Smt.G.Vasanthakumari, President
Complaint filed Under Section 12 of the Consumer Protection Act claiming compensation of Rs.2,10,000/- alleging medical negligence.
Complainant’s case is that the first opposite party is the administrator, second opposite party is the Doctor and third opposite party is the staff nurse of St.Mary’s Hospital Aryankavu, Punalur, that the second and third opposite parties are the employees of the said hospital working under the first opposite party, that the complainant was suffering from back – ache and she consulted Dr.AnilKumar, who was working as Orthopaedic surgeon of Taluk Hospital, Punalur and the said Doctor prescribed Neurobion forte injection, that the complainant approached the second opposite party Physician of St.Mary’s Hospital, Aryankavu on 16.02.2003 for taking injection since that hospital is situated near to her residence, that the second opposite party directed the mother superior to take the injection and after receiving charges for medicines, syringe etc, the mother superior took one injection on her buttock on the same day and the remaining six injections were taken by opposite party 3 on alternate days as per the directions of the first and second opposite parties, that after some days she felt pain on her buttock where the injection has been taken and she informed the matter to the opposite parties but according to them there will be some pain on the said part but it will be cured gradually, that after some weeks a swelling developed on the injected parts and she again consulted opposite parties 1 and 2, that opposite party 2 had given ointment and medicines, that on 16.09.03 the complainant again approached opposite party 2 and opposite party 2 prescribed voveran tablets and a gel for five days, that on 22.09.03 and 29.09.03 she approached opposite party 3 as there was no relief and on 29.09.03 opposite party 2 adviced her to consult a surgeon if there is no improvement, that thereafter she consulted Dr.K.E.Moorthi, the Surgeon of NSS Mission Hospital, Panthalam and on 14.10.03 she was admitted there for operation and on 16.10.03 she was discharged from there, but started discharge from the said part, that the wounds were cleaned and dressed periodically, that thereafter the complainant consulted Dr.Pushpangathan, Surgeon of Sree Shanmughavilasom Hospital, Punalur, that there was no improvement and she was referred to Medical College Hospital, Thiruvananthapuram and as such she consulted Dr.K.V.Viswanathan, that the Histopathology Report shows that chronic inflammatory lesion skin with sinus tract formation and no evidence of tuberculosis seen, that on 21.12.2004 she has undergone an operation on the gluteal region and on the same day she was discharged and the treatment there is continuing, that the complainant suffered much pain and spent lakhs of rupees due to the injection abcess, that she has also suffered mental pain, that the opposite parties have not taken the minimum care while taking injection, that the third opposite party is not qualified and experienced for taking injunction, that they had not used disposable syringe for taking injection, that the syringe used were not sterilized also, that there was deficiency in service on the part of the opposite parties while administering the injection, that the majority of injection were taken by the third opposite party who was not technically qualified and having no skill or experience, that they have not taken minimum degree of care at the time of taking injection, that when the swelling was formed the second opposite party has not seriously treated the complainant which resulted in injection abcess, that he has not referred the complainant in time and the complainant was not given treatment as per established procedure and hence this complaint.
Opposite parties filed joint version contenting that the complainant was a patient of Punalur Government Hospital under the treatment of Dr.Anilkumar, an Orthopedic Surgeon for her back-ache and the Doctor has prescribed neurobion forte injection, that the prescription was brought by the patient herself and it was shown to the second opposite party and the second opposite party in turn directed the third opposite party, the then staff nurse to take injection and accordingly the third opposite party administered injunction on the buttock of the patient, that injection was administered by using disposable syringe by the third opposite party who is a qualified staff nurse who has passed her auxiliary nurse – midwives course in July 1998 and till now she has been working as nurse, that she is also registered nurse as per the nursing council, that after completing the entire course of injection the complainant went home without any pain or complaints, that after that only on 16.09.03 she came to the Hospital with the complaint of pain on the left buttock, that she was seen by the second opposite party and prescribed analgesics and other supporting medicines, that on 22.09.03 also the patient came with the compliant of pain, that on examination it was seen that there was some swelling developed on the left buttock of the patient and hence she was adviced to consult a surgeon if there is no improvement after taking prescribed medicines, that thereafter she has not turned up and from the complaint it is learnt that she consulted Dr.E.K.Moorthi, Surgeon of the NSS Mission Hospital, that the alleged abscess sustained by the complainant is not at all due to any negligence or deficiency on the part of the opposite parties, that if there was really injection abscess, the symptoms of injection abscess might have manifest within a maximum period of one month and the patient might have approached the opposite party’s Hospital, within that period, that there was no injection abcess as alleged by the complainant, that it was only mal absorption of the injection medicine on the injected part, that even according to Dr.K.E.Moorthi, who has opened the swelling part there was no pus from the injected part but it was only a sterile fluid which indicates that there was no infection or abscess on the injected part, that the further allegation that the opposite parties have not taken minimum degree of care while taking injection and the third opposite party is not qualified and experienced in administering injection and also that disposable syringe not used for taking injection and the syringe used were not sterilized are mere allegations, that the third opposite party is a qualified nurse having five years of professional experience since she had passed her auxiliary nurse – midwives course in the year 1998 and there after she has been working as nurse, that the first opposite party the then mother superior also is a qualified nurse, that any qualified nurse can administer the injection to the patient and the hospital has been using disposable syringes and needles for administering the injection, that when there was no improvement the complainant was rightly adviced by second opposite party to have a surgical consultation, that the complainant has been under the treatment of opposite party’s hospital even before her administration of the injection on 16.02.03, that there is no negligence or deficiency in service on the part of the opposite parties and the complaint is only to be dismissed with compensatory cost.
The points for consideration are :
1. Whether there is any negligence or deficiency in service on the part of the opposite parties?
2. Reliefs and costs.
For the complainant PWS 1 to 5 were examined and marked Exts.P1 to P15. For the opposite parties DWs 1 to 3 were examined and marked Exts.D1 to D8 series..
The POINTS:
In this case the complainant was examined as PW.1 . Her husband was examined as PW.2. PW.3 is Dr. Anilkumar, Orthopedic Surgeon, who was working in Govt. Hospital, punalur during 2003 who prescribed neurobion forte injection for back ache to the complainant. PW.4 is Dr. Viswanathan, who was Associate Professor of Surgery, Medical College Hospital, Thiruvananthapuram during 2004, who conducted surgery [I & D] to the complainant at Medical College Hospital, Thiruvananthapuram. PW.5 is Dr. Pushpangathan, Surgeon, Shanmughavilasom, Hospital, Punalur whom complainant consulted on 11..7..04. DW.1 is Opp.party 2, Dr. Sethu Subhramanyan, Physician , St. Mary’s Hospital, Aryankavu. DW.2 is opp.party 3. DW.3 is Dr. K.E. Moorthy, Surgeon, Chithra Multi Specialty Hospital, Panthalam who conducted I&D to the complainant in 2003.
According to the complainant due to the negligence and carelessness of the opp.parties the abscess formed on the injected area and it was developed due to the service deficiency of opp.party 3 a non qualified and non-experienced nursing assistant who took the injection without using disposable or sterilized syringe. But according to the opp.parties the injection was taken after test dose and with disposable syringe and third opp.party is a qualified nurse who passed auxiliary mid-wife course in July 1998. It is after a lapse of 7 months the complainant came there with complaint of pain on the left buttock and further contended that there is no negligence on their part and the complaint is to be dismissed.
The complainant who was examined as PW.1 would swear before the forum in tune with the allegations in the complaint . Nothing was brought out in her cross examination to discredit the witness. She would swear before the forum that she was under the treatment of PW.3 for back ache and she went to the opp.party’s hospital on 16..2..2003 for administering the injection prescribed by PW.3. The mother superior had administered one injection and the remaining six by opp.party 3 on alternate days on her gluteal region. Her further case is that after some days she felt pain in her injected area and she informed the matter to the opp.parties but according to them there will be some pain on the said part but it will be cured gradually. Her further case is that after some weeks a swelling developed on the injected area and she again consulted the opp.parties 1 and 2 and opp.party 2 had given ointment and medicine and on 16..9..2003 she again approached opp.party 2 and opp.party 2 prescribed voveran tablets and a gel for five days and on 29..9..2003 opp.party 2 adviced her to consult a surgeon and accordingly she consulted Dr. K.E. Moorthy, Surgeon of NSS Mission Hospital, Panthalam on 14..10..2003. She was admitted there on14..10..2003 and undergone an operation[ I &D] and on 16..10..2003 she was discharged but after healing the wound, on the 25th day again started discharge and so the wound was again dressed and cleaned. On 11.7.2004 she consulted Dr. Pushpangathan, of Shanmughavilasom Hospital and after some treatment she was referred to Medical College Hospital, Thiruvananthapuram and PW.4 treated her and on 21..12..2004 she has undergone an operation. But according to the opp.parties after administrating the injection she approached them only after a laps of seven months. At this juncture Ext. D1 OP ticket assumes more importance. That shows that on 2.9.08 she consulted opp.party’s hospital c/o Fever, body ache. Thereafter on 9...12..1998, 13..1..2008, 27..5..2001, 18..8..2001, 16..9..2001, 29..9..2001, 29..4..2002, 13..1..2003. 16..2..2003, 16..9..03, 22..9..03 and on 29..9..2003 she consulted the doctor in opp.party’s hospital for various ailments. It contains only three sheets. First sheet is outpatient ticket form. In that the consultation dated 2..9..2008, 9..12..98, 13..1..2000, 27..5..2001 and 13..8..2001 stated. That is very old paper. The other two sheets are new papers and in the seal affixed there is no date. In that after 16..2..2003 her visit on 16..9..2003 and 22.9.03 and 29..9..03 alone mentioned. But according to the complainant as we have already mentioned after someday of administering injection she felt pain on her injected area and she informed the matter to the opp.parties. But they returned her stating that there will be some pain on the said part but it will be cured gradually. Her further case is that after some weeks a swelling developed on the injected area and she again consulted the opp.parties 1 and 2 and Opp.party 2 had given ointment and medicine and thereafter on 16..9..2003, 22..9..2003 and 29..9..2003 she again approached opp.parties 1 and 2 and on 29..9..2003 opp.party 2 adviced her to consult a surgeon and accordingly she consulted DW.3. According to the learned counsel appearing for the complainant the two sheets which looks new are prepared and attached to the earlier op ticket for the purpose of this case. It shows that she consulted opp.party 2 only after seven months of taking the injection. Here it is pertinent note that op ticket is to be with the patient and what is to be maintained in the hospital is the case record. So the case of the complainant that the two sheets in Ext.D1 is manipulated for the purpose of the case cannot be brushed aside.
The specific case of the complainant is that due to the negligence and carelessness of the opp.parties the abscess formed on the injected area and it was developed due to the service deficiency of opp.party 3 a non qualified and non experienced nursing assistant who took the injection without using disposable or sterilized syringe. But according to the opp.parties injection was taken with disposable syringe and third opp.party is a qualified nurse who passed auxiliary nurse and mid-wives course in July 1998. With the available evidence, let us examine whether the injection was taken using disposable or sterilized syringe. PW.1 would swear before the Forum that “injection …Ф·©¸¡þ Dr. ‚¿¡ð¢ñ¤¼¤. plastic cover ý ›¢¼¤ disposable ö¢ú¢Õ¤ …Ф·¤® ‚üˆ®õü …Ф´¤ˆð¡ð¢ñ¤¼¤? [a] •¿ ‡ñ¤ œ¡±Ä·¢ ý›¢¼¤ …Ф·¤ ¨óøø·¢ý ‚С¨Äð¡Ã® injection …Ф·Ä®. •Ð¸¢¿¡· ‡ñ¤ steel basin •¡ð¢ñ¤¼¤;” PW.3 , Dr. Anilkumar would swear before the forum that ‘’injection abscess ö¡š¡ñà ƒÙ¡ˆ¤¼Ä® ö¢ú¢Õ¢ý›¢¼¤«ö¥¢ð¢ý ›¢¼¤« ƒøø •Ã¤—¡š»¥ò»¡Ã¤.’’ In cross-examination he has stated that ‘’‡ñ¤ qualified nurse disposable ö¢ú¢Õ¤ ƒœ©ð¡Š¢µ® ‚ü®ˆõü…Ф·¡ý injection abscess óñ¡ü ö¡Ú¬Äð¤©Ù¡? ‚¿ ‘’ PW.4 Dr. K.V. Viswanathan would swear before the forum that ‘’sterilized syringe ‡¡ sterilized need ©ò¡ ƒœ©ð¡Š¢´¡Ä¢ñ¤¼¡ý ‚üÈü abscess ƒÙ¡ˆ¡ü c¡š¬Äð¤Ù¤®. He has further stated that ‘’ö¡š¡ñà injection abscess immediate 𤫠delay 𤫠óñ¡«’’ Opp.party produced Ext. D8 series invoices and argued that they used disposable syringe and the case of the complainant that the injection abscess was due to the non use of disposable syringe is only to be discarded. But those invoices are dated 26..5..2003, 16,6,2003 and 22..10..2003. It is not sufficient to substantiate that while opp.party 3 had administered injection to the complainant from 16..2..2003 to 28..2..2003 she used disposable syringe. Complainant’s specific case is that opp.party 3 administered injection using unsterilized syringe after taking from a basin and not used disposable or sterilized syringe which stands unshaken by the production of Ext. D8 series.
The further case of the complainant is that the abscess formed on the injected area and it was developed due to the service deficiency of opp.party 3 , a non -qualified and non --experienced nursing assistant who took the injection. PW.1 would swear before the forum that “”neurobion …¼ injection …Ф·¡ý ÄТ¸¤Ù¡ˆ¢¿…¼¤ ©°¡ˆ®Ðû œúº¤:’’ injection speed ý …Ф·Ä¤¨ˆ¡Ù¡Ã®‚¹¨› ó¼Ä®…¼¤ « ö¢ú¢Õ¢ý ˆ¤ù¸« ƒ¨Ù¼¤« œúº¤ PW.2 would swear before the forum that “”slow ý injection …Ф´¡·Ä¡Ã® technical mistake No.1 ñÙ¡»©·Ä® injection site ý ©óÙ ñ£Ä£ð¢ ý massage ¨Äí¢¶¤Ù¡ó¢¿. PW.3 would swear before the forum that “‡ñ¤ qualified nurse disposable syringe ƒœ©ð¡Š¢µ® ‚üˆ®õü …Ф·¡ý injection abscess óñ¡ü ö¡š¬Äð¤©Ù¡ ? ‚¿.’’ PW.5 would swear before the forum that Medicine apply ¨à¤¼technicality ð¤¨Ð ó£ù®¨ˆ¡Ù¤« »ñ¤¼¤ apply ¨à¡ü óô¬»¡ð ö»ð« …Ф´¡Ä¢ñ¤¼¡ò¤« absorb ¨à¡¨Ä ˆ¶¢ð¡ð¢ñ¢´¡»©¿¡? A. •¹¨› óñ¡«’’ The specific case of the complainant is that opp.party 3 has passed only auxiliary nurse and Mid--- ----------wives course and not a qualified nurse having Registration in Kerala Nursing council. But according to the opp.parties she was a qualified nurse at the time of administering the injection. Before the Form DW.1 [OP2] pleaded ignorance about her qualification. According to him he has not enquired about her qualification. PW.2, the husband of the complainant would swear before the Forum in cross examination that ‘’ mj cA.if\fjrk SC,A Doctor Qqjsdukxx c\MlEjsrsuh\hlA Lijsm rjr\rk alMj;’’ But according to DW.2 [op.3] she was a qualified nurse at the time of administering the injection and to substantiate the same she has produced Ext. D4 attested copy of the certificate of registration from the Gujarat Nursing Council which shows that she passed the examination for auxiliary nurse -mid-wives conducted by the Gujarat Nursing council on 16..7..1998. Further she has produced Ext. D7 attested copy of Registration Certificate from the Kerala Nurses and mid- wives council which reads as ‘’this is to certify that Deepa Augustine having taken a course of training at AECS Maaruti School of Nursing Bangalore from September 2004 to August 2007 has passed the examination for General Nursing and Midwifery conducted by the Government of Karnataka in August, 2007 and is admitted to the Register maintained under the provisions of the Nurses and Midwives Act 1953, as amended as a registered Nurse under Section 2[d] . The number assigned to her in the Register is 54135 Dated the 21st day of December 2009 ‘’ It shows that she attended a course of training for General Nursing and Mid-wifery at Bangalore from September 2004 to August 2007 which is subsequent to the cause of action in this case. It follows that while administering injection to the complainant she was not a qualified nurse having Kerala Nursing Council Registration.
Further the learned counsel appearing for the opp.parties tried to bring out that the alleged swelling was not injection abscess. PW.5 , Dr. V.K.. Pushpangathan, who issued Ext. P10 would swear before the forum that ‘’injection abscess tr\rk\ LfjH record svu\fj}n\m\. Further down he would swear before the Forum that ‘’tr\srconsultsvu\fth\hl eJgJ/jhkA injection abscess sdln\mkxx sinus dischargesvu\ukr\rkn\mlujgkr\rk; PW.4 would swear before the forum that ‘’ patient was admitted with discharging sinus in the gluteal region Lfk ijigj]kr\r prescription Llnk\ Ext.P13” Further down he would swear before the forum that “ complainant rk\ injection aohakn\mlu abscess Llnk\ tr\rk Ext.P14 sdkn\mk\ eyukilR dqjukSal ? subsequent to injection tr\rk eyukr\rkn\mk\;” Ext. P14 is the medical certificate [Attending Doctors report]. In that in column 8 it is categorically stated that c\o pain subsequently with discharge. Further the learned counsel appearing for opp.parties tried to establish that injection abscess can be formed in TB patients and in the case of complainant TB not ruled out. But in Ext.P15 Histo Pathology Report Diagnosis is “ chronic inflammatory lesion skin with sinus tract formation. No evidence of tuberculosis seen” So it cannot be said that whether she was suffering from tuber culosis not ruled out. Ext.P14 would show that she was admitted in Medical College Hospital, Thiruvananthapuram on 21..12..2004 and discharged on the same day after operation [I & D]. For the above reasons we find that there is negligence and deficiency in service on the part of the opp.parties. Opp.party 3 who was a non qualified staff was allowed by the hospital authorities to administer injection to the complainant which resulted in injection abscess to her left buttock and the opp.parties are liable to compensate the same. Ext. P4 and P11 series available medical bills produced would show that she has spent Rs.3542/- for medicines etc. She has suffered much pain and mental agony and undergone two I & D
In the result, the opp.parties are directed to pay a compensation of Rs. 1,00,000/- [one lakh] to the complainant. They are also directed to pay cost to the tune of Rs.1000/-. The compensation and cost is to be paid within 30 days from the date of this order and in default, the compensation amount will carry interest at the rate of 9% per annum from the date of this order..
Dated this the 26th day of March, 2012.
I N D E X
List of witnesses for the complainant
PW.1. – Radhamony
PW.2. – Sukumaran
PW.3. Dr. Anilkumar.K.G.
PW.4. – Dr. K.V. Viswanadhan
PW.5. – Dr. V.K. Pushpangadan
List of documents for the complainant
P1. – Prescription by Dr. Anil Kumar
P2. – Prescription of Dr.A.A. Fazlul Rehiman
P3. – Discharge card fro NSS Medical Mission Hospital, Pandalam
P4. – Medical bill dated 16..10..2003.
P5. – Prescription by Dr. K. Anil Kumar
P6. – Prescription from 16..2..2003 to 29..2..03
P7. – Sri. Shanmughavilasom hospital prescription
P8. – Photocopy of prescription
P9. – prescription dated 5..11..2004
P10. – Prescription of Dr. Pushpangadan
P11. - Medical bills [8 Nos.]
P12. – Refer letter by Dr. V.K. Pushpangadan
P13. – Prescription by Dr. Viswanathan K.V.
P14. – Medical certificate
P15. – Histopathology report
List of witnesses for the opp.parties
DW.1. – Dr. Sethu Subramanyan
DW.2. – Deepa Augustin
DW.3. – Dr. K.E. Moorthy
List of documents for the opp.parties
D1. – Out Patient Ticket
D2. – Advocate notice
D3. – Reply notice
D4. – Certificate of registration
D5. – Certificate
D6. – Certificate
D7. – Registration certificate from the Kerala Nurses and Mid-wives
Council dated 21..12..2009.
D8.series– Invoices dated 26..5..2003, 16..6..2003 and 22..10..2003
