(Passed this on 20th January, 2017)
Shri. S.P. Muley, President –
1. The complainant has made complaint of medical negligence against the Opposite Party, Dr. Sanika Raghtate in treatment of his eye problem.
2. Facts in short are that the complainant is a retired person of Jabalpur. Since August 2012 he was experiencing discomfort, hazy vision and pain in his left eye. The O.P. is an Ophthalmic Surgeon at Nagpur. The complainant decided to take treatment from the O.P. On 27/8/2012 he came to the clinic of the O.P. On check up he was informed that he was having Glaucoma in his left eye for which surgery was required, otherwise it may cause permanent damage to left eye leading blindness, if left untreated. Therefore he consented to go for surgery. He was assured that the O.P. has all the facilities at her clinic to take his pre and post operative care. He was also assured that after operation his left eye would get clear vision and he would not feel any discomfort or pain. However, the O.P. did not apprise him of procedure of operation or any complications, if any. Before surgery, he had visited the clinic many times for check up.
3. On schedule date of surgery he deposited an amount of Rs.8000/- for operation cost. For further review and check up he paid Rs.1000/-. Before surgery his physical fitness check up was not done. Even his blood pressure, blood sugar, hemoglobin and allied tests were also not conducted by the O.P. On 26/9/2012 the O.P. operated his left eye. But after surgery there was no improvement in vision nor his discomfort and pain subsided. It is alleged that no summery of operation or discharge card or receipt of amount was given to him. To his surprise, the O.P. told him that she performed cataract operation in his left eye. In fact, he was all the while told operation would be done for Glaucoma. This is sheer negligence of the O.P. He was told for some period only medication should be done. He left for Jabalpur in utter dismay. He got himself tested for fasting and post meal blood sugar at Jabalpur on 2/10/2012. His fasting sugar was 166 and post meal sugar was 493. He was shocked that the O.P. performed surgery on him despite he having high blood sugar. He then took treatment from his family doctor. On 8/10/2012 he came back to O.P. clinic at Nagpur for follow up and after prescribing some medicines he was asked to come again for review after 15 days. On 8/10/2012 when he told the OP about his family doctor observation, the O.P. for the first time checked him for RBS, BO and P. He thereafter visited the O.P. clinic on 24/10/2012 and 31/10/2012. His BP was 130/80. Inspite of pain and suffering and his Blood Sugar was 323 , the O.P. re operated his left eye on 31/10/2012. He had to suffer pain due to negligence of the O.P. However even that time also the O.P. did not treat him for Glaucoma. Even after second operation there was no relief from pain and discomfort and vision also was not improved. When he asked explanation to the O.P., she without explaining referred him to Suraj Eye Hospital for further check up and management. He visited that hospital on 17/12/2012 where he had to spent Rs.3000/-, though receipt of Rs.2200/- was issued, on examination. There also it was confirmed that he was having Glaucoma in left eye. On 16/1/2013 he again went to the O.P. along with report and CD given by the Suraj Eye Hospital and asked her why she operated him for cataract instead of Glaucoma. But she did not satisfy him and gave some more prescription. However, having lost faith in doctors in Nagpur, he went Medical Research Foundation in Chennai for proper treatment. There he was advised that advance surgery for Glaucoma was required. It was also informed that due to Glaucoma in left eye his right eye also developed Glaucoma. He was asked to deposit Rs.70,000/- for surgery and exact amount could only be ascertained after surgery. As he could not deposit the amount no surgery was done. He thereafter issued him legal notices for compensation but the same were not claimed by the O.P. Alleging gross negligence of the O.P., he now claimed refund of Rs. 9000/- paid to the O.P., Rs.4000/- for expenses incurred on follow ups, Rs. 6000/- for traveling expenses, Rs.3000/- incurred on check up at Suraj Hospital, Rs.70,000/- proposed expenses for Glaucoma surgery, Rs.10 lakh for mental agony and hardship and Rs.1300/- for notice charges, total Rs.10,93,300/-.
4. The O.P. filed her written version denying any medical or professional negligence on her part in treating the complainant. It is stated that the complainant was properly examined, diagnosed and treated as per his requirement and knowledge and as per prescribed norms and procedure. She is well experienced and qualified eye specialist. The complainant was given proper advice and after explaining diagnosis, treatment and known complications, treatment was given. It is alleged he has filed the complaint with ill intention to extract money for further treatment, because he is unable to bear that expenses. Glaucoma surgery cannot be done in Rs. 8000/- since such surgery on one eye costs minimum Rs. 30,000/-. Admitting that he had come to her for diminishing vision in both eyes, it is stated that he was diagnosed with cataract and Glaucoma in both eyes. The complainant, considering his financial constrains, opted for surgery of only cataract in his left eye. He was explained that he would be operated on for cataract only in left eye. Before surgery several tests were conducted to bring down his sugar level and when all parameters were normal cataract operation was done successfully.
5. It is denied that she advised the complainant to have immediate surgery for Glaucoma in her clinic. However, since he was also diagnosed with Glaucoma, she provided the treatment for the same by prescribing some medicines and eye drops. He was never given assurance of clear vision as he was a known case of blurred vision and has been using spectacles for last 15-20 years. The O.P. rightly referred him to Suraj Eye Hospital as certain tests were available there only. There is nothing adverse against the O.P. in the report of the Suraj Hospital. The condition of the complainant was fully monitored time to time and notes of the same were properly maintained by the O.P. he was satisfied with the treatment and therefore followed her advice. He was properly explained the procedure of the surgery. So also post operative care was well taken. It is stated that the complainant did not have funds for Glaucoma surgery and therefore even at Chennai eye hospital he did not go for that surgery. The complaint is filed to extract money from the O.P. for his further treatment. Thus denying the allegations of any kind of negligence, it is submitted to dismiss the complaint.
6. We have heard Ld counsels for the complainant and the O.P. Perused documents filed on record, rejoinder and notes of argument. Upon consideration of the same, we record our findings and reasons as under.
FINDINGS AND REASONS
7. Precisely, the grievance of the complainant is that he had vision problem in his left eye for which he approached to the O.P. for treatment. The O.P. after examination told him he had Glaucoma in left eye for which surgery was required. He consented for the said surgery, but actually he was operated upon for cataract, instead of Glaucoma, though he had paid for Glaucoma surgery. This has been vehemently denied by the O.P., who has said the complainant was told that he had Glaucoma as well as cataract in both eyes.
8. To ascertain the facts alleged by both the parties, it would be convenient to examine the reports of the complainant. Document no.1 filed by the complainant is the examination report dated 27/8/2012 given by the O.P. As per the said report the complainant was diagnosed with Immature Senile Cataract (IMSC) and Glaucoma in both eyes. There is nothing on the report to show that he was advised to undergo for Glaucoma surgery. Admittedly he was operated on for cataract. Here we may point out that as per set procedure, before any surgery consent form has to be obtained from the patient. The O.P. has filed on record the Indoor Case Report as document No.3 wherein consent was given by the complainant for cataract surgery. It is specifically mentioned by him that the surgery was for cataract only and not for other eye problem for which medication would continue. It is signed by the complainant and he has not made any grievance or allegation about this consent letter. Therefore, these two documents contradict the case of the complainant that though he was told that surgery would be done for Glaucoma, it was done for cataract and further he was not told about having cataract as well.
9. It is further allegation of the complainant that before surgery, his routine tests like BP, Blood sugar, etc were not conducted. In fact, in the Indoor Case Report findings on these parameters are mentioned. But Ld counsel for the complainant alleged that these findings were written subsequently. He reasoned that the O.P. putting her signature below the findings itself suggests that the writing was subsequent when her signature was already there at the place where it should be. The basis on which such allegation is made is far fetched. Subsequent reports show that the complainant was monitored regularly for his vital parameters. If he was operated upon without caring for his high blood pressure or blood sugar, there ought to have been serious complications during and after operation. But there were none, from which it can be inferred that he was operated only after his vital parameters were brought under control. He has filed some reports of his Blood sugar and BP showing high range, but those are post discharge. He was discharged on 27/9/2012 and reports are of October 2012. Therefore from these reports it cannot be concluded that he was operated upon without examining his BP, Blood sugar, etc.
10. From the discharge card it is evident that the complainant has been using spectacle for 15-20 years and blurred vision, redness and pain were his main complaints. It is specifically mentioned that small incision cataract surgery was done. Medicines for glaucoma were prescribed. What is to be noted is that he has no complaint regarding cataract operation. It is not his case that because of cataract operation he has suffered further complications or trouble in the eye. As a matter of fact, cataract operation was successful without any complication. This can be verified from the report of the Suraj Hospital and Medical Research Foundation, Chennai where he had gone for surgery for glaucoma. Nothing adverse is mentioned in the report about cataract surgery.
11. The conduct of the complainant is also contrary to his allegations. If he was dissatisfied with the O.P. and has complaint against her for doing unnecessary cataract surgery, yet he continued to take follow up treatment from her. He kept visiting her after operation and taking her advice and medicines prescribed to him. Under natural course, a patient dis satisfied with a doctorś treatment will not go to him/her again for treatment.
12. It may also be stated that he had paid Rs.8000/- to the O.P. for surgery and according to him that amount was paid for Glaucoma surgery and no receipt was given to him. This allegation is also found to be incorrect from his own document. He has filed receipt as document No.8 himself, whereby receipt of Rs.8000/- was acknowledged towards charges of cataract operation. Ld counsel for the O.P. submitted that for Glaucoma surgery charges are much higher than for cataract surgery. For Glaucoma surgery on one eye minimum Rs.30,000/- is required. This can also be ascertained from the complainantś own averment in the complaint. He has stated that he had gone to Medical Research Foundation at Chennai for proper treatment of his left eye. There, after examining his eye, he was told that advance surgery of Glaucoma was required to be done for which Rs.50,000/- would be expected expenses and he was asked to keep ready Rs.70,000/-. Since he could not afford to spend that much amount he did not go for surgery at Chennai. This fact supports the contention of the Ld counsel for the O.P. that the O.P. had given him idea of expected expenses of Glaucoma and cataract surgery when he was diagnosed by her. But he opted for cataract surgery as he did not have that much amount to afford surgery for Glaucoma.
13. Ld counsel for the complainant has placed on record some judgments. But these judgments are of no help to support his case unless negligence of the O.P. is prima facie established. However, we may note down the judgments. In Christian Medical Centre v/s A. Shajahan III (1998) CPJ 242 (AP St. Comm) the doctor operated the complainant for cataract without asking him whether he was diabetic. Consequently second operation for removal of eye became necessary. This was held to be negligence on the part of the doctor as such complication could have been avoided if precaution was taken. Such is not the case in the present complaint; no complication was developed after cataract surgery and he was examined for BP, Blood sugar, etc before surgery. In Vinubhai J. Patel (Dr) v/s Thakuuar Kalpesh Kumar 2012 STPL 5692 NC the doctor misdiagnosed the case as being cerebral malaria because he did not conduct any clinical or blood tests and reached the conclusion in perfunctory manner. In Dr. Shyam Kumar v/s Rameshbhai H. Kachhiya 2006 STPL 1070 NC principle of res ipsa loquitur was applied. In that case the patient had lost his vision after three operations as the doctor could not give any explanation for losing of the eye sight. In H.S.Sharma v/s Indraprashta Apollo Hospital 2007 STPL 3896 NC also the complainant was a diabetic patient but his sugar level was not monitored. He lost eye sight, therefore medical negligence was proved.
14. In all the above cited judgments, facts were different and negligence was held proved on those peculiar set of facts. Therefore the complainant cannot derive any support from these judgments.
15. Ld. Counsel for the OP has also relied on some judgments. Hon´ble Supreme Court in C.P.Sreekumar (Dr.) v/s S. Ramanujam (2009) 7 SCC 130 has discussed on what constitutes medical negligence. It is held, there may be divergence of opinion as to choice of procedure amongst doctors and a doctor may adopt any particular method which he feels to be appropriate. Therefore merely on the ground that the doctor adopted a particular procedure, does not mean that the doctor has chosen wrong method. In that case consent of the patient was taken for particular procedure of operation. In the present case also consent of the complainant was taken for cataract operation, though clear idea was given to him that he had Glaucoma and cataract in both the eyes. The O.P. prescribed medicines for Glaucoma also which shows she had taken precaution in that respect also. The State Commission of Maharashtra in Anil Ratiram Choudhary v/s Nagpur Nagrik Sahakari Rugnalaya and Othr in F.A No. A/851/2006 Dated 14/10/2016 has discussed elaborately on medical negligence and necessity of expert medical opinion. There is no expert opinion in this case and on facts and circumstances of the case it is not even necessary.
16. In view of the facts emerging from the documents, we are unable to agree with the case of the complainant. We find no medical negligence on the part of the O.P., who performed her professional duty as per the consent of the complainant. The cataract surgery was done with prescribed procedure. The O.P. would be liable only where her conduct fell below that of the standards of a reasonably competent practitioner in her field. Negligence cannot be attributed to a doctor so long as she/he performs his duties with reasonable skill and competence. As discussed before, the complainant could not show that his cataract surgery was a failure and he suffered complications after surgery. We therefore do not find merits in the complaint, which is liable to be dismissed. Hence, we pass the following order.
ORDER
1. The complaint is dismissed with no order as to cost.
2. Copy of the order shall be given to both the parties, free of cost.
