F.A.No.536 OF 2008 AGAINST C.C.No.584 OF 2007, DISTRICT FORUM-III, HYDERABAD

Between:

1. Dr.A.Ramesh Reddy, M.S.,

    S/o.A.Venku Reddy

    Aged about 43 years,

    Occ:Consultant Ophthalamologist

    Kamineni hospital,

    L.B.Nagar, Ranga Reddy Dist.                                                   Appellant/Opp.party No.1

        And

1. R.Venkata Krishna Murthy,

    S/o.late Ramaiah, age 68 years,

    Occ:Retired BSNL Employee

    R/o.H.No.3-95/4, Vaninagar

    Street No.1, Malkajgiri

    Hyderabad-500 047.                                                                 Respondent/ Complainant

2. Kamineni Hospital,

    Rep. by its Administrative Officer,

    L.B.Nagar, Ranga Reddy District.

3. Dr.Rohit Khanna, aged about 30 years,

    Consultant Ophthalmologist,

    L.V.Prasad Eye Institute,

    Managed by Hyderabad Eye Institute

   Jubilee Hills, Hyderabad.

4. Dr.Annie Mathali

    Age 30 years, Retina Specialist.

    L.V.Prasad Eye Institute

    Managed by Hyderabad Eye Institute,

    Jubilee Hills, Hyderabad.

5. L.V.Prasad Eye Institute,

    Managed by Hyderabad Eye Institute

    Rep. by its Administrative Officer,

    Jubilee Hills, Hyderabad.

6. The Administrative Officer,

    Central Government Hospitals (CGHS)

    Begumpet, Hyderabad.

(Respondent No.2 is not necessary party)       Respondents/O.Ps 2 to 6

Counsel for the Appellant:            Mr.Srinivasa Rao Pachwa

Counsel for the Respondents:       Mrs.Anitha Jain.S-R1

                                                Mr.Adnan Mohd.-R3 to R5

QUORUM:                   SRI SYED ABDULLAH, MEMBER.

                                                AND

SRI R.LAKSHMINARASIMHA RAO  MEMBER

THURSDAY THE SIXTEENTH DAY OF DECEMBER

TWO THOUSAND TEN

(Oral Order ( As per R.Lakshminarsimha Rao, Member)
                                               ***

1.     The opposite party no.1 is the appellant.  The parties are referred to as they had been arrayed in the complaint.  The complainant approached the opposite party no.1 at the opposite party no.2 hospital where he was diagnosed with immature senile cataract (IMSC) in his left eye for which he had undergone surgery on 6.6.2005 and was asked to come for a review the next day i.e., 7.6.2005.  At the time of review the complainant said to have complained of loss of vision in his left eye and the opposite p[arty no.2 stated to have asked the complainant to come for review on 27.6.2005 on which date he was said to have been informed that a part of the cataract was remaining in his left eye for which he was required to undergo surgery once again.

2.     The complainant approached L.V.Prasad Eye Institute where Dr.Rohit Kumar diagnosed him with “decentred  and retained matter” and performed surgery on 14.7.2005 by implanting a lense whereon as his vision has not improved, he had consulted the opposite party no.4, Dr.Annie Mathali, a Retinal specialist at L.V.Prasad Eye Institute who diagnosed the complainant to have suffered from retinal detachment and performed surgery once again which had not improved the condition of the complainant whereby he had undergone third and fourth surgery on 20.1.2006 and 22.11.2006 respectively.  The complainant had lost complete vision in his left eye. 

3.     It is the contention of the complainant that he is a non-diabetic and the first cataract surgery performed in his right eye at Apollo Hospital was successful and there was negligence in treatment rendered by the opposite parties of whom the opposite party no.3 performed surgery for removal of lens matter which was not disclosed by B-Scan and the opposite party no.4 had performed retinal surgery without advising for B-Scan.

4.     It is the version of the opposite parties no.1 and 2 that after the cataract surgery with IOL implementation was conducted on 6.6.2005, the following day it was found that some amount of cortical matter present behind the lens was found to be obstructing the complainant’s vision, which would resolve naturally in due course of time and if it fails to do so, it would be removed by way of second surgery.  In support of their contention that these would be remnant of cataract after the surgery, the opposite parties no.1 and 2 relied upon the opinion of   Jaffe’s in his textbook of Ophthalmology.

5.     The opposite parties no.3, 4 and 5 contended that silicon removal procedure was adopted on 11.11.2006 to reduce the intraocular pressure and that on 4.4.2007 the cornea was found to be edematous due to corneal decompression though the retinal was attached.  It was contended that 50% of the retinal detachment after cataract surgery presents itself within one year of surgery and that the complainant had a complicated  cataract surgery done else where for the first time and had  3 of the 4 risk factors for detachment due to the first surgery.

6.     The complainant is a non-diabetic and he contends that the opposite party no.1 had negligently conducted cataract operation and that after performing surgery, the opposite party 1 had not informed  him to wait for 3 weeks for natural absorption of cortical matter or go for surgical removal of the lens cortical matter. The opposite party No.2 has admitted in his cross examination that it was not noted in the discharge summery. The pleading without evidence in suggestive thereof, as such is not proved.

7.     The intraoccular tests prior to the time of operation said to have been conducted by the opposite party No.1 does not find any place in the evidence placed on record. In his cross examination, the opposite party no.1 has stated as,

“I conducted intraoccular tests syrenging and extensive examination of extraoccular and intraoccular condition of the eye and type of the cataract and A-scan. The above mentioned tests are  not been recorded in the O.P.card except A-scan. It is recorded in the case sheet. I have not filed the A-scan report on the file.”

8.     According to the opposite party No. 1, the intraoccular tests are mandatory prior to performing of the cataract surgery. However, the opposite party No.1 failed to bring on record to prove that he had conducted extensive examination of intraoccular and extra condition of the complainant’s left eye before proceeding for cataract surgery. It is not difficult for the opposite party no.1 whose service had been engaged by the opposite party No.2 hospital.

9.     The Hon’ble National Commission in “Dr.Pahwaks Surindra Mohan Ghose” reported in (2004)II CLD 173 held that carrying out cataract surgery without conducting test of B-Scan which is pre-requisite  for knowing the exact status of the eye as well as retinal detachment which the surgeon came to know during surgery was a lapse and a clear case of negligence.

10.    The Opposite party No.2 has stated in his evidence that B-Scan is not necessary to know the cataract condition and it is necessary to know the retinal condition of the eye whether the cataract is matured.   The opposite party No.1 has not filed any medical literature in absence of which it cannot be said that B-Scan test is not prerequisite for carrying out cataract surgery particularly in the circumstances during post operative period. The retinal detachment was treated at O.P No.5 hospital by performing surgery repeatedly. In the circumstances and in the light of decision of the Hon’ble National Commission, we are of the considered opinion that the O.P.No.2 has not treated the complainant with due care and diligence as is required to be shown by a ordinary member of medical profession in the like circumstances of the case.

11.    The claim for `3,00,000/- and award for  `2.00,000/- is out of all propositions.  The compensation should commensurate with the facts and circumstances of the case. The complainant is an aged person and he had to undergo a complicated cataract surgery and had 3 of the 4 risk factors that predispose to the development of the retinal detachment. Another factor to be noted is the complainant not turning up for review on 27/06/2005 and his statement is that he had no confidence in the opposite party No.1.

12.    The complaint against the opposite parties 2,3,4 and 5 was dismissed holding that there was no negligence on their part in rendering treatment to the complainant. The complainant has not filed appeal against the finding and if the treatment rendered by the Opposite parties 3 to 5 is viewed in the back drop of the treatment rendered by the opposite parties 1 and 2, the magnitude of the negligence on the part of the opposite parties no 1 and 2 is considerably negligible so as not to warrant an award for  `2,00,000/-. Taking into consideration the circumstances of the case, we reduce the compensation from an amount of  `2,00,000/- to   `50,000/-. 

13.    In the result, the appeal is allowed. The order of the District Forum is modified. The OP No.1 is directed to pay  `50,000/- together with costs of  `2,000/- to the complainant.  Complaint against opposite parties 2 to 5 is dismissed.  There shall be no order as to costs in the appeal.

                                                                            Sd/-

MEMBER.

                                                                           Sd/-

                                                                        MEMBER

                                                                                              Dated: 16.12.2010

JM/KMK*