DOF.11.7.2008 DOO.9.2 2011 IN THE CONSUMER DISPUTES REDRESSAL FORUM, KANNUR Present: Sri.K.Gopalan: President Smt.K.P.Preethakumari: Member Smt.M.D.Jessy : Member Dated this, the 9th day of February 2011 CC.162/2008 K.P.Sarala, Rajani Nivas, P.O.Kizhunna, Kannur Dist. Complainant (Rep. by Adv.T.V.Haridasan ) 1.Secretary, AKG Memorial Hospital, Talap, Kannur. (Rep. by Adv.V.Balan) 2.Dr.Prajual, AKG Memorial Hospital, Talap, Kannur. Opposite parties (Rep. by Adv.V.Balan) O R D E R Sri.K.Gopalan, President This is a complaint filed under sectin12 of consumer protection Act for an order directing the opposite parties to pay an amount of `1,00,000 as compensation with cost. The facts of the case of the complainant in brief are as follows:- The complainant approached the hospital of 1st opposite party on 26.3.08 due to an injury sustained on her left leg. 2nd opposite party attended the complainant and she was subject to undergo incision and drainage to the wound and discharged her on the same day advising to take medicine prescribed and to attend for review after 3 days. Complainant again came back on 28.3.08 with severe pain on the injury. 2nd opposite party attended the wound and prescribed medicine for 2 days asking him to attend again. Since pain and abscess increased she went to the hospital again and again on 3.3.08, 8.4.08, 12.4.08 15.4.08, 22.4.08 and 29.4.08. The 2nd opposite party attended the patient/complainant on all those days and assured the speedy recovery. But the pain and puss increased day by day. Finally complainant went to District Hospital, Kannur. From there antibiotics were administered and medicine prescribed for 7 days to reduce pain and abscess. Complainant went again on 14.5.08 and the surgeon advised surgery on 20.5.08. Accordingly she was admitted on 20.5.08 and operation was conducted. by which the foreign body ‘cotton’ that had been left behind by 2nd opposite party at the time of surgery was removed from the wound. Complainant was discharged on the same day. It is the negligence on the part of opposite parties that caused pain and sufferings to the complainant. Hence this complaint. Pursuant to the notice opposite parties entered appearance and filed version. 1st opposite party filed version in the form of counter statement. The brief fact of the version filed by the 1st opposite party is as follows:- Complainant came to AKG hospital with complaint of Cellulites with abscess on 25.3.08 She was examined and the wound was opened and cleaned. She was discharged on the same day with necessary prescription and instructions. She again visited on 3.4.08 as the surgical wound was not fully healed. When she finally came the wound had healed. The complication that had been arising subsequently is only due to the carelessness of the complainant. This opposite party does not know whether the complainant was taken to Govt. Hospital, Kannur. It is incorrect to say that the surgeon has taken out cotton from the wound of her leg. If there is any infection on the surgical wound it is only on account of the lack of hygiene and carelessness on the part of the complainant. Opposite parties 1 and 2 has no liability to compensate the complainant. Hence to dismiss the complaint. 2nd opposite party filed version separately. The brief facts of the version filed by 2nd opposite party are as follows: the complainant consulted the 2nd opposite party on 25.3.08 with complaint of pain and swelling of the sole of the left foot. Complainant gave a history of injury with iron nail penetrating the sole of the left foot months back, which she had removed by herself. She was on treatment of local physician for the same, but there was no relief of symptoms. On examination there was a swelling on the sole of the foot with pain and local tenderness suggestive of an abscess. The patient was advised to come to hospital the next day for admission and drainage of abscess. On 26.3.08 she was admitted. Incision and Drainage of pus was done on that day. The wound was explored but no foreign body was seen. The wound was left open to allow drainage of pus. And the patient was discharged on the same day since she was willing to come daily as an outpatient for cleaning and dressing. She was advised oral antibiotics. Patient came for review to the opposite party after 3 days as advised. On examination there was no evidence of any spreading infection except for a slight discharge from the wound. The patient requested that she would do the daily dressing from a local hospital and come for review to the second opposite party every third day. On subsequent reviews she was again advised daily dressing from the local hospital and antibiotics. The wound appeared to be healing well. When she came for review 12th, 15th and 22nd April she was not given any antibiotics, since there was no evidence of any infection. But when she came for review on 29.4.08 there was mild infection, for which she was given antibiotics for 4 days. She was also informed that if the infection persists, the wound would have to be re-explored after suitable investigations. The patient did not come for further review. According to complainant she went to District Hospital, Kannur which is not within the knowledge of this opposite party. But it is seen the surgeon at District Hospital had offered the same advice given by the 2nd opposite party. She consulted the surgeon on 7.5.08.Surgeon had then given her oral antibiotics for 7 days. On 14.5.08, surgeon had once again given her antibiotics for 5 days and advised exploration if there was no relief Exploration was done on 20.5.08., 13 days after the first consultation. The allegation that the surgeon at District Hospital removed the cotton that had been left behind is baseless and false. If the foreign body removed by the surgeon was a piece of cotton it proves that the second opposite party had not missed any foreign body during the surgery done by him on 26.3.08 at the 1st opposite party hospital. The wound was not sutured and hence there was no question of placing something inside the wound. This cotton piece could have been introduced subsequently during the dressing done at either the local hospital or by the patient himself. There is nothing to prove that it was the second opposite party itself, who had introduced the piece of cotton into the wound. Following the I &D adequate medication and daily dressing vast improvement was noticed by the 2nd opposite party during the subsequent reviews. It was only on 29.4.08 that there was again pain at the site. The complainant never met the 2nd opposite party after 29.4.08. This opposite party correctly diagnosed as a case of abscess. The requisite treatment in the form of incision and drainage was done. The wound was explored to rule out the presence of any foreign body. It was the patient who requested that to do dressing from a local hospital. Later on patient herself began doing the dressing at home. There is no negligence on the side of opposite party hence to dismiss the complaint. On the above pleadings the following issues have been taken for consideration. 1. Whether there is any deficiency on the part of opposite party? 2. Whether the complainant is entitled for the relief as prayed in the complaint? 3. Relief and cost. The evidence consists of oral evidence of PW1, PW2, and DW1 Exts. A1 to A7 and X1 case sheet. Issue Nos.1 to 3 Admittedly complainant approached the hospital of 1st opposite party on 25.3.08; and was examined by 2nd opposite party, doctor She was subject to undergone incision and drainage in her wound of her left leg on the same day of her admission. The complainant’s case is that due to the negligence of 2nd opposite party pain and pus increased on the site of wound. Though she attended many days for treatment pus formation continued to be increased and hence she went to District Hospital. The surgeon therein conducted operation and removed the foreign particle ‘cotton’ that had been left behind by 2nd opposite party doctor at the time of the surgery. The wound healed under the treatment of doctor in Govt. Hospital. The case of the opposite party on the other hand is that she was examined and then opened and cleaned her wound. No foreign body was found even after exploring the wound thus she was prescribed necessary medicine and discharged on the same date. Treatment continued only up to 29.4.08 though she was informed that the wound have to be re-explored after suitable investigation.She did not come afterwards.2nd opposite party doctor correctly diagnosed the case and given requisite treatment. Dressing from outside and by herself might have caused spreading of infection. There is no negligence on the part of opposite parties. It can be seen that the complainant was admitted on 26.3.08 and discharged on the same date as per Ext.A1 discharge summary. Ext.A1 also reveals that the case was provisionally diagnosed as case of abscess. Page 3 of Ext.A1 seen recorded as back history’ injury 2 months back’. Case paper reveals that the patient/complainant was admitted on 26.3.08 07:50:57 in Ward 347 GENERAL. In page No.4 of Ext.X1 also recorded history and ‘injury 2 months back–iron nail removed by patient’. Operation notes recorded abscess sole of (L) foot. That means opposite party doctor has provisionally diagnosed as a case of abscess. Operation note clearly noted ‘pus drained wound left open, no evidence of FB’. Graphic (TPR) chart shows that patient was normal. Thus the case proves that the patient/complainant admitted to opposite party’s hospital on 26.3.08 with complaint of cellulites with abscess and after examination incision and drainage was done. Since operation note recorded no evidence of FB it can be taken in to account that no foreign body could be find out by wound exploration. Anyway it is evident that exploration had been done by opposite party properly to rule out the existence of foreign body. It is the fact that complainant was under treatment of 2nd opposite party as outpatient. Evidence of opposite party confirmed the allegation of the complainant partly that the wound was not healed on the date of last visit of the complainant on 29.4.08. Admittedly there was miled infection and pain. The entry in Ext.A1 revels that he was prescribed antibiotics i.e. Last entry in Ext.A1 which makes clear that the contention of opposite party that the patient did inotturned up there after for further review is correct. Complainant’s case is that since pain and pus increased at the site of the wound she approached Dr.Sreenivasn in Govt. Hospital, Kannur on 7.5.08. From that day she was prescribed medicine for 7 days. She went again on 14.5.08, on that day she was advised to come on 20.5.08 i.e. One week thereafter for an operation again. Accordingly she was admitted on 20.5.08. Complainant pleaded that “AXp {]Im-cT 20-þ5-þ2008 Kh¬saâv Bip-]-{Xn-bn AUvanäv sNbvXp. Hm¸-td-j³ \S-¯n-b-Xn ap³]v F\n¡v cmT FXr-I£n Hm¸-td-j³ \S-¯nb kb¯v Imen-\p-f-fn \n¶pT \o¡T sN¿m³ _m¡n-h-¶n-cp¶ ]ªn-bpT aäpT FSp¯v amäp-I-bpT sNbvXp. FSp-¯p-am-än-bh Kh: Bip-]-{Xn-bnse kÀP³ lc-Pn-¡m-cnsb ImWn¨v Xcn-I-bpT lc-Pn-¡m-cnsb tF¸n-¡p-I-bpT sNbvXn-cp-¶p. Ext.A7 notice sent by the complainant dt.25.5.08 to opposite parties reveals her specific case that “BWn Xd-¨-Xn-t\m-sSm-¸-T D-mbncp¶ sNcp-¸nsâ Ij-W-§-fpT aäpT BZy Hm¸-td-j-\n tUmIvSÀ¡v Is-¯m³ km[n-¡m-¯-XvsIm-mWv tcmKT C{X-tb-sd-h-j-fm-b-Xv. But the pleadings in the complaint has not mentioned with respect to the piece of chappals. So also there is no mention about the piece of chappals in the complaint. She was specifically pleaded that ‘cotton’ that has been left behind by 2nd opposite party at the time of operation by 2nd opposite party was removed by the Doctor in Govt. Hospital, Kannur. In the cross examination she has deposed that “A¶v Iodn sNcp-¸nsâ Ij-WT apdn-hnÂ\n-¶pT At±-lT FSp-¯p-X-¶n-cp-¶p. The evidence adduced by her by way of affidavit states that “ A\-ym-b-¡mcn 20-þ5-þ2008 \p I®qÀ Kh: Bip-]-{Xn-bn t]mhp-I-bpT kÀP³ Imen\v hopT Hm¸-td-j³ \S-¯p-I-bpT sNbvX-Xn 2þ#mT FXr-I£n A\-ym-b-¡m-cn-bpsS Imen\v Hm¸-td-j³ \S-¯p¶ ka-bT 2þ#mT FXr-I-£n-bpsS A\m-Ø-Im-c-WT \o¡T sN¿m³ _m¡n-h-¶n-cp¶ ]ªn-bpT aäpT FSp-¯p-am-äp-I-bpT hopT dress sNbvXv discharge sN¿p-I-bpT Dmbn”.Both in complaint and affidavit she has stated that it was the cotton that was removed from the wound. But in cross examination and in Ext.A7, evidence, affidavit her case is entirely different changing material foreign body as piece of chappal , this inconsistency crates feel doubt for fixing deficiency in service on the part of 2nd opposite party. What has been stated by PW2 Doctor in chief examination is thus “I don’t remember the nature of the foreign body. He has also given an answer to another question that “ after conducting incision and drainage if the wound is not healed and the patient is walking by bare foot, there is a possibility of entering foreign body to the wound. So the possibility of subsequent entries of foreign body could not be ruled out. When there is contradictory version with respect to the foreign body removed from the wound, the allegation of the complainant against opposite party with respect to the foreign body is not at all sustainable. The evidence of PW2 goes to show that after incision and drainage doctor advised antibiotic, painkiller and ointment, it is right way of treatment. It can be seen that patient attend before 1st opposite party last on 29.4.08. She went to Govt. Hospital on 7.5.08. It is after more than one week. On the first day she was given only medicine. Treating doctor, PW2 deposed in cross examination that he also advised the same medicine Ceftas, which is a good antibiotic on her first visit. That means the doctor in Govt. hospital continued the same treatment that was advised by 2nd opposite party. He has also deposed that incision and drainage is an operation and the usual practice is to keep the wound open. In the absence of pleadings and evidence when the removal of suturs. It can be assumed that the wound had been kept opened. If that be so, the possibility of subsequent entrance of foreign object, cannot be ruled out since the wound kept open inconsistence version of complainant with respect to the material of foreign object and probability of subsequent entering of foreign body in to the wound, which remained kept open etc. does not allow to be concluded that the foreign body entered into the wound as a result of negligence of the opposite party, Doctor. The treating doctor of the Dist. Hospital, started treatment with the same medicine given by 2nd opposite party/ Doctor which confirms that in the usual course the treatment of 2nd opposite party was in right way. It can be seen that the patient/complainant met the Doctor in District Hospital on 14.5.08. She was asked to come on 20.5.08 i.e. 5 days after for operation. In other wards Doctor in govt. Hospital explored the wound and removed the foreign body only after a period of 20days of the last visit of the patient to 2nd opposite party. During this long gap there is nothing to show that any different treatment has been given to complainant by the govt. doctor. Moreover there is no evidence to show what is removed from the wound. PW2, the treating doctor was not able to say what exactly the material removed from her wound. The circumstances reveals that the date, PW2 examined the complainant there was no such a compelling situation to explore the wound then and there. She met PW2 on 7.5.08 he was not advised operation on that day. If that be so naturally the condition would have been much better 8 days before when she met 2nd opposite party on her last visit on 29.4.08. PW2 doctor took decision, even according to complainant to advise operation i.e. Incision and drainage only after 15 days of treatment of the same way as that of 2nd opposite party doctor. In this situation it is difficult to expect an advice of operation on 29.4.08 from those who attended the patient. Complainant could not succeeded to establish that the treatment of the 2nd opposite party has been went wrong in the usual course and thus caused aggravation of the surgical wound insisting operation. In the light of the above discussion we are of the view that complainant failed to prove that there is deficiency in service on the part of 2nd opposite party doctor. Hence issues 1 to 3 are found against complainant. In the result, the complaint is dismissed. No cost. Sd/- Sd/- Sd/- President Member Member APPENDIX Exhibits for the complainant A1.Discahrge summary issued by OP A2. Lab report A3. Case paper A4. Cash bills. A5. OP ticket issued from Dist. Hospital, Kannur. A6. Cash receipt issued from “ A7. Copy of the letter sent to 1st OP Exhibits for the opposite party: Nil Exhibits for the court X1.Case sheet of complainant maintained in 1st OP. Witness examined for the complainant PW1.Complainant PW2.Dr.Sreenivasan Witness examined for the opposite party: DW1.Vipin Chandran /forwarded by order/ Senior Superintendent Consumer Dispute Redressal Forum, Kannur.
| | [HONORABLE PREETHAKUMARI.K.P] Member[HONORABLE MR. GOPALAN.K] PRESIDENT[HONORABLE JESSY.M.D] Member | | 
