainant suffered with amputation, it could be seen that as rightly pointed out by the opposite parties as per the case sheet of ESIC hospital the complainant had undergone debridement several times before amputation which clearly establish that debridement is only the standard protocol treatment for foot ulcer and once when it is uncontrollable, amputation is the only remedy to avoid sepsis which may even leads to death.  Thus negligence becomes actionable only on account of an injury resulting from any act or omission on the part of the medical professional and non-fulfillment of any duty owed by the professional  or breach of the said duty. When the breach and resultant injury was not proved to the satisfaction of the commission we cannot hold that the opposite parties had committed any medical negligence resulting in deficiency in service leading to amputation of leg below the knee to the complainant.  Thus we answer the point accordingly in negative against the complainant and if favour of the opposite parties.

Point No.2:-

As no medical negligence was established by the complainant against the opposite parties the complainant is not entitled any relief as prayed for in the complaint.  Thus we answer the point accordingly. 

In the result the complaint is dismissed.  No order as to cost. 

Dictated by the President to the steno-typist, transcribed and computerized by him, corrected by the President and pronounced by us in the open Commission on this the 13th day of December 2022.

 

    Sd/-                                                        Sd/-                                                     Sd/-

 MEMBER-II                                         MEMBER-I                                        PRESIDENT

 

List of document filed by the complainant:-

 

 

Ex.A1 .............. Lab Reports. Xerox

Ex.A2 11.07.2020 Discharge Summary of the complainant. Xerox

Ex.A3 10.08.2020 Cash Bill. Xerox

Ex.A4 10.08.2020 Pharmacy Bill. Xerox

Ex.A5 ............ Treatment Book given by ESIC hospital, K.K Nagar, Chennai. Xerox

Ex.A6 27.07.2021 Legal notice issued by the complainant to the opposite parties. Xerox

Ex.A7 ........... Acknowledgement card. Xerox

Ex.A8 03.08.2021 Reply notice issued by the opposite parties. Xerox

Ex.A9 07.09.2021 Detailed reply notice issued by the opposite parties. Xerox

 

List of documents filed by the opposite parties:- 

 

Ex.B1 ............ Copy of case sheet. Xerox

 

 

 

   Sd/-                                                        Sd/-                                                   Sd/-

MEMBER-II                                        MEMBER-I                                        PRESIDENT