Order-21.
Date-14/09/2015.
In this complaint Complainant Md. Ramjan by filing this complaint has submitted that complainanton 18.06.2012 visited the chamber of op no.1 at SVS Marwari Hospital for his treatment of stomach ache and op no.1 after examining the complainant opined that complainant has been suffering fromInguinal Hernia and advised for immediate operation and referred to complainant to Rameswara Nursing Home and on the same day complainant on good faith followed the advised of the op no.1 and complainant was operated in the said nursing home under the supervision of op no.1 on 18.06.2012 on advice and as per order of op no.1 and thereafter complainant was discharged from the said nursing home on 25.06.2012.
But complainant was not feeling well and was suffering from post-operative ailments till that date.Thereafter complainant repeatedly visited the chamber of op no.1 and tried to inform him about the post operative ailments but op no.1 neglected to meet the complainant and refused him.Finding no other alternative complainant consulted with another doctor P.K. Sarkar of Saviour Clinic for further treatment and the said doctor again operated the complainantand complainant had to remain admitted in the said clinic on and from 18.06.2012 and remained in the said clinic up to 12.07.2012.
Complainant was admitted third time in Saviour Clinic on 24.07.2012 and remained up to 02.08.2012 for the said operation and for that operation complainant had to incur huge expenses for treatment in both the nursing homes and as retired primary school teacher complainant was compelled to borrow a large amount on interest which is yet to be cleared with interest.
In fact complainant is unwell with the service mated out to ops and for which he claimed adequate compensation of Rs. 2,00,000/- for medical negligence of the op no.1 and this apathetic and apparently deceitful attitude of the op no.1 reflects its indifference to the complainant’s plight.
So, in the above circumstances, complainant has filed this complaint for redressal and also for compensation.
On the other hand op no.1. Dr. P.D. Saraf by filing written statement submitted that complainant has failed to produce any document to show that there is any medical negligence by proving the same on the basis of opinion of medical expert/specialist in the field and moreover this op no.1 after discharge from the op’s hospital and from treatment from the op no.1 on 25.06.2012 did not turn up and had been treated by several doctors who are not made party in the present complaint and only to suppress the material fact, this complaint is filed falsely with some false allegation.
It is specifically mentioned by the op no.1 that complainant is a male patient aged about 65 years and he was examined by him for complaints of Obstructive Inguinal Hearnea and on clinical examination op no.1 opined that the complainant was suffering from Stangulated Inguinal Hearnea of left side causing intestinal obstruction and as such he was advised Exploration and Repair of Inguinal Hearnea surgery by the op no.1.
Accordingly complainant was admitted to Rameswara Nursing Home on 15.06.2012 under his care and patient was diagnosed as Left sided obstructed inguinal hernia which is a protrusion of abdominal-cavity contents through the inguinal canal and they are very common in men and surgical repair is one of the most frequently performed surgical operations for his treatment and thereafter the patient was examined by the anesthetist and was found fit for surgery and accordingly the surgery was planned on 18.06.2012.
During the whole operation patient was stable and did not require blood transfusion and he was shifted toward after the surgery and the patient is a slow and steady recovery under the watchful eye of op no.1 and his assistants.However after post-surgery the patient had developed paralytic ileus which is a known complication of the surgery as done on the patient and further Paralysis of the intestine is often termed paralytic ileus, in which there is an obstruction in the passage of food through the intestine and lead to intestinal blockage and paralytic ileus is a common side effect of the surgery done on the complainant and Paralytic ileus causes constipation and bloating and on listening to the abdomen with a stethoscope, no bowel sounds are heard because the bowel is inactive and a temporary paralysis of a portion of the intestines occurred typically after an abdominal surgery.
Traditionally nothing by mouth was considered to be mandatory in all cases, but gentle feeding by enteral feeding tube is advised to help to restore motility by triggering the gut’s normal feedback signals, so this is the recommended management initially which was also followed in this particular case and the patient was recovered and was discharged after removing the stiches and the patient was passing stool and urine normally.The patient was advised for further stay in the nursing home but due to his financial difficulty the patient requested for release and accordingly the patient was discharged on 25.06.2012 with an advice of taking liquid diet and take medicines like PAN-D, Inj. Xone to review with op, the patient was directed to meet after discharge, but he did not make any contact with the op/doctor.So, in the above circumstances there was no scope on the part of the op nos. 1 & 2 to examine him further and for his further treatment.
It is to be mentioned that complainant was duly operated and the details of the surgery has been narrated above and it is further stated that the complainant disclosed certain certificates of the doctors who had treated him after he was operated by the op and in all certificates it has been specifically stated that the complainant was suffering from post-operative complications and as such it is conclusively proved that there was no negligence on the part of the op no.1.But the patient had suffered a known complication of the surgery for which op no.1 had no control whatsoever.
It is further stated that the Paralytic Ileus was also treated by the op no.1 and there were signs of normalcy for which the patient was discharged from the nursing home with advice to consult with the op no.1.But the patient did not meet with doctor or the nursing home for further treatment if it is found that complainant faced any problem.
In fact there was no negligence and deficiency in respect of the treatment and operation or after operation management by the op.So the claim of the complainant is completely baseless and without any foundation, for some ill purpose, this complaint is filed and in fact the entire complaint is baseless and no foundation for which this complaint should be dismissed.
Decision with reasons
On comparative study of the complaint and the written version and also hearing the Ld. Lawyers of both the parties and further on overall assessment of the medical reports i.e. discharge summary and other papers, it is found that undisputed fact is that complainant was admitted on 15.06.2012 to Rameswara Nursing Home Pvt. Ltd. under Dr. P.D. Saraf for treatment as he was suffering from Left sided Inguinal Hearnea.Thereafter initial investigation and operation was done on 18.06.2012 and he was discharged on 25.06.2012 from the said hospital and at the time of discharge from the discharge summary, it is found that it was specifically mentioned by the doctor that liquid diet to be continued and contact family physician and in case of review, contact P.D. Saraf and that discharge certificate was issued on 25.06.2012.
After operation blood test was done and it was detected that there is toxic granules present in some neutrophils and other reports that in respect of blood etc. and also hematological reports dated 21.06.2012 and 22.06.2012 were otherwise okay.
But complainant’s complaint is that during his stay at the said Nursing Home he was feeling unwell, but no doctor properly treated him for which he contacted with another doctor Prasanta Kumar Sarkar and from the document filed by the complainant, it is clear that complainant after release from the op’s Hospital on 25.06.2012 went to Dr. Prasanta Kumar Sarkar of Saviour Clinic where he was admitted on 27.06.2012 and discharged on 12.07.2012 and that doctor made exploratory of abdomen (Laparotomy) and that operation was done on 28.06.2012 and fact remains that the said Dr. P.K. Sarkar and also from the report of the doctor Saraf, it is fact that on 25.06.2012 at the time of discharge stiches on the operation side was removed and from the discharge summary of the P.K. Sarkar it is found that doctor was informed of residence of the complainant over phone in the evening of 27.06.2012 and that doctor was requested the complainant to examine and considering the seriousness on that date and x-ray of abdomen erect was done and thereafter Dr. P.K. Sarkar treated him and holding abdomen erect x-ray and it was found that total loss of mortality of the intestine that is the main problem after discharge from the op’s hospital.
Complainant has alleged that due to negligent manner of operation, subsequent problem was practically caused and in fact for negligent and deficient manner of service on the part of doctor, complainant suffered from paralytic ileus.Anyhow the subsequent doctor P.K. Sarkar treated him after final diagnosis that he was suffering from paralytic ileus.
Anyhow the subsequent doctor P.K. Sarkar examined him after final diagnosis found that he was suffering from paralytic ileus.Complainant has alleged that he has been suffering from such diseases due to wrong treatment and operation done by Dr. P.D. Saraf.In this regard we have gathered from different books of elite doctors of different hospitals of United Kingdom that Paralytic ileus describes the condition in which the biles ceased to function and there is no Peristalsis and the term ileus is now most often used to imply non-mechanical intestinal obstruction and the term paralytic ileus is sometimes used when the problem is inactivity of the bowel and Postoperative ileus is a significant problem and reduced handling of the bowel at operation is recommended.
In this regard from the said author’s research book it is clear that to determine the said problem it is required by placing a stethoscope on the abdomen to listen for bowel sounds and in obstruction they are very active and tinkling bowel sounds are characteristic and in ileus the bowel is silent or nearly so, that bowel sounds are very irregular and so auscultation must not be rushed if a true picture is to be achieved and in this regard water-soluble contrast enema X-ray may be helpful and water-soluble contrast may also be helpful in small bowel obstruction due to adhesions.About treatment and after considering the said books of UK doctors and also European guidelines it is found that the typical clinical symptoms associated with obstruction include nausea, vomiting, dysphagia, abdominal pain and failure to pass bowel movements and clinical signs include abdominal distention, tympany due to an air-filled stomach and high-pitched bowel sounds and this type of complication is generally found after lapse of few daysafter operation and in fact in that case the patient must have to take only liquid for certain period as per direction of the doctor.But it is not always possible to search out the acute problem within certain period and for management of such problem it must be conservative, including fluid resuscitation, electrolyte replacement, intestinal decompression and bowel rest.Resuscitation is very important and correction of fluid and electrolytes considerably reduces after post-operative stage.In Paralytic ileus a nasogastric tube will reduce vomiting.In view of the risk of perforation and absorption of toxins from ischemic bowel, prophylactic antibiotics for gut surgery are advised and it is specifically mentioned that if adhesions are thought to be the cause of obstruction then conservative measures may be sufficient.
So, considering the said medical opinions of different doctors of different medical colleges of UK and European guideline, we find that paralytic ileus is a complication generally found after operation and it may be controlled by conservative treatment.But after operation patient must have to follow the direction of the doctor that he must not have to take hard food.But he shall always take liquid till doctor give him advice to take such hard food and in complicated case Laparotomy may be required and resuscitation of the bowel may be required.But it is specifically mentioned that after any such operation it is worth awaiting full resuscitation and fluid replacement but if the patient is toxic with possible perforation or infarction of bowel, early intervention is required.
After considering the treatment of the Dr. P.D. Saraf we have found that the guideline as mentioned in different books in respect of Epidemiology and Intestinal Obstruction and Ileus were duly followed.
Another factor is that complainant has admitted in his reply against questionnaire made by the op against question No.21 that as he was not satisfied with treatment of Dr. P.D. Saraf, he did not feel necessary to contact op after discharge.Considering that fact it is proved that complainant did not go to ops after discharge though he was advised by discharge summary to meet Doctor P.D. Saraf in case of any complication but he did not follow any such advice and went to another doctor for which the complaint of the complainant that ops did not attend complainant after discharge is proved a false story.
Moreover the procedure of treatment as made by the ops are found in order of medical science.So apparently no negligence on the part of the ops is found and at the same time procedure of treatment as adopted by the op during the stay of the complainant in the said ops’ Hospital is also found quite correct in view of the world wide theorization as made by different doctors and hospitals of UK and European countries and truth is that post-operative ileus that is Paralytic Ileus is common problem and it can be reduced generally by conservative process and in extreme case because operation is required and truth is that ops took all initiative as per adopted method for management by observing conservative treatment initially and that is the method and post-operative ileus that is Paralytic ileus as found in this case was not for any negligence on the part of the ops at the time of operation or subsequent to post-operative stage and fact remains that the determination of ileus can be madeby placing a stethoscope on the abdomen to listen for bowel sounds and in obstruction they are very active and tinkling bowel sounds are characteristic and in ileus the bowel is silent or nearly so, that bowel sounds are very irregular and so auscultation must not be rushed if a true picture is to be achieved.
In case of operation of inguinal Hearnea, Paralytic ileus may becaused but risk factor is low but it is much more common in most of the cases and considering the situation of the complainant till his discharge doctor advised for continuation of liquid food.But probably that was not followed for which abdominal distention was caused and further it is interesting that the patient did not go to the doctor (Ops) though op’s advice in case of any complication complainant must have to report.But complainant did not take the service of the ops and refused to go there as per his own wish and selected another doctor where that doctor practically treated post-operative Paralytic Ileus that is fact because prescription of doctor Sarkar supports that.
So, the entire allegation of the complainant is proved a false allegation against the ops who are found not negligent in discharging their duties as doctor and hospital in relation to operation of Inguinal Hearnea by the op doctor and their entire procedure and process of treatment and operation and subsequent management are in order as per authenticated medical research opinion on different doctors of Europe, and different countries and we have followed those findings of the authors after collecting it from different world famous medical institution through internet.In this context it is to be mentioned that chance of Paralytic ileus after Inguinal operation in case of older patient is highly common and after operation early recognition and management are vital for the purpose of avoiding perforation and method is to use electrolyte imbalances and correction of fluid and that was completely done by the ops.
So, no part of the service of the ops is found irregular or illegal.In this context from the authoritative books we have gathered that Paralytic ileus incident is 10 times higher than in Europe and North America and most common case of intestine obstruction is found in Africa and Asia.
So, considering all the above materials and also relying upon the authoritative books and findings and after applying the same in the present case on evaluation of the medical papers issued by the ops we are confirmed that complainant has miserably failed to prove any sort of negligence on the part of the ops and also have failed to prove that the treatment of the ops was incorrect or not at par medical standard.
In the result, complaint fails.
Hence, it is
Ordered,
That the complaint be and the same is dismissed on contest without any cost against the ops.
