Order-24.
Date-16/11/2015.
This is an application u/s.12 of the C.P. Act, 1986.
Complainant by filing this complaint has submitted that he had been suffering from the problem of vision, especially in the left eye for quite some time and for the cure of his left eye he went to medical college and hospital, Kolkata. There the attending doctor advised him for admission and he was admitted to Regional Institute of Opthalmology Medical College & Hospital on 09-02-2012 and on 10-02-2012 at 3:30 p.m. on examination the attending doctors performed surgery to complainant to remove malignant cataract, even though he was taken to the Operation Theatre at 9:00 a.m. and waited there for 6½ hours. While the operation was going on he felt some pressure was exerted upon his said left eye to set the lens there but he was told to have patience. But to his utter surprise he heard that doctors saying that the disease had been malignant and so consequently blood was oozing out of his eye. After the operation he felt that he had lost his eye sight and he was promptly told that his left eye was getting hot and that he should take rest for a few days. He was also told that everything would be alright afterwards and that he should go to the hospital after a day.
As per advice he again visited hospital on 12-03-2012 and immediately admitted that day and his left eye again operated on 13-03-2012. The lens was again set in his left eye and he was discharged on 15-03-2012 though his eye-sg\ight was not restored/improving. But without a word he was given the discharge letter with the words “you are being absconded, we are going to inform the police of it’. And he was handed the discharge letter only. He was returned none of the papers submitted at the time of operation. Finally he was told to go to the hospital after a week and in the said document it was written “Retinal Detachment”.
On 20-09-2012 he was sent to Eye-Department (Power), he got an optical lens but still his vision was not improved and failed to see anything with the left eye till 18-09-2013. No operation was done so far.
Finding negligence/beach of duty of care the patient wrote a letter of complaint to the Direcor, Medical College & Hospital, Kolkta – 700 073 dated 18-09-2013 for which patient was requested to appear before an Enquiry Committee at Regional Institute of Opthalmology, Medical College, Kolkata at 12 noon on 13-11-2014. The patient followed suit but in spite of complying with all the formalities he was found OK but even after two months’ time he did not receive any report. So, he wrote again to the Director, Medical College & Hospital, and also sent a copy of the letter to the Superintendent, Medical College & Hospital, Kolkata – 700 073 and later the patient was requested to appear on 09-04-2014 at 12 noon in the Teachers’ Room of R.I.O. and as the patient complied with the request of the Director, Director sent an Enquiry Report against the patient’s complaint and as per the report of the Enquiry Committee dated 03-05-23014 the doctors find besides Retinal Detachment in the left eye, poor visual prognosis but they clearly stated that there is no negligence on the part of the attending doctors. So, finding no other alternative complainant filed this complaint for medical negligence and deficiency in service against the OP before this Forum praying for relief.
On the other hand, OP by filing written statement submitted that the entire complaint is false and frivolous and not maintainable in the eye of law as ther is no medical negligence on the part of the OP and their doctors.
It is specifically mentioned that admittedly complainant Deep Narayan Saha was admitted to the OP’s Medical College and Hospital on 09-02-2012 under Prof. Himadri Dutta and thereafter consider the condition of eye he was underwent Small Incision Cataract Extraction (manual) on 10-02-2012 and was discharged on 13-02-2012 and was advised to join OPD after 7 days and on 05-04-2013 he was diagnosed as aphakia LE with vitreous in anterior chamber PT and he was advised vitrectomy with AC IOL in LE and he was admitted on 12-03-2012 and ant. vitrectomy with PC IOL was done in LE on 13-03-2012 and the patient was discharged on 15-03-2012 with the advice to attend OPD after 1 week but he attended OPD on 02-04-2012 ignoring the advice of discharge. Subsequently it was found that LE was pseufophakic (IOL in place) and was diagnosed to be suffering from uveitis and vision on that day was PLPR + and he underwent USG which revealed Retinal detachment in LE. Pt. was examined on the same day and was explained about poor visual prognosis and on 16-04-2012 and 21-04-02012 at special Retinal Clinic revealed that LE had Retinal Detachment with PVR changesand in RE peripheral retina was normal but there was a posterior staphyloma and prognosis of LE was extremely poor and was explained. Thereafter complainant revisited the hospital on 03-06-2013 and complainant also visited on the same day as mentioned above but complainant never visited the OP nor he complained to the OP regarding any negligency in treatment from this hospital during the whole period of 13-03-2013 to 08-10-2013, but OP received a letter regarding allegation of negligence and breach of duty from the complainant on 09-10-2013 and after receiving the said letter OP performed his duty by performing a committee with the Senior Professors of this Institute and requested the complainant to appear before the enquiry committee on 13-11-2013 and thereafter, complainant received second letter from the complainant on 26-03-2014 and again OP arranged a committee and for enquiry and asked the said committee to look into the matter of allegation of the complainant who appeared before the committee on 13-08-2012 with all documents and report was sent to the complainant on 02-05-2014 and it was detected that there was no negligence on the part of the doctor who were examined and complainant was aware of his condition of his eye from 09-04-2012 as noted in his OPD tickets. So, the instant complaint should be dismissed.
Decision with Reasons
On proper consideration of the materials on record and also the prescription and finally 3 Board Professor doctors’ opinion it is found that three professor of Regional Institute of Opthalmology Medical College examined the complainant including all the documents and found there is no negligence on the part of the OP doctor and they have specifically mentioned that operative procedures were performed accordingly to the condition of the eye during operation and retinal detachment is a common complication in Myopia after or without surgery and prognosis regarding vision was informed accordingly and considering the entire materials on record they are confirmed that no negligence was found in the whole procedure as adopted by the doctor of the op and no doubt this report was received by the complainant long back and complainant has also admitted that fact. Now, the question is whether there is any negligence on the part of the OP’s doctor.
On overall evaluation of the entire materials on record and the report of the 3 doctors of the Medical Board we find that complainant was suffering from complication in Myopia and in case of Myopia RK operation procedure (Redial Keratotomy Surgery) is only possibility to improve the eyesight and as such there is no option but to conduct such operation without any fault or default and in hopeless cases like the present case one where retina detachment is likely or imminent there was no option but to adopted RKD operation but in the present case it is found that complainant is admittedly a patient of Myopia but the doctor of the institute diagnose it as cataract and so underwent Immature Small Incision Cataract Extraction (manual) on 10-02-2012 and he was discharged on 13-02-2012 but in the prescription it has not been noted that he has been suffering from Myopia and glaucoma.
Truth is that on 13-02-2012 at the time of discharge complainant was asked to meet OPD after 7 days but complainant did not attend but he attended on 05-03-20121 when it was detected that he suffered from aphakic LE with vitreous in interior chamber so complainant was advised vitrectomy with SE IOL in LE and was admitted in 12-03-2012 and vitrectomy with PC IOL was done on LE on 13-03-2012. Patient thereafter discharged on 15-03-2012 with an advice to meet on OPD after one week but he attended on 02-04-2012 ignoring the advice of discharging doctor and it was found that LE was pseudophakic (IOL in place) and was diagnosed to be suffering from uvetis and vision on that day was PLPR + and he underwent USG when found retinal detachment in LE and complainant was examined on same day and found he was suffering from poor visual prognosis. Thereafter complainant was examined on different dates and ultimately on 01-08-2012 antiglaucoma drug was prescribed for LE. Refraction was done on 20-08-2012vision of RE with glass was 6/9 but vision in LE was hand movement only. Antiglaucoma drug for LE was continued with addition of oral drug on 17-12-2012. Record showed he attended OPD on 11-12-2013, 31-05-2013 and 03-06-2013 and the pressure within the eye (LE) was controlled in the last visit and pain was also reduced. But thereafter, complainant did not turn up.
After considering the final report of the medical board it was found that complainant is a patient of Myopia with glaucoma but cataract was operated but in the prescription nowhere it is noted that complainant was suffering from Myopia and glaucoma. At the same time from the prescription and report it is found that entire treatment was done in respect of cataract operation. But there was no note at the time of cataract operation that he was also suffering from glaucoma but ultimately glaucoma treatment was started after retinal detachment.
Moreover in this case Redial Kevatotoury surgery was not done which is the most scientific process and only possible treatment to improve the eyesight in case of a patient who has been suffering from Myopia and Glaucoma. Fact remains in case of a patient of myopia if cataract surgery is made chance of retinal detachment of his age is higher but any RK Surgery done on cornea can never cause retinal detachment and generally as per terms of medical science and expert medical opinion retinal Redial Kevatotoury surgery is must and admittedly from the prescription of the OPs it is found that complainant has been suffering from low poor sight but from the prescription it is found that OP hospital authority failed to search out or to note that complainant has been suffering from myopia and he also suffered from glaucoma but from the medical board’s opinion the patient is a patient of myopia and retinal detachment is common obligations but in the prescription nowhere it is noted that complainant was suffering from myopia and Glucoma. Moreover, no R.K. operation was done by the doctor but that was only treatment in case of the patient who has been suffering from myopia and Glucoma Moreover, after operation no B-Scan was done urgently because without B-Scan it is impossible to know the status of posterior scan of eye and it is a pre-requisite condition after eye operation and if any doctor states that B-Scan report is not required in that case it is the liability of the doctor to express the total status of the eye after operation in the prescription but that has not been done. In this case no B-Scan was done but as per medical science B-Scan should be done after any cataract operation to know the status of the eye including the status of retina and each may come to the knowledge of the doctor after surgery. Fact remains without B-Scan no IOL can be implanted but in this case without B-Scan and IOL was implanted for the second time but OP has not stated that they followed all the scientific process in case of eye operation of the patient like the present complainant and no doubt this is a clear case of negligence and in fact, the OP is a renowned institute for Opthalmology and Skilled and Expertised Institute but operation without any B-Scan is no doubt negligent manner of decision on the part of the skilled doctor and practically for not adopting R.K. Procedure and not for holding any B-Scan damage of the eye of the complainant was caused and, in fact, during operation that damage had been caused and from the expert opinion we found that no R.K.D. operation was held, no B-scan was done and about that expert doctors are also silent because they are the professor of OP’s institute and invariably they support their Colleague doctor by so many manner for which the board has not explained the manner of treatment etc. Moreover, in this case it is admitted by the medical board that complainant is a patient of myopia and further it was found that he had been suffering from glaucoma and as per medical science in case of any operation for restoring the sight of patient suffering from myopia, glaucoma must be performed at first and OP’s doctors as expert eye specialists are well aware of the fact but that has not been done. Moreover, in case of surgery of a eye of the patient like the complainant it is mandate that first glaucoma operation would be performed thereafter for improving eyesight R.K.D. operation should be done. But OP Institute as an expert institute of Eastern Region did not perform all these medical procedure in case of a patient like complainant who suffered from glaucoma, myopia and cataract. Not only that B-scan was also not done.
Truth is that complainant is a patient aged about 69 years, he went to the OP’s hospital as he found that he was losing his left eye sight. OP’s institute so called renowned institute of Eastern Region diagnosed that complainant suffered from cataract and in normal circumstances IOL is implanted but it could not be done for the status of the eye of the complainant but no B-scan was held or no B-scan report was obtained but yet Op carried 2 surgeries leaving a lost eye to the complainant.
Moreover, it is Proved that in case of the complainant if glucoma operation on the left eye would be done at final in that case there was chance of detachment of retina so to protect the retina and to save from detachment of retina the procedure of R.K.D. should be taken for implantation of IOL etc. but that was also not done.
At the same time as per medical science if it is found that one person who is sufferes from glaucoma with cataract and with myopia in that case before removing the myopia the glaucoma operation must be performed first. But that has not been done but ultimately it was reported by the committee, (board of OP’s doctor) that on 01-08-2012 glaucoma treatment was started and refraction was done on 20-09-2012. Whereas on 10-02-2012 small incision cataract extraction (manual) was done thereafter vitrectomy of PC IOL was done on 13-03-2012 and he was discharged on 15-03-2012 but from 15-03-2012 to 01-08-2012 there was no note in the prescription that complainant was suffering from glaucoma and glaucoma treatment was started from 01-08-2012 that means complainant as a myopic patient was suffering not only from cataract but also from glaucoma but on the date of first diagnosis of the case of the complainant it was noted that complainant was a patient of immature senile cataract and (RE) pseudophakia but there is no note that complainant was suffering from myopia and also glaucoma. Admitted position is that complainant was loosing his vision and it is their case that complainant did not properly attend the institute for which condition of his eye was damaged. But in the present case from the very beginning it is found from the prescription that OP failed to diagnose the condition and status of the eye properly and when after first and second operation the sight of the complainant was not improved then one after another cause is noted by the OPs doctor in the prescription showing retinal detachment and thereafter it is noted that he was suffering from glaucoma. All these matters directly and indirectly confirmed that this complainant has been suffering from myopia with cataract and glaucoma but as per medical literature with heading cataract retinal detachment and glaucoma we have gathered that it is the mandate of the different doctors author that in such a case glaucoma should be operated first but glaucoma was not operated through in this case the complainant had been suffering from glaucoma. Another factor is that complainant is myopic that was not disclose in the prescription but in the medical board’s report it is noted and for which they have confirmed that retina detachment is possible in case of myopic patient but in the present case nowhere in the prescription or during operation the OP doctors ever reported that complainant suffers from myopia and glaucoma also. Considering all the above materials and the findings we are confirmed that the procedure as adopted by the doctors are completely negligent in manner and not as per medical science in ophthalmology and the first requirement of operation was for glaucoma that was not done. Complainant was suffering from myopia so, the operation must be a RKD operation that was not also done. Another factor is that to know the status of the patient B-Scan was not done and that is also vital negligence on the part of the OP and their doctors. Considering all the above fact and materials and conduct of the doctors it is found that OP as a reputed institution has ignored all medical procedure but performed operation twice about cataract without operating glaucoma. Further R.K.D. operation was not adopted for cataract and to know the status of the eye no B-scan was done and considering all these aspects we are convinced to hold that there was deficiency in service and negligence in performing the operation and also for not producing the necessary record before this Forum regarding determination of glaucoma myopia B-Scan adopting of R.K.D. procedure and any operation of glaucoma at first by the OPs. Might be the OPs are qualified doctors competent to handle the case but truth is that they did not apply their skill and in terms of medical science and expert medical opinion. In the result we are convinced to hold that admitted position is that complainant has lost his eye sight and that was due to negligent and deficient manner of service on the part of the OP and their doctor and it is no doubt medical negligence on the part of the OP and for their negligence complainant lost his left eye sight and for that reason he has been suffering much at this stage and chance of improvement of eyesight was there if OP used to adopt scientific procedure of medical science and expert medical opinion about process of operation in case of a patient which has been suffering from myopia glaucoma and cataract but in the present case from the medical board’s report it is clear medical board is silent about all these procedure but they supported that there was no negligence but their report supports that they did not follow the skilled procedure as adopted in case of a patient who suffers from myopia, cataract and glaucoma. In the light of the above observation and in view of the above discussion we are of view that no doubt for medical negligence on the part of the OP the present complainant has suffered and for which complainant is entitled to get compensation from the OP.
In the present case OPs submitted that the doctor who examined that is Dr. Prof. Himadri Dutta is not made a party but in this regard we are convinced that it is the negligence on the part of the entire institute because institute deputed the doctors and the present patient was not admitted by Dr. Himadri Dutta but he was admitted to OP’s hospital if OP’s doctor discharged their negligent manner duties and for their medical negligence if any patient suffers then entire government institution is responsible and so there is no question to make the Dr. Himadri Dutta as party when the entire institute that is government institute is made a party and it is their liability to prove that there is no deficiency or negligence on the part of the OP.
In the light of the above observation and findings the complaint succeeds.
Hence,
Ordered
That the case be and the same is allowed on contest against the OP with a cost of Rs.10,000/-.
OP is directed to pay a sum of Rs.5 lakhs for causing loss of sight of the complainant and also causing harassment, mental pain and agony and future sufferings of the complainant when all the above sufferings are caused due to medical negligence on the part of the OP and their doctors.
OP is directed to pay the total compensation of Rs.5 lakhs and Rs.10,000/- as litigation cost totaling Rs.5,10,000/- to the complainant within one month from the date of this order failing for non-compliance of the Forum’s order penal damages shall be assessed at the rate ofRs.300/- per day till full satisfaction of the decree and if it is collected at least 50 percent will be disbursed to the complainant.
OP is directed to comply the order very strictly within the stipulated period of time even if it is found that OP is reluctant to comply the order in that case penal action u/s.25 read with Section 27 of the C.P. Act shall be started against them for which further penalty and fine shall be imposed.
