Karnataka

Bangalore 4th Additional

CC/13/2041

Sri. Rajendran S/o. Late Krishnan Aged about 54 years - Complainant(s)

Versus

St, John's Medical College Hospital - Opp.Party(s)

Mr. M. U. Poonacha

30 Dec 2019

ORDER

Complaint Filed on:03.10.2013

Disposed On:30.12.2019

                                                                              

BEFORE THE IV ADDL DISTRICT CONSUMER DISPUTES REDRESSAL FORUM BENGALURU

1^ST FLOOR, BMTC, B-BLOCK, TTMC BUILDING, K.H ROAD, SHANTHINAGAR, BENGALURU – 560 027.

 

 

   30^th DAY OF DECEMBER 2019

 

PRESENT

SMT.PRATHIBHA. R.K., BAL, LLM - PRESIDENT

SMT.N.R.ROOPA, B.A., LLB, MEMBER

                          

                      

Complaint  No.2041/2013

 

 

 

COMPLAINANT	Sri.Rajendran, S/o Late Krishnan, Aged 54 years, R/at No.1/305-12 Krillam, Kotakondappali Post, Hosur Taluk – 635109, Krishnagiri District, Tamilnadu.   Advocate – Sri.M.U Poonacha.       V/s
OPPOSITE PARty	St. John’s Medical College Hospital, Department of Endocrinology, Bangalore – 560 034. Represented by the Administrator.   Advocate – Sri.Ganapathi Hegde.

                                       

 

O R D E R

 

SMT.PRATHIBHA. R.K., PRESIDENT

 

This complaint is filed by the complainant against the Opposite Party (herein after called as OP) under section 12 of the Consumer Protection Act, 1986.  The complainant prays to direct the OP to a sum of Rs.20,00,000/- together with Rs.1,00,000/- towards damages, costs and interest thereon @ 18% p.a and grant such other reliefs.

 

2.      The brief facts of complaint is as under:

 

Complainant submitted that he is an Ex-service man presently working as a operator in TVS Motor Company Ltd., during June 2011.  The complainant had neck pain and as a result of the same he was referred to OP hospital by the company in which he is working.  The said company has got tie up with OP hospital as per the welfare scheme.  The TVS Company pays the medical expenses to the OP hospital on behalf of the employees.  Hence the TVS Company is not relying on a insurance scheme for any reimbursement.

 

Complainant submitted that he was admitted to OP hospital on 17.06.2011 with regard to the treatment of neck pain for internal fixation of screws (titanium implants) by Dr.Manmeet and the complainant was discharged on 29.06.2011.  That subsequent to the discharge from the hospital on 29.06.2011 the condition of the complainant did not show any improvement and as a result of the same he was advised to undergo MRI scanning procedure on 19.09.2011 and the said scanning report reveal that there is no improvement in the condition of the complainant and infact the report indicated that the condition remained the same without any improvement.

 

Complainant further submitted that in view of the fact that there was no improvement in the condition of the complainant even after the treatment under gone with the OP Hospital.  During his stay from 17.06.2011 to 29.06.2011 he was once again advised to get admitted to the OP Hospital on 05.10.2011 and he was diagnosed with “Operated C-5-6 Stabilization with post of C-5-6 right Disc ostephytic compression of roots, right eye, orbital compartment syndrome with CRAO, Hypertension”.  During this time the complainant has undergone C-5-6, right Laminoforaminotomy partial medial facetectomy and excision of posterior ostophyte by Dr.A.K Chand on 10.10.2011, right lateral canthotomy with cantholysis under GA by Dr.Manju on 12.10.2011.

 

Complainant further submitted that once again he was admitted to OP Hospital on 08.11.2011 and discharged on 15.11.2011.  That subsequently MRI scanning was done on 13.02.2012.  The said MRI scanning was done in Command Hospital (AIR Force) Bangalore and the same reveal as follows:

 

Cervical lordosis is maintained.

 

Anterior metallic plate fixation is noted at C5-6 level with presence of magnetic susceptibility artefacts.

 

Disc dessication is seen at all cervical levels.

 

At C3-4 level: There is diffuse disc bulge causing anterior tehecal sac indentation.  No existing nerve root compression.  The anteroposterior diameter of spinal canal at this level is 8.8 mm.

 

At C4-5 level: There is posterocentral protrusion causing anterior thecal sac indentation.  No existing nerve root compression.  The anteroposterior diameter of spinal canal at this level is 9.3 mm.

 

At c5 vertebra, C5-6 IV disc and C6 vertebra: There is disc osteophyte complex noted to the right side causing stretching of PLL and causing cord indentation with focal cord myelomalacia.  There is left neural foramina narrowing seen.  No exiting nerve root compression. 

 

The facet joints are normal.

 

The cervical cord appears normal in size and signal characteristics.

 

The paravertebral soft tissues appear normal.

 

The cranio-cervical junction appears normal.

 

Complainant further submitted that the doctors at Command Hospital, Bangalore have given a finding that the condition of the complainant had detiorated inspite of the treatment at the OP hospital.  Hence, it is clear that there is medical negligence on the part of the doctor at the OP hospital.  Infact, the complainant has undergone 5 operations and one eye surgery.  That inspite of the medical procedure done at OP hospital.  There was a cascading effect on the health of the complainant in as much as the vision in the right eye of the complainant is lost by 100%.  This has occurred because of the operations conducted by the OP hospital.

 

Complainant further submitted that he is unable to grip his right wrist and finders and the gait of the right leg is also affected and he is not able to walk normally as he was doing prior to the operations conducted by the OP hospital.  The complainant further submits that on account of the medical negligence on the part of the OP hospital, the vision of the right eye of the complainant is affected on account of the defective surgeries carried out by the OP hospital.  The medical assessment made by Manipal Hospital clearly reveals that the vision in the left eye is also affected.  The said sequence of events clearly establishes the fact that the two surgeries carried out at the OP hospital has worsened the condition of the complainant and the same is due to the medical negligence on the part of the doctors at the OP hospital and as such there is deficiency of service on the part of the doctors at the OP hospital.

 

Complainant further submitted that after discharge from the OP hospital he has undergone treatment at Military Command hospital, Bangalore, Manipal Hospital and also Agarwal Hospital.  But the doctors who treated the complainant subsequently have informed the complainant that in view of the defective surgeries carried out at the OP hospital, the complainant is also likely to lose the vision of the left eye as well.  The medical records pertaining to Command Hospital, Bangalore, Manipal Hospital, Bangalore and Agarwal hospital, Bangalore are produced along with this complaint along with a separate list of documents.  On the last occasion the complainant was admitted to Command Hospital on 06.05.2013 and discharged on 13.05.2013.

 

The complainant further submitted that the OP has repudiated the claim in a arbitrary fashion and the reason stated in the repudiation letter dated 19.04.2012 are hyper technical and untenable grounds.  Hence, there is deficiency of service on the part of the OP in repudiating the claim in question.  It is needless to say that the OP is due and liable to pay the claim amount as per the terms and conditions of the policy.  That on account of the complications created as a result of the operations conducted by the doctors at the OP Hospital, the complainant is on long leave from 2011 to 2013.  On loss of pay and the OP is liable to make good the said loss.  The complainant further submits that the wrong treatment given by the doctors at the OP Hospital the blood sugar level of the complainant has increased resulting in further complications.  There is deficiency of service of the doctors at the OP hospital and as such the complainant has entitled to claim damages.  Hence complainant approached this Forum for seeking reliefs.

 

3. In response to the notice issued, OP appeared through their advocate and filed their version in brief as under:

 

OP submitted that the complainant is a 52 years old man visited the OP hospital on 17.06.2011 with a complaint of neck pain for 15 days and sudden onset of pain while working, associated with radicular pain in the right upper limp in C6 distribution.  He had a history of hypertension and had been undergoing treatment for the same.  The complainant was diagnosed with C5-6 Intervertebral Disc Prolapse (IVDP) with right C6 radiculopathy and admitted under the neurosurgery team at the OP hospital.  In view of his condition, the complainant was advised surgery.  After thorough counselling about the nature and details of the surgery and possible complications, the complainant gave consent in writing for the surgery.  On 20.06.2011, the complainant underwent standard anterior cervical C5-C-6 discectomy with bony fusion and stabilization from C5 to C6 using Anterior Cervical Plate and Screws (titanium implants)

 

OP further submitted that, post operation, the complainant noticed complete relief of right upper limb radicular pain.  The complainant was discharged from the OP hospital on 29.06.2011 with advice on medication and follow up.  On 16.07.2011, during follow up the complainant complained of recurrence of pain in the right side of the neck.  The complainant was immediately evaluated with an X-Ray which revealed that the implants and the screws fixed in the complainant’s spine by way of the first surgery were in the correct position and in proper alignment.  The complainant was prescribed appropriate medicines and advised further evaluation with CT/MRI scan in the event that he is not relieved of the pain with medicines.  On 19.09.2011 the complainant again visited the OP hospital with the complaint of pain in the neck.  As planned earlier, the condition of the complainant was evaluated by way of MRI and CT scan.  The CT scan dated 09.10.2011 of the spine revealed right sided posterior osteophyte (growth of bony spur) at lateral C5-C6 level which was causing root compression.  This osteophyte (bony spur) is a result of healing process during bone fusion.  The CT scan also showed that the titanium implants were normal in position and alignment.  The doctors treating the complainant planned to decompress the root using the posterior approach (prone position), since it was the shortest trajectory approach to the bony spur which was causing the root compression.  The risks and benefits of the second surgery were also discussed with the complainant and after obtaining informed consent from him in writing.  On 10.10.2011, the doctors of the OP Hospital performed C5-6 right laminoforaminotomy, partial medial facetectomy and excision of posterior osteophyte.

 

OP further submitted that in the immediate post-operative period, the complainant complained of swelling and complete blindness in his right eye and freezing of extra ocular movement.  The complainant was immediately attended to by the Ophthalmologists in the OP hospital.  Urgent CT/MRI scans were done.  The complainant was also examined by the ENT department which conducted an emergency endoscopy and nasal endoscopic examination was found to be normal.  On 12.10.2011 the complainant underwent lateral canthotomy with cantholysis as a palliative procedure.  This procedure was also performed with the written and informed consent of the complainant’s attendant.  The surgery was performed after duly explaining to the complainant’s attendant, the poor prognosis of vision in the right eye.  It was explained that the vision in the right eye will not improve and that the procedure was being performed to decrease intra-ocular pressure.  The complainant was evaluated through a Vision Evoked Potential (VEP) Test which was found to be normal for the left eye.  Thereafter also, throughout the stay of the complainant in the OP hospital and even during follow up on 01.12.2011, the vision recorded in his left eye was normal.  At the time of discharge from the OP hospital on 26.10.2011, the complainant had 80% relief in radicular pain with no fresh motor deficits and his power (grade 5/5) in all the four limbs was found to be normal.

 

OP further submitted that the complainant once again visited the OP hospital on 08.11.2011 with complaints of pain in the neck, high intermittent fever since one month, dysuria, vomiting sensation and poor vision in the right eye.  Upon examination and various pathological tests, the complainant was diagnosed with type 2 diabetes.  An MRI scan of the spine again confirmed that the titanium implants were in place.  The complainant was given appropriate treatment and his condition improved gradually.  He was discharged from the OP hospital on 15.11.2011.  The complainant presented himself for follow up in the OPD of the OP Hospital on 30.11.2011 and 02.08.2012 during which he reported complete relief from radicular pain of the right upper limb.

 

OP further submitted that the mode of treatment of the complainant adopted by the doctors of the OP hospital is in line with well established medical procedures and practice.  The doctors who treated the complainant are highly skilled and experienced specialists who have performed several such and more complicated spinal surgeries.  Dr.Ashis K. Chand (MBBS; MS (Gen Surgery); M.Ch. (Neurosurgery) is the Professor and Head of the Department of Neuro and Spine Surgery at the OP Hospital.  He has been performing brain and spine surgeries since 1995 after obtaining specialized training from Germany.  He has performed approximately 2500 cervical spine surgeries till date.  Dr.Manmeet Chhabra (MBBS; MS (Gen Surgery); M.Ch. (Neurosurgery) is Associate Professor in Neuro and Spine Surgery at the OP hospital.  He has more than 500 cervical spine surgeries to his credit.  There has been no negligence or deficiency in the care and treatment of the complainant.  All investigations, surgical procedures, pre and post-operative care were done with due diligence and skill and in strict compliance of accepted practices and hospital protocol.  The loss of vision in the right eye of the complainant is a rate and well-documented complication arising out of surgeries in the prone position, especially spinal surgeries.  Such occurrences are not attributable to negligence by doctors treating the patient.  There is no deficiency of service on the part OP.  Rest of the allegations made by the complainant is denied by OP.  Hence OP prayed for dismissal of the complaint with costs.

 

4. In the course of enquiry into the complaint, the complainant and the OP have filed their affidavit reproducing what they have stated in their respective complaint and objections.  Complainant and OP has submitted written arguments.  Complainant and OP have produced certain documents.  We have heard the arguments of complainant and OP and we have gone through the oral and documentary evidence of both parties scrupulously and posted the case for order.

 

5. Based on the above materials, the following points arise for our consideration;

 

1. Whether the complainant has proved that there is deficiency in service on the part of the OP, if so, whether he is entitled for the relief sought for?

 

 

2. What order?

 

6. Our findings on the above points are as under:

 

Point No.1:  Negative

Point No.2:  As per the order below

 

REASONS

 

 

7. Point No.1:  The case of the complainant that, the complainant was admitted to OP hospital on 17.06.2011 for treatment of neck pain for internal fixation of screws and surgery and discharged on 27.06.2011.  The complainant alleged that he did not get any relief inspite of the said operation and he was again advised to admit to the hospital.  The complainant was again admitted to the hospital on 05.10.2011.  During his stay in the said hospital he underwent surgery on 10.10.2011. 

 

8. It was alleged that after the surgery there was total loss of vision on the right eye and blurring of vision of the left eye and also the walking gait of the complainant was not proper.  The complainant’s condition deteriorated and was also advised to get admitted to OP hospital on 08.11.2011.  The complainant was admitted to the OP hospital on 08.11.2011 & discharged on 15.11.2011.  After that the complainant developed Type 2 Diabetes and the condition of the complainant deteriorated completely and the doctors of the OP hospital were not in a position to give relief to the complainant.  Hence with no other option, the complainant approached the Military Command hospital for further treatment and also approached Manipal Hospital and also Agarwal Eye Hospital, Bangalore for which the complainant incurred huge expenses but the complainant did not show any improvement and complainant was not able to discharge his duties as a Senior Operator in his company due to the negligence of the OP hospital.

 

9. Per contra the OP submitted that the doctors who treated the complainant are highly skilled and experienced specialists.  The OPs have taken pre & post operative care and all investigation and surgical procedures were done with due diligence and skill.  Hence there is no negligence and deficiency in service.  Further the complainant has not led any expert evidence to prove negligence on the part of OPs.

 

          10. Admittedly the complainant was admitted to OP hospital twice after the surgery of standard anterior (front) cervical C5-C6 discectomy with bony fusion and stabilization from C5 to C6 using Anterior Cervical Plate and Screws (titanium implants).  As per the OP the said surgery which was undergone by the complainant is complicated.  Before surgery the OPs have explained the nature and details of surgery and possible complication.  Complainant gave a consent in writing for surgery then the OP hospital had done the surgery.  On careful reading of the reports the OPs have advised two months complete rest and also advised follow-up treatment, scanning and X-rays.  OPs have done their duty utmost care and caution.  Further on perusal of the report nowhere in the report it is mentioned due to defective surgery carried out by the OPs hospital doctors the complainant loss his right eye vision and walking gait of the complainant also affected.  Further the complainant has not produced any second opinion by any independent doctor with regard to the defective surgery done by the OP hospital.  In absence of any medical report given by independent doctor we cannot go into the intricacies of the mode of treatment given by the OPs.  Further the complainant has not given the complaint against the doctors before the Karnataka Medical Council.  Karnataka Medical Council is a statutory authority coupled with the power to investigate and give a report with regard to medical negligence.  Therefore in the absence of any such report, this Forum cannot accept the contention of the complainant.  So looking at the material evidence of both parties, we are of the considered opinion that, the oral and documentary evidence of OP is more trustworthy.  The complainant seek relief on the ground of medical negligence has miserably failed to prove the medical negligence of OPs by placing the convincing evidence.  Accordingly we answer the point No.1 in the negative.

 

11. Point No.2: In the result, for the foregoing reasons, we proceed to pass the following order:          

 

 

                 

  O R D E R

 

 

The complaint filed by the complainant is dismissed.  No order as to costs.

         

 Supply free copy of this order to both the parties.

   

(Dictated to the Stenographer, transcribed and typed by him, corrected and then pronounced by us in the Open Forum on this, the 30^th day of December 2019)

 

 

 

 

(ROOPA N.R)                                             (PRATHIBHA R.K)

   MEMBER                                                     PRESIDENT

 

                         
             

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

                      

Witnesses examined on behalf of the complainant by way of affidavit:

 

1. Sri.Rajendran.
2. Sri.V.R Seshadri.

 

 

Copies of documents produced on behalf of complainant:

 

Ex-A1	Copy of discharge summary.
Ex-A2	Copy of MRI Scan report dated 19.09.2011.
Ex-A3	Copy of discharge summary date 12.10.2011.
Ex-A4	Copy of discharge summary date 15.11.2011.
Ex-A5	Copy of MRI cervical spine on 17.06.2011.
Ex-A6	Copy of MRI cervical spine on 30.11.2011.
Ex-A7	Copy of MRI scanning was done on 13.02.2012.
Ex-A8	Copy of MRI scanning was done on 06.11.2012.
Ex-A9	Copy of discharge slip date 13.05.2013.
Ex-A10 to 33	Copies of pay slip of complainant - TVS Motor Company Ltd., for the period from 01.06.2012 to 13.07.2014.
Ex-A34	Copy of medical treatment record of poly clinic Krishnagiri referred to the Command Hospital, Bangalore.
Ex-A35	Copy of Discharge summary 21.10.2012 dated 19.11.2012.
Ex-A36	Copy of physical examination report dated 18.02.2011.
1)	Copies of authorities ( two in numbers)

 

 

Witnesses examined on behalf of the OP by way of affidavit:

 

Dr.Manjoo S. Reddy.

 

Documents produced on behalf of Opposite Party:

 

Ex-B1	Copy of consent letter dated 12.10.2011 obtained from the complainant’s attendant.
Ex-B2	Copy of Vision Evoked Potential (VEP) test conducted on 12.11.2011.
Ex-B3	Copy of outpatient record of the complainant.
Ex-B4	Copy of consent letter dated 19.06.2011 given by the complainant to OP Hospital.
Ex-B5	Copy of in-patient record pertaining to the admission of the complainant in the OP hospital between 17.06.2011 and 29.06.2011.
Ex-B6	Copy of discharge summary dated 29.06.2011 of the complainant.
Ex-B7	Copy of consent letter dated 09.10.2011 given by the complainant.
Ex-B8	Copy of in-patient records of the complainant pertaining to his admission in the OP hospital between 05.10.2011 and 26.10.2011.
Ex-B9	Copy of discharge summary dated 26.10.2011 of the complainant.
Ex-B10	Copy of discharge summary dated 15.11.2011 of the complainant.
Ex-B11	Copy of medical literature pertaining to loss of vision the eye as well-documented albeit a rare complication arising out of spine surgeries performed in the prone position.
Ex-B12	Copy of medical literature pertaining to the presence of artifacts in an MRI scan at operated levels of the spine.
1)	Copies of authorities (3 in nos.)

 

 

 

 

(ROOPA N.R)                                             (PRATHIBHA R.K)

   MEMBER                                                     PRESIDENT

 

 

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