Date: 20-08-2015

Sri Kamal De, President

Brief facts of the Complainant’s case are that he met with an accident on 20-05-2013, as a result of which, his left leg got injured and he was brought to the chamber of the OP No. 1 at 12 noon on the self-same day. The OP No. 1 advised him to undergo immediate operation and asked him to get admitted in the OP No. 2 hospital.  After receiving due payment, the OP No. 1 operated him in the evening on 20-05-2013.  The OP No. 1 fixed a steel plate in order to join the tibia.  On 21-05-2013, foot drop was noticed and on 24-05-2013, he was discharged from the OP No. 2 hospital.  After returning home, on 25-05-2013, the Complainant felt temperature in his body and noticed that push was coming out from the infected portion that was operated upon, so he met the OP No. 1 on 26-05-2013.  On 26-05-2013 and again on 28-05-2013, dressing was done, but it did not yield any positive result, also body temperature was running high.  So, the OP No. 1 advised the Complainant to get admitted at the said hospital and on 30-05-2013, the OP No. 1 removed the steel plate.  During second operation, tibial condyle with sepsis and necrosis of the leg muscles was detected.  It was also found that there was multiple drill home over the exposed left tibial shaft.  As a result of such complications, the left leg of the complainant became stiff and there was no sensation, also there was no movement of the left leg fingers and the condition of the Complainant deteriorated gradually.  On such precarious condition, the Complainant and his parents and other well-wishers decided to get proper medical treatment from another specialist doctor and accordingly, on 01-06-2013, he got released on request and went to Cuttack and primarily got admitted at the Riverine Hospital and undergone treatment from 02-6-2013 to 11-06-2013 and subsequently, he went to Ashwini Hospital and remained therein till 14-07-2013.  The Complainant also went there for follow up treatment on 24-07-2013, and 14-08-2013, and from 13-11-2013 to 18-11-2013, and further on 06-12-2013.  Despite such treatment, at present the Complainant cannot move without the assistance of others, nor can he fold his left leg, even he has to discharge natures call in a bed pan.  The Complainant has somehow managed to join his workplace with the assistance of a private care, but not in a position to do board work in the class room. 

Case of the OP No. 1, on the other hand, is that the Complainant visited his chamber on 20-05-2013.  On clinical examination of the patient, he was of the opinion that the patient was suffering from a scalp hematoma over left frontal region and comminuted fracture tibial condyle. The Complainant was primarily treated at his chamber by administering medicines aspiration of knee hematoma, application of knee brace.  He was also advised various blood tests, viz., ECG, CT scan of brain.  The lady who accompanied the Complainant was explained of the nature of the fracture and also apprised of the necessity of surgical intervention. The procedure of operation and the prognosis of operation, including the possible high chances of complications relating to infections and others were clearly explained to them at the chamber of the OP No. 1 and was codified in the prescription itself.  It was also mentioned in the consent paper.  Before admission at MAS Clinic, the patient and his companion were explained in detail about the increased risk of skin complications and infection in that type of fracture than other fracture.  The patient party was informed that for this type of surgery complications rate is 1 – 54%, whereas chances of most severe complication is between 3 – 38%.  After understanding the nature of the treatment, the patient was admitted at MAS Clinic on 20-05-2013.  On 20-05-2013 itself, pre-anesthetic checkup was done as is done in case of emergency surgeries and as the patient was young with no major history of illness and all the parameters were within acceptable range, it was decided to proceed with the surgery.  Further, on clinical examination it was found that there was no skin edema or skin abrasion.  No pain was complained of by the patient.  So, it was decided to proceed with such operation.  It is the settled principle that in case of intra articular fracture, being suffered by the Complainant, the same is treated by open reduction and stable internal fixation and early joint movement exercises.  The major aim of surgery is to restore articular congruity, joint stability, allowing early pain free movement, full functional recovery and to avoid post traumatic arthritis.  Prior to OT and during OT, every step was taken meticulously like administering Antibiotic prophylaxis – Cephalosporin + aminoglycosides  given 6 hours before OT and just before induction of anesthesia and postoperatively.  The time of surgery was 8 hours after injury and as there was no development of skin edema, or pain and toe movement was normal and painless, hence the surgery was proceeded with.  The surgery was uneventful and it lasted fifty minutes as proper implantation was done under real time image intensifying C-arm for accurate fixation and less duration of operation.  The patient was shifted to the ward after the patient revived from anesthesia.  There was no footdrop at any point of time though in the complaint, the Complainant has said so.  Patient was examined by the OP No. 1 on 20-05-2013 at 10.00 p.m. when there was no sign of footdrop.  The patient was also seen by Dr. D. Bhattacharya on 21-05-2013 when no footdrop was seen.  Thereafter, the patient was seen by Dr. B. Sarkar on 22-05-2013 when no such footdrop was seen and even subsequently on Riverine Hospital’s discharge note of 11-06-2013, no footdrop was mentioned.  The discharge note of Ashwini Hospital dated 19-07-2013 neither recorded footdrop.  Subsequent follow ups dated 29-07-2013, 14-08-2013, 28-09-2013, 13-11-2013 and 18-11-2013 do not reveal any footdrop.  It can, therefore, be concluded that the allegation of footdrop is baseless and has been made only to mislead the Ld. District Forum and draw sympathy towards the Complainant.   During the stay in the Nursing Home, the patient was administered medicines like cephalosporin, aminoglycosides.  The patient took discharge on request on 24-05-2013.  At that time, patient was stable.  Subsequently, on 26-05-2013, dressing was done when 10 ml. serosanguinous fluid came out and there was also complaint of fever.  On 28-05-2013, the patient discharged 5 ml, pus was sent for culture and sensitivity test, urine for RE/ME.  On 30-05-2013, during dressing, pus was noticed and patient was advised for admission and debridement.  Culture and sensitivity test was negative which indicated that the patient was not suffering from any major bacterial infection. On 30-05-2013,  through debridement of necrotic muscle fascia of anterior compartment and thin margin of skin was removed.  Purulent discharge was found around the plate.  Therefore, the OP No. 1 decided to remove the plate in order to prevent biofilm formation and to prevent chronic osteomyelitis which is very difficult to treat.  Wound irrigation was done.  Wound was closed over a negative suction drain.  So, there was no complete exposure of tibia after second operation.  Patient was quite well after thorough debridement.  On 01-06-2013, the patient complained of pain over left leg.  On that evening, patient and his companion had a discussion with the OP No. 1 when he advised them to visit Apex Orthopedic Hospital for consultation.  Fresh dressing was done.  There was no gap in wound margin, only small amount of discharge.  There was tingling sensation of foot and sole.  The movement was slightly diminished.  Treatment paper of Riverine Hospital, Cuttack proves that there was no facility for orthopedic surgery in the said hospital and there was no specialist orthopedic surgeon.  In spite of that, the Complainant got admitted there under a general Surgeon.  There he lost 10 crucial days which was vital for specialist treatment.  At Ashwini Hospital, Cuttack, the Complainant underwent multiple debridement and was discharged from there on 14-07-2013.  Stiffness of knee is very common in such type of injury.  As per the prescription disclosed by the Complainant, the range of motion of knee was 5-100^o on 13-11-2013, which would have been improved by physiotherapy.  With 100 degree flexion, one can do almost all daily activities.  Dorsiflexion of toe was absent.  Plantar flexion, invasion and eversion of foot was present on examination on 13-11-2013.  Due to necrosis and repeated debridement (5 times in total), muscle bulk of anterior compartment of leg was removed those were involved in dorsiflexion.  As an occurrence of normal phenomenon, the patient was unlucky to develop infection.  The infection which was caused to the Complainant post-surgery, most likely occurred due to low immune profile of the Complainant and several other physical conditions of the patient. The infection of the Complainant was not detected in spite of repeated tests.  Had bacteria been detected in the culture sensitivity test, treatment of the patient could have been tailor made.  After admission in Cuttack Hospital, the treating doctors had advised culture sensitivity tests several times and on all occasions, the report was negative which indicated no growth and accordingly, a broad spectrum antibiotic was advised.  Organism was isolated on 22-06-2013.  In medical science, all injuries and/or complications cannot be cured to its fullest extent, attempts are made to return the maximum utility of the bones after surgery.  From the documents it is apparent that the Complainant was bending the operated knee up to 100 degree with which, almost all kinds of day to day activities is possible save and except sitting on the floor with folded knees.

OP No. 2 also contested the case by filing WV wherein it has stated that the Complainant has not alleged any deficiency and/or shortcoming in the facilities of the OP Nursing Home, but has drawn the OP No. 2 with ulterior motive.  On 20-05-2013 itself, pre anesthetic checkup was done as is done in case of emergency surgeries and as the patient was young with no major history of illness and all the parameters were within acceptable range, it was decided to proceed with the surgery.  The OT which was provided by the Nursing home was an absolutely aseptic OT where periodic fumigation is done as a routine matter.  Before the surgery of the Complainant, several patients were operated upon and after the surgery of the patient, several patients have been operated upon who have not suffered any kind of infection at all till date.  It conclusively proves that the infection which the patient suffered, developed outside the nursing home.  The Complainant was provided with all possible medicines and support as was advised by the consultant at all point of time during the stay of the patient in the hospital.  The Complainant seems to have based his entire complaint over his inability to stand for a prolong hour and teach which is difficult immediately after a major knee surgery, but in course of time, by adopting proper exercise and physiotherapy, all major activities can be done by the patient.

Point for consideration

1. Whether the treatment meted out to the Complainant by the OPs disclose any medical negligence on the part of the OPs, or not.

2. Whether the Complainant is entitled to any relief, or not.

Decision with reasons

Point Nos. 1&2:

For the sake of brevity of discussion, both these points are taken up together.

Ld. Advocate for the Complainant has submitted that as per standard medical journals in case of treatment of tibial plateau fracture, possibility of success depends on the quality of reduction, ligament stability, treatment of associated soft tissue injuries, and preservation of the soft tissue envelope, coupled with good visualization of the articular surface with minimal dissection aid achieving this goal.  The timing of surgery and handling of the soft tissue in the affected area are critical to treatment success. Worldwide research conducted by different countries do suggest that high incidence of wound complications occur due  to the failure of the concerned surgeon to make proper evaluation of soft tissue damage and inappropriate timing to do surgical intervention.  The OP No. 1 went ahead with the operation in a casual manner without making any endeavour whatsoever to ascertain the vascular status of the extremity or detail examination of the neurologic status of the affected limb, resulting which, the infection developed. Only because of the sheer negligence of the OPs, the condition of the Complainant has turned beggar description.  A patient generally approaches a doctor/hospital based on his/its reputation.  Expectations of a patient are two-fold: doctors and hospitals would provide medical treatment with all the knowledge and skill at their command and secondly, they will not do anything to harm the patient in any manner, either because of their negligence, carelessness, or reckless attitude of their staff.  The instant case is a clear pointer of gross negligence on the part of both the OPs, for which they cannot avoid their liability.  Therefore, exemplary costs be imposed upon them.

Ld. Advocate for the OPs has submitted that the Complainant/patient party was duly apprised of the high risk factors associated with this kind of operation.  After due consultation and taking due consent of the patient party, the operation was carried out following Open Reduction Internal Fixation (O.R.I.F.) method by fixing the bone with plate on 20-05-2013.  As per the request of the patient, he was released on 24-05-2013 with proper advice/instructions.  The patient returned on 26-05-2013 with fever and pain.  So, dressing was done when 10 ml. serosanguinous liquid drained out.  On  28-05-2013 again dressing was done and swab and urine sent for culture and sensitivity test and PUS drained out.  On 30-05-2013, debridement was done and under spinal anesthesia, the implants were removed.  The decision for such removal was taken as there was chances of biofilm formation and chronic osteomyelitis which is very difficult to treat and the said second operation was also quite satisfactory.  But, on 01-06-2013, the patient complained of pain over left leg.  As the patient party wanted to visit Chennai for further treatment, all necessary arrangements were made for sending the patient to Chennai.  However, the Complainant instead visited Cuttack for treatment.  Significantly, the Complainant underwent treatment at Riverine Hospital, Cuttack from 02-06-2013 to 11-06-2013 although the said hospital had no such facility for orthopedic treatment.  In the process, the Complainant wasted 10 crucial days in undergoing treatment at a wrong hospital that lack due expertise and infrastructure to treat this kind of complicated treatment.  Stiffness of knee, as complained of by the Complainant, is very common in this type of surgery.  The whole treatment plan and procedure was followed as per approved medical practice and procedure and there was not a single instance of any sort of medical negligence or deficiency in rendering proper and satisfactory service to the Complainant.  So, the instant complaint case be dismissed.

First of all, the OPs have questioned the judiciousness of the decision of the Complainant to undergo treatment at the Riverine Hospital, Cuttack on the ground that the said hospital did not have facility for orthopedic surgery and moreover, there was no specialist orthopedic surgeon.  On perusal of the Discharge Summary dated 11-06-2013, however, we find that the Complainant was treated by Dr. Sandeep Biswal (MS), Ortho and Dr. Baikunthanath Mohapatra (MS), Ortho at the said hospital and he also underwent surgery on 03-06-2013 under SA at the said hospital. Significantly, the OPs could not earmark a single fault with the surgical procedure adopted by the said hospital for the treatment of the Complainant. Clearly, the allegation of the OP No. 1 on this front is totally misplaced.

On one hand, the OP No. 1 has stated that vital parameters of Complainant’s health were within acceptable range, and on the other, he has blamed the low immune profile of the Complainant and several other physical conditions (without elaborating what did he mean by “other”) for the development of post-operative infection and consequent complications.  This is self-contradictory.

There can hardly be any debate as to the fact that treatment of tibial plateau encompass a wide range of severity, from stable non displaced fractures with minimal soft tissue injury to highly comminuted unstable fractures with massive soft tissue injury that threaten limb viability.  Careful and thorough assessment of severity, with particular attention to identifying high-energy injuries is critical to achieve optimal outcome and avoid complications. 

It being a high risk operation, a focused, yet complete approach should have been taken by the OP No. 1 before proceeding with the operation.   As an experienced physician, we are sure, the OP No. 1 was not oblivious of the importance of doing elaborate physical examination of the patient in order to evaluate the extent of fracture sustained by the Complainant.  At the same time, it is needless to say that taking note of the patient factors also bears immense significance to draw up appropriate treatment plan.  It is common knowledge that patients with concurrent health problems such as coronary artery disease, emphysema, smoking habits, poorly controlled diabetes are at greater risk of suffering a variety of complications.  

On going through the prescription of the OP No. 1 dated 20-05-2013, we find that it only contains the BP of the patient.   Vide his said prescription, the OP No. 1 advised some routine blood tests, CT scan, ECG for the patient.  Apparently, the OP No. 1 did not deem it necessary to perform full clinical evaluation of the entire limb circumferentially for evidence of swelling, lacerations, blisters, bruising, deformity, angulation, and distal perfusion, nor documenting the vascular status of the extremity, or examining the neurologic status of the affected limb crossed the mind of the OP No. 1.  Be that as it may, fact remains that from the bed head ticket of the OP No. 2 hospital, we find that only pulse rate, body temperature, B.P., were noted down in the said treatment sheet.  Whether the prescribed tests were at all done before operation or not, no credible evidence is forthcoming before us. Thus, on what basis, the OP No. 1 came to the conclusion that vital parameters of the Complainant were within acceptable range is not understood.   

As per medical journals, Compartment Syndrome is more commonly associated with the severe types of plateau fractures in which the muscle in the proximal posterior calf sustains significant injury. The OP No. 1, vide his prescription dated 20-05-2013 cautioned the patient about the risks of compartment syndrome.  Surprisingly, however, documents on record do not suggest that the OP No. 1 did ever give any advice for clinical diagnosis for compartment syndrome.  On going through the Discharge Summary dated 11-06-2013 of Riverine Hospital, Cuttack we find that the Complainant developed post-operative compartment syndrome.

It is argued by the Ld. Advocate appearing from the side of the OPs that it appears from the Discharge Certificate of OP No. 2 hospital dated 24-05-2013 that the patient was warned of the possibility of stiffness of knee.   But, there is nothing on record that the patient was warned of such possibility before operation.  Such warning in the discharge certificate, therefore, appears to be nothing but after thought. The OP No. 1 has further stated in his WV that he noticed from the treatment sheet dated 13-11-2013 that range of motion of knee of the Complainant was 5-100^o and he has opined that the same would have improved through physiotherapy.  Knee stiffness is perhaps the most common complication seen after tibial plateau fracture.  However, to our utter surprise, we find that no such specific averment is made by any of the OPs as to whether the Complainant was advised to undergo physiotherapy on a regular basis when he was discharged from the OP No. 2 hospital although according to the OP No. 1, the patient was released from the said hospital on 24-05-2013 in a stable condition. Also, it transpires from the copy of “Register of Expenditure incurred by a patient for treatment in the Clinical Establishment” of the OP No. 2 hospital when the Complainant stayed over there for the first time for 4 days that the OP No. 2 did not charge anything for imparting physiotherapy to the patient. 

It is claimed by the OP No. 1 in his WV that on further clinical examination it was found that there was no skin edema or skin abrasion.  However, he has stopped short of specifying what explicit tests he suggested to satisfy himself about the condition of the skin of the Complainant before proceeding with the operation.  On going through the prescription of the OP No. 1/treatment sheet, we have not come across mentioning of any test in the said papers, nor the same (treatment sheet) contains result of such findings, also no document is forthcoming before us to support the contention of the OP No. 1 in this regard.  Thus, we see no good reason to take the averment of the OP No. 1 as gospel truth.

The OP No. 1 has relied upon the Rockwood and Green’s write up namely “Fractures in Adults” to show that infection rate in respect of tibial plateau fractures hover around 3% to 38% cases.  The said literature, however, suggests that such risk factor depends on which technique is employed.  It also transpires from the said write up that the time of surgery depends on the condition of the soft tissues.  Early postinjury swelling represents hematoma.  Earlier surgery in high-energy injuries through compromised soft-tissues is inadvisable and may lead to a higher incidence of wound problems.  Such opinion has been echoed by Dr. Douglas R. Dirschl, MD (Distinguished Professor & Chairman, Department of Orthopedics, University of North Carolina Hospitals, Chapel Hill), and Dr. Daniel Del Gaizo, MD (Orthopedic Resident, University of North Carolina Hospitals, Chapel Hill)  in a write up, under the caption “Staged Management of Tibial Plateau Fractures” where they have opined that, “failure to apply staged management can result in soft tissue compromise, wound dehiscence, superficial and deep infection, stiffness, and poor function, and even loss of limb…. Any amount of swelling in the leg should induce the orthopedist to perform a full clinical evaluation for the presence of compartment syndrome….. Since insatiability of the knee to mediolateral stress is one of the most important surgical indications in managing tibial plateau fractures and one of the most important indicators of prognosis, accurate assessment of medio-lateral stability is critical for operative planning and prognosis”.

K J Koval and D L Helfet, Orthopedic Fracture Service, Hospital for Joint Diseases, New York in an article under the caption “Tibial Plateau Fractures: Evaluation and Treatment” opined that, “Surgical reduction and stabilization of displaced tibial plateau fractures, when indicated, requires careful evaluation of both the ‘personality’ of the fracture and the soft-tissue envelope”.

It requires no emphasis that post operation, first 72 hours are extremely crucial for a patient and therefore, the treating doctor is expected to keep a patient under close watch during this period.  From the treatment sheets of OP No. 2 hospital, however, it transpires that apart from seeing the Complainant at 10 p.m. on 20-05-2013, the OP No. 1 did not visit the patient for two consecutive days on 21-05-2013 and on 22-05-2013. As per the Register of Admission and Discharge Form placed on record, the Complainant was treated by one Dr. D. Bhattacharya, MS apart from the OP No. 1. However, there is no clarity as to whether Dr. Bhattacharjee holds any specialized degree/due expertise to treat an orthopedic patient. So, pot operation, whether the patient was left at safe hands remains an open question.   

Further, we find several disparities in the bed head ticket vis-à-vis advice of the doctor on the treatment sheets insofar as administering medicines/injections is concerned. 

All these factors do not speak high of the sincerity of purpose on the part of the OPs.  While the err is human, a hospital and medical professionals entrusted with treatment and often life of a patient, who generally follow the advice of these professionals, unquestioningly, are expected to exercise greater degree of care and caution while discharging their duties.  Gross medical mistake will always result in a finding of negligence. 

Sounding out due caution to a patient about possible peril, does not, in anyway, absolve the treating doctor/hospital authority of any and/or all liabilities.  Failure of a doctor or hospital to discharge their responsibilities towards a patient in a proper manner is essentially a tortuous liability.  A tort is a civil wrong as against a contractual obligation – a breach that attracts judicial intervention by way of awarding compensation/damages.  Thus, a patient’s right to receive medical attention from doctors and hospitals is essentially a civil right.  The relationship takes shape of a contract to some extent because of informed consent, payment of fee, and performance of surgery/providing treatment. etc., while retaining essential elements of tort.

Without any dispute, documents on record, sufficiently prove that the Complainant, who is presently suffering from limitation of knee and ankle motions (left) with muscle wasting and weakness of left leg and partial sensory deficit over anterolateral aspect of left leg which has caused permanent impairment, is the victim of gross negligence/deficiency in service on the part of the OPs.  While the Medical Board of the SSKM Hospital, Kolkata vide its Report dated 23-12-2014, has measured the extent of PPI at 57%, as per the Disability Certificate issued by the Office of the Medical Superintendent cum Vice Principal, Midnapore Medical College & Hospital, Paschim Medinipur dated 01-07-2014, the percentage of permanent disability of the Complainant is 60%.   It is noteworthy that Report of the Expert Committee dated 02-05-2014, constituted by the CMOH, Purba Medinipur did not exonerate the OP No. 1 of all kinds of medical negligence though as per the opinion of said expert committee, there was no gross medical negligence on the part of the OP No. 1 in performing the said operation.  Also significant to note that Dr. A. K. Pal, HOD Ortho, IPGMER-SSKM Hospital, Kolkata, who deposed before this Forum opined that, “the disability of the patient appeared after the surgical operation of the patient/complainant, Surajit Das.” He has further stated when crossed by the Ld. Advocate of the OPs that, “Disability occurred after operation but the disability is directly related with the trauma or surgery, it cannot be ruled out”. Case history noted by the Riverine Hospital, Cuttack dated 11-06-2013 states that. “Left Type V Plateau # of knee, treated outside, now developed post Op compartment syndrome and wound infection of about 10-12” long”.  Case history noted in the Discharge Summary of Ashwini Hospital, Cuttack dated 14-07-2013 reads as under: “20 days old fracture left tibial condyles. Treated with lateral condylar buttress plating (Outside), got infected and plate removal done on 30/05/2013.  Now patient present with infected surgical wound over proximal tibia left, exposing the tibia& underlying necrosis of the muscles with high grade fever”.  In fact, the OP No. 1 has also not disputed the fact that infection developed post operation of the tibial plateau fracture of the Complainant by him.

Hospital Administration and Management are as important as the role played by a doctor in treatment of a patient or that of a surgeon in performing surgery.  It is well known that negligence on the part of the persons entrusted with the responsibility of management of a hospital or nursing home may lead to infection, medical complications and even death.  Thus, negligence in pre or post-operative care can be as much the cause of medical complication or death as negligence of the operating surgeon or attending doctor. We find it quite intriguing that the patient was not attended to by any physician at the OP No. 2 hospital immediately after his admission overthere on 20-05-2013.

It appears that OP No. 1 operated the injury portion of left leg of the Complainant on 20-05-2013 in the evening and a steel plate was fixed at the injury fixed in order to join the same.  But, on 21-05-2013 morning, foot drop found on checking and on 24-05-2013, the Complainant was released but on 25-05-2013, after the operation, the Complainant ran temperature on his body and it was found that pus was coming out from the operated portion and the said portion got infected.  Further dressing was done on 26-05-2013 and again on 28-05-2013 for washing out the infected portion, but to no good and high temperature persisted.  The Complainant got re-admission in the same nursing home where he was operated on 30-05-2013 and the OP No. 1 made a surgical operation on the self-same portion and removed the plate which was placed on the first time operation. 

We think, that both the OPs are vicariously liable resulting in the whole consequences and subsequent disability of the Complainant to the extent of 57 – 60%.

Let us now switch over to the factum of compensation. 

It is true that the Complainant has joined his service and he is presently working as an Assistant Teacher in a junior higher school under Jhargram P.S. and he is getting salary.  So, it cannot be said that there has been loss of income for good.  But, at the same time, we must keep it in mind that he has suffered permanent disability to the extent of 57% to 60% and the Complainant is a young man of 28 years and the rest of life lies before him and such loss cannot be compensated in terms of money alone.

Be that as it may, in absence of relevant medical bills, save and except copy of one “Register of Expenditure incurred by a patient for treatment in the clinical establishment” of the OP No. 2 Hospital for a sum of Rs. 5,231/-, it becomes increasingly difficult to figure out the exact quantum of expenditure incurred by the Complainant for the treatment of tibial plateau fracture.  However, taking into consideration the prolong period of treatment at different hospitals, travelling and other incidental expenses incurred by the patient/Complainant for this purpose, as also tremendous mental and physical stress, pain and agony suffered by the Complainant and his family members, above all present handicapped condition, disability of the Complainant, and the young age of the Complainant we are of view that a monetary compensation of Rs. 10,00,000/- would be just and fair to mitigate the sufferings of the Complainant to some extent.  That apart, the Complainant is also entitled to a litigation cost of Rs. 10,000/-.

In the result, the complaint case succeeds.

Hence,

ORDERED

that the C.C. No. 20/2014 be and the same is allowed on contest against the OPs.  The OPs are jointly and severally liable to pay a sum of Rs. 10,00,000/- to the Complainant together with litigation cost for a sum of Rs. 10,000/-,  - each OP to pay the aforesaid amount in equal share within 40 days from the date of passing this order.  Failure to comply with this order would entail interest @ 9% p.a. over the aforesaid decreetal amount of Rs. 10,00,000/- from this day till full and final payment is made, and non-compliance of the order would entitle the Complainant to take recourse to execution as mandated in the Act.