Tamil Nadu

StateCommission

FA/255/2012

THE DIRECTOR, E.S.I.C. HOSPITAL - Complainant(s)

Versus

M. PUSHPA RANI - Opp.Party(s)

K.C. RAMALINGAM

17 Apr 2015

ORDER

IN THE TAMILNADU STATE CONSUMER DISPUTES REDRESSAL COMMISSION, CHENNAI.

Present:   Hon’bleThiru.Justice R.REGUPATHI,             PRESIDENT.

                                                      Thiru.J.JAYARAM,                                              JUDICIAL MEMBER.

                                                                  TMT.P.BAKIAVATHY,                                        MEMBER.

                                                                                              F.A.No.255/2012

 (Against the order in C.C.No.419/2007, dated 21.07.2011 on the file of DCDRF, Chennai (South) 

                                                               DATED THIS THE 17^TH DAY OF APRIL 2015.                                                                                          

1. The Director,

    E.S.I.C. Hospital,

    K.K.Nagar,

    Chennai – 600 078.                                1^st Appellant/2^nd Opposite Party

2. The Medical Commissioner,

    E.S.I.Corporation Head Quarters Office,

    C.I.G. Road, (Kotla Road),

    New Delhi – 110 002.                             2^nd Appellant/4^th Opposite Party

3. The Director General,

    E.S.I.Corporation Head Quarters Office,

    C.I.G. Road, (Kotla Road),

    New Delhi – 110 002.                             3^rd Appellant/5^th Opposite Party

                                Vs

1.  M.Pushpa Rani,

     W/o. D. Arun,

     No.47, BajanaiKovil Street,

     Choolaimedu,              

     Chennai – 600 094.                               1^st Respondent/Complainant

2. The Residential Medical Officer,

    E.S.I. Hospital,

    Kodambakkam Dispensary,

    Chennai – 600 026.                                2^nd Respondent/1^stOpposite Party

3. The Superintendent,

    E.S.I. Hospital,

    No.37, Medavakkam Tank Road,

    (Kilpauk), Chennai – 600 010.                  3^rd Respondent/3^rd Opposite Party

Counsel for Appellants 1 to 3 /Opposite Parties 2, 4 & 5                                                           : M/s. K.C. Ramalingam,

Counsel for Respondent-1/ Complainant            :  M/s. Nandini Ram,

Counsel for Respondent-2/Opposite Party-1       :  Served. Called Absent.

Counsel for Respondent-3/Opposite Party-3       :  Mr. Ravikumar,

                     This appeal coming before us for final hearing on 05.02.2015 and on hearing the arguments of both sides and upon perusing the material records this Commission made the following: 

ORDER

THIRU.J. JAYARAM,  JUDICIAL MEMBER.

1.       This appeal is filed by the opposite parties 2, 4 and 5 against the order of the District Forum, Chennai (South) in C.C.No.419/2007 dated 21.07.2011, allowing the complaint.

2.                The case of the complainant is that she approached the 1^st opposite party on 12.07.2006 for abdominal pain who referred her to the 2^nd opposite party hospital and so she went to the 2^nd opposite party for treatment where Copper-T was removed and the duty Doctor of the 2^nd opposite party assured her that she would be relieved of the pain.  But even after that the pain did not abate and so she was advised to take oral medicines and to take Ultra Sonogram of Abdomen and she went to 2^nd opposite party on 28.09.2006 with

the Diagnosis report issued by the scan centre and she was informed by the 2^nd opposite party that she had renal calculus and she was advised to undergo IVP and accordingly she underwent the IVP test on 03.10.2006 and the 2^nd opposite party advised her to take some medicines and she was also referred to Ayurvedic treatment.

3.                 The complainant did not have any relief and so again she went to the 2^nd opposite party hospital on 12.10.2006and she was advised to undergo pregnancy test and she tested positive and the 2^nd opposite party advised her to undergo MTP since she had undergone IVP test  and exposed to radiation and she was admitted in the hospital on 16.10.2006 and medical termination of pregnancy was done on 17.10.2006 and she was discharged on 19.10.2006 and even then her problem did not subside and so she was forced to consult a private medical practitioner and fresh tests were conducted which revealed the pregnancy (single live foetus) and she was shocked to find that she was pregnant in spite of the MTP and so another scan was taken on 15.11.2006which confirmed the extra uterine ectopic pregnancy and so she got admitted in private nursing home where she underwent left Salpingo/Oopherectomy. The foetus with Sac and Placenta were removed with Omentectomy and was finally discharged on 21.11.2006. All these amount to gross negligence and deficiency in service on the part of the opposite parties and hence the complaint.

4.                 The 1^st opposite party has stated that the 1^st opposite party was in charge of the dispensary/ a referral centre and when the complainant came complaining of abdominal pain she was referred to 2^nd opposite party hospital and the 1^st opposite party had nothing to do except referring the complaint to the 2^nd opposite party and there is no deficiency in service on the part of the 1^st opposite party.

5.                 According to the other opposite parties CU-T is a known cause of pain in the abdomen and hence CU-T was removed and ectopic pregnancy was not suspected since her periods were not overdue at that time and she was advised to take an ultrasound abdomen scan in the authorized scan centre and after taking ultrasound scan, she was advised to undergo IVP test to confirm the presence of renal calculus and even after taking necessary medicines there was no relief of pain but she was found to be pregnant and because of radiation exposure to the foetus, she was advised to do medical termination of pregnancy and MTP was done on 17.10.2006 and the patient was discharged on 19.10.2006 and this procedure was not done to relieve her pain;  it was done to prevent the birth of an abnormal baby.

6.                 Normally for routine medical termination of pregnancy, ultrasound scan is not done because it will overburden the ultrasonologist and drain the meager health resources. It could have been a case of heterotopic pregnancy (two foetus – one in the uterus, and another in the tube – ectopic pregnancy).Presence of renal calculus, causes pain like ectopic pregnancy creating complications and there is no medical negligence as contented by the complainant.

7.                 The District Forum considered the rival contentions and allowed the complaint holding that there is deficiency in service on the part of the opposite parties. Aggrieved by the impugned order the opposite parties 2, 4 and 5 have preferred this appeal.

8.                 It is pertinent to note that the appeal has been preferred only by the opposite parties 2, 4 and 5 and the opposite parties 1 and 3 have not preferred any appeal.

9.                 It is relevant to note that the opposite parties/appellants have contended that ectopic pregnancy can be confirmed only by ultrasound scan and normally for routine medical termination of pregnancy; ultrasound scan is not done because it will over burden the ultrasonologist and drain the meager health resources. We have to note that the ultrasound scan was not done because it would over burden the ultrasonologist and drain meager health resources. Itis an improper practice and the contention cannot be accepted at all. Therefore there is gross deficiency in service on the part of the opposite parties in not taking ultrasound scan at that point of time and had ultrasound scan been taken, subsequent problems and complications and major surgery could have been averted. Therefore not taking ultrasound scan in time amounts to negligence and deficiency in service on the part of the opposite parties and the contention of the opposite parties in this regard is untenable.

10.               It is further relevant to note that the 2^nd opposite party could not give any concrete opinion whether it was the case of heterotopic pregnancy  (two foetus – one in the uterus, and another in the tube – ectopic pregnancy) but would contend that the foetus from the uterus was removed. It is to be noted that even at this stage the opposite parties could not say for certain whether there was one foetusor two.  It is to be further noted that a scan was taken as advised by the private hospital and the scan report Ex.A4 disclosed that there was “No Evidence of Intra Uterine Gestational Sac” and that there was “Extra Uterine Abdominal Gestation”. These go to establish the negligence and deficiency in service on the part of the opposite parties.

11.               It is further contended by the opposite parties, that presence of renal calculus also causes pain like ectopic pregnancy which complicated the diagnosis and so the difficulty in diagnosis of the complex case cannot belabelledas negligence and it cannot be accepted that any doctor with reasonable skill could have diagnosed the problem in this case. There is no force in the contention.

12.     It is clear that the opposite parties failed to diagnose the ectopic pregnancy and on account of the negligence on the part of the opposite parties the complainant had to undergo major surgery involving not only removal of foetus but also removal of ovary, fallopian tube and peritoneum etc., and the major surgery could have been avoided by proper diagnosis at the right time by taking a scan. It substantiates the further negligence and deficiency in service on the part of the opposite parties.

13.               The failure to take a scan before a major surgery is deficiency in service on the part of the opposite parties.

14.              In this case the doctrine of res ipsa loquitur applies as laid down by the Hon’ble Supreme Court in the case of V.KishanRao –Vs-  Nikhil Super Speciality Hospital - (2010) CPJ 1 SC.

15.               On consideration of entire materials on record we hold that the complainant has made out her case of negligence against the opposite parties and therefore, we hold that there is negligence and deficiency in service on the part of the opposite parties.

16.               The District Forum has rightly held that there is negligence and deficiency in service on the part of the opposite parties and has passed an order directing the opposite parties jointly and severally to pay a sum of Rs.35,000/- towards medical expenses incurred by the complainant and Rs.1,00,000/- as compensation for mental agony and to pay costs of Rs.5000/-.

17.     There is no infirmity in the order of the District Forum and we agree with the finding and the decision of the District Forum. There is no merit in the appeal.

18.               In the result, the appeal is dismissed confirming the order of the District Forum. No order as to costs in the appeal.

 

P.BAKIAVATHY                       J.JAYARAM                       R.REGUPATHI

     MEMBER                            (J) MEMBER                         PRESIDENT