KERALA STATE CONSUMER DISPUTES REDRESSAL COMMISSION VAZHUTHACAUD, THIRUVANANTHAPURAM. APPEAL No. 683/2001 JUDGMENT DATED: 17-11-2009 PRESENT:- JUSTICE SHRI.K.R. UDAYABHANU : PRESIDENT SHRI.M.K. ABDULLA SONA : MEMBER 1. The Director, : APPELLANTS Govt. Ophthalmic Hospital, Thiruvananthapuram. 2. Health Secretary, Ministry of Health, Government of Kerala, Thiruvananthapuram. (Rep. by Sri. S. Vijayakumaran , Addl. Govt. Pleader) Vs 1. K. Albert, : RESPONDENTS Smitha Bhavan, Kurissadi, Puthukulangara P.O. 2. Dr. Kala, Ophthalmic Hospital, Thiruvananthapuram. (R1 rep. by Adv.Sri. R. Kumaran & Sri. B.R. Syam) (R2 rep. by S.S. Kalkura, Sri. R.S. Kalkura & Sri. G.S. Kalkura) JUDGMENT JUSTICE K.R. UDAYABHANU: PRESIDENT The appellants are opposite parties 4 and 5, the Government Ophthalmic Hospital represented by its Director and the Health Secretary, Government of Kerala, who are under orders to pay a sum of Rs. 2,00,000/- to the complainant as compensation with future interest at 16.5% and costs of Rs. 2,000/- in OP 513/97 in the file of CDRF, Thiruvananthapuram. 2. The case of the complainant is that on 08-05-1996 he had watering, pain and redness to his left eye. He is a person making out his livelihood by running a small poultry farm. He immediately rushed to the Ophthalmic Hospital, Medical College, Thiruvananthapuram. He was attended by the second opposite party who gave him an injection and advised to use eye drops. He was examined by the opposite parties 2 and 3 on the succeeding dates ie, 9th, 10th, 11th, 12th, 13th and 14th and the doctors advised him to put the eye drops prescribed earlier. On 13-05-1996 pain was so intense that he requested the doctors to admit him as an inpatient. But they refused to do so and directed him to continue the treatment as advised. On 14-05-1996 he was shocked to realize that he has totally lost the sight of the left eye and he got admitted at Chaithanya Eye Hospital and Research Institute at Thiruvananthapuram on 16-05-1996. He was admitted as an inpatient and the doctors extracted pus from the left eye and subjected to various tests. The left eye had to be removed due to perforated corneal ulcer. He was discharged on 20-06-1996. It is alleged that it is only on account of the negligence of the opposite party doctors that it resulted in the loss of his eye sight. He had availed loan to the tune of Rs. 58,000/- from the Co-operative sector mortgaging his property. He is unable to repay the same on account of his illness and consequential expenditure for treatment. He has sought for a sum of Rs. 2,00,000/- as compensation for loss of eye sight etc. and Rs. 20,000/- for the treatment expenses and also Rs. 29,450/-, the amount to be paid towards the bank loan. 3. The second opposite party was deleted from the party array on the application of the complainant as the second opposite party produced the relevant documents that would show that during the period she was attending a course at Aravind Eye Hospital, Madurai. 4. The 3rd opposite party subsequently arrayed as second opposite party has contended that she was a Post Graduate Student on the alleged dates of treatment and that it was one Dr. Antony who attended the complainant in the hospital. On 08-05-1996 she only assisted the duty doctor. The illness of the complainant was diagnosed as corneal ulcer on the anterior segment and the standard medicines were prescribed ie, subconjuctival injection gentamicine and broad spectrum antibiotics ie, ciplox eye drops, chlorophenicol eye ointment; and pad and bandage was given. The same was noted in the OP card. She only wrote the OP card as per the instructions of the attending doctor. She did not attend the OP department on subsequent days ie, from 09-05-1996 to 14-05-1996. The doctor had advised the complainant that the illness is a serious one and unless proper care is taken it will lead to loss of eye sight. Inspite of application of medicines there is every possibility of the corneal ulcer getting perforated. The above is a serious complication. It appears that the corneal ulcer that the complainant was having was a non healing corneal ulcer. It led to the further complication ie, endophthalmitis. Organisms that caused ulceration inspite of best treatment might have gained access to the interior of the eye resulting in endophthalmitis. The allegation that had the complainant been given appropriate treatment, the eye could have been saved is incorrect. It was a known complication; proper medicines were administered to the complainant. There was no element of carelessness involved; anyway the second opposite party is not liable as she has not treated the complainant. 5. The 3rd opposite party, the Director of the Hospital has filed a version on behalf of the 4th opposite party Health Secretary also disputing the jurisdiction of the Forum and also supporting the version of the second opposite party as to the treatment administered and the complications of the illness. It is pointed out that the duty doctor on 08-05-1996 had directed the complainant to attend the OP daily for review. This pointed out that on 12-05-1996 there was considerable reduction in the size of the ulcer and it is noted in the OP ticket. The day-to-day entries would show that there was considerable reduction in the size of the ulcer. At no point of time there was any evidence of worsening of the ulcer. If there was any sign of deterioration he would have been admitted as an inpatient. The alleged negligence is denied. It is pointed out that he was treated for a prolonged period at the private hospital and the eye was removed on 24-06-1996. The eye has been removed only on 14-06-1996. The private hospital doctors ought to have removed it as early as possible if the condition had worsened that much. Evidently, it is subsequent to the admission in the private hospital that the condition was deteriorated and led to the removal of the eye. The opposite parties have denied any negligence in the treatment. 6. The evidence adduced consisted of the testimony of PWs 1 to 3, DW1, Exts. P1 to P10, D1, X1 and X1(a). 7. PW1 is the complainant and PW2 the Bank Manager who was examined to prove the loan dues of the complainant, PW3 the doctor at Chaithanya Eye Hospital and DW1 is the second opposite party, the PG student. Ext.P1 is the OP ticket of the 4th opposite party/hospital; Ext.P2 is the discharge summery of the Chaithanya Eye Hospital. Ext.P3 and P5 are the cash receipts for amounts paid at the Chaithanya Eye Hospital etc. Ext.P4 is the test report from the lab DDRC. Ext.P6 and P7 are the medical certificates. Ext.P8, P9 and P10 are the certificates from the bank and notices from the LIC. Ext.D1 is the certificate with respect to the second opposite party wherein it is mentioned that she was an MS student during the relevant period. 8. The Forum has found that the evidence of the treatment of the complainant as seen in the treatment records clearly indicated that the doctors of the 4th opposite party hospital were negligent and it was on account of their lapse in not admitting the complainant as an inpatient and giving appropriate treatment that resulted in the loss of his eye sight. The second opposite party was exonerated as it was established that she was a PG student and that she is not empowered to treat the complainant. The 3rd opposite party Director has also exempted from personal liability as she has not treated the complainant. The opposite parties 4 and 5 ie, the hospital and the government were directed to pay the amount of compensation. 9. It is the contention of the appellants that the doctors of the 3rd opposite party hospital cannot be found fault with as they had provided the standard treatment and it was only on account of the negligence of the complainant in not properly following the directions of the doctors that might have aggravated the illness. It is also contended that the ulcer had reduced considerably and that the details of the treatment at Chaithanya Eye Hospital are not forthcoming. Hence no liability can be fixed on the opposite party. It is also pointed out that the doctor who treated the complainant has not been impleaded. 10. We find that the contention reiterated by the appellant in the argument notes filed that the Forum has no jurisdiction cannot be countenance in view of the decision of the apex court in Indian Medical Association Vs. V.P Santha and Others in AIR 1996 SC 550. 11. PW1 has testified as per the averments in the complaint. His case that he was not admitted as an inpatient inspite of his request and inspite of his conveying to the doctors that he is having severe pain has not been denied as such in the version filed. Infact the opposite parties have not revealed the names of the doctors who attended the complainant in the OP from 08-05-1996 to 14-05-1996. It is the case of the complainant that he was attended by lady doctors including the second opposite party. Although the name of Dr. Antony is mentioned by the second opposite party, the designation etc. has not been mentioned. The version of the 3rd and 4th opposite parties did not contain the name of Dr. Antony also. Who were the doctors, who treated the complainant at the OP from 08-05-1996 to 14-05-1996 is best known only to the opposite parties. The reluctance to reveal the names of the doctors who attended the complainant in the OP would indicate that the case of the complainant that he was attended by certain lady doctors is true. PW1 has mentioned the names of certain other PG students who allegedly assisted the duty doctors. Whether the complainant was attended by only the PG students is not clear. 12. Ext.P1 mentions that on 08-05-1996 the complainant had redness, watering and pain in the left eye; conjunctiva, cornea, scelera not affected; pupils normal and reactive; CC+ gentamicine injection, pad and bandage, ointment, ciplox eye drops are prescribed and a review on the next day is noted. There is a sketch of the ulcer site. On 09-05-1996 also nothing else is noted. On the subsequent days also pad and bandage is mentioned, scraping for tests is also noted on 10/05. No test results are seen. On11-05-1996 it is mentioned as corneal ulcer +. On 12-05-1996 also there is a sketch of ulcer. On 13-05-1996 also scraping is noted and the pupil is mentioned as constructed. On 14-05-1996 again it is noted as pupil constructed; CC+ and photophobia+. The discharge summery of the Chaithanya Eye Hospital only mentions as the IP treatment from 15-05-1996 to 20-06-1996 . Diagnosis is mentioned as perforated corneal ulcer and evisceration left eye under general anaesthesia. Post discharge medicines are prescribed and review after 10 days indicated. The biopsy report of DDRC of the eviscerated specimen from left eye mentions chronic ulcer cornea with suppurative endophthalmitis. The mycroscopic examination sought suppuration and necrosis. 13. At the time of appeal the respondent/complainant has produced certificates that would show that the complainant has lost his eye sight of the right eye also subsequently and he has became totally blind. 14. PW3, the doctor of Chaithanya Eye Hospital who issued the discharge summery has testified in proof of the treatment provided to the complainant. He has mentioned that at the time of the admission the condition of the left eye of the complainant was very serious. He has stated that it is not mentioned in Ext.P1 OP ticket of the opposite parties that the condition of the complainant had improved. According to him it was a case of mixed infection of fungus and bacteria. He has stated that antibiotics, antifungal medicines and supporting measures were given to the complainant. According to him the improvement of the condition of the ulcer is quite difficult and would depend upon the kind of the bacteria involved also. He has stated that the ulcer was in a very advanced stage and it was not possible to cure the complaint. No better treatment could have been given than that was given at the Chaithanya Eye Hospital. There was only 50-50 chance at the time of admission. Of course he has stated that it cannot be mentioned that it was on account of not admitting the patient as inpatient earlier that the condition worsened. 15. The Counsel for the opposite party has relied on Parsons’ Disease of Eye, 20th Edition which is a standard treatise on the subject. Page 189 to 193 of the above would show that even in the treatment to uncomplicated ulcers, close attention should be given, failing which the above can result in perforation. Microbiological investigations are mandatory. The opposite parties have not produced any evidence of the results of the investigations conducted. Perforated ulcer evidently requires inpatient treatment. It is mentioned that the patient must be reassessed twice daily for response to the treatment and that the patient should be given complete rest. It is evident that despite the condition of the complainant aggravated, the doctors of the opposite party/hospital did not admit him as an inpatient although he complained of severe pain. The evidence of PW3 would show that at the time of admission at the Chaithanya Hospital the condition was very severe. The case set up by the opposite parties is that there was considerable improvement in the condition of the complainant which is evidently incorrect. The fact that the opposite parties could not identify even the doctors who attended the complainant in the OP amounts to irresponsibility. It is evident that there was sheer negligence and carelessness in properly attending the complainant at the OP and in taking the required measures in the treatment of the complainant. We find that there is no illegality in the order of the Forum below. The compensation ordered to be paid is reasonable. We find that the order to pay interest at the rate of 16.5% is excessive. The same is reduced to 12%. The rest of the order of the Forum is sustained. With the above modification in the order of the Forum as to the rate of interest, the appeal is dismissed. JUSTICE K.R. UDAYABHANU: PRESIDENT M.K. ABDULLA SONA : MEMBER Sr.
......................JUSTICE SHRI.K.R.UDAYABHANU
......................SRI.M.K.ABDULLA SONA | | 
