By Sri. MOHANDASAN.K, PRESIDENT
The complaint in short is as follows:
1. The complainant was admitted to the first opposite party hospital for her third delivery on 29/03/2016. On the same day at about 3.11 pm she gave birth to a male baby. The delivery was normal one and she was shifted from labour room to the ward at 6.pm itself. Thereafter it was decided to undergo post-partum sterilization (PPS). On 30/03/2016 the complainant was taken to the operation theater at about 10.45 am and she was undergone PPS and thereafter at 11.30 am she was shifted to post operative ward. Thereafter at 8.30 pm she was shifted to room. She was undergone examinations by the medical staff and was taken prescribed medicines. Thereafter, she felt gastric pain and she had not passed motion, for those medicines prescribed, injection and suppository were also placed. Then she passed motion. At about 8 pm on the same day complainant had mild abdominal distention, heavy headache, body pain and pain in the abdomen. At that time the second opposite party examined the complainant and the complainant was becoming worse but the second opposite party understood now by the complainant, took leave, and left the station. The second opposite party advised to install tube for release of gas and accordingly it was installed and advised not to have food further.
2. On 02/04/2016 at about 1.30 hours at night the second opposite party was called over phone from the hospital and accordingly the second opposite party prescribed certain medicines to the complainant. Since the pain was not subsided the second opposite party was called again after one hour and then also the second opposite party instructed certain medicines. The complainant felt pain on the next day also. Though it was informed to the second opposite party and the staff of the first opposite party, there was no care or attention from the opposite parties but the complainant let to lay in the hospital. During the evening of the same day the compliant was suffering from heavy pain and so decided to undergo a scanning of the complainant. But there was no facility to do the same and so a vehicle was rented from outside and the complainant was taken to a scanning center nearly 2 kilometers away from the hospital and the scanning was done. The complainant alleges the scanning report was not disclosed to the complainant. There were no further medicines based on scanning report. The condition of the complainant was turned more difficult but there was no sufficient care from the opposite parties. The opposite party did not made attempt to diagnose the exact condition of the complainant but continued treatment without any responsibility and even without identifying the real issue of the complainant. The second opposite party conducted telephonic treatment despite physically verifying the condition of the complainant.
3. On 03/04/2016 the complainant felt respiratory discomfort and the same also informed to the second opposite party. But there was no attempt to diagnose the condition of the patient. The condition of the complainant was turned more difficult and the opposite party did not provide any details about the condition of the complainant. The complainant and the bystanders were afraid of the treatment given by the opposite party and was under the threat of death and as per the same it was demanded to discharge from the hospital to any other higher treatment center. But the opposite party refused to do the same. The complainant was suffering from the treatment of opposite parties from the date of surgery with the complaint of abdominal pain, abdominal distention etc. But there were no facilities to attend the complainant and the opposite party did not provide proper treatment and as a result the complainant was referred to Alshifa hospital Perinthalmanna.
4. On examination of the complainant at Alshifa hospital, it was found that there was obstruction in the small intestine and there was gastric issue and puss in the abdomen. It is further noted that there was infection also in the abdomen. The complainant alleges there was gross deficiency in service on the part of the second opposite party. There was gross negligence from the side of opposite parties. All the complications to the complainant were caused due to deficiency in service from the part of opposite parties.
5. The complainant was undergone immediate surgery and it was revealed that there was puss and perforation to the intestine. From the Alshifa hospital, the perforation was closed and drainage was installed to remove stools. The complainant submits that there was cut injury to large intestine and as a result the food articles were brought out and there was infection. Thereafter the complainant was undergone surgery at Alshifa hospital and she was in the hospital from 04/04/2016 to 21/04/2016. The complainant was suffering severe pain and inconvenience. The complainant was deprived from seeing her child and could not breast feed. The family of the complainant compelled to arrange facilities for the care of infant. The complainant was discharged from the Alshifa hospital with special arrangement to take out the stool. So, the complainant was deprived from seeing the child and breastfeeding even after turn back to home.
6. The complainant alleges there was gross deficiency in service from the side of opposite parties. Though the complainant complained about her pain and difficulties, the opposite party was not prepared to examine the real cause for the discomfort to the complainant, but instructed medicine over phone. The opposite party administered various medicines without duly assessing the real cause for the discomforts of the complainant. Though complainant talked about discomfort regularly but the opposite party retained the complainant at the first opposite party hospital.
7. The complainant spent more than 4 lakh rupees for the treatment purpose and even now she is continuing treatment. The complainant prays for compensation from the opposite party on various heads. The complainant though caused lawyer notice, there was no proper response from the opposite party. The complainant demanded treatment documents from the opposite party, but the opposite party did not issue the same. Hence, the complainant alleges deficiency in service and unfair trade practice on the part of the opposite parties and claims compensation from the opposite parties.
8. On admission of the complaint notice was issued to the opposite parties and on receipt of notice both the opposite parties entered appearance and filed version in detail.
9. Both the opposite parties denied the entire allegations and averments in the complaint. It is contended that the complaint is not maintainable either in law or on facts. Complaint is frivolous, vexatious, and devoid of truth or bonafides. There is no negligence or deficiency in service as alleged by the complainant and the complainant is not entitled to get any relief as prayed in the complaint. The complaint is filed on ill advice and solely for the undue financial advantage of the complainant. The first opposite party submitted the true facts of the case according to them as follows:
10. The first opposite party is running a 60 bedded hospital situated at Vadapuram, Nilambur offering services in maternity care, pediatric and trauma care. The hospital has round the clock services of two consultant gynecologist, two anesthesiologists, one pediatrician, one orthopedic surgeon and two resident duty doctors. The first opposite party have two fully equipped operation theaters, NIC, ICU, Pharmacy, lab and in short, fully equipped as a secondary level care center. The first opposite party has a department of obstetrics and gynecology which has two doctors, Dr. Sarasija Varma, Senior consultant with nearly 16 years of experience in her specialty and Dr. Shanty Sebastian with 8 years of experience and has been practicing in Nilambur for the last 8 years. The first opposite party has nursing staff who are well experienced. The department of obstetrics run by the first opposite party conducts nearly 75 deliveries per month and nearly 30 postpartum sterilization per month. The complainant had regular anti natal consultation with the second opposite party in connection with her fourth pregnancy at first opposite party’s hospital. Her antenatal period was uneventful and she was admitted to the hospital for safe confinement at 10 AM on 29/03/2016 and she gave birth to male baby by normal vaginal delivery on the same day at 3.11 pm. The complainant and her husband had voluntarily decided for postpartum sterilization and requested to the second opposite party for the same. The second opposite party had explained the prose and cones of sterilization operation, chances of failure and the risk and complications involved in the surgical procedure. The complainant had signed the written informed consent and the surgery was posted to 30/03/2016. Under all aseptic care and precautions the second opposite party conducted sterilization under spinal anesthesia done through 4 cm transvers incision in the sub – umbilical region. Intra operatively the tubes were identified bilaterally and ligated by adopting modified Pomeroy’s method. The procedure was uneventful.
11. Post operatively the complainant was shifted to her room at 8.40 pm on 30/03/2016 as her condition was stable with normal vitals. On 31/03/2016 during morning rounds the second opposite party had examined the patient and found to have normal vital signs and she had no complaints. On 01/04/2016 the patient complained mild gastric pain and had not passed motion and she was treated symptomatically with injections and suppository and she passed motion on the day after suppository. By 6 pm on the same day the patient had attended and advised for flatus tube insertion and blood was sent for electrolytes and blood counts. Since the second opposite party had to take leave for two days for urgent personal matters, the complainant and her bystanders were informed that another senior consultant Dr. Sarasija Varma would take care of the patient in her absence and appropriate instructions were given to the bystanders regarding this and they were willing to continue treatment under the care of the said doctor. Dr. Sarasija Varma has also seen the patient at 7.30 pm on the same day and since the abdominal distension was persisting, she had advised Ryle’s tube aspiration on a provisional diagnosis of post-operative paralytic ileums. The vital signs were stable but bowel sounds were sluggish, there was no rigidity or guarding of the abdomen. The second opposite party had discussed the condition of the patient with doctor Sarasija Varma and the diagnosis and modality of treatment measures were discussed with bystanders of the patient and they were willing to continue the treatment under the care of said doctor. The patient was briefly better after Ryle’s tube aspiration but she was complaining of abdominal pain again at 1.30 am on 02/04/2016. Ward sister had also contacted the second opposite party over telephone and proper instructions were given for close observation. In discussion with Dr. Sarasija Varma it was decided to give her anti spasmodic and to continue the same line of treatment. On 02/04/2016 at 6 am Dr. Sarasija Varma had seen the patient and evaluated her condition and in view of low potassium level (Serum K + was 3.0 Meq /1) it was decided to start on KCL drip and for close monitoring the patient was shifted back to ICU. Before shifting the patient back to ICU Dr. Sarasija Varma had called the patient’s husband and mother in law and other relatives available in the hospital and given an option to take the patient to another center if they wanted so, since the second opposite party was not available in station. But the patient’s husband and other relatives decided to continue treatment in the hospital under care of the said doctor. The management of the first opposite party was in constant touch with the patient relatives from time to time. The nursing staff of first opposite party had taken utmost care in every step of the treatment.
12. The patient was shifted to ICU on 02/04/016 and kept under close monitoring of vitals, abdominal girth measurement, monitoring of urine output and on Ryle’s tube aspiration. She was started on IV fluids and KCL drip. The second opposite party was in constant touch with the staff of ICU and resident doctor Dr. Reni and was constantly enquiring about the condition of the patient. Her symptoms subsided and she was better for the day but in the evening, she had mild abdominal pain and hence Dr. Sarasija Varma had advised for an ultrasonogram and plain X-ray abdomen. Since the patient had to be shifted to Nilambur Town which is two kilometers away from the hospital and since it was Saturday evening Dr. Sarasija Varma had discussed with patient’s husband and other relatives and they agreed for taking the patient for the ultrasonogram and X-ray. The second opposite party had called with Dr. Jossey, consultant radiologist at doctor’s scan center, Nilambur, and the patient was shifted Nilambur for USG and X-ray. USG and X- ray reports were normal and Dr. Jossy had called back the second opposite party and informed about the findings. Thereafter the patient was shifted back to hospital.
13. The patient was better symptomatically except for a mild reduction in urine output as she was on KCL drip. Her vitals were stable and abdominal girth had come down without any symptoms of vomiting and she had passed flatus, abdomen was distended but non-tender and there was no grading or rigidity. Urine output was better after starting on IV fluids. On 03/04/2016 Dr. Sarasija Varma had seen the patient in the morning and the patient was better and hence started on oral sips of fluids. Serum K + level returned to normal 4.4. Patient passed stools after giving Dulcolax suppository. Dr. Sarasija varma had discussed the modality of treatment with the bystanders and since the patient was symptomatically better, they wished to continue the treatment in the hospital. Dr. Sarasija Varma had also suggested for a surgical opinion but since it was Sunday and the patient was better the relatives were not keen on that. The second opposite party had also contacted the patient relatives especially her husband and mother-in-law over phone and had discussed with them regarding a general surgery consultation or patient being shifted to another center but since the patient was found symptomatically better at the time, they did not prefer to shift the patient to higher center.
14. The patient continued to be in the ICU on Sunday and she was symptomatically better except for the abdominal distension which was better that before. She had no symptoms of nausea or vomiting, passed flatus and stools, her vitals were stable, no guarding or rigidity of abdominal and bowel sounds was present. Since the patient’s symptoms were improved after correction of K + levels the management on a provisional diagnosis of post operative paralytic ileus due to hypokalemia was continued and the patient did not manifest any adverse symptoms to suspect otherwise. The second opposite party retuned back to the hospital in the evening on 03/04/2016 and examined the patient and she was symptomatically better with stable vitals and continued oral sips. The second opposite party had discussed the condition with general surgeon at Kozhikode and the surgeon had agreed to come to the hospital to see the patient on the next day and it was informed the bystanders as well. On 04/04/2016 the second opposite party had seen the patient during morning rounds and found she was symptomatically better and decided to remove Ryle’s tube. Abdominal distension had come down but not completely relieved and waiting for general surgeons’ consultation and opinion. By 12 pm the patient complained abdominal pain and the second opposite party had attended the patient and on examination there was mild abdominal distension. The relatives were called and discussed the condition of the patient regarding reference to higher center for further evaluation and management as general surgeon would come in the afternoon. The relative after discussion decided to take the patient to another center and accordingly the patient was referred to higher center as per request on 04/04/2016.
15. The second opposite party had done post-partum sterilization of the patient with utmost care and caution and post operative abdominal symptom shown by the patient was timely attended and treated as per accepted medical practice and protocol. The symptoms of abdominal pain and distension post operatively are common manifestation due to paralytic ileus and conservative management is the accepted line of treatment as per protocol. The patient had initially well responded to treatment and clinically stable with normal vitals and she did not have nausea, vomiting or fever to refer immediate surgical consultation. The bystanders were informed about the condition of the patient and line of treatment and even during absence from the hospital the second opposite party had been in constant touch with treating doctors, nursing staff and complainant’s bystanders, the patient was subjected to necessary blood investigations, USG and X-ray abdomen and the findings were the supportive of the provisional diagnosis of post operative paralytic ileus due to hypokalemia. On 03/04/2016 general surgery consultation was suggested and bystanders were given option to take the patient to their center but they preferred continuation of treatment as the patient’s condition was responding to treatment. The patient was re-offered for surgical consultation when had developed abdominal pain with mild distension again around 12 pm on 04/04/2016. In the light of the above stated facts there was absolutely no negligence or deficiency in service on the part of the second opposite party and she is not liable to compensate the complainant. The first opposite party had provided also the necessary facilities in the hospital and utmost medical nursing care was given to the patient in all stages of treatment.
16. The first opposite party submitted that the complainant filed this complaint suppressing the real facts pertaining to the modality of treatment of the complainant. The complainant is silent about the diagnosis made by doctors at Al shifa hospital and it does not disclose necessary details of surgery nor produced any documents regarding further treatment. The modality of treatment of the complainant at Alshifa hospital is also not pertaining to the knowledge of the first opposite party and hence the first opposite party reserve the right to file fresh version on that aspect after production of documents from the side of complainant. The complainant’s case that she was diagnosed to have intestinal obstruction and infection at Alshifa hospital is not pertaining to the knowledge of the first opposite party and hence not admitted. However, the diagnosis of the second opposite party that the symptoms manifested by the complainant post operatively were suggestive of paralytic ileus is proved correct diagnosis by the evidence of intestinal obstruction and gaseous distension which may occur after any abdominal surgeon. There can be some probable pre-existing intestinal pathology aggravating the condition post operatively.
17. The averment that the second opposite party had prescribed medicines through phone consultation is misleading and so it is denied. The second opposite party was on leave for two days and in her absence senior consultant gynecologist Dr. Sarasija Varma took case of the patient and the patient and her bystanders conceded to undergo treatment under care of the said doctor. The patient was properly attended and treated by the said doctor in the absence of the second opposite party and each step of medical management was done in joined discussion with the patient’s bystanders and the second opposite party. The opposite party denied that the complainant had been suffering from severe pain and distress and nobody take care of the patient despite complaining the same to the second opposite party and other hospital staff. The opposite party denied that the complainant was wriggling with pain when she was taken for scanning and the result of this scanning was not disclosed to the complainant and her relatives. The opposite party denied that she was not given necessary treatment as per scan report. The finding of X-ray and USG report were normal and the same was informed to the complainant and her bystanders. The opposite party denied the allegation that treatment was irresponsible and carelessly continued without caring to ascertain her condition on examination is ill motivated. It is submitted that in the absence of the second opposite party the complainant was properly managed by a senior consultant and she was never left un attended in the first opposite party’s hospital. The allegation that the second opposite party had given treatment instructions over telephone is false and purposely stated with ulterior motive and hence denied.
18. The allegation that the condition of the complainant became serious with increased pain due to administration of medicines without attempting to find out actual cause with precise investigation and treatment is not tenable or sustainable and so denied. It is further contended that in spite passing information regarding aggravation of pain, the doctors simply gave instructions over telephone is false and misleading. It is also denied that the second opposite party conducted usual examination on 04/04/2016 and nothing was disclosed to the relatives about the condition of the patient. The allegation that the opposite parties did not heed to the request for discharge of the patient is highly ill motivated and hence denied. the opposite party further submitted that the case of the complainant that the demand for discharge was refused since the second opposite party was on leave and Dr. Sarasija Varma was the consultant who had attended the patient in her absence and they were given option for reference to higher center and treatment continued in the first opposite party hospital as they preferred to continue the treatment.
19. The opposite party denied that the second opposite party has caused to aggregate the post-operative abdominal pain and distension without providing proper treatment, is highly ill motivated. The opposite party denied the allegation that the complainant was finally referred to Al shifa hospital at the instance of the relatives is misleading. The second opposite party had treated the post-operative complaints on a provisional diagnosis of paralytic ileus based on investigations and clinical symptoms as per accepted treatment protocol. The complainant was given option for reference to higher center for surgical consultation from the earlier stage of development of symptoms but her relatives preferred to continue treatment in the first opposite parties’ hospital. The opposite parties submitted that the findings noted as per examination conducted at Alshifa hospital are not pertaining to the knowledge of the second opposite party and so the first opposite party denied the same. The allegation there was failure from the part of second opposite party even in the usual treatment provided to a patient after PPS is unfounded and unsustainable. The allegation that the complainant developed intestinal obstruction, gas formation, swelling and infection due to carelessness and culpable failure on the part of the second opposite party is highly ill motivated and so denied. The opposite party submitted that the examination findings and treatment procedures are not pertaining to the knowledge of the first and second opposite parties and so not admitted. The allegation that the complainant was happened to undergo IP treatment from 04/04/2016 to 21/04/2016 following surgery in another hospital on account of fall and failure in treatment and carelessness on the part of the opposite parties is highly ill motivated and so denied. The discomfort and difficulties allegedly suffered by the complainant during treatment as stated in the complainant is not due to any negligence or deficiency in service and the first and second opposite parties are not liable for the same.
20. The first opposite party submitted that the line of conservative treatment measures, medicine and supportive care given to the patient in the first opposite party’s hospital are strictly in accordance with standard and accepted medical practice followed in a patient with post-operative abdominal system and she was clinically stable and responding to treatment and refereed for surgical consultation as the systems persisted despite proper conservative management. The allegation that the complainant was treated with telephonic consultation and put her in a dangerous condition by giving several medicines without considering the cause of her complaints is highly ill motivated and so denied.
21. The amount shown as expended for the treatment of the complainant is exaggerated and so the opposite party denied. It is further submitted that the complainant could not look after the child and thus required special treatment care and set up to take care of the child and the amount claimed on the head of treatment of the child is unfounded and so denied. The amount claimed on the head of loss of amenities and consortium is highly exaggerated and the complainant is not entitled to get any amount from the opposite parties on that head as well. The opposite party submitted that they had denied all the allegations raised against in the complainant’s lawyer’s notice, that the statement, the first opposite party refused to issue treatment records is baseless. The opposite party submitted that the complainant is filed by misrepresenting the facts in view to extract money from the first opposite party without any just or sufficient cause. There is no negligence or carelessness in the treatment of the complainant from the part of the opposite parties. The amount quantified as compensation is highly exorbitant, exaggerated and without any substance, merit or rational behind it and so denied. In the light of above facts and circumstances the complaint is to be dismissed finding there is no cause of action against the opposite parties as stated in the complaint, the complaint is to be dismissed with cost to the opposite parties.
22. The second opposite party also filed detailed version in tune with the version of first opposite party. In addition to that the second opposite party submitted that they are well experienced and qualified consultant gynecologist. The second opposite party contended that the complainant filed by misrepresenting the facts with view to extract money from the second opposite party without any just or sufficient cause. There was no negligence or carelessness in the treatment of the complainant from the part of second opposite party. The complainant is not entitled for any relief as claimed in the complaint.
23. The complainant and opposite parties filed affidavit and documents. The documents on the side of complainant marked as Ext. A1 to A59. Hospital records, case sheet marked as Ext.X-1. The complainant and Dr. Muhamed Sajid examined as PW1 and PW2 respectively. The second opposite party examined as DW1.
24. Heard complainant and opposite parties, perused affidavits, and documents. Both sides filed notes of argument.
The following points arise for consideration
- Whether there is negligence and deficiency in treatment on the side of opposite parties?
- Whether the complainant could establish the allegation of medical negligence?
- Whether the complainant is entitled for any relief and cost?
25. Points No.1 & 2
The contention raised by the second opposite party is that the post-partum sterilization of the patient was done with utmost care and caution and post operative abdominal symptoms shown by the patient was timely attended and treated as per accepted medical practice and protocol. The symptoms of abdominal pain and distention post operatively are common manifestation due to paralytic ileus and conservative management is the accepted line of treatment as per protocol. The patient was subjected to necessary blood investigation, USG and X ray abdomen and the findings were supportive of the provisional diagnosis of post operative paralytic ileus due to hypokalemia. On 03/04/2016, general surgery consultation was suggested and bystanders were given option to take the patient to higher center but they preferred continuation of treatment under the opposite party as the patient’s condition was responding to treatment. The second opposite party contended that the patient was referred for surgical consultation when she had developed abdominal pain with mild distension on 04/04/2016. So, there is no negligence or deficiency in service on the part of the second opposite party and she is not liable to compensate the complainant. It is further submitted that the first opposite party had provided all the necessary facilities in the hospital and utmost medical and nursing care was given to the patient in all stages of treatment. Moreover, it is submitted that the symptoms manifested while the complainant post operatively were suggestive of paralytic ileus is proved correct diagnosis by the evidence of intestinal obstruction and gaseous distension, may occur after any abdominal surgery. It is further contended that there can also be some probable pre-existing intestinal pathology aggravating the condition post operatively. The second opposite party stated that the complainant was finally referred to Al Shifa hospital at the instance of the relatives is misleading and so denied. The complainant was given option for reference to higher center for surgical consultation from the earlier stage of development of symptoms but her relatives preferred to continue treatment in the first opposite parties’ hospital.
26. Now the issues arises whether the complainant was suffering due to paralytic ileus, whether she was referred for surgical consultation at the request of the complainant or at the direction of the opposite parties and whether the complainant was provided due care and attention from the side of opposite parties.
27. The complainant raised series of allegations against the opposite parties. The complainant submitted that immediately on the day of post-partum surgery she felt constipation, abdominal distension, gaseous complaints, moreover heavy headache, shoulder pain and body pain. Though the complainant undergone post-partum surgery on 30/03/2016, a doctor examined her only on 01/04/2016 in the evening at 6pm. She alleges on 31/03/2016 no doctor was turned to her. The complainant submits that on 02/04/2016 in the morning at 1.30 hours opposite party no.2 was called from the hospital over phone and was advised certain medicine. Again, after one hour second opposite party was called over phone and then also prescribed certain medicine over phone. On 01/04/2016, after 6pm due to gaseous problem the flatus tube was applied and instructed not to have food. Since there was no relax to the issues during the evening it was suggested to undergo ultra sound scan. But there was no facility in the hospital. The patient who was in ICU and from there she was taken to nearest town which is more than two kilometers away from the hospital for the ultra sound scan and the result was not revealed to the complainant. The complainant alleges the opposite party provided medicine to the complainant without diagnosing the exact cause of the issues of the complainant and so the condition of the complainant aggravated. On 03/04/2016 the second opposite party examined the complainant in the evening as usual and it was found considerable shortage in urine count. Even on 04/04/2016 there was no proper explanation from the side of second opposite party regarding the issues of the complainant. The complainant had requested for reference but it was not allowed. At last, the complainant was referred to Alshifa hospital and on examination from the Alshifa hospital it was found there was perforation to her intestine, puss, and gas and also infection to the stomach. There was inordinate lapse on the side of the second opposite party and thus resulted all the complications. The patient undergone three surgeries from the Alshifa hospital and for that purpose alone she was in the hospital for nearly 34 days. The nature of allegation of the complainant is that there was no properly and timely investigation or diagnosis on the part of the opposite parties even after the complainant complaint about the symptoms and deteriorating condition.
28. The complainant submits that on the day of postpartum sterilization itself the complainant started complaints of gastric pain, abdominal distension, body pain etc. The second opposite party admitted that while the complainant was about to discharge on the third day of the surgery the complainant shown all the symptoms as alleged and on examination also it was found as correct. The second opposite party states that she had conducted examination to find out the reason of the discomfort to the complainant and which is evident from the document. But she admitted that the documents do not reveal what sort of examination conducted by her to verify the cause of discomfort. She claims she has written her assumption based on symptoms shown by the complainant. The specific allegation of the complainant is that the opposite party has not conducted or made any effort to diagnose the exact cause of the discomfort to the complainant. The condition of the patient while examining by PW2 was as follows: “04/04/2016 ന് പരാതിക്കാരിയെ ഞാu കാണുമ്പോw വയറു വേദന ഉÙ¡യിരുന്നു. വയറ് തള്ളി ഇരിക്കുന്നുÙ¡യിരുന്നു. വയര് പെട്ടെന്ന് അമര്ത്തി കൈ വിടുമ്പോw കുറച്ച് കൂടുതv വേദന ഉÙ®. സ്റ്റെത്ത് വെച്ച് നോക്കുമ്പോw കുടലിന്റെ Sound കേള്ക്കാം അതുÙ¡യിരുന്നില്ല.. C.T scan ചെയ്യാu പറഞ്ഞു. ചെറുകുടലിv block (തടസ്സം) ഉÙ¡യിരുന്നു. വയറിv നീര് (വെള്ളം) കെട്ടി കിടക്കുന്നുÙ¡യിരുന്നു. Ext. A8 യിv ഗ്യാസ് നിറഞ്ഞതായി എന്നാണ് കാണുന്നത്. വയറ് തുറന്ന് ശസ്ത്രക്രിയ ചെയ്യാu തീരുമാനിച്ചു. Peritonitis ആണ് എന്ന് കÙത് കൊÙ¡ണ് അങ്ങനെ തീരുമാനിച്ചത്. Which shows that the condition of the complainant was serious while admitting at Alshifa Hospital. The second opposite party admitted at the time of cross examination that കുടലിന്റെ പുറത്തും ഉള്ളിലും Infection & Inflammation വളരുന്ന അവസ്ഥയാണ് Peritonitis. Paralytic ileus വന്നാv ഈ രÙ® അവസ്ഥയിലേക്കും develop ചെയ്യാനുള്ള സാധ്യതയുÙ®. പരാതിക്കാരിക്ക് Paralytic ileus യുടെ സാധ്യതയില്ല. അതുപരിഗണിച്ചിട്ടില്ല.. Now it can be seen that though the opposite party had contended the symptoms of the complainant was paralytic ileus but she has not considered the same. The second opposite party issued referral letter Ext. A56, which states that the complainant was having paralytic ileus. But in the Alshifa hospital it was diagnosed the complainant had developed peritonitis. During the cross examination of the DW 1 she has stated that on 01/04/2016 at about 6pm while she met the patient, her conclusion was paralytic ileus but that was not recorded in the case sheet. DW1 further revealed in the cross examination that “Bowel injury വന്നാv 3,4 മണിക്കൂറിനുള്ളിv തന്നെ രോഗിക്ക് ഇതേ വയര് സ്തംഭനവും വേദനയും വിറയലും അന്നു തന്നെ ഉÙ¡വും. 2/4/16 ന് രാവിലെ 6 മണിക്ക് രോഗിയെ കാണുമ്പോള്ത്തന്നെ വയറിv തൊടുമ്പോള്ത്തനെ ശക്തമായ വേദന ഉÙ®. Bowel Sound slow ആയിരുന്നു. 2/4/16 ന് post-operative ward ലേക്ക് മാറ്റി. സാധാരണ ഗതിയിv PPS കഴിഞ്ഞാv ഇത്തരം Complications develop ചെയ്യാറില്ല എന്ന് പറഞ്ഞാv ശരിയാണ്. 2/4/16 ന് ICU വിലെക്ക് മാറ്റിയപ്പോw വയറിന്റെ ചുറ്റളവ് 1-inch വര്ദ്ധിച്ചു. PPS കഴിഞ്ഞാv സാധാരണ നിലയിv മൂന്നാം ദിവസം discharge ചെയ്യും. Operation കഴിഞ്ഞ് മൂന്നാമത്തെ ദിവസമാണ് Symptoms തുടങ്ങിയത് എന്ന് പറഞ്ഞാv ശരിയാണ്. Operation day ആണ് First day. 1/4/16 ന് 6 മണിക്ക് മുമ്പ് രോഗിയുടെ അവസ്ഥ ഈ Case Sheet കൊÙ®. കാണില്ല. ഈ Case Sheet v രേഖപ്പെടുത്തിയ സമയം മുതv ഈ ലക്ഷണങ്ങw കാണിക്കുന്ന അപകടാവസ്ഥയിലാണെന്ന് പറഞ്ഞാv ശരിയല്ല. The opposite party has stated that there are several methods to find out internal injury caused during surgery. There were no such facilities in the first opposite party hospital. She admitted that there is scanning facility but the doctor was not available on that day. She admitted that as per case sheet it cannot be find out that the complainant was having paralytic ileus. It is further contended in the deposition of second opposite party regarding surgical consultation. The DW 1 was aware the case was suitable for surgical consultation. But none of the document produced by parties reveal the idea of surgical consultation with surgeon. It is an admitted fact that no surgeon was working in the first opposite party hospital. The second opposite party submitted that she had discussed the condition with a general surgeon at Kozhikode and he had agreed to come to the hospital to see the patient on the next day and it was informed to the bystanders as well. But the opposite party do not reveal the name of surgeon with whom she made consultation. The treatment records also are silent on the averments. At the same time, it appears that even without physically examining the complainant, the second opposite party thought of consultation with surgeon since the condition of the patient was not good.
29. In a case of bowel injury, the second opposite party deposed that a patient cannot be advised to take food or water. In this case once it was restrained initially but later it was directed to have. In the case of paralytic ileus, the most of time food will not be provided. In the case of bowel injury patient, will not be directed to walk. In this case the patient was directed to walk also. The DW1 further deposed that if the symptom shown by the complainant was not properly treated, will lead to peritonitis and which may even lead to death of the patient.
30. The perusal of affidavit and deposition of DW1 it appears there are contradictions in the contention of the opposite parties. The complainant produced Ext. A56, the referral letter issued by the second opposite party and which reveals the complainant was suffering from paralytic ileus. It is noted in A56 document that she was treated conservatively, bowel sound was present, and patient passed gas and motion. It is further noted that the abdominal distention has not come down. The bystander wanted to take the patient elsewhere. So, it can be seen from Ext. A56 the condition of the patient was normal except abdominal distension has not come down. The bystanders wanted to take the patient elsewhere, hence the patient was referred. So, two aspects are evident from Ext. A56 that the patient was suffering from paralytic ileus according to opposite party and the complainant was almost normal except abdominal distension and the reference was made at the request of bystanders of complainant. But the deposition of PW2, the treated doctor at Alshifa
was that- “04/04/2016 ന് പരാതിക്കാരിയെ ഞാu കാണുമ്പോw വയറു വേദന ഉÙ¡യിരുന്നു. വയറ് തള്ളി ഇരിക്കുന്നുÙ¡യിരുന്നു. വയര് പെട്ടെന്ന് അമര്ത്തി കൈവി
ടുമ്പോw കുറച്ച് കൂടുതv വേദന ഉÙ® . സ്റ്റെത്ത് വെച്ച് നോക്കുമ്പോw കുടലിന്റെ Sound കേള്ക്കാം അതുÙ¡യിരുന്നില്ല.. C.T scan ചെയ്യാu പറഞ്ഞു. ചെറുകുടലിv block (തടസ്സം) ഉÙ¡യിരുന്നു. വയറിv നീര് (വെള്ളം) കെട്ടി കിടക്കുന്നുÙ¡യിരുന്നു. Ext. A8 യിv ഗ്യാസ് നിറഞ്ഞതായി എന്നാണ് കാണുന്നത്. വയറ് തുറന്ന് ശസ്ത്രക്രിയ ചെയ്യാu തീരുമാനിച്ചു. Peritonitis ആണ്”. The PW 2 the doctor arrived a conclusion that the complainant was suffering peritonitis. PW2 further deposed that “Operation നടത്തിയപ്പോw 1) വയറിനകത്ത് പഴുപ്പ് നിറഞ്ഞ ദ്രാവകം കÙ¤. അടിവയറ്റിലും ഉÙ¡യിരുന്നു. 2) പഴുപ്പിന്റെ flakes കുടലിv ഒട്ടിപ്പിടിച്ചിരിക്കുÙ¡യിരുന്നു.3) വu കുടലിന്റെ Sigmoid ഭാഗത്ത് ഒരു ദ്വാരം .4) ആ ദ്വാരം കുടv ഒട്ടിപിടിച്ചിരിക്കുന്ന ഭാഗത്തിന് മുകളിലാണ്. Colostomy നടത്താu തീരുമാനിച്ചു. After stitching Peritonitis വരാu സാധ്യത കുടv ഒട്ടിപിടിച്ച ഭാഗത്തിന്റെ മുകളിലുള്ള ഭാഗത്ത് വികസിക്കുകയും, ആ ഭാഗത്ത് പൊട്ടുകയും ചെയ്തു. പൊട്ടിയ ഭാഗത്ത് Infection വന്നു. ആ ദ്വാരത്തിv കൂടി മലവും മറ്റും പുറത്ത് വരാതിരിക്കാനാണ് അത് തുന്നുന്നത്. ഇങ്ങനെ പൊട്ടുന്നത് കൊÙ® fluid വരാം.”). The Deposition of the PW2 reveals the condition of the complainant at the time of discharging from the hospital of the opposite party. Moreover, the discharge card issued from the Alshifa hospital, Exhibit A8 reveals the history of ailment of five days. The second opposite party, DW1 admitted as follows: - “30/3/16 ഉം 31/3/16 ഉം 1/4/16 ഉം രാവിലെ വരേയും രോഗിയെ ആരെങ്കിലും കÙതായി Case sheet കൊÙ® കാണില്ല. operation കഴിഞ്ഞ രോഗിയെ സംബന്ധിച്ച് ഈ സമയം വളരെ പ്രധാനപ്പെട്ടതാണ്. 1/4/16 ന് ഞാu 6 മണിക്കാണ് രോഗിയെ കാണുന്നത് അപ്പോw വയറ് വീര്ത്ത അവസ്ഥയിലാണ് കÙ.ത്. അതിനെ സംബന്ധിച്ച് കേസ് ഷീറ്റ് കൊÙ® കാണും. Ext.X1 Page – 2 back side. 1/4/2016 ന് വൈകുന്നേരം 6 മണിക്ക് രോഗിയെ കാണുമ്പോw Paralytic Ileus ആണെന്ന നിഗമനത്തിലാണ് Investigation നടത്തിയത്. Case Sheet – v അക്കാര്യം രേഖപ്പെടുത്തിയിട്ടില്ല. രോഗിയെ സംബന്ധിച്ച് യാതൊരു ആശ്വാസവും അതിനെ തുടര്ന്ന് ഉÙ¡യിട്ടില്ല. PPS കഴിഞ്ഞ് കിടക്കുന്ന രോഗിയെ സംബന്ധിച്ച് Paralytic Ileus ഒരു ഗൌരവമായ അവസ്ഥയാണോ? (A) അല്ല. 1/04/2016 ന് 7.30 മണിക്ക് മുതv രോഗിക്ക് അസ്വസ്ഥത അനുഭവപ്പെട്ട് എന്നെ വിളിച്ചു. എനിക്ക് അസൗകര്യമായതിനാv ഡോക്ടര് Mrs. വര്മ്മയാണ് പരിശോധിക്കാu പോയത്. ഡോക്ടര് കÙത് X1 page 3 യിv രേഖപ്പെടുത്തിയിട്ടുÙ®. Distention എന്ന് രേഖപ്പെടുത്തിയിട്ടുÙ®. Pain abdomen with distention എന്നാണ് രേഖപ്പെടുത്തിയത്. നേരത്തെ കÙ അവസ്ഥയിv നിന്ന് കൂടുകയാണ് ഉÙ¡യത്. അത് Paralytic Ileus എന്ന നിഗമനത്തിലാണ് Dr. വര്മ്മയും എത്തിയത്. ഒരു രോഗിക്ക് Paralytic ileus വരണമെങ്കിv ഒരു പാട് കാരണങ്ങw ഉÙ® .. ഈ രോഗിയെ സംബന്ധിച്ച് Paralytic Ileus വന്നു എന്ന തരത്തിലുള്ള Investigation നടത്തിയിട്ടു¨Ù¡? (A) അത്തരം ഒരു Investigation ഇല്ല. ഈ രോഗിയെ സംബന്ധിച്ച് Paralytic ileus എന്തുകൊÙ® . വന്നു എന്ന തരത്തിലുള്ള Investigation നടത്തിയിട്ടില്ല. The above deposition reveals that on 01/04/2016 the second opposite party seen the complainant and she was under the impression of paralytic ileus. But that aspect has not recorded in the case sheet. But on the same day at 7 .30 pm doctor Sarasija varma was seen the complainant and she has noted her impression of possibility of paralytic ileus. Moreover, the fact reveals the surgery was completed at 11.30 am on 30/03/2016. But the next visit of doctor is only on 01/04/2016 at 6 pm. It is relevant to not the case of the complainant that she was suffering from pain abdomen with distension and the complaint of not passing motion. The case sheet Ext. X1 page No.2 reveals the PPS started at 10.50 am on 30/03/2016 and ends at 11.30 am. Thereafter on 01/04/2016, 6 pm the doctor has noted complaint of gaseous distension, BS sluggish. The next examination is at 7 p m on the same day on the call to see the patient with complaint of pain abdomen and complaint of distension. Then the next consultation is on 02/04/2016 6 am. The observation is no improvement in the symptoms and so she was shifted to post-operative intensive care unit to start KCL dip and close monitoring. The opposite party has stated that the patient was under the care of doctor Sarasija varma from 01/04/2016 evening onwards. On 02/04/2016 by 5.30 pm the doctor Sarasija Varma advised X-ray abdomen and USG and she was shifted in ambulance to doctor Jessy George for the same. On 03/04/2016 by 6 pm it appears the second opposite party reported in the hospital and examined the complainant. Admittedly the second opposite party was on leave for two days i.e., 02/04/16 and 03/04/16. Though the patient was taken for X-ray and USG there is no entry regarding the findings of X ray and USG in the doctor’s order. It appears the complainant was taken to the nearest scan and diagnostic center but non recording of the finding is not simple one in case sheet document X1. The case sheet reveals that the complainant was examined by the doctor on 03/04/2016 at 6.30 am. The doctor has not recorded that whether scan report was seen by the doctor at that time. The next occasion the doctor seen the complainant was at 6.pm on the same day. Both the occasions i.e in the morning and in the evening recorded that the complainant consented to continue the treatment with the opposite party. Thereafter on 04/04/2016 at 12 pm in discussion with the bystanders the complainant was referred to higher center. But the nursing record it appears the complainant was discharged by 2.30 pm on 04/04/2016 at request.
31 The perusal of Ext.X1 shows that the surgery of the complainant was completed on 30/03/2016 at about 11. 30 Am. Thereafter doctors order sheet find that the complainant was examined by the doctor on 01/04/2016 at about 6 pm and noted that gaseous distention, BS sluggish. The issue arises, what was the condition of the complainant from 11.30 am on 30/03/2016 to 01/04/2016 at about 6 pm. It appears there was no presence of doctor nearly two days in the hospital. The case sheet is totally blank of the days 31/03/2016 and up to 6 pm on 01/04/2016. The further perusal of Ext. X1 shows that in the nurse’s record, administration of medicine of 30/03/2016 except tablet, lactaid 2 TID on 31/04/2016, which shows that the patient was there in the hospital but no presence of the doctor. The treatment records and the averments in the affidavit of the opposite parties reveals that the second opposite party attended the complainant on 01/04/2016 at about 6 pm after the surgery on 30/03/2016 at 11.30 am and left the hospital for two days i.e 02/04/2016 and 03/04/2016. The treatment record does not reveal the fact when the complainant started the complaint of gaseous pain, not passing motion and abdominal distention. Exhibit A8 noted treatment history with complaint of pain abdomen, abdominal distension for five days, which means the complainant was suffering from the date surgery onwards. The complainant has got a case that she started those complaints on the day of surgery itself and it appears correct from exhibit A8.
32. It is relevant to note the absence of proper medical treatment record with the opposite party. In a case of medical negligence, the hospital as well as the doctor can prove the exact condition of the patient and treatment given to the patient and the investigation results through treatment record which a doctor and hospital can establish the proper mode of treatment and the procedure undergone during the treatment. It is held in 2022 CPJ 384 (NC) Dr. Jagdish Lalwani, Dr sushi acharaya Vs Madan Lal yadhav and five others, the National Commission held that “it should be born in mind that the medical record is , itself , a vital document to prove the duty of care of the treating doctors or hospital. In our view, good medical record is a “good defense”, poor medical record is a “poor” defense and no medical record “no defense”. In this complaint the opposite party failed to keep a proper treatment record of the complainant. Though the opposite parties claimed there was proper care and attention and treatment in accordance with accepted medical protocol, the documents produced by the complainant and the case sheet produced from the opposite party hospital disprove the claim of opposite parties. Though the second opposite party conducted the PPS, thereafter there was no due care in the treatment of complainant. The complainant alleges the second opposite party provided treatment to the complainant through telephonic conversation. The nurse’s record reveal that the second opposite party advised medicine to the complainant over telephone on 02/04/2016 at about 1.30 am. Thereafter at about 2.30 am the patient was having complaint of abdominal pain and so informed to second opposite party and she advised medicines further. Then, thereafter at 8.30 am informed to doctor Sarasija varma and she advised certain medicine. Thereafter at 9 pm there is phone order from doctor Sarasija varma to follow certain medicine and other procedures. Thereafter at 10 pm and 10.30 pm there are orders from the second opposite party. On 03/04/2016 at about 2 am Dr. Sarasija varma was informed the condition of the complainant and nothing was advised to do by that time. Thereafter at 3 am and 4 am there were calls from Doctor Sarasija Varma to the hospital and advised certain procedures to be followed. So, the perusal of the document reveals that the treatment of the complainant was mostly through telephonic conversation and the presence of the second opposite party was for limited period. The submission of the second opposite party is that she was on leave for two days for her personal requirement and the patient was entrusted with the senior doctor Sarasija Varma for the relevant period. But doctor Sarasija Varma also seen taken care of the complainant most of the occasion through the telephonic calls. The opposite party not examined the doctor Sarasija Varma before this Commission who treated the complainant for relevant days that is on 01/04/2016 night, 02/04/2016 and 03/04/2016. So, the document reveals the lack of due care and attention on the part of opposite parties to the complainant who was under the treatment of opposite parties.
33. The specific allegation of the complainant is that the opposite parties administered medicines to the complainant without diagnosing the exact cause of the ailment to the complainant. The perusal of documents as well as the averments of the complainants reveals that the opposite parties could not identify exact condition of the complainant. The opposite party claims that she was under the impression that the complainant was suffering from paralytic ileus but on the other hand the second opposite party admit that there is no chance for paralytic ileus to the complainant and there is no treatment for the same. The opposite party issued Ext. A56 referral letter stating the complaint of complainant as paralytic ileus. But while examined PW 2, the doctor treated the complainant at Alshifa hospital, it was revealed the complainant was suffering from peritonitis. The condition even may cause death of the complainant. Hence the complainant was subjected for surgical procedure at Alshifa hospital. The second opposite party has got a contention the patient was referred to Alshifa hospital at the request from the side of complainant. In other words, if the complainant was retained in the hospital of the first opposite party, the situation may be different. It is also revealed from the evidence that there is no facility for surgical consultation and to treat the condition of the complainant in the first opposite party hospital. The suggestion of surgical consultation from the side of second opposite party cannot be considered as a genuine version since the opposite party has not revealed the so-called consented surgeon to visit the complainant.
34. The opposite party deposed before the commission that “കുടലിന്റെ പുറത്തും ഉള്ളിലും Infection & Inflammation വളരുന്ന അവസ്ഥയാണ് Peritonitis. Paralytic ileus വന്നാല് ഈ രÙ® അവസ്ഥയിലേക്കും develop ചെയ്യാനുള്ള സാധ്യതയുÙ®. പരാതിക്കാരിക്ക് Paralytic Illus യുടെ സാധ്യതയില്ല. അതുപരിഗണിച്ചിട്ടില്ല”.. The deposition of the opposite party is against the very case of the opposite party. The case of the opposite party is that she was under the assumption of paralytic ileus to the complainant and the same is stated in the referral letter also. The second opposite party deposed that on 2/4/16 ന് രാവിലെ 6 മണിക്ക് രോഗിയെ കാണുമ്പോള്ത്തന്നെ വയറിv തൊടുമ്പോള്ത്തനെ ശക്തമായ വേദന ഉÙ®. Bowel Sound slow ആയിരുന്നു. But the fact remains that the DW1 was on leave on that day and there is no chance to examine the complainant by the opposite party No.2. The case sheet also does not find note of opposite party No.2. The second opposite party deposed before the commission that there was facility to take USG but on that day the doctor was not available and that is the reason for taking the complainant for the nearest scan centre.
35. Considering the affidavits, documents, and depositions of the parties, it appears the complainant could substantiate the allegation of the complainant. The documents especially Ext. X1 does not reveal exactly at what time the complaint of complainant commenced. The second opposite party seen the complainant at the time of PPS i.e. on 30/03/2016 at about 11.30 am and thereafter the second opposite party examined the complainant on 01/04/2016 6pm. Thereafter the second opposite party met the patient on 03/04/2016 at 6 pm as per Ext. X1. Though the second opposite party contended that she was on leave due to personal reasons on 02/04/2016 and 03/04/2016 there is lack of care from the side of second opposite party towards the complainant. Second opposite party has admitted that in a case of paralytic ileus no food will be advised to the patient. In the matter of bowel injury case the patient will not be advised to walk also. In this case the patient was advised to take food which is against the protocol of treatment as admitted by the second opposite party. The complainant herein was advised to walk which is also against the accepted protocol. All these things happened due to non-diagnosing of the condition of the patient. Now the question is that whether these facts can be treated as lack of care and negligence in the treatment of a patient.
36. The complainant herein was admitted in the opposite party hospital for the delivery and it was normal one. It is also revealed the PPS on the next day was also uneventful. The opposite parties contended that the complications are not due to negligence on the part of opposite parties.
37. The opposite parties filed detailed argument note which strictly denied the case of negligence on the part of the opposite parties. The contention raised is that faecal perforation after PPS is not due to any negligence or deficiency in service on the part of the treating doctors and it is an accepted complication. It is submitted that no bowel injury was suspected to the complainant and so no further investigation was done. PW2 deposed that the site of PPS and the perforated area will never contact and peritonitis may lead to paralytic ileus. It is further stated that there is chance for bowel obstruction after abdominal surgery and it is an accepted complication. In spinal anaesthesia the veins of the area where the surgery is performed will be blocked. The muscles connecting those veins will be dilated and ceased functioning. When it affects intestine, it is called paralytic ileus. The counsel for opposite party submitted that courts would indeed be slow in attributing negligence on the part of a doctor if he has performed his duties to the best of his ability and with due care and caution. Simply because a patient has not favourably responded to a treatment given by a physician or surgery has failed, the doctor cannot be held liable per-se by applying the doctrine of res ipsa loquitur. A medical practitioner is not to be held liable simply because things went wrong from mischance, misadventure or through an error of judgement in choosing one reasonable course of treatment in preference to another. The counsel for opposite parties presented case report on post-partum spontaneous colonic perforation due to antiphospholipid syndrome and seal preparation due to paralytic ileus following primary caesarean section. But the fact remains that the medical negligence is to be examined each case on its own merit. In this complaint the opposite party admitted that “പരാതിക്കാരിക്ക് Paralytic ileus യുടെ സാധ്യതയില്ല. അതുപരിഗണിച്ചിട്ടില്ല”.. The doctor further deposed that “ഈ രോഗിക്ക് സ്വാഭാവിക complication ആയത് കൊÙ® .supportive treatment ന്റെ ആവശ്യമേ വന്നിട്ടുള്ളു. അന്ന് supportive treatment കൊÙ® . രോഗിയുടെ അവസ്ഥ മാറിയിട്ടില്ല.. DW1 further deposed “operation സമയത്തോ അതിനുശേഷമോ യാതൊരു complication നും തിയ്യേറ്ററിv വച്ച് അനുഭവപ്പെട്ടിട്ടില്ല... ആ വിശ്വാസത്തിന്റെ ഭാഗമായാണ് bowel injury ഉണ്ടോ എന്ന് പരിശോധിക്കാതിരുന്നത്. “ചികിത്സയുടെ ഘട്ടത്തിv X-ray യും USG യും ഞാu കÙ . ട്ടില്ല . ചികിത്സിച്ചത് സരസിജവര്മ്മ ഡോക്ടറാണ്.”. It is very important to state that DW1 deposed that case sheet v കാണാത്ത പല കാര്യങ്ങളും ചികിത്സയുമായി ബന്ധപ്പെട്ട് നടത്തിയിട്ടുÙ®. എന്നു പറഞ്ഞാv ശരിയാണ്” So the perusal of the deposition of the DW1 is sufficient to hold that there was no care and attention from the side of opposite parties towards the complainant to the best of ability of the doctor. Hence the commission cannot endorse the argument of the learned counsel of the opposite party and we find there is lack of care and negligence on the part of opposite parties.
38. Point No.3
The complainant submitted that due to the negligence in the treatment of the complainant she was constrained to undergo three surgeries from Alshifa hospital Perinthalmanna and she was hospitalized for more than 34 days. The complainant also submitted that she incurred huge amount for the treatment. The complainant produced Ext.A7, A8, A9 and A10 to prove the period of hospitalization. Exhibits A4, A5 and A6 are document to show the medical expenses incurred by the complainant. The documents produced as medical bills exceeds the claim amount of Rs.4,00,000/- towards medical bills. The perusal of Exhibits A7 to A10 substantiates the hospitalization and Exhibits. A4, A5 and A6 substantiate the medical expenses claimed by the complainant. The complainant further submitted that due to the prolonged treatment after the delivery the infant was also put to irreparable turmoil and pain. The complainant lost the company of the child and was not able to breastfeed the baby. So, the complainant and the child is still undergoing treatment for the ill effects of the condition. The complainant also undergone inconvenience, hardship, and mental agony. The claim of the complainant is Rs.4,00,000/- towards the medical expenses which is supported by Exhibits . A4, A5, A6. The complainant claimed Rs.5,00,000/- towards pain and suffering and Rs.2,00,000/- towards the suffering of the child. The commission consider Rs.3,00,000/- towards pain and suffering will be sufficient on that count to end justice. The complainant submitted that she is entitled Rs.5,00,000/- towards permanent disability and future treatment expense. But there is no document is produced by the complainant towards the disability and future treatment. Hence the commission disallow the claim under that head. The commission also find Rs. 25,000/- as cost of the proceedings. Since there is no other documents to show the traveling expenses and review expenses we disallow the claim.
39. The second opposite party is the doctor treated the complainant who is working under the first opposite party, the owner of the hospital. Hence, the opposite parties are jointly and severally liable to compensate the complainant.
40. In the above facts and circumstances, we allow this complaint as follows:-
1) The opposite parties are directed to pay Rs.4,00,000/- (Rupees Four lakh only) to the complainant towards the treatment expenses of the complainant.
2) The opposite parties are directed to pay Rs.3,00,000/- (Rupees three lakh only ) to the complainant as compensation on account of negligence and deficiency in service and thereby caused inconvenience, hardship and mental agony suffered by the complainant.
3) The opposite parties are directed to pay Rs.25,000/- (Rupees twenty-five thousand only) to the complainant as cost of the proceedings.
The opposite parties shall comply this order within one month from the date of receipt of copy of this order, failing which the opposite parties are liable to pay interest @rate of 9% per annum from the date of filing this complaint to till date of payment.
Dated this 29th day of May , 2023.
Mohandasan . K, President
Preethi Sivaraman.C, Member
Mohamed Ismayil.C.V, Member
VPH
APPENDIX
Witness examined on the side of the complainant: PW1 & PW2:
PW1: Mini Aneesh, D/o P.M. Thomas (Complainant)
PW2: Dr. Muhamed Sajid
Documents marked on the side of the complainant: Ext.A1 to A59
Ext.A1: Copy of registered lawyer notice with postal acknowledgment dated
30/11/2016.
Ext.A2: Reply notice issued by the first opposite party dated 09/12/2016.
Ext A3: Reply notice issued by the second opposite party dated 09/12/2016.
Ext A4: Series of Medical bills issued from new life hospital Vadapuram (43 in
number)
Ext A5: Series of medical bills issued from KIMS Alshifa hospital
Perinthalmanna (68 number)
Ext.A6: Series of medical bills issued from KIMS Alshifa hospital Perinthalmanna and
also from MES ,Medical college, Perinthalmanna, Chungathara medi land
Medicals (42 number)
Ext.A7: Discharge card issued from New Life hospital Vadapuram dated 29/03/2016.
Ext A8: Discharge summary issued from AL shifa hospital MR. No.001335216, DOA
04/04/2016, DOD21/04/2016
Ext A9: Discharge summary issued from AL shifa hospital MR. No.001335216, DOA
30/05/2016, DOD 08/06/2016
Ext A10: Discharge summary issued from AL shifa hospital MR. No.001335216, DOA
06/04/2017, DOD 11/04/2017.
Ext.A11: Operation theatre record issued by Alshifa hospital perinthalmanna dated
04/04/2016(1 pages)
Ext.A12: Inpatient record issued by KIMS Alshifa hospital perinthalmanna dated
04/04/2016(1 pages )
Ext A13: Peripheral Venous access documentation dated 07/04/2016.
Ext A14: Copy of STAT/SOS dated 04/04/2016.
Ext A15: Doctors daily progress report dated 04/04/2016
Ext.A16: Pain assessment form dated 04/04/2016
Ext.A17: Lab result dated 04/04/2016.
Ext A18: Nurses care plan dated 04/04/2016 (40 pages)
Ext A19: Initial assessment form nil dated .
Ext A20: Copy of consent letter dated 04/04/2016
Ext.A21: Copy of ECG
Ext.A22: Nursing clinical chart dated 05/04/2016.
Ext A23: Copy of Anaesthesia Record dated 04/04/2016.
Ext A24: Copy of in patient record dated 04/04/2016.
Ext A25:Copy of initial assessment form dated 04/04/2016
Ext.A26:Copy of Daily nursing care check list 05/04/2016
Ext.A27: Copy of special critical care monitoring chart dated 05/04/2016.
Ext A28: Copy of admission check list dated 05/04/2016.
Ext A29: Copy of falls Risk Assessment status issud by KIMS AL- shifa, Hopital,
Perinthalmanna dated 05/04/2016
Ext A30: Copy of HIV antibody examination consent letter dated 05/04/2016.
Ext.A31: Copy of nursing initial assessment dated 05/04/2016.
Ext.A32: Cross consultation request dated 05/04/2016
Ext A33: Copy of physiotherapy treatment record dated 06/04/2016.
Ext A34: Copy of physiotherapy treatment form dated 06/04/2016.
Ext A35: Copy of cross consultation request dated 07/04/2016
Ext.A36: Copy of special critical care monitoring chart dated 07/04/2016
Ext.A37: Copy of cross consultation request dated 07/04/2016
Ext A38: Copy of Cross consultation request date 07/04/2016.
Ext A39: Copy of Daily nursing care checking list dated 08/04/2016
Ext A40: Copy of Daily nursing care checking list dated 09/04/2016
Ext.A41: Copy of Daily nursing care checking list dated 10/04/2016.
Ext.A42: Daily nursing care checklist dated 12/04/2016.
Ext A43: Copy of Drug chart dated 12/04/2016.
Ext A44: Copy of cross consultation request 15/04/2016
Ext A45: Copy of Daily nursing care check list dated 17/04/2016.
Ext.A46: Copy of Daily nursing care check list dated 18/04/2016
Ext A47: Intake and output chart dated 08/04/2016.
Ext A48: Intake and output chart dated 19/04/2016
Ext A49: Nutrition assessment/ re-assessment form dated 19/04/2016
Ext.A50: Daily nursing care check list nil dated
Ext.A51: Daily nursing care check list dated 20/04/2016
Ext A52: Daily nursing care check list dated 21/04/2016
Ext A53: Drug chart dated 21/04/2016.
Ext A54: Inpatient record dated 08/06/2016.
Ext. A55: Prescriptions issued by Dr. Jabid T.K.
Ext.A56: Referral letter dated 04/04/2016 issued by Dr. Santhi Sebastain
Ext. A57: Discharge summary dated 12/03/2019 issued from KIMS Alshifa ,
Perinthalaman .
Ext. A58: Prescription issued from KIMS Alshifa hospital dated 13/06/2017 (12 in
Number)
Ext. A59: series, Medical bills issued from Alshifa Hospital, Perinthalmanna and
Elamkulam Hospital.
Witness examined on the side of the opposite party: DW1
DW1: Dr. Shanti Sebastian (Second opposite party)
Documents marked on the side of the opposite party: Nil
Ext. X1: Inpatient record of IP No.5433/16, New life hospitals vadapuram.
Mohandasan . K, President
Preethi Sivaraman.C, Member
VPH Mohamed Ismayi
