Per Mr.S.R.Khanzode, Hon’ble Presiding Judicial Member This complaint pertains to alleged medical negligence vis-à-vis deficiency in service on the part of hospital and its treating doctors. It is a case of complainant Mrs.Shweta Jain that she had abdomen pain for last few years and, therefore, at Mumbai after consultation she had undergone Laparoscopy at the hands of one Dr.Neeta Verti. O.P.no.2-Dr.Rajeev Garud at that time gave anesthesia. However, pain continued. She was further advised by O.P.no.2-Dr.Garud who claimed to be a Pain Management Specialist to administer alcohol injection into the spine in order to get relief for her abdomen pain. Dr.Neeta Verti also supported said opinion and advised the complainant accordingly. At that time of her Laparoscopy on 10/12/2008,complainant opted for said advice/ treatment of alcohol injection after about 1½ months and for that purpose, she was admitted in O.P.no.1 hospital on 24/1/2009. Around 11 a.m. O.P.no.2-Dr.Garud administered her alcohol injection. However, around 1.30 p.m. on that date she felt that her entire left limb was not able to move and she was experiencing burning sensation therein. Thereafter, on 25/1/2009 in the morning she felt loss of senses of her right and left limb also and, therefore, complained about it to O.P.no.2 -Dr.Garud. She was advised MRI at Nirman High Tech and, then, was admitted at Lilavati hospital as per the advice of O.P.no.2- Dr.Garud on the same day. She was treated there by Dr.Vinay Chauhan- Neurologist, who told her that the complainant’s lower half body got paralysed and senseless because of alcohol injection in spine. Complainant thereafter was also under care of Nidhi Nursing Home, Kandivali(W), Mumbai, but there was no much improvement in her condition. She could not walk and sit on her own and was passing urine and motions in bed only. Therefore, this consumer complaint was filed alleging that by the negligent acts of O.P.no.1 to O.P.no.4 she suffered paralysis of both lower limbs. Consumer complaint was filed accordingly claiming Rs.3,12,679.50 ps. as compensation towards the actual expenditure she incurred at Navjeevan Hospital, Lilavati hospital and Nidhi Nursing Home and I.C.C.U. Further, claimed Rs.8,00,000/- as for future expenses needed for further treatment, to and fro visits to Mumbai and to various specialists in time to come and, in addition to that also claimed Rs.10 lakh as compensation for mental agony, physical incapacity and damage to both lower limbs. As per then directions of the apex court in the matter of Martin F.D'Souza V/s. Mohd. Ishfaq reported in (2009) 3 Supreme Court Cases 1, the matter was referred to expert committee, Government of Maharashtra, J.J.Group of Hospitals. It’s report dated 21/4/2010 was received by the Commission which opined as under:- “Opinion : Avachanoiditis with Myelitis, caused by extravasation of absolute alcohol, which is one of the complications following “Hypogastric plexus block” with absolute alcohol.” We heard Mr.Rajendra Choudhary -Ld.counsel appearing for the complainant and perused the record, inter-alia including the clinical case papers of hospitalization, operation notes particularly in respect of giving of alcohol injection, notice dated 10/2/2009 sent by the complainant to O.P. prior to filing of consumer complaint and reply of O.P.no2- Dr.Garud dated 12/3/2009 as well as affidavit of Dr.Alok Singhai, who had done MRI of the complainant on 25/1/2009. As revealed from the record, complainant lady of 29 years old had old complaint of chronic pelvic pain. As per the history recorded at Lilavati hospital, she had possible ectopic pregnancy in 2005, followed by chronic pelvic pain and in 2006 Laparoscopic procedure was done. Tuberculosis of adnexa was considered and she was started on AKT, however there was no relief in the pain. She underwent Adhesinolysis with removal of right adnexal mass in December 2008. There was no evidence of kochs in the specimen and hence AKT was discontinued. As earlier recounted, at the time of her Laparoscopy at the hands of Dr.Verti she was advised to take alcohol injection with which it was hoped to get relief from her pain. So advice by Dr.Verte and O.P.no.2- Dr.Garud after thinking over it and after spending of about 1½ month she conceded to undergo such treatment and, therefore, was admitted on 24/01/2009 in O.P.no1- hospital as explained in its reply by Dr.Garud of O.P.no.2- hospital since Karuna Hospital Borivali was not immediately available as per requirement of the complainant. O.P.no1- hospital was properly equipped to undergo the procedure. Para 13 to 17 of the said notice is reply describing in detail the procedure followed and which reads as under:- “13. After taking valid and informed consent, the patient was taken inside O.T. at 1.00 p.m. on 24th January 2009. Procedure of neurolytic block was carried out under local anesthesia in prone position. A long needle was passed in front of Vertebral column at L5 level. Needle position was confirmed under C-arm X-ray screen. Radio-opaque dye was injected through needle to confirm position of needle. After confirming this, alcohol 5 ml was injected through needle on left side. Similarly, the needle was passed from right side in front of the vertebra. After confirming position under C-arm, 5ml of 70% alcohol was injected, the patient’s pulse, blood pressure and oxygen saturation was monitored continuously, which was normal. The patient was shifted out of O.T. to bed at 1.30 p.m. The patient complained of backache and pain in left leg for which analgesies were injected. 14. At 3.00 p.m. the patient complained of inability to move left leg and moderate sensory loss on left leg. Right leg was normal. The patient had pain in left leg. 2 Neuro physicians were contacted for visit but both were unable to come due to conference going on in the city. 15. Nearest physician Dr.Tunerre, M.D. (Medicine) was called. He visited, opined and treatment was started according to his opinion. Physiotherapist, Miss Shyna was called who gave Physiotherapy and exercises. The patient’s muscle power slightly improved on left side. 16. Next day i.e. 25th January 2009, Sunday morning at 10.00 a.m., the patient developed weakness in right lower limb. There was partial sensory loss on right side lower limb also. The senior pain management specialist Dr.Baheti from Bombay Hospital was contacted. He visited, wrote down his findings and suggested treatment. 17. As the disease progressed rapidly in a day, we decided to go urgent MRI of spine and brain. It was done at 3.00 p.m., at Nirman Diagnostic Center, Malad. Dr.Alok who is related to the patient, performed the MRI. He said MRI showed diffuse arachnoditis. It means inflammation of membrane covering entire spinal cord. There was spinal cord endema also. According to him, it looked like infective in nature and not due to alcohol. He suggested to shift the patient to Bombay Hospital. But no neurologist was available on Sunday evening at Bombay Hospital. Neurologist Dr.Vinay Chauhan from Leelavati Hospital was contacted and patient was shifted to Leelavati Hospital under Dr.Chauhan’s care.” As far as above referred factual situation in notice reply is concerned, it finds corroboration from the material and hospital records and her clinical examinations from time to time related by the complainant. Dr.Garud in his notice reply also brought it to the notice of the complainant that Arochnoiditis is commonly caused by immunological hypersensitivity reaction to any procedure or chemical and the site of alcohol injection was far away from the major body nerves and spinal cord and, therefore, it appears like hypersensitivity reaction by complainant’s body to procedure/alcohol. The risk undergoing the procedure was already informed to the complainant and her consent was taken in writing for undergoing the procedure. In his affidavit of Dr.Alok Singh, supra, had opined that complainant had suffered from both lower limbs due to alcohol injection in spine given by Dr.Rajeev Garud and which is given negligently. For his such opinion absolutely there is no corroboration. He was engaged only for taking MRI and, therefore, he may be versed with the actual condition of the complainant as reflected from MRI. The cause therefore was not the subject matter of Dr.Alok Singhai. Furthermore, certainly he had no material before him to rush to the conclusion that the alcohol injection administered by O.P.no.2- Dr.Garud was administered negligently. It may be pertinent to note that nowhere Dr.Vinay Chavan who examined and given treatment to complainant at Lilavati Hospital at no place indicated that it was a negligence on part of the O.P.no.2-Dr.Garud to administer said injection. O.P.no.2- Dr.Garud is well experienced and qualified to undergo the procedure in question. He in his notice reply, supra, had already given possible reason for the present condition of the complainant, which is unfortunate but perhaps unavoidable. Expert committee of the doctors which was constituted on reference by the Commission, supra, gave the opinion to which a reference is made earlier since the present condition of the complainant is one of the possible complications to alcohol reaction. It cannot be considered as medical negligence as tried to be complained by the complainant vis-à-vis any deficiency in service on the part of O.P.no.2-Dr.Garud while administering alcohol injection into the spine. There is absolutely no iota of material to suggest any deficiency in service on the part of other O.Ps. Consequently, we find that it is not a case which should be admitted for further consideration. Hence the order:- ORDER Complaint stands rejected as not admitted. No order as to costs. Copies of the order be furnished to the parties. |
