Karnataka

Kolar

CC/12/2014

Smt. H.B. Hemavathi, - Complainant(s)

Versus

Sri Devaraj Urs Academy of Higher Education & Research and R.L. Jalappa Hospital & Research Centre,& - Opp.Party(s)

K.Narendra Babu

25 Feb 2016

ORDER

Date of Filing: 06/02/2014

Date of Order: 25/02/2016

BEFORE THE KOLAR DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, D.C. OFFICE PREMISES, KOLAR.

 

Dated: 25^th DAY OF FEBRUARY 2016

PRESENT

SRI. N.B. KULKARNI, B.Sc., LLB,(Spl.)    …….    PRESIDENT

SRI. R. CHOWDAPPA, B.A., LLB               ……..    MEMBER

SMT. A.C. LALITHA, BAL., LLB         ……  MEMBER

CONSUMER COMPLAINT NO :: 12 OF 2014

Smt. H.B. Hemavathi,

W/o. Chandrappa,

Jayamangala Village,

Gollahalli Post,

Bangarpet Taluk.

                                 

(Rep. by Sriyuth. K. Narendra Babu, Advocate)          ….  Complainant.

 

- V/s -

(1) Sri. R.L. Jalappa, Chairman,

Sri Devaraj Urs Academy of Higher

Education & Research & R.L. Jalappa

Hospital & Research Centre,

Tamaka, Kolar.

 

(2) Sri.G.H.Nagaraj, Secretary,

Sri Devaraj Urs Academy of Higher

Education & Research & R.L. Jalappa

Hospital & Research Centre,

Tamaka, Kolar.

 

(3) Sri. Sriramulu, Medical Superintendent,

R.L. Jalappa Hospital & Research Centre,

Tamaka, Kolar.

 

(4) Dr. Deepa, Medical PG Student,

R.L. Jalappa Hospital & Research Centre,

Tamaka, Kolar.

 

(5) Dr. Ambarish, Doctor,

R.L. Jalappa Hospital & Research Centre,

Tamaka, Kolar.

 

(6) Dr. Arunkumar, Doctor,      

SNR Hospital, Kolar.

 

(7) Dr. Aravind,

R.L. Jalappa Hospital & Research Centre,

Tamaka, Kolar.

 

(OP Nos.1 to 7 are Represented by Sriyuths.

K.V. Shankarappa, & T.G. Byre Gowda,

& K.C. Prasad, Advocates)                                …. Opposite Parties.

-: ORDER:-

BY SMT. A.C. LALITHA, MEMBER

01.   The complainant having submitted this complaint on hand as envisaged Under Section 12 of the Consumer Protection Act, 1986 (hereinafter if necessary, referred in short as “the Act”) has sought, relief of Rs.7.30 Lakhs towards expenses spent for treatment of Sushmitha, compensation towards amputation of her left hand permanently – in total Rs.20,00,000/- (Twenty Lakhs) and any other relief as forum deems fit.

 

02.   The facts in brief:-

It is contention of the complainant that, she got admitted her daughter Sushmitha aged about 9 years at R.L. Jalappa Hospital at Kolar on 09.09.2013 as an in-patient for fever and convulsions.  And that Dr. Deepa (OP.4), Dr. Ambarish (OP.5), Dr.Arun (OP.6) and Dr.Aravind (OP-7) had given treatment since 8.00 AM to 12.00 noon. 

 

(a)    Further it is her contention that, Dr.Deepa (OP.4) being P.G. student instead of learning under guidance of Senior Doctors, in their absence she had treated Sushmitha voluntarily.

 

(b)    Further it is her contention that, the nursing staff, other medical staff of the said hospital have also treated Sushmitha without being guided by Senior qualified Doctor. 

 

(c)    Further she has contended that, the Medical staff, Medical students of R.L. Jalappa Hospital during their training period had given treatment to her daughter Sushmitha when she was in casualty ward, and to administer ½ DNS, they gave 13-15 times pricks by removing such pricks frequently.  And that, due to this in some places of left hand of her daughter blood veins got blocked.

 

(d)    Further she has contended that, students under training gave over dosage of medicines than required dosage to 15 kg weighing and of 9 years aged Sushmitha without giving sufficient intervals between each injection to her left hand.

 

(e)    Further she has contended that, the medical staff and students have given treatment of high dosage medicines by assuming it as epilepsy without investigating as for what reason convulsions appeared, for which the OP.1 to OP.3 had permitted them.

 

(f)     Further she has contended that, at 8.30 AM ½ DNS was given through IV as 16000 ML/24 Hrs, 16 macrodrops/(minutes), at 8.30 AM Inj. Phenytoin 500 mg, loading dosage given slowly through I.V. for 30 minits, Inj Phenobarbitone 500 mg loading dosage given through IV at 10.00 AM, Inj. Levipil loading dosage 500 mg given through IV then afterwards Inj. Phenytoin 60 Mg, Inj. Phenobarbitone 60 Mg, Inj. Levinil 1 G.M., Inj. Midaz, Inj Xone 1 G.M, Inj. Mannital 2 Ml/1kg given to Sushmitha. 

 

(g)    Further she has contended that, there was a direction to conduct tests of complete blood count, chest x-ray, serum electrolyte (sodium-potassium) urine routine and fits paplatial edema to diagnose these, referred for fundoscopy and that they had not done these two tests.  And that they did not check central nervous system (CNS) and weight of her said daughter.

 

(h)    Further she has contended that, within three hours of commencement of treatment left hand of her said daughter had turned black as well hard and that subsequently became cool.  And that when she brought this development to the notice of doctors, instead of giving any treatment they forcibly discharged and directed to go to Nimhan’s in Bangalore.

 

(i)     Further it is contended that, thus Ops committed offences punishable Under Sections 269, 284, 287, 320, 322, 324, 338, 491, 24, 25 and 107 of IPC. 

 

(j)     Further it is contended that, when they visited Nimhans in Bangalore, there they were directed to visit Indiragandhi Childrens Hospital and they were told by the said hospital doctors that, due to complete blockage of blood veins in left hand they were bound to visit Jain Hospital.  And that accordingly they approached Mahaveer Jain Hospital on 10.09.2013. 

 

(k)    Further it is contended that, the said Jain Hospital after thorough investigations diagnosed as “Left Hand Gangrenous and dis-colouration” and the soft tissue of venous was affected.  Accordingly, they conducted surgery and Left Elbow Amputation was done under arm and allowed it to dry and again conducted one more surgery for wound debridement and re-suturing of left forearm flap under arm.  And that thus the child Sushmitha underwent surgeries thrice. 

 

(l)     Further she has stated that, a legal notice came to be issued to the Ops on 19.11.2013.  And that the Ops in-spite of receipt of the same did not reply.

(m)   Further it is contended that, the said permanent disability resulted to her said daughter because of negligence and lethargic attitude of the Ops.  So contending, the complainant has come up with this complaint on hand to seek above set out reliefs.

 

03.   Along with the complaint the complainant has submitted Xerox copies of the following documents:-

(i)    Admission Record issued by R.L. Jalappa & Research Centre.

(ii)   Case History Sheet issued by R.L. Jalappa & Research Centre.

(iii)  Nurse Record issued by R.L. Jalappa & Research Centre.

(iv)   TPR Chart issued by R.L. Jalappa & Research Centre.

(v)    Bill Sheet along with the bills issued by R.L. Jalappa & Research Centre.

(vi)   Discharge Summary dated: 10.09.2013 issued by Nimhan’s Hospital, Bangalore along with the bills and reports.

(vii)  Out-patient Record dated: 10.09.2013 issued by Indira Gandhi Institute of Child Health South Hospital Complex, Bangalore, along with bills and reports.

(viii) Discharge Summary towards in-patient from 10.09.2013 to 21.09.2013 issued by Bhagwan Mahaveer Jain Hospital, Bangalore, along with reports and bills.

(ix)   Discharge summary towards in-patient from 09.10.2013 to 19.10.2013 issued by Bhagwan Mahaveer Jain Hospital, Bangalore, along with bills and reports.

(x)    Discharge summary towards in-patient from 21.02.2014 to 24.02.2014 issued by Bhagwan Mahaveer Jain Hospital, Bangalore, along with bills and reports.

(xi)   Memo dated: 06.01.2016 with regard to total expenditure incurred towards treatment of child Sushmitha.

 

04.   On registration of the case on the strength of the said complaint notices came to be issued to the Ops.  The said learned counsel has put in his appearance for these Ops and put in their written version through OP Nos.5 & 6 resisting the claim of the complainant in toto, whereas, Memo has been submitted by rest of the Ops adopting the same.

 

(a)    These OP.5 and OP.6 have denied various allegations leveled against them with regard to the contended negligence in treating the patient Sushmitha daughter of the complainant.

 

(b)    It is specifically pleaded that, the complainant got admitted her said daughter at their hospital on 09.09.2013 at 10.55 AM with complaint of fever and convulsions (Epilepsy).  And that she gave the history of the patient to the effect that, her said daughter had Epilepsy 5 years before and had taken treatment but no documents were produced in this regard.

 

(c)    Further it is contended that, the attenders of patient Sushmitha did not allow them to treat for required period and to conduct necessary tests.  And that thus they treated only for three hours, during which they gave the best treatment available in the said hospital.

 

(d)    Further it is contended that, Dr. Ambarish (OP.5), Dr. Arun (OP.6) treated the patient, Dr. Deepa (OP.4) and Dr. Aravind (OP.7) assisted them and thus due care was taken of this patient Sushmitha and also advised for further tests to know the cause for Epilepsy.  And that, but the uncle of this patient had forced them to discharge.  And that due to his pressure the patient was discharged on 09.09.2013 at 2.30 PM against the medical advice.

 

(e)    Further it is contended that, they have taken due care and gave the best treatment.  And that in-spite of this complainant has submitted the present false complaint.  And that the case-sheet would clearly indicate that there could be no negligence on their part.  So contending, dismissal of the complaint with exemplary costs has been sought.

 

05.   The very complainant got herself examined as PW.1 by preferring affidavit evidence and by even facing the cross-examination.  On behalf of the complainant Exhibits-P.1 to P.6 came to be marked.

 

06.   OP.5 Dr.Ambarish, OP.6 Dr. Arunkumar, OP.7 Dr.Aravind submitted their affidavit evidence, but only OP.5 Dr.Ambarish, OP.6 Dr. Arun Kumar faced cross-examination as DW.1 and DW.2.  Even after several opportunities given to OP.4 Dr. Deepa and Dr. Aravind OP.7 for cross-examination they have not appeared before this Forum.

 

07.   On 20.06.2014 the learned counsel appearing for the Ops has submitted the following document:-

(i)       The OPD Card with regard to patient Sushmitha.

 

08.   On 28.12.2015 the learned counsel appearing for complainant has submitted written arguments and on same day the learned counsel appearing for Ops has also submitted written arguments.

 

09.   On 21.01.2016 the learned counsel for complainant has submitted below mentioned nine citations:-

i)        AIR 1969 SC 128

ii)      AIR 1998 SC 1801

iii)     1995(6) SCC 651

iv)      2001(8) SCC 731

v)       AIR 1996 SC 2111

vi)      1998(4) SCC 39

vii)     AIR 1974 SC 890

viii)   2004 (8) SCC 56

ix)      AIR 2005 SC 3180

10.   On 15.02.2016 the learned counsel for Ops has submitted Memo with Medical literature pertaining to the line of treatments by way of Xerox copies.

 

11.   On 16.02.2016 heard the oral arguments as advanced by the learned counsel appearing for both sides.

 

12.   Therefore the points that do arise for our consideration in this case are:-

(a)  Whether OP Nos.1 to 7 are guilty of deficiency in service?

(b)  If so, to what compensation the complainant is entitled to? And who shall be liable to pay the same?

(c)  What order?

 

13.   Findings of this District Forum on the above stated points for the following reasons are:-

POINT 1:     In the Affirmative.

 

POINT 2:     The complainant is held entitled to Rs.4,64,000/- (Four Lakhs Sixty Four Thousand Rupees Only) towards expenses incurred and also sum of Rs.11,34,000/- (Eleven Lakhs Thirty Four Thousand Rupees Only) as compensation towards permanent partial disability incurred, in total Rs.15,98,000/- (Rupees Fifteen Lakhs, Ninety Eight Thousand Only) together with interest @ 9% per annum from 06.02.2014 being the date of the complaint till realization for being recovered exclusively from the OP.1.

 

POINT 3:     As per final order for the following:-

 

REASONS

POINTS 1 & 2:-

14.   To avoid repetition in reasonings and as these points do warrant common course of discussion, the same are taken up for consideration at a time.          

(i)     The learned counsel appearing for the Ops by placing reliance on medical literature with regard to line of treatment and principles enunciated in the said literature is to contend that at no time there was negligence on the part of OP.5 to 7 right from time of admission on 09.09.2013 at 8.00 AM till discharge up to 2.30 PM.  Further he mentioned that, the intervening treatments including amputation of left hand of patient Sushmitha was not due to the treatment given by OP.5 to 7.  And he contends that, the complainant got discharged her daughter against the medical advice.  And that, if she were to follow their advice, needful remedial measures could have been resorted-to.  And that failure on the part of the complainant should not be termed as deficiency in service on the part of the OP Nos.5 to 7 and hence on the part of the Ops.1 to 3. 

 

(ii)    In the first instance the said line of approach on the part of the learned counsel appearing for the Ops seems real, but a little probe in to the matter would indicate that, the contentions so raised are totally devoid of merits. 

 

(iii)   In the first instance let us concentrate on the very oral evidence of Dr. Arunkumar OP.6/DW.2 who was in-charge of PICU on 09.09.2013 from 9.00 AM till discharge of patient Sushmitha.  On going through the pleadings and evidence as maintained and adduced by this OP.6/DW.2, it is crystal clear that, the patient Sushmitha daughter of complainant had visited Ops hospital with complaints of fever and convulsions only and her left hand was good without any other complications.  (Reliance placed on cross-examination and pleadings and affidavit evidence of OP.6/DW.2).

(iv)   Dr. Arunkumar/OP.6/DW.2 has asseverated in Page-3 last Para continued in next page too of his cross-examination which is thus:-

“I also stated in my affidavit evidence that, complainant’s daughter is suffering from fever and convulsions (Epilepsy).  We have tested the patient for convulsion only, we tested compete hemogram, serum-sodium, serum-potassium and glucose, we have not taken the weight of the patient Sushmitha before administering the injections, we have tested patients complete blood count (CBC).  Also done chest X-ray of the patient.  It is true to suggest that we also done Fundoscopic test, we also tested central Nervous system.  When the convulsion patient comes on emergency treatment of injection like diazepaw, Midazolam, lorrezpaw through I.V. for epilepsy emergency drugs used to treat the patients namely phenobarbitone, phenetoin, sodium valporate, when this patient approached us we have given emergency drugs”.

 

(v)    Further even according to Dr. Ambarish OP.5/DW.1 has admitted in his affidavit evidence and in his cross-examination, that the patient Sushmitha had come with fever and convulsions and weight of the patient was not taken and also not done Central Nervous System that, within duration of his treatment to this patient from 8.00 AM to 9.00 AM on hand first and second line of treatment were given.  And also admits that the treatment given to this patient was for Epilepsy.

 

(vi)   It has been specifically pleaded by the complainant that, she got admitted her daughter Sushmitha to Ops Hospital on 09.09.2013 at 8.00 AM with the complaints of fever and convulsions and also she gave past history of this patient as she was treated for Epilepsy five years back, had taken anticonvulsants for 2 years and then stopped.  And there were no past documents as to what line of treatment was taken.

 

(vii)  This fact is very much in the knowledge of OP doctors.  (reliance placed in Exhibit P.1, Exhibit.P.2, admission record, out-patient record).

 

(viii) From the aforesaid discussion it is clear that, the patient Sushmitha while approached to Ops hospital only with fever and convulsions. The same fact is admitted by Dr. Ambarish and Dr. Arunkumar also as stated above.  It was bounden duty of OP.5 and OP.6 that, when an emergency patient came by doing preliminary investigations to confirm cause for convulsions, was it due to high fever or else previous disease Epilepsy had reoccurred?  Without doing any investigations as admitted by OP.5 and OP.6 and also no documents with regard to tests, simply by assuming as Epilepsy based on previous history given by her mother, given medicines of Epilepsy amounted to rashness.  Thus OP.5 and OP.6 were deficient in service.

 

(ix)   As per the principles enunciated in AIR 1969 SC 128 as relied by the learned counsel appearing for the complainant, reads thus:-

“The duties which a doctor owes to his patients are clear.  A person who holds himself out ready to give medical advice and treatment impliedly undertakes that he is possessed of skill and knowledge for the purpose.  Such a person when consulted by a patient owes him certain duties viz; a duty of care in deciding whether to undertake the case, a duty of care in deciding what treatment to give or a duty of care in the administration of that treatment.  A breach any of those duties gives a right of action for negligence to the patient”. 

                                                            

(x)    Further with regard to medicines given to the patient Sushmitha, is summarized as under:-

(Reliance placed on Nurse’s Record Exhibit-P.1)

 

On 09.09.2013           

At 8.00 AM- A female child got admitted in PICU with fever and convulsions.

At 8.05 AM- On admission child is not common convulsing/fever viz. checked/recorded viz. are temp: 100.6, Pulse-96, Res P-32

At 8.30 AM – Inj Phenytoin 500 Mg I.V. loading given as per Dr. Deepa’s order.

At 9.00 AM – Inj. Phenobarbitone 500 Mg I.V. loading given as per Deeps’s order.

At 10.00 AM – Inj. Levipil 500 Mg loading given as per Dr. Deepa’s order

 

Dr. Ambarish has asseverated in his cross-examination that “on 09.09.2013 by 8.00 AM patient Sushmitha had come to their hospital, he was on duty from previous night, same was concluded by 9.00 AM on 09.09.2013 and he had treated this patient for one hour only.  And he had administered to this patient Inj. Phenytoin 500 Mg loading dosage through IV for 30 minutes duration and then Inj. Phenobarbitone 500 Mg loading dosage for I.V. for 30 minutes and stopped as his duty time was over.

 

(xi)   Dr. Arunkumar has asseverated in cross-examination that, his duty began on 09.09.2013 at 9.00 Am and he had treated this patient from 9.00 AM to 2.00 PM.  He has given Inj. Diazepam, Phenytoin, and Phenobarbitone.  And he had not administered the Levipil injection (loading dosage)because as he asseverated in his Cross-examination it would be generally administered after the gap of 10 hours and hence not thus administered.  And even he had not administered Midaz Injection and Mannital injection.  So, by this it is clearly revealed that at 10.00 AM Inj. Levipil 500 Mg loading injection was given (Reliance Nurse’s record Exhibit -P.2 )

The Inj. Phenytoin and phenobarbitone was repeatedly given twice from 8.30 AM to 10.00 AM.

As per the principles enunciated in Para-10 of AIR 1998 SC 1801 : (1998) 2 SCR 428: as relied by the learned counsel appearing for the complainant reads thus:-

 

“Gross medical mistake will always result in a finding of negligence.  Use of wrong drug or wrong gas during the course of anesthetic will frequently lead to the imposition of liability and in same situations even the principle of Res ipsa loquitur can be applied.  Even delegation of responsibility to another may amount to negligence in certain circumstances.  A consultant could be negligent where he delegates the responsibility of his junior with the knowledge that the junior was incapable of performing the junior was incapable of performing of his duties properly.”

 

(xii)  So, in the instant case by allowing PG student Dr. Deepa OP.4 in PICU to give Injection Levipil without any reference of Dr. Arunkumar/OP.6 as he admitted.  Thus Dr. Arunkumar/OP.6 was negligent in his service.

 

It has been specifically pleaded by the complainant that, within 3 hours from the commencement of treatment her daughter Sushmitha had irritations in her left hand subsequently it turned black and hard and became cool.

Dr. Arunkumar/OP.6/Dw.2 in his cross-examination has asseverated the relevant portion which reads thus,

“He administered Xone Injection through IV (Intra Veins) I am observing the patient when I was on duty.  We have not observed when the patients hand becoming black in colour or regarding discolouring of the left hand.  It is true to suggest that, after administering the injections to this patient Sushmitha, after three hours irritation was found in the left-hand and same was recorded in the history of examination.  At the time of discharge I noticed the left hand of Sushmitha was cold and discoloured.  We have given first-Aid on noticing the hand in question was discoloured and thereby instructed to subordinates to remove the IV canula.  We have also provided symptomatic treatment to remove coldness of the hand, we will take all precautionary methods to avoid reactions to the treatment under emergency condition.  At the time of admitting her hand was alright.  We have put IV canula to the right hand of Sushmitha to give Inj. And as a precautionary measure we have supplied oxygen and glycerin.”

 

(xiii) With this it is clear that, left hand of Sushmitha was affected only after repeated loading injections through intra veins between 8.00 AM to 10.00 AM.  As per say of Dr. Arunkumar/OP.6, as a first-aid we removed IV Canula and supplied oxygen it reveals that blood veins in her left hand were blocked thus it led to the further complications.  Thus cause occurred here at Ops hospital for amputation of left-hand of Sushmitha.

 

(xiv)  The Ops contend that, the pressure came from the side of the complainant and uncle of patient for discharge and hence being helpless they discharged the patient and as orally submitted by Ops counsel that, the signature in admission card and discharge consent one and the same and hence being helpless they discharged the patient.  It cannot be believed.  When these Ops from 8.00 AM to 10.00 AM while treating in PICU the complainant and another had stayed out of PICU and remained silent, how come with-in, a fraction of minutes the situation turned opposite?  Theory of complainant and uncle of Sushmitha pressurizing and signature of her uncle in discharge consent form, even we doubt this document the contended consent for discharge. 

 

(xv)   Who was uncle by particular name, who brought pressure to get discharge, ought to have been recorded in detail and a document ought to have been brought out in this context.  Failure to do so, points out utter irresponsibility, hence negligence on the part of Ops.

 

(xvi)  There is overwriting in the “X” mark and also same differs from the signature in admission card by first look itself.  Thus it would compel us to come to the conclusion that, this consent was a mechanical process, with ulterior purpose on the part of Op Nos. 4 to 7 to save themselves.

 

(xvii) Exhibit-P.1 admission card issued by hospital of the Ops indicating that, on 09.09.2013 at 10.55 AM this patient Sushmitha was admitted as in-patient, Page-3 being a continuation sheet discloses examination commenced at 10.00 AM, back page of continuation sheet would disclose that, the discussion with regard to treatment had taken place by 12.05 AM (In the fitness of things to be taken read as 12.05 PM).  Whereas further continuation sheet No.5 disclose that, case was discussed at 10.00 AM.  This would indicate that, the records were maintained unmindfully and at any rate such records were not in cronological order.  Why because, if the entry in continuation sheet No.5 were to disclose discussion time as 10.00 AM back page entry of sheet No.4 should be earlier to 10.00 AM.  Whereas it is 12.05 PM. 

 

(xviii)        Admission card sheet No.1 discloses that, the patient was admitted at 10.55 Am if it were so, how come entry in continuation sheet No.6 disclose that, discussion had taken place at 10.00 AM much-much before admission?

 

(xix) Furthermore records maintained by the Nurses attached to this hospital of the Ops are to disclose that, treatment had already commenced by 8.00 AM.  If the admission could be 10.55 AM how come that the treatment had commenced at 8.00 AM even earlier to the admission?  This indicates that the treatment had commenced without any qualified doctors attending on the patient.

 

(xx)  This discloses poor maintaining of medical records possibly because these OP doctors were in a hurry to impose discharge of this patient.  Moreover we repeat as per the principles enunciated in “AIR 1969 SC 128”, on getting this patient admitted these OP doctors invited the duty of the care in deciding whether to undertake the case and further duty to decide what should be the treatment and further duty to take care while administering the prescribed treatment.  These OP doctors very soon after admitting the patient lacked in their said duties in as much as in the midway they imposed discharge of the patient trying to give colour of discharge against medical advice.  This, we find that was the severely dereliction in duty of these OP doctors.

 

(xxi) On the very same day i.e., 09.09.2013 at around 6.30 PM complainant took her daughter Sushmitha to Nimhans Hospital at Bangalore.  There they had done Head CT Scan and all other preliminary investigations including Central Nervous system (CNS) which was very much in order.  And diagnosed as [L] UL Edema /redness, and immediately referred to Indira Gandhi Institute of Child Health, Bangalore-29, along with referral letter stating, it is emergency case of “[L] UL Edema/redness, severe pain over entire limb.  (Reliance on Discharge Summary of Nimhans dated: 10.09.2013).

 

(xxii) Accordingly on 10.09.2013 at 9.09 AM the child Sushmitha was shifted to Indira Gandhi Institute of Child Health, Bangalore.  There, the child was examined thoroughly and that the findings of the said doctors, which is thus:-

In the column of Examination findings:-

“K/C/o seizure disorder – recent convulsion three days ago ; IV Antiepileptics given following which “[L], UL-edema/redness, C/o. severe pain over entire limb.

In the column, Diagnosis:

[L], Upper Limb:- “Discoloured up to mid arm, swollen areas of purplish discoloured skin cold in finger tips, brancheal pulse not felt. 

Thus referred for Doppler test to confirm as, “Acute Vascular insufficiency to [L], UL? Arterial Thrombosis and diagnosed as,

“Axillary artery partial blood flow”

“Branchial artery no blood flow”.

Immediately referred to Mahaveer Jain Hospital, Bangalore, as an urgent need for vascular surgery. (Reliance on out-patient record of Indira Gandhi Institute of Child Health, Bangalore, dated: 10.09.2013).

 

(xxiii)       Accordingly on the very same day i.e. 10.09.2013 at 12.14 PM the child Sushmitha was admitted at Mahaveer Jain Hospital as an in-patient after thorough investigations diagnosed as “Left hand gangrenous with discolouration extending up to distal ¼ of arm” and after necessary investigations and also by taking opinion of Hand Surgeon, Neurologist (specifically with regard to GTCS) they planned for salvage of elbow and waited till it demarcates and then on 09.10.2013 Left elbow amputation was done under GA and on 11.10.2013 was done wound debridement + abdominal flap cover – Biceps Tendon Transfer under GA and on 16.10.2013 re-suturing of left forearm flap under GA, on 19.10.2013 the child was discharged, and adviced for follow-up surgery.  Again on 21.02.2014 the child admitted at Jain Hospital for follow-up surgery after relevant investigations were done and patient underwent Flap division and inset of left abdominal flap under GA and discharged on 24.02.2014 in a stable condition.

 

(xxiv)        During the course of treatment in Nimhan’s, Bangalore, and in Indira Gandhi Institute of Child Health, Bangalore, and in Mahaveer Jain Hospital, Bangalore, no where the said contended pleading of pre-ailment Epilepsy of the said child was the cause for “Left Upper Limb acute Ischemia” and in all the way of said hospitals investigations in CNS (Central Nervous System) and report revealed that the patient was conscious and no vomiting, which was the very essential preliminary test where the OP doctors failed to do and there by showed negligence and deficient in service.

 

(xxv) It should not be that, “remedy is worse than the malady”.   For, left hand, forearm and arm thus left upper limb of this patient was totally in healthy condition at the time of admission in the hospital run by the Ops.  It became a fact that the left upper limb/left hand forearms and arm became critical when this patient was forced to quit hospital of these Ops which aspect has been seriously taken note of by the hospital authority at Nimhan’s Indiragandhi Hospital and Mahaveer Jain Hospital, Bangalore.

 

(xxvi)        Rest of the citations relied by the learned counsel for complainant since not applicable to the facts of case on hand the same are not necessary for taking in to consideration.

(xxvii)       Thus the Ops without doing any proper diagnosis, since proceeded to administer drugs that resulted in adverse reaction and improper administration of IV canula affected soft tissue and blocked intra venous thrombosis leading to edema and thus ultimately resulted in amputation of her left hand.  And also when things got worsened, the OP.5 Dr. Ambarish and OP.6 Dr. Arunkumar instead of giving further treatment forcibly discharged and thus negligent and deficient in service.

 

(xxviii)      The bills of pharmacy, scan bills, x-ray and other tests and towards surgery and all other medical bills spent towards treatment of Sushmitha in all aforesaid hospitals altogether disclose that, the complainant had spent Rs.4,64,914/-.  Thus the total amount spent as above, which amount complainant is entitled to recover.

 

(xxix)        Now, we are bound to assess the compensation with regard to the child Sushmitha’s medical treatment, including medical expenses and the disability suffered permanently though partially.  So, the complainant is entitled to compensation on the following counts:-

i) For pain and sufferings

ii) For medical and incidental expenses

iii) For loss of amenities and

iv) For loss of partial permanent earning capacity in future.

 

i) For pain and sufferings:-

Discharge summary of Nimhans, out-patient record of Indira Gandhi Child Health Care, Bangalore, and Discharge summary of Mahveer Jain Hospital, Bangalore, disclose that this child Sushmitha suffered following pains:-

1. Left hand swollen, severe pain over entire limb, cold in finger tips.

Therefore, under this head for the pain she suffered, we have awarded compensation of Rs.30,000/-.

 

ii) For medical expenses:-

        Medical bills, the expenditure made for medical treatment throughout all the four hospitals would come to Rs.4,63,914/-.  The same is taken to the round figure of Rs.4,64,000/-.  Besides we are bound to award compensation for the expenditure made with regard to one attendant on her and in this context sum of Rs.40,000/- has been awarded.

 

iii) For Loss of Amenities:-

        For the reasons noted above, the child Sushmitha cannot make use of her left hand permanently and thus she has been handicapped.  She is to suffer anguish throughout her life.  Besides she is bound to develop adaptability.  Moreover dependability is forced on her.  Hence under this head compensation of Rs.2,00,000/- has been awarded.

 

iv)    For loss of partial permanent earning capacity in future:-

        Now that the said victim Sushmitha is of tender age and pursuing her education the earnings on her part might not rise right now.  However when she would be quite adult to start her earnings, this partial physical permanent impairment would come in her way and by placing reliance on the schedule – under the provisions of workmen compensation Act – 1923 (as amended Act No.46 of 2000) we are reckoned that the percentage of the disability would be 80%.

        In these hard days a house wife confined to domestic activities could be deemed as earning Rs.6,000/- per month.  Therefore, following shall be the equation looking to the age of this victim the multiplier shall be 15 to work out loss in future earning capacity though partially

Rs.6,000/- x 12 x 15 = Rs.10,80,000/-

80% of the same would come to Rs.8,64,000/-.  Thus this victim is entitled to total compensation of Rs.15,97,914/- and the same is taken to the next round figure of Rs.15,98,000/- (followed the principles enunciated in 2009 ACJ 1298 at Para-25).

 

(xxx) Now we are bound to fix the liability.  Indisputably OP.5 and OP.6 were employed as doctors, and OP.4 and OP.7 were PG students, in the medical institution run by the OP.1.  And OP.2 and Op.3 are part and parcel of Op.1 institution.  Indisputably for the negligence and hence deficiency in service on the part of the OP Nos. 2 to 7 the OP.1 is bound to be held as exclusively accountable to the said compensation together with interest as noted above.

 

POINT 3:-

15.   We proceed to pass the following:-

ORDER

01.   For foregoing reasons, the complaint stands allowed with costs of Rs.5,000/-(Rupees Five Thousand Only) as hereunder:-

                        

(a)    The complainant is held entitled to total compensation of Rs.15,98,000/- (Rupees Fifteen Lakhs Ninety Eight Thousand Only) together with interest at the rate of 9% per annum from 06.02.2014 being the date of complaint till realization for being recovered from the OP.1.  And same shall be deposited in this Forum Only. 

 

(b)    We grant 30 days time to OP.1 to comply the order from the date of communication of it.

                             

(d)    The complainant being mother of the victim on receipt of the said sum is held entitled to receive Rs.3,98,000/- (Rupees Three Lakhs Ninety Eight Thousand Only) together with the entire interest amount in cash whereas “Rs.12,00,000/- (Rupees Twelve Lakhs)” shall stand deposited in the name of the said victim Sushmitha through the next friend Smt. H.D. Hemavathi being the mother/complainant by way of FD till three years even after this victim to attain majority, in any one of the Nationalized or scheduled bank within limits of Bangarpet Taluk or in Kolar and hence within jurisdiction of this Forum.  And this office shall attend the needful in making the said FD.

 

(e)    During minority of the said victim the said next friend is entitled to realize the admissible periodical interest.  And thereafter the very said victim shall be entitled to realize such interest.

 

(02)  Send a copy of this order to both parties free of costs.

(Dictated to the Stenographer in the Open Forum, transcribed by him, corrected and then pronounced by us on this 25^th DAY OF FEBRUARY 2016)

 

 

 

 

MEMBER                          MEMBER                       PRESIDENT