Tamil Nadu

StateCommission

CC/153/2015

Mr.S.Sathiyaraj, S/o.V.Subramanian - Complainant(s)

Versus

M/s.Fortis Malar Hospital, its rep by Mr.Malvinder Mohan Singh, Executive Chairman - Opp.Party(s)

M/s.N. Vanaraj

15 Mar 2023

ORDER

Date of filing : 18.08.2015

 

IN THE TAMIL NADU STATE CONSUMER DISPUTES REDRESSAL COMMISSION, CHENNAI.

 

Present: Hon’ble Thiru Justice R.SUBBIAH       ... PRESIDENT

             Thiru.R VENKATESAPERUMAL     … MEMBER

 

C.C. No.153 of 2015

 

                               Orders pronounced on: 15.03.2023

 

S.Sathiyaraj,

S/o.V.Subramanian,

No.3, Selvam Street,

Kannankurichi Post,

Salem Taluk & District -636 008.         … Complainant.

 

vs.

 

M/s.FORTIS Malar Hospital,

Rep. by its Executive Chairman,

Mr. Malvinder Mohan Singh,

No.52, 1st Main Road,

Gandhi Nagar,

Adyar,

Chennai-600 020.                                        ... Opposite Party.

 

             For Complainant      :  M/s.N.Vanaraj

             For Opposite Party   :  M/s.R.Parthasarathy

 

 

This Complaint came up for final hearing on 22.07.2022 and, after hearing the arguments of the counsels for the parties and perusing the materials on record and having stood over for consideration till this day, this Commission passes the following:-

O R D E R

R.Subbiah, J. – President.

 

 

             Alleging medical negligence against the OP/Hospital, the complainant seeks this Commission to direct the OP to pay to him a sum of Rs.19 lakh as compensation for monetary loss, mental agony, etc., another sum of Rs.5 lakh as interim medical expenses and costs of the complaint.

 

             2. In brief, the case of the complainant is as follows:-

             The complainant is a Ph.D. Student in Polymer Science and, on 14.07.2014, while he was doing a scientific research in the Laboratory, the Glass Beaker containing acid had suffered explosion, as a result of which, the scattered glass pieces got pierced all over his body, more severely in his eyes.   Immediately, he was taken to the OP Hospital where first aid alone was given to him, however, despite complaining acute pain in the eyes, no eye test was done and, without proper treatment in that regard, the complainant was discharged by giving some eye-drops on 15.07.2014.  Left with no other alternative, the complainant went to an Eye Hospital/Sankra Nethralaya, where he was admitted and the examination there revealed that he was about to lose his vision since numerous glass pieces were found inside the eyes, retina was badly affected and also, there was tearing of the cornea.  At the said Eye Hospital, after undergoing corneal tear repair in the right eye, the vision of the complainant was saved to some extent; however, he has not recovered completely.  When the complainant was at the OP specifically complaining about acute pain in his eyes due to piercing of glasses that had virtually torn the retina & cornea, the said major injury was not dealt with except some simple treatment and as a result, with severe pain, he was forced to approach the other Hospital.  The lethargic act of the OP clearly amounts to medical negligence and service deficiency that has caused monetary loss and mental agony to the complainant and the OP is liable to pay compensation to him. In this regard, the complainant issued a legal notice on 15.10.2014 and, despite receipt of the same, the OP did not bother to even send a reply.  Hence, the present complaint.

 

             3. The OP has filed a written version, inter alia stating thus:-

             As a result of the lab accident that had happened on 14.07.2014, for azide exposure, the complainant was admitted in the OP/Hospital at 10.39 PM with glass piercing injuries at the face, abdomen & upper limbs.  He also had multiple small lacerations on the face & in the right eye where corneal abrasions and conjunctival hemorrhage could be noticed.  Azide is a potentially lethal chemical and exposure to the same could result in convulsions, low BP, loss of consciousness, lung injury, respiratory failure leading to death or slow heart rate, etc., however, in the case of the complainant, there was no breathlessness, vomiting or visual disturbances.  After checking his vitals and finding the same to be normal, the General Physician managed him by administering TT injection to guard against infection and Dynaper injection as painkiller.  After washing the wounds, the Plastic Surgeon removed the glass pieces and sutured the cuts.   At that night time, his eye condition was discussed with Dr.Rathi Malar, who advised first line treatment in the form of eye irrigation which is the standard protocol for chemical injuries and chemical exposure concerning eyes.   Apart from that, Refresh Liquigel TID and Vigomox QID Drops were administered.  His condition was observed throughout the night for azide-poisoning and, on the next date/15.07.2014 at 9.30 A.M. he was reviewed by the Doctor, who found him to be normal with his vitals to be stable, except for his eye condition that there was difficulty in opening the right eye with periorbital edema (swelling around the eyes).  The General Physician examined him at 11.15 AM. and noted that the patient did not show signs of Metabolic Acidosis which would have been present if he had been adversely affected by the accidental ingestion of the toxic substance.  He also noted that the multiple injuries at the face and chest had been cleaned and sutured.  It was further found that his eyelids were edematous (having an excessive accumulation of fluids in the cells) while the vision was normal.   As the condition of his eye required further investigation and treatment that could be done only at a Specialty/Ophthalmological Institution, he was advised to follow up on that after discharge.  The patient's own conduct in immediately going to the Eye Hospital for treatment soon after discharge from the OP Hospital and also the Nurse's Notes at the time of discharge indicating that he was explained to follow up would demonstrate the falsity of the complainant's case. After giving first aid, ensuring that the complainant was out of imminent danger and duly noting the eye injuries,  he was discharged with clear instructions to visit an Eye Specialty Hospital.   The Hospital Records show that only a provisional discharge summary was issued, which is indicative of the fact that further follow-up was required.   Given the Hour at which the complainant was admitted, since the OP is not a specialized Hospital for treatment of eyes, they provided eye care to the extent possible by doing preliminary examination followed by eye irrigation; while so, after his discharge from the OP Hospital at 12.15 PM. on 15.07.2014, with instructions to take follow-up for the eye injuries, he duly complied with such instructions of the OP, by rushing to the eye hospital on the same date, which is evident from the payment receipts filed along with the complaint. On 24.07.2014, the complainant came to the OP Hospital for review and it was noted by the Plastic Surgeon that treatment at the Eye Hospital for the right eye was over and it indicates that the complainant was originally instructed to follow up his eye treatment at a specialized eye hospital.  The main focus of the treatment given by the OP was on removal of glass splinters and to look for and treat azide poisoning.  The legal notice served on the OP only mentions the eye injury without reference to the major treatment given for azide poisoning.   On receipt of the legal notice issued by the complainant, a reply, dated 02.12.2014 was sent, denying all the allegations.  The claim for compensation is wholly without basis and there being no medical negligence on the part of the OP, the complainant is liable to be dismissed.

 

             3-A.  In support of the claim and counter-claim, the parties have filed their respective proof affidavits and, while the complainant has filed 65 documents as Exs.A1 to A65, on the side of the OP, 21 documents have been filed as Exs.B1 to B21.

 

             4. It is the prime submission of the learned counsel for the complainant that a broken glass piece measuring 4.7 mm x 2.3 mm, which was present superficially on the surface of the eye/conjunctiva, got embedded deep into the eye due to the pressure applied at the OP-Hospital  and in that process, the glass piece had torn the eye, as could be seen from Ex.A41/Right Eye Scan.  The Duty Doctor and the Nurse, who are not competent to treat the eye, ought to have referred the complainant to an eye specialist on coming to know that there is an injury in the right eye.  But, they wrongly treated by way of irrigating the complainant's injured eye without any professional competence which nearly caused blindness in the right eye and it is also evident from Ex.A58 issued by the Eye Hospital.  At the time of discharge from the OP Hospital, no proper advice was given by the Doctors, however, the complainant on his own initiative immediately rushed to the Eye Hospital on 15.07.2014 at about 2 PM., as could be seen from Ex.A7.  The Doctors there, on examination of the complainant's right eye and on seeing the severity of the injury caused by the negligence of the OP Hospital, advised him to immediately get admitted in their Hospital at Nungambakkam.  He complied with such advice and he was immediately operated upon for the wound in the cornea by doing primary cornea wound repair on the same date/15.07.2014 itself  and advised to remain in the Hospital as in-patient. On further examination, the Doctors could not locate any visible foreign body/glass piece in the right eye as the same was pushed deep into the eye by the negligent act of the OP Hospital.  On 16.07.2014, they referred the complainant to VRR Scan at T. Nagar for CT Scan of the right eye and the report revealed that there is a glass piece in the retina of the right eye.  Thereupon, on 19.07.2014, a multiple operation process was done for removal of the deeply penetrated glass piece.   The complainant, who previously had a vision of 6/6 in both the eyes, has become almost blind now with only 36/36 vision in the right eye.  Ultimately, he could not attend the lectures as well as the Lab since 15.07.2014, nearly for 3 months.  The complainant, who joined the Ph.D. Course in the year 2012 was to complete the same during April 2016 by submitting his thesis and completing the viva-voce by appearing before the Examiner. The stipend paid by the CSIR @ Rs.18,600/- per month has come to an end in March, 2016.  All such trauma and troubles suffered by him are only on account of the negligent treatment given at the OP Hospital, for which, they are legally bound to compensate the complainant as claimed by him. So pointing out, learned counsel pleads that this is a deserving case for grant of the relief as sought for by the complainant.

 

             5. Countering the above submissions, learned counsel for the OP primarily argues that this complaint is liable to be dismissed since no opinion by a medical expert about the alleged negligence has been adduced by the complainant.  In that regard, he has relied upon a decision in Bombay Hospital & Medical Research Centre vs. Asha Jaiswal and Others (2021-SCC Online-1149), wherein, the Apex Court highlighted the following proposition laid down in Jacob Mathew vs. State of Punjab:-

     " Negligence in the context of medical profession necessarily calls for a treatment with a difference. To infer rashness or negligence on the part of a professional, in particular a doctor, additional considerations apply. A case of occupational negligence is different from one of professional negligence. A simple lack of care, an error of judgment or an accident, is not proof of negligence on the part of a medical professional. So long as a doctor follows a practice acceptable to the medical profession of that day, he cannot be held liable for negligence merely because a better alternative course or method of treatment was also available or simply because a more skilled doctor would not have chosen to follow or resort to that practice or procedure which the accused followed. When it comes to the failure of taking precautions what has to be seen is whether those precautions were taken which the ordinary experience of men has found to be sufficient; a failure to use special or extraordinary precautions which might have prevented the particular happening cannot be the standard for judging the alleged negligence. ...."

In the present case pertaining to azide exposure,  the Doctors of the OP Hospital have provided the best medical care to the complainant, who had exposure not to any acid as projected by him, but Azide, a lethal chemical which may cause hypotension and even subsequent death within about an hour of exposure, and have treated him in a diligent manner for the chemical exposure and also removed the glass particles embedded in his body, ensuring that he had an uneventful recovery within a short while. For the eye injury, they advised him to approach an Eye Specialty Hospital at the earliest, which the complainant did immediately and hence, as held by the Apex Court in the above ruling, inasmuch as the doctors followed a practice acceptable to the medical profession, they cannot be held liable for any negligence particularly when the complainant, without any loss of time, went to the Eye Hospital on the very same date for getting treatment regarding the eye injury.  In such circumstances, just by hurling allegations without any basis for the same in the form of any expert opinion/evidence, the complainant cannot be allowed to succeed in capriciously charging the OP with medical negligence or service deficiency.

   By referring to Ex.B13/Nursing Assessment, wherein it is entered at the bottom 'explain to follow up care', learned counsel states that the said entry would show that necessary advice was given to the complainant at the time of discharge for proper follow-up on his part regarding the remaining issue of eye problem.  He further argues that the complainant has endeavoured to project a claim as if on 15.07.2014, there was a failure on the part of the OP Hospital in removing the glass particle in the eye and the same was however removed at the Eye Hospital immediately on the same date.  But, a perusal of the Case Summary under Ex.A56 of the Eye Hospital shows that on 15.07.2014, only primary corneal wound repair was done and that only subsequently, after taking scans, the removal of glass piece inside the eye was done 4 days later, on 19.07.2014 at the Eye Hospital and these sequence of recorded events would render the entire line of allegations by the complainant against the OP a blatant lie.  To sustain the other allegation of the complainant that the glass particles were pushed inside the eye due to the negligent handling at the OP Hospital, not a single piece of material has been filed and hence, the said allegation is nothing but a figment of feeble imagination. Thus, there being no scope or room for any medical negligence in this case, the complaint is liable to be dismissed at the threshold, he pleaded.

 

             6. From the rival submissions advanced on either side, we could notice that the main and major allegation of the complainant is that, for the eye injury sustained as a result of the lab accident, treatment was provided at the OP by a General Physician, due to whose mishandling, a glass piece measuring 4.7 x 2.3 mm, which was superficially present on the surface of the eye, was further pushed negligently  and further, no Ophthalmologist was summoned to attend him for removal of the embedded glass  piece and, on that score, there is a clear medical negligence on the part of the OP, but, this allegation is denied by the OP by saying that, when the complainant was admitted upon a lab accident for azide exposure with injuries all over body due to pierced glass pieces,  by giving necessary treatment for azide-poisoning, they ensured his uneventful recovery and, in respect of the eye injury, since they had no specialized team to treat that problem, by giving first aid, they discharged him on the very next day with an advice to immediately approach an Eye Specialty Hospital and the complainant also had duly complied with such advice;  hence, they cannot be charged with any medical negligence.

      Here, we have to keep in mind that there is no dispute that it is a case of chemical explosion in the Lab, due to which, the broken particles of glass beaker got pierced into the complainant's body including the eye and the velocity of piercing as a result of a chemical explosion would be more severe compared to other ordinary instances. Thus, while the impact of the explosion being so severe that the glass particles got pierced all over the body, the allegation of the complainant that a single glass piece alone was present in the surface of the right eye and the same was negligently pushed further into the said eye during the eye irrigation done at the OP appears to be highly hypothetical for a variety of reasons.  

     Firstly, even as per his own account in the pleadings at paragraph No.6 of the complaint, numerous glass pieces were found in his ‘eyes’, the retina was seriously affected and the cornea was torn.  Such notings, according to him, are said to have been made at the Eye Hospital during the examination on 15.07.2014. It should be borne in mind that the lab accident was on 14.07.2014 and the discharge of the complainant from the OP/Hospital and his admission in the Eye Hospital were on the very next date date/15.07.2014, on which date, according to the complainant himself, primary corneal wound repair was done at the Eye Hospital and the Doctors could not locate any glass piece in the right eye. If really one single glass piece alone got stuck in the eye due to the mishandling at the OP, numerous glass pieces would not have been noticed at the Eye Hospital as pleaded by the complainant.  Only based on the scan that was taken on 16.07.2014, the complainant speaks about the remnant foreign body/glass piece measuring 4.7 x 2.3 mm.  Such detection was not subsequent to the eye irrigation performed at the 1^st OP but it was after the primary corneal wound repair at the Eye Hospital.  That being so, when detection of the remnant glass piece was immediately after the corneal repair done at the Eye Hospital, who are not impleaded by the complainant, there lies a burden on his shoulders to satisfactorily clarify that further embedding of the particle was not a result of the corneal repair that was done at the Eye Hospital on 15.07.2014 and also to equally, link the glass-piece removal surgery directly with the eye irrigation process done at the OP.  But, the very averments of the complainant that, after his discharge from the OP, numerous glass pieces were found in his eyes at the Eye Hospital and his own case that the scan detected the remnant glass piece only after the primary corneal wound repair performed at the Eye Hospital only undo the allegation of negligence against the OP.  Further, by over-zooming the eye injury, in parallel, the complainant endeavours to eclipse the major treatment received by him at the OP for the azide exposure. Had the eye injury been the only major issue, the complainant would have been taken to a Eye Hospital straight away and there also, considering the gravity of the injury caused by the pierced glass particles, the Eye Hospital would have taken a couple of days’ time to treat the problems.  Only because of the extensive nature of injuries all over the body, probably, he was taken to the OP Hospital where they seemed to have provided right treatment for the azide exposure and sutured the cut wounds caused by the glass pieces.  During his short span of stay in the OP, the complainant was mainly treated for his bodily injuries and for the eye injuries, he was advised to visit the Eye Hospital.  As such, when there is nothing to infer any sort of medical negligence against the OP, it is quite unsafe to act upon the abrupt allegation of the complainant.

        As argued now, if really the Doctors at the Eye Hospital had informed the complainant that the OP was wrong or negligent in treating the eye injury that had ultimately driven him to undergo the glass-particle removal surgery, nothing prevented the complainant from obtaining a report/opinion/affidavit in that regard from the Doctors of the said Eye Hospital and filing it before us or otherwise, from impleading the said Eye Hospital as a party to speak about the alleged negligence of the OP. 

     Even otherwise, by merely looking into the pleadings and the formal documents that do not throw sufficient light over the disputed fact as to whether the embedding of glass particle in the eye was a direct consequence of chemical explosion itself or it was during the treatment process at the OP or at the Eye Hospital, no just conclusion can be arrived at. In such circumstances, as held in Bombay Hospital (cited supra) -

       "It may be mentioned here that the complainant had led no evidence  of experts to prove the alleged medical negligence except their own affidavits. The experts could have proved if any of the doctors in the Hospital providing treatment to the patient were deficient or negligent in service. A perusal of the medical record produced does not show any omission in the manner of treatment. The experts of different specialties and super-specialties of medicine were available to treat and guide the course of treatment of the patient. The doctors are expected to take reasonable care but none of the professionals can assure that the patient would overcome the surgical procedures.",

in the present case also, as already mentioned above, the complainant has not adduced any expert opinion or solid evidence to prove the alleged medical negligence against the OP except his own pleadings and set of documents which are only self-serving in nature.  After a careful assessment, we are not able to see any negligence or deficiency in the treatment provided by the OP and it appears that they had given timely first aid/treatment to the complainant for the chemical poisoning. As such, this is not a case where the principles of res ipsa loquitur come into play. Since the complainant has miserably failed to substantiate his case and claim, we have no other option except to dismiss the complaint.

 

             7. In the result, the Complaint fails and it is dismissed as devoid of any merit. No costs.

 

 

R VENKATESAPERUMAL                                           R.SUBBIAH, J.

MEMBER                                                                             PRESIDENT.

 

 

LIST OF DOCUMENTS MARKED ON THE SIDE OF THE COMPLAINANT

 

•                 Date                      Description of Documents

 

		Copy of student Identity Card issuedby the University of Madras
		Copy of IP Deposit Receipt of opposite party for Rs.15,000/-
		Copy of Radiology Bill of the opposite party for Rs.880/-
		Copy of bill for various treatment given by the opposite party for Rs.15,774/-
		Copy of Inpatient bill (Summary)
		Copy of Discharge Summary
		Copy of advance paid for Sankara Netheralaya worth Rs.15,000/-
		Copy of Scan Bill paid by the complainant for Rs.3,000/-
		Copy of Dark Glass bill paid by the complainant Rs.70/-
		Copy of Ultra sound bill for Rs.1,100/-
		Copy of physician bill paid by the complainant for Rs.300/-
		Copy of Flexi BCL paid by the complainant for Rs.100/-
		Copy of appointment slip
		Copy of Dark Glass Bill paid by the complainant for Rs.70/-
		Copy of Sterile Tissue paper bill for Rs.75/-
		Copy of Drug bill for Rs.394/-
		Copy of OP cash bill for dressing of the opposite party for Rs.200/-
		Copy of OP Cash bill for plastic surgery for Rs.500/-
		Copy of Drug bill for Rs.1,383/-
		Copy of Drug bill
		Copy of Drug bill for Rs.703/-
		Copy of Flexi BCL
		Copy of Dark Glass
		Copy of Drug bill
		Copy of appointment slip
		Copy of receipt
		Copy of Drug bill
		Copy of bills
		Copy of Drug bill
		Copy of Drug bill
		Copy of Drug bill
		Copy of receipt
		Copy of legal notice with postal receipt issued to the opposite party
		Copy of Drug bill
		Copy of receipt
		Copy of Drug bill
		Copy of Drug bill
		Copy of Drug bill
		opy of Medicine bill
		Copy of medical receipt issued by Sankara Nethralaya
		Copy of CT Scan of right eye
		Copy of medical receipt issued by Sankara Nethralaya
		Copy of medical receipt issued by Sankara Nethralaya
		Copy of bill for Flexi BCL
		Copy of Drug bill
		Copy of Drug bill
		Copy of Drug bill
		Copy of Drug bill
		Copy of Drug bill
		Copy of OP/IP Consolidated bill issued by Sankara Nethralaya
		Copy of Medicine Bill
		Copy of Medicine Bill
		Copy of Medicine Bill
		Copy of EYE Specs Bill
		Copy of Drug bill
		Copy of case summary issued by Sankara Nethralaya
		Copy of Drug bill
		Copy of Glass prescription issued by Sankara Nethralaya visibility right Eye less than N36
		Copy of medicine bill
		Copy of Drug bill
		Copy of Adayar Drug House Medicine cash bill
		Expenses incurred by the complainant so far in treating the right eye
		Procedure to be followed for irrigation of Eye (CD)
		Procedure to be followed in case of injury caused to eye by any sharp object
		Postal receipt and acknowledgment for the legal notice dt.25.10.2014

 

LIST OF DOCUMENTS MARKED ON THE SIDE OF THE OP

 

•                 Date                     Description of Documents

 

Ex.B1	-	Copy of Admission form - Admission History & Physical Assessment Form
Ex.B2	14.07.2014	Copy of M.L.C. Consent Form
Ex.B3	14.07.2014	Copy of General Consent for treatments
Ex.B4	14.07.2014	Copy of General Consent
Ex.B5	-	Copy of Emergency room – Nursing Assessment
Ex.B6	-	Copy of Medication Admission
Ex.B7	-	Copy of patient & Family Assessment
Ex.B8	-	Copy of History & Examination Sheet
Ex.B9	14.07.2014	Copy of Triage Form
Ex.B10	15.07.2014	Copy Vital Sign Chart
Ex.B11		Copy of Pain Management
Ex.B12	14.07.2014 to 15.07.2014	Copy of Physician Instructions & Notes, Nursing Notes
Ex.B13	14.07.2014	Copy of Nursing Assessment
Ex.B14	15.07.2014	Copy of Daily Nursing Assessment
Ex.B15	14.07.2014	Copy of Refund Request Form
Ex.B16	-	Copy of Discharge Summary
Ex.B17	-	Copy of acknowledgment form
Ex.B18	14.07.2014 to 15.07.2014	Copy of Final Summary Sheet
Ex.B19	15.07.2014	Copy of clearance
Ex.B20	02.12.2014	Copy of reply notice of opposite party
Ex.B21	15.10.2014	Copy of legal notice of the complainant

 

 

 

 

 

R.VENKATESAPERUMAL                                           R.SUBBIAH, J.

MEMBER                                                                             PRESIDENT.

 

 

ISM/TNSCDRC/Chennai/Orders/MARCH/2023.