ORDER

(Passed this on-23^rd  December, 2016)

Shri Shekhar P. Muley, President.

01.    This is a complaint of medical negligence by the Legal Representatives of the deceased complainant.

02.    Since there is no unanimous decision after reading my draft judgment, I propose to write a separate judgment

03.    Facts in short are that the deceased complainant was the wife of the complainant No.-1 and mother of minor complainants No.- 2 and 3. The O.P.-1 is Deputy Director of the State Health Services, No.-2 is a Medical Superintendent and No.-3 is a Medical Officer at Rural Hospital, Katol, Dist. Nagpur, No.-4 is a private medical practitioner and No.-5 is a Nurse attached to Rural Hospital at Katol. On 01/04/2011 the deceased got herself admitted to the Rural Hospital at Katol for family planning operation. The O.P.-3 was in charge of the ward in which the deceased was kept. Next day on 02/04/2011 the deceased was operated upon for family planning and the operation was done by the O.P.-4. The deceased was under post operative care of the O.P.- 2 to 5 at the hospital till 05/04/2011. On 05/04/2011 in the evening, the O.P.-5, on the instruction of the O.P.-2 injected TAXIM on the right hand of the deceased. Immediately thereafter she started feeling burning sensation with severe pain and swelling to her right hand. The middle and little finger and thumb of her right hand started turning bluish and skin of middle finger was completely exposed. Her husband complained to the O.P.-2, 3 and 5. Looking to her condition she was sent to Govt. Medical Hospital in an ambulance. There she was kept overnight and number of tests were conducted on her. Some medicines were also given to lessen her pain. She was asked to visit again after a week. Thereafter she was again brought to the Rural Hospital, Katol. There stitches were removed and she was discharged. After a week she again went to the Govt. Hospital, Nagpur because pain to her right hand was unbearable. After examining her, doctor told her that two middle fingers of her right hand needed amputation and plastic surgery. Then she again went to Rural Hospital, Katol and told to the O.P.’s that she was advised amputation of her two fingers and accused them for her miseries. But she was only threatened.

04.    On 27/04/2011 she filed complaint to P.S. Katol, but no action was taken. On 03/12/2011 she issued legal notice to the O.P.- 2 to 4; it was received by the O.P.- 3 and 4 and a false reply was given. The O.P.- 2 and 5 avoided to receive the notice. Thereafter in order to avoid amputation of fingers she took treatment from various private doctors, but there was no relief. At last on 13/12/2011 she was admitted to Govt. Hospital, Nagpur where two fingers of her right hand were amputated and plastic surgery was done. On 16/01/2012 on her request and risk she took discharge. Before the incident she was earning monthly Rs.6000/- , but due to the incident she had suffered permanent disability. She therefore alleged negligence in her post operative treatment by the O.P.’s and claimed compensation of             Rs.-5 lakh and litigation cost Rs.15,000/-. During pendency of the complaint she died. Her husband and two minor children have joined themselves to continue the proceeding.

05.    The O.P.-1 filed written version at Ex.24 and stated that no medical negligence is alleged against it. All the treatment to the deceased at Rural Hospital was given by the O.P.- 2 to 5. No notice was even issued to it. Since medical negligence is alleged it is personal responsibility only which can be considered. Hence prayed for dismissal of the complaint against it.

06.    The O.P.-2 and 5 filed their joint reply at Ex.-23. Admitting the fact that family planning operation was performed on the deceased at Rural Hospital, it is denied that there was any negligence in their service. It is admitted that the deceased underwent the operation on 02/04/2011 and was under post operative care under the O.P.- 2 to 5 till 05/04/2011. On 05/04/2011 TAXIM injection was given to her. This TAXIM injection was given to her daily from 02/04/2011 to 04/04/2011 and she had no complaint from it. But it is admitted that since morning of 05/04/2011 her right hand was under pain, but it is denied that bone of her middle finger was exposed. It is also admitted that she was taken in an ambulance to Govt. Hospital in Nagpur and was asked to visit again after a week. At Nagpur hospital tests were conducted and the report had come normal. Therefore next day she was discharged. On 06.04.2011 she came to Rural Hospital and was treated for two days under expert guidance. On 08/04/2011 stitches were removed. But swelling to her right hand again appeared, hence, she was again referred to Govt. Hospital at Nagpur with refer slip. But she did not go there. After discharge from Rural Hospital on 08/04/2011 what treatment she had taken is not known. When the nurse of the Rural Hospital had paid visit to the deceased residence, she was there and said she on her own accord took treatment from elsewhere. There was no advice of amputation from the doctors of Govt. Hospital, Nagpur. She never came to Rural Hospital after 8/4/2011 nor did she meet with any of the O.P.’s or tell about amputation. These O.P.’s have no knowledge about amputation or treatment from private doctors. When she was under treatment in Rural Hospital her tests were normal and blood circulation in her right hand was also normal. She was asked to visit daily for dressing, but she came only one day and thereafter she never came for dressing. Therefore it is not known whether or not she had taken medicines regularly. She did not take advise from them about amputation nor did take treatment. Therefore, how dry gangrene was developed and amputation was required is not revealed from the papers of the Govt. Hospital. In fact, she did not follow doctors advise which caused her such condition. In Govt. Hospital at Nagpur also TAXIM was injected to her for surgery. Even in Rural Hospital TAXIM was injected to her for three days before the alleged incident and that time there was no complaint of pain or swelling. Therefore it is false to allege that because of TAXIM injection given to her by the OPs she suffered such disability. Denying all other allegations, it is prayed for dismissal of the complaint.

07.    The O.P.- 3 has denied any negligence in his service. He was not on duty on 4th and 5th April 2011 when the alleged incident occurred. The family planning operation was without any event. The deceased was being given TAXIM right from the first day of admission by IV and she did not suffer any problem. Therefore it is denied that because of TAXIM she suffered reaction. Since he was not on duty on the day and on previous day of the incident he cannot be responsible. No charges were taken from the deceased for her operation. Therefore she was not his consumer. She did not take proper care as per advise. Denying other allegations as false, he prayed for dismissal of the complaint.

08.    The O.P.-4 filed her reply at Ex.-20. Her reply is similar to the one given by the O.P.- 2 and 5. She further stated that she has ample experience of doing family planning operation. She operated upon the deceased and thereafter the deceased was under post operative care at the Rural Hospital to which she had no concern. Rest of the averments being similar to the one given by the other O.P.’s it is not reproduced. Alleging the complaint as false, it is prayed to dismiss the same.

09.    We have heard arguments of the counsels and perused documents and various judgments cited by the counsels. As said before, there being no unanimous decision, I record my findings and reasons separately as under.

FINDINGS  AND  REASONS

10.    On going through the medical papers of the deceased I find that there was slow onset of cyanosis, which ultimately developed into dry gangrene to her right index and middle finger. Therefore, her two fingers were amputated. It is undisputed that the deceased had developed pain in her hand where TAXIM was injected. According to the complainants the deceased was administered TAXIM which had caused such condition of the deceased, though, it has not been specifically alleged.

11.    Before I proceed further it would be helpful to know what is TAXIM drug, what is cyanosis and what causes gangrene. TAXIM is used to treat a wide variety of bacterial infections. It may also be used to prevent infections from certain surgeries. This medication belongs to a class of drugs known as cephalosporin antibiotics. It works by stopping the growth of bacteria. This medication is given by injection into a muscle or vein as directed by doctor. The dosage is based on medical condition of a patient and response to treatment. Side effects of TAXIM injection are rare and do not always occur. Possible side effects that may occur from TAXIM injection are Fits, Rash, Increased level of blood cells, Decrease in kidney function, Increase of creatinine, etc. Swelling, redness, or pain at the injection site may occur. The list, though, not comprehensive, no gangrene as side effect of TAXIM is so far reported.

12.    Cyanosis refers to bluish discoloration of skin, nail beds and mucous membranes. Normally hemoglobin carries most of the oxygen in blood. When the deoxygenated hemoglobin in blood reaches to certain level, cyanosis may occur. It is of two types: central and peripheral. Since the deceased had developed cyanosis in fingers tips, it was peripheral cyanosis which results from decreased local blood circulation in the peripheral organs, arms and legs. This is common if the arterial blood stagnates too long in the limbs and loses most of its oxygen.

13.    Gangrene is a condition that occurs when body tissue dies. It is caused by a loss of blood supply due to an underlying illness, injury and infection. Fingers, toes, and limbs are most often affected.

14.    Now, if the chronology of events as described by the complainants are perused, one could see that 1 mg TAXIM was given intra venously to the deceased continuously for three days prior to the incident. During those three days there was no reaction or complications nor she complained of any discomfort. That means the TAXIM injection had suited her. If it was a reaction or side effect of TAXIM, it should have occurred on the very first day when it was injected. Therefore there is hardly any possibility of a reaction or side effect by TAXIM. However, as per the complaint it was the reaction of TAXIM which caused pain and cyanosis to her fingers. I have carefully gone through her medical papers. Medical papers of Rural Hospital, Katol show that the deceased was operated upon on 02/04/2011. She was given injection TAXIM 1 mg on 3rd and 4th April 2011, i.e. during post operative care. Both the days were uneventful. Then on 5th April in the morning TAXIM 1 mg injection was given. Injection was given intra venously. After some time she showed severe pain in right forearm, thumb, index and middle finger. There was slow onset of cyanosed bluish discolouration in the above mentioned area. This findings do not reveal that her middle two fingers had exposed bone as stated in the complaint. She was taken to the Govt Hospital at Nagpur where some tests were conducted. That time no amputation was advised. She was again referred back to Rural Hospital. Her doppler test was done and it was normal. She was advised to take follow up at Govt. Hospital after 7 days. On 7th and 8th April 2011 she took treatment at Rural Hospital. During those days swelling of fingers had subsided but pain was there and there was burning sensation over cyanosised fingers. She was again referred to Govt. Hospital. There are no medical papers of Govt. Hospital of 7th April 2011. Therefore it cannot be ascertained what happened on that day. But she stated that doctors conducted some tests again and then advised her to get her two fingers amputated.

15.    Here it is pertinent to peruse evidence of Dr. Brijesh Gupta, who was then Professor, Surgery Department of the Govt Hospital, Nagpur. He is examined as a witness for the complainant. He has deposed that on 05/04/2011 when the deceased was referred from Rural Hospital, she was not told that amputation of fingers was required.  He further admits that day it was not felt necessary to ampute her fingers and so she was referred back to Rural Hospital, Katol. He further said that he cannot opine with certainty whether gangrene was caused due to TAXIM. It is to be noted that whatever facts he deposed pertain to the events from 13/12/2011. He said that on 15/12/2011 surgery was done on the deceased and that time TAXIM injection was given to her. The Discharge Card, Ex. 40 issued by the Dept. Of Surgery, Govt. Hospital confirms this fact. He said that on the day of surgery she was given TAXIM injection and no side effect occurred, therefore the injection suited her. If TAXIM was the cause of gangrene or it was not suitable to her condition, the doctor would not have given it at the time of plastic surgery. The doctor, who performed the surgery was very much aware of the history of the deceased condition. The witness has also said  TAXIM is a very effective anti biotic on gangrene.

16.    From documentary as well as oral evidence one can say that TAXIM is not a harmful drug and possibly it was not the cause for developing cyanosis or gangrene. The  deceased in her complaint has not mentioned what she did after her stitches were removed. It is stated she was asked to visit again after 07 days and when she visited the Govt Hospital, Nagpur after 07 days doctors told her to go for amputation and plastic surgery. This must be on 13/04/2011. But, according to Dr. Gupta till then she was not told about amputation. It was on 20/04/2011 for the first time she was told that amputation would be necessary. The complaint further reveals that till 13/12/2011 i.e. for 07 months she was taking treatment from private doctors. In this respect nothing has been placed on record. We do not know what kind of treatment was taken. Finally she got herself admitted to Govt Hospital on 13/12/20111 and on 15/12/2011 amputation was done. So it appears she herself delayed the treatment for considerable time. The complainants did not get expert opinion, which in our opinion was very essential looking to the facts and circumstances of the case. Dr. Brijesh Gupta himself is not certain what could have been the cause for developing dry gangrene. She did develop some reaction, but it cannot be said for certain that it was due to TAXIM injection. It is clear that the stage for gangrene developed much later. For almost 7 months the deceased preferred to take treatment from elsewhere. It is also not certain whether she really took treatment after discharge from Rural Hospital. Therefore only because she felt pain and sensationn in her right hand after TAXIM was injected to her, it does not ipso facto establish negligence of the OPs in giving the said drug. Medical negligence cannot be inferred in every case on the maxim of res ipsa loquitur.

17.    As said before, cyanosis occurs when level of deoxygenated hemoglobin in blood becomes high and gangrene is caused when blood supply to tissue is blocked and tissue becomes dead. In order to find out supply of blood, doppler test was done on her on 5/4/2011. The results showed normal blood supply through right arteries and veins. Thus there was no stoppage of blood supply and if it was so, there was no possibility of gangrene. But the deceased did not follow doctorś advise for few months. She was advised to take follow up. What she did during 7 months is not known and that might have caused gangrene. When a particular drug is administered intra arterial instead of intra venous, it may cause sudden reaction to a patient. In this case TAXIM was administered intra venous. It is nobodyś case that it was administered intra arterial.

18.    The counsel for the complainant placed reliance on following judgments.

1. M/s Niki-Ta Care v/s Surya Palace 2015 (4) CPR 283 (NC)
2. Jyoti Devi v/s Sukethospital 2015 (4) CPR 286 (NC)
3. B.T. Sridhar v/s Vokkaligara Sangh IV (2015) CPJ 215 (NC)
4. Varsha Gajjar v/s Dr. Tiwariś Maternity & Nursing Home IV (2015) CPJ 209 (NC)
5. Health Secretary, Ministry of Health v/s K.Albert 2015(3) CPR 395 (NC)
6. Ramesh Chndra v/s C.M.O. Medical Healthn&Family Welfare 2015(3) CPR 24 (NC)
7. Sunil Bhandari v/s Pooja Kori III (2013) CPJ 142 (NC)
8. Royapettah Govt. Hospital v/s R. Lakshmi II (2016) CPJ 639 (NC)
9. Alfred Benddict v/s M/s Manipal Hospital, Banglore 2014(9) SCALE 451

          10.    V. Krishna Kumar v/s St. Of Tamil Nadu

                  III (2015) CPJ- 15 (SC)

          11.  Nizam Institute of Medical Sciences v/s

               Prasanth Dhananka II  (2009) CPJ 61 (SC)

          So far as the first citation is concerned, its Head Notes and facts of the case are totally different. So it is of no help. In the second case, Jyoti Devi the patient had undergone appendectomy operation. She had pain at the site of surgery. She was treated conservatively, but pain persisted. Since there was no relief for 05 years, she went to other hospital where a 2.5 cm needle was detected at the site of surgery. Negligence of the hospital and doctor was established since the patient for two years visited the hospital but the O.P.’s failed to diagnose the cause of pain and treatment was casual. It was thus a clear case of medical negligence. If after surgery a foreign body like sharp needle is found in in the abdominal wall and despite the patient feeling pain and visiting the O.P.’s several times for treatment but not getting relief, it certainly amount to causal approach of the O.P.’s in giving treatment to the patient. In the third case, B.T. Sridhar, a nurse administered Tracurium injection to a patient without instruction from any treating doctor, which caused problem. Tracurium is an injection which can be given only by or under direct supervision of anesthetist. It is not meant to be used outside Operation Theater. Under such circumstances medical negligence of the hospital and nurse was  upheld. In fourth case, Varsha Gajjar, Tubectomy operation was performed in an unsterilized operation theater. Therefore infection was acquired. Without any justification, O.P. administered several medications, like antibiotics, anti-malerial drugs and anti-tubercular drugs for 49 days. There was no cure, but it led to collection of abscess in abdomen. Patient also not followed advice of O.P.’s. Hence, it was contributory negligence. In the fifth case, Health Secretary, Ministry of Health the patient had eye problem. He was given an injection and advised to use eye drops and ointment. He, thereafter visited the hospital on several times as pain in the eye was unbearable. He requested to admit him but it was refused and advised to continue the same treatment. He thereafter lost the vision in his eye. It was held that the doctor should have advised appropriate investigation in order to identify cause of infection and decide upon future course of treatment. But the doctor took the ailment very lightly despite the fact that corneal infection could have resulted in permanent deprivation of eye sight. In Ramesh Chndra case there was no clear finding on medical negligence as the case was dismissed on other ground. But a reference is made on the state of affairs in a govt. Hospital. The patient after delivering a baby died within a span of few hours. The hospital was unable to provide her blood transfusion and handle the emergency situation. In the case of Sunil Bhandari during orthpedic surgery neurovascular damage was caused when undue pressure was put on the knee in a bid to straighten it and after which tight plaster was cast by the doctor causing a tear in the popliteal artery and ultimately resulting in gangrene. No treatment was advised or undertaken on how to deal with onset of gangrene and plaster was merely put back. It was found that no proper post operative care was provided by the doctor, particularly since no medical records or notes of surgery were produced by the doctor to counter the case of negligence. An expert opinion was taken, but he could not give opinion regarding medical negligence since the documents sent to him were incomplete. Royapettah Govt. Hospital case is based on res ipsa loquitur. The doctor applied POP to a fractured hand. The patient had more pain. The doctor removed the plaster little bit and gave injection. But the doctor ignored the patientś say that he had severe pain throughout the night. Next day there was smell from the bandage and pus was coming out. The patient had severe pain and was taken to the same doctor. But the doctor did not care. After much delay he was advised to go to the Govt hospital. There the doctors opined that because of POP blood circulation was blocked, therefore the hand was decomposed, which was ultimately amputated. Thus casual approach of the doctor was held to be negligent act. In Alfred Benddict case the patient was given intra venous fluids by inserting needle on dorsal aspect of right wrist for two days. However the patient developed gangrene initially in finger tips, which spread to the portion of the hand. There was medical record which revealed the patient was on higher antibiotics and several IV medications. There was clear evidence that inadvertent intra-arterial injection in the radial artery was the main cause of gangrene. In V. Krishna Kumar case there was negligence towards premature baby. All infants with a birth weightless than 1500 gms or gestational age less that 32 weeks are required to be screened for Retinopathy of Prematurity ( ROP). This well known medical phenomenon that a premature baby who has been administered supplemental oxygen and given blood transfusion is prone to a higher risk of a disease known as ROP. In Nizam Institute of Medical Sciences case there was incomplete investigation prior to operation. The patient was operated for tumour and developed acute paraplegia immediately after surgery. Had MRI/Myclography been performed, intraspinal extension could have been revealed at pre- operative stage and paraplegia could have been avoided.

19.    I have exhaustively dealt with every citations placed before us. It will be seen that in all the cases there was prima facie material of medical negligence. Leaving a foreign body in patientś body after surgery, administering a potentially hazardous  drug outside an OT by a nurse without instruction from treating doctor, doing surgery in an unsterilized OT, not treating eye patient properly, not keeping post operative records and casually treating patients, giving intra venous fluids through artery, or ignoring precautions to be taken of premature baby are all sort of negligence by treating doctors and hospitals. The facts of the present case do not disclose such rank negligence on the part of the O.P.’s. Soon after receiving complaint of pain, the deceased was referred to Govt. Hospital with a nurse. She was advised to take follow up treatment. But she did not take treatments from the O.P.’s or from the Govt. Hospital for 07 months. Even after amputation she took discharge on her own accord before completing post operative treatment. All these conducts of her show that the deceased was not careful in following doctors' advise. She was also negligent to her condition. There is no expert evidence. Medical literature reveals TAXIM is a safe antibiotic and it was given intra venously for 2-3 days before family planning operation and even at the time of amputation and no side effects were then noticed. Her blood supply through arteries was normal. Sometimes body reacts to a known drug so unexpectedly that even an experienced doctor could not anticipate it. Looking to these facts expert opinion was very much essential in this case. Unfortunately it is not available. Initial burden to prove medical negligence is to be discharged by the complainant and thereafter it shifts on hospital/attending doctors. Therefore the citations, on facts, are not helpful to the complainants to prove medical negligence. 

20.    The O.P.’s have taken one objection that the complainants are not consumers as the O.P. Hospital is a Govt. Hospital. This argument is not correct. In Savita Garg v/s Director, National Heart Institute, IV (2004) CPJ 40 (SC) it was held that Govt. Hospitals are also liable for medical negligence. There is evidence to show the O.P. 3 was not on duty on 4 and 05/04/2011 at the Rural Hospital. There is no evidence that TAXIM was administered in presence or instruction of the O.P.-3. There is no allegations against the O.P.-1. The O.P.-4, who performed family planning operation has ample experience and trained in Tubectomy/ Routine Vasectomy/ Laparoscopic Tubectomy and has performed several case of Medical Termination of Pregnancy. It is not alleged that the family planning operation was conducted by inexperienced doctor or no proper procedure was adopted. Whenever the deceased had visited the O.P.’s for her pain, she was immediately referred to Govt. Hospital. This all show proper care was taken of her, but she herself was not following advice and follow up treatment. Therefore we do not see medical negligence in this complaint

21.    There is another aspect of locus standi of the present complainants, which needs to be examined. If the negligence has resulted in injury of personal nature, the suit or appeal will abate on death of the complainant. National Consumer Commission in Shanti Devi & Ors v/s Dr. Manoj Sharma & Ors III (2012) CPJ 742 (NC) has ruled on the basis of some judgments of Hon´ble Supreme Court that the right to sue or the complaint survives only during the life time of a complainant and abates the moment he expires. Particularly if negligence has resulted in injury of personal nature, the complaint will abate on death of the complainant and L.Rs. of the deceased will not be entitled to be impleaded.

22.    Upon aforesaid discussion, I conclude that the complainants failed to prove medical negligence against the Opposite Parties. Therefore, the complaint is liable to be dismissed. Hence, I pass the following order.

ORDER

1. The complaint is dismissed with no order as to cost.

2.

                           (Shri Shekhar P. Muley)

                                      President.

मा.सदस्‍य श्री नितीन माणिकराव घरडे यांनी उपरोक्‍त नमुद निकालपत्रा व्‍यतिरिक्‍त वेगळे निकालपत्र (Differ Judgment) पारीत केलेले असून ते खालील प्रमाणे आहे-

                  आदेश

        ( पारित दिनांक-23 डिसेंबर,2016)

मा.सदस्‍य श्री नितीन माणिकराव घरडे-

       तक्रारकर्तीची तक्रार थोडक्‍यात अशी आहे की-

01.   तक्रारकर्तीला दिनांक-20 फेब्रुवारी, 2011 ला हातला या गावी मुलगा झाला. त्‍यानंतर त्‍यांची भेट आरोग्‍य सेविका कु. शालु दशरथ वाघमारे यांचेशी झाली व तिने कुटूंब नियोजनाच्‍या शस्‍त्रक्रिये बद्दल माहिती व सल्‍ला दिला व त्‍यामुळे दिनांक-01 एप्रिल, 2011 ला सायंकाळी 06 वाजून 30 मिनिटानी ग्रामीण रुग्‍णालय, काटोल येथे कुटूंब नियोजनाच्‍या शस्‍त्रक्रिये करीता वॉर्ड क्रं 3, केस रजिस्‍टर नंबर-479 प्रमाणे तिला भरती करण्‍यात आले. विरुध्‍दपक्ष क्रं-2) हे वॉर्ड क्रं-3) चे प्रमुख देखभाल करणारे वैद्दकीय अधिकारी होते तसेच विरुध्‍दपक्ष क्रं-5) पारिचारीका होत्‍या व विरुध्‍दपक्ष क्रं-4) हे खाजगी व्‍यवसाय करणारे डॉक्‍टर आहेत. दिनांक-02/04/2011 ला दुपारी-1.00 वाजता विरुध्‍दपक्ष क्रं-4) ने तक्रारकर्तीवर कुटूंब नियोजनाची शस्‍त्रक्रिया केली व त्‍यानंतर दिनांक-01/04/2011 ते 05/04/2011 पर्यंत विरुध्‍दपक्ष क्रं-2) ते क्रं-5) यांच्‍या निर्देशना खाली तिचेवर औषधोपचार करण्‍यात आले. दिनांक-05/04/2011 ला सायंकाळी 06.00 वाजता विरुध्‍दपक्ष क्रं-5) ने तक्रारकर्तीला, विरुध्‍दपक्ष क्रं-2) ते क्रं-4) यांचे सल्‍ल्‍यानुसार टॅक्‍झीम नावाचे इंजेक्‍शन उजव्‍या हाताला टोचले. इंजेक्‍शन टोचल्‍या नंतर लगेच तिच्‍या उजव्‍या हाताला मुंग्‍या येऊ लागल्‍या व ताबडतोब हातावर सुज येऊन सहन न होणा-या वेदना सुरु झाल्‍यात तसेच त्‍याच हाताची बोटे, आंगठा व करंगळी निळी पडू लागली व मधली दोन बोट संपूर्णपणे गळालीत, त्‍यांचे मास देखील गळलेले दिसू लागले., त्‍यावेळी ताबडतोब तिच्‍या पतीने घटने बाबत विरुध्‍दपक्ष क्रं-2, 3 आणि क्रं-5 यांचेकडे तक्रार केली तसेच तिची दयनीय अवस्‍था बघून तिला ताबडतोब अम्‍बुलन्‍समध्‍ये टाकून तिच्‍या बरोबर एक परिचारीका देऊन शासकीय वैद्दकीय महाविद्दालय, नागपूर येथे पाठविण्‍यात आले. शासकीय वैद्दकीय महाविद्दालय, नागपूर येथे एक रात्रभर तिचे हातावर अनेक चाचण्‍या करण्‍यात आल्‍यात व हाताचे दुखणे कमी करण्‍या करीता औषधी देण्‍यात आली. शेवटी डॉक्‍टरांनी तक्रारकर्तीची मधली दोन बोटे कापून प्‍लॅस्‍टीक सर्जरी करावी लागेल असा सल्‍ला देऊन तिला सुट्टी दिली. तक्रारकर्तीने त्‍याच दिवशी ग्रामीण रुग्‍णालय, हातला येथे सदर घटने बाबत माहिती दिली व सांगितले की, शासकीय मेडीकल कॉलेजच्‍या डॉक्‍टरांनी माझी दोन बोटे कापण्‍याचा सल्‍ला दिलेला आहे व ही घटना घडण्‍याचे कारण तुम्‍ही मला निष्‍काळजीपणाने दिलेले इंजेक्‍शन आहे आणि त्‍यामुळे असे घडले. परंतु विरुध्‍दपक्ष क्रं-2) यांनी तक्रारकर्तीला धमकी दिली “  तु माझे काही करु शकत नाही” त्‍यानंतर तक्रारकर्तीने दिनांक-27/04/2011 ला पोलीस स्‍टेशन येथे तक्रार नोंदवली.

     तक्रारकर्तीने दिनांक-03/12/2011 रोजी अधिवक्‍ता मालती खांडेकर यांचे मार्फतीने विरुध्‍दपक्ष क्रं 2 ते 4 यांना कायदेशीर नोटीस पाठविली. सदर नोटीसचे उत्‍तर विरुध्‍दपक्ष क्रं-3) व क्रं-4) यांनी दिले परंतु विरुध्‍दपक्ष क्रं-2 व क्रं 5 यांनी हेतुपुरस्‍परपणे नोटीस स्विकारली नसल्‍याने ती नोटीस परत आली. तक्रारकर्तीच्‍या उजव्‍या हाताच्‍या बोटाला व संपूर्ण हाताला सहन न होणारे दुखणे सुरु झाल्‍यामुळे दिनांक-13/12/2011 रोजी शासकीय वैद्दकीय महाविद्दालय, नागपूर येथे तिच्‍या उजव्‍या हाताच्‍या मधल्‍या व शेवटच्‍या बोटाचे ऑपरेशन करुन ते कापण्‍यात आले व दिनांक-16/01/2012 रोजी तिला स्‍वतःहून सुट्टी घ्‍यावी लागली, त्‍याचे कारण असे आहे की, तिची आर्थिक परिस्थिती अतिशय नाजूक असल्‍याने व तिच्‍या कुटूंबाला वैद्दकीय उपचारासाठी नागपूर सारख्‍या शहरात राहण्‍याची पर्यायी व्‍यवस्‍था नसल्‍याने तिने डॉक्‍टरांना दर आठवडयातून एकदा वैद्दकीय उपचारासाठी व तपासणीसाठी येईल असे सांगून सुट्टी घेतली.

        तक्रारकर्तीच्‍या उजव्‍या हाताच्‍या बोटाची शस्‍त्रक्रिया झाल्‍यामुळे तिला दैनंदिन कामकाजात अडचणी येऊ लागल्‍यात व मोलमजुरीला जाणेपण अशक्‍य झाले. घरचे संपूर्ण कामकाज व स्‍वतःच्‍या दोन्‍ही मुलांचे संगोपन करण्‍याचे काम संपूर्णतः ठप्‍प झाले, त्‍यामुळे तिला आर्थिक, मानसिक व शारिरीक त्रास सहन करावा लागत होता.

       म्‍हणून शेवटी तक्रारकर्तीने सदरची तक्रार मंचात दाखल करुन विरुध्‍दपक्षाच्‍या निष्‍काळजीपणामुळे आलेल्‍या अंपगत्‍वा मुळे                    रुपये-10,00,000/- नुकसान भरपाई मिळावी तसेच शारिरीक व मानसिक त्रासा बद्दल रुपये-5,00,000/- व तक्रारखर्च रुपये-15,000/- विरुध्‍दपक्षा कडून देण्‍याचे आदेशित व्‍हावे अशी विनंती केली.

02.   विरुध्‍दपक्ष क्रं-3) यांनी त्‍यांचे उत्‍तरात असे नमुद केले की, तक्रारकर्तीने सदरची तक्रार विरुध्‍दपक्ष क्रं 3 ला त्रास देण्‍याचे उद्देश्‍याने मंचात दाखल केलेली आहे. तसेच तक्रारकर्ती कडून कोणतेही शुल्‍क प्राप्‍त केलेले नसल्‍याने तिची तक्रार खारीज होण्‍यास पात्र आहे. विरुध्‍दपक्ष क्रं-3) हे दिनांक-04/04/2011 व 05/04/2011 या दोन्‍ही दिवशी कामावर गैरहजर असल्‍याने त्‍यांचा या प्रकरणाशी कोणताही संबध नाही, सबब त्‍यांना तक्रारीतून मुक्‍त करण्‍याची विनंती केली.

03.   विरुध्‍दपक्ष क्रं-4) यांनी आपल्‍या उत्‍तरात असे नमुद केले की, तक्रारकर्तीने प्रस्‍तुत तक्रार ही फक्‍त त्‍यांना त्रास देण्‍याचे उद्देश्‍याने दाखल केलेली आहे. विरुध्‍दपक्ष क्रं-4) यांना कुटूंब नियोजनाची शस्‍त्रक्रिया करण्‍या करीता बोलविलेले होते व त्‍या प्रमाणे त्‍यांनी तक्रारकर्तीवर शस्‍त्रक्रिया व्‍यवस्थितरित्‍या पार पाडलेली होती परंतु तक्रारकर्ती कडून त्‍यांनी कोणतेही शुल्‍क प्राप्‍त केलेले नसल्‍याने ती त्‍यांची ग्राहक होऊ शकत नाही तसेच तिने  विरुध्‍दपक्ष क्रं-4) यांचा चुकीचे प्रतिपक्ष म्‍हणून तक्रारीत समावेश केलेला असल्‍याने त्‍यांचे विरुध्‍दची तक्रार खारीज करण्‍याची विनंती केली.

04.    विरुध्‍दपक्ष क्रं-2) व क्रं-5) यांनी आपले लेखी उत्‍तरात  असे नमुद केले की, तक्रारकर्तीने सदरची तक्रार विरुध्‍दपक्ष क्रं-2) ते क्रं-5) यांचेतील सेवेतील त्रृटी संबधाने दाखल केली आहे परंतु तक्रारकर्तीची  तक्रार त्‍यांनी अमान्‍य केली.तसेच त्‍यांनी कोणत्‍याही प्रकारचा निष्‍काळजीपणा केलेला नाही व तक्रारकर्तीची तक्रार खोटी असल्‍या बाबत नमुद केले. त्‍यांनी आपल्‍या उत्‍तरात ही बाब मान्‍य केली की, तक्रारकर्तीवर दिनांक-02/04/2011 ला दुपारी-1.00 वाजता रुग्‍णालयात विरुध्‍दपक्ष क्रं-4) डॉक्‍टरां कडून कुटूंब नियोजन शस्‍त्रक्रिया करण्‍यात आली व तिचेवर उपचार हे दिनांक-05/04/2011 पर्यंत विरुध्‍दपक्ष क्रं-2) व क्रं-5) यांच्‍या निर्देशनाखाली चालू होता. तसेच 05/04/2011 रोजी सकाळ पासून तक्रारकर्तीचा डावा हात कोपरा पासून दुखायला सुरुवात झाली परंतु मधली 02 बोट ही संपूर्णपणे गळलीत व त्‍याचे मास देखील गळले हे म्‍हणणे खोटे असल्‍याचे नमुद केले. तसेच तक्रारकर्तीला त्रास झाल्‍या बरोबर कोणतेही हयगय न करता ग्रामीण रुग्‍णालय काटोल येथील रुग्‍णवाहिके मध्‍ये एक पारिचारीका सोबत देऊन शासकीय वैद्दकीय महाविद्दालय, नागपूर येथे त्‍याच दिवशी पाठविण्‍यात आले व तेथे तिची संपूर्ण वैद्दकीय तपासणी तसेच चाचण्‍या करुन तिला शासकीय वैद्दकीय महाविद्दालय, नागपूर येथून दुसरे दिवशी सुट्टी देऊन 07 दिवसा नंतर पुन्‍हा येण्‍यास सांगितले. परत तिला ग्रामीण रुग्‍णालय, काटोल येथे 02 दिवसा करीता वैद्दकीय उपचारार्थ भरती करण्‍यात आले, यावरुन विरुध्‍दपक्ष क्रं-2 व क्रं-5 यांनी तिचे वैद्दकीय उपचारात कुठलाही निष्‍कळजीपणा व हयगय केली नाही. तसेच दिनांक-08/04/2011 रोजी कुटूंब नियोजन शस्‍त्रक्रियेचे टाके काढण्‍यात आले, त्‍यावेळी तक्रारकर्तीचे हाताची सुज परत वाढली असल्‍याचे दिसून आले, त्‍यामुळे तिला सुट्टी देऊन शासकीय महाविद्दालय, नागपूर येथे परत जाण्‍यास सुचित केले व रेफर स्लिप पण दिली.

     पुढे विरुध्‍दपक्ष क्रं-2 व क्रं-5 यांनी उत्‍तरात नमुद केले की, दिनांक-08/04/2011 नंतर तक्रारकर्तीने उपचार घेतल्‍या बाबत कोणतीही माहिती त्‍यांना दिली नाही, त्‍यामुळे आरोग्‍य सेविकेने तक्रारकर्तीच्‍या घरी जाऊन भेट दिली, तेंव्‍हा तिने दुसरीकडे वैद्दकीय उपचार घेत असल्‍याचे सांगितले परंतु दिनांक-19/04/2011 रोजीचे शासकीय वैद्दकीय महाविद्दालय, नागपूर येथील केस रिपोर्टचे दस्‍तऐवज पाहता कुठेही बोटे कापण्‍या बाबतचा सल्‍ला दिलेला नाही. दिनांक-26/04/2011 रोजी काटोल पोलीस मध्‍ये तक्रारकर्तीने रिपोर्ट दिला परंतु पोलीसांनी कोणतीही कारवाई केली नाही, हे म्‍हणणे खोटे आहे. तसेच शासकीय वैद्दकीय महाविद्दालय, नागपूर येथील डॉक्‍टरांच्‍या सल्‍ल्‍याने भरती होऊन शेवटच्‍या व मधल्‍या बोटाचे ऑपरेशन दिनांक-13/12/2011 रोजी केले व तसेच प्‍लॅस्‍टीक सर्जरी सुध्‍दा केली या बद्दल विरुध्‍दपक्ष क्रं-2 व क्रं-5 यांना कोणतीही माहिती नाही. तसेच  ऑपरेशन करण्‍या पूर्वी व झाल्‍या नंतर डिसचॉर्ज कॉर्ड वर नमुद केल्‍या प्रमाणे तक्रारकर्तीला टॅक्‍झीमचेच इंजेक्‍शन देण्‍यात आलेले होते व तेच इंजेक्‍शन तक्रारकर्तीला कुटूंब नियोजन शस्‍त्रक्रियेच्‍या वेळी देण्‍यात आले होते, त्‍यामुळे स्‍पष्‍ट दिसून येते की, तक्रारकर्तीला टॅक्‍झीमच्‍या इंजेक्‍शनामुळे कोणतेही विपरीत परीणाम झालेले नाहीत. तिचेवर उपचार योग्‍यरितीने करण्‍यात आलेत, तिला कोणतेही कायमस्‍वरुपी अंपगत्‍व आलेले नाही, त्‍यामुळे तक्रारकर्तीची तक्रार खोटी असल्‍याने ते कोणतीही मागणी पूर्ण करण्‍यास जबाबदार नाहीत.

05.    तक्रारकर्तीने सदरच्‍या तक्रारी सोबत अक्रं 1) ते 17 दस्‍तऐवज दाखल केले असून त्‍यात प्रामुख्‍याने ग्रामीण रुग्‍णालय काटोल येथे कुटूंब नियोजन शस्‍त्रक्रिये करीता दिनांक-01/04/2011 रोजी भरती केल्‍या बाबतचे कागदपत्र व त्‍या दरम्‍यानचे वैद्दकीय उपचाराचे संपूर्ण दस्‍तऐवज दाखल केलेत.तसेच शासकीय वैद्दकीय महाविद्दालय, नागपूर येथे दिनांक-10/05/2011 रोजीचे केस पेपर्स व दिनांक-27/04/2011 रोजीचा पोलीस स्‍टेशन काटोल येथे दिलेल्‍या रिपोर्टची प्रत दाखल केली. दिनांक-03/12/2011 रोजीची कायदेशीर नोटीसची प्रत दाखल केली. दिनांक-17/01/2012 रोजीचे शासकीय वैद्दकीय महाविद्दालय, नागपूर येथील डिसचॉर्ज कॉर्डची प्रत दाखल केली.

06.   उभय पक्षांचे वकीलांचा मौखीक युक्‍तीवाद, तसेच उभय पक्षानीं दाखल केलेले दस्‍तऐवज यावरुन मंचाचा निष्‍कर्ष खालील प्रमाणे देण्‍यात येतो-

:: निष्‍कर्ष   ::

07.  तक्रारकर्तीवर कुटूं‍ब नियोजन शस्‍त्रक्रिया दिनांक-01/04/2011 रोजी करण्‍यात आली व दिनांक-05/04/2011 पर्यंत तक्रारकर्तीला ग्रामीण रुग्‍णालय काटोल यांच्‍या देखभाल व नियंत्रणा खाली ठेवण्‍यात आले, ही बाब विरुध्‍दपक्षानीं मान्‍य केलेली आहे परंतु तक्रारकर्तीचे उजव्‍या हाताला दिनांक-05/04/2011 रोजी टॅक्‍झीम 1 ग्रॅम इंजेक्‍शन दिल्‍या नंतर ताबडतोब तिच्‍या उजव्‍या हाताला अतिशय सुज येऊन उजव्‍या हाताची बोटे सुन्‍न पडली व सहन न होणा-या वेदना सुरु झाल्‍यात. हाताची बोटे हिरवी निळी पडायला लागलीत व मधल्‍या बोटाचे मास गळायला लागले, त्‍या करीता ताबडतोब ग्रामीण रुग्‍णालय, काटोल यांनी तक्रारकर्तीला रुग्‍णवाहिकेव्‍दारे एक पारिचारीका सोबत देऊन शासकीय वैद्दकीय महाविद्दालय, नागपूर येथे वैद्दकीय उपचारा करीता पाठविले ही बाब विरुध्‍दपक्षानीं मान्‍य केलेली आहे. तसेच तक्रारकर्तीने तक्रारी सोबत दाखल केलेले नि.क्रं-2 महाराष्‍ट्र आरोग्‍य विकास सेवा प्रकल्‍प कार्यालय, वैद्दकीय अधिक्षक, ग्रामीण रुग्‍णालय काटोल संदर्भ चिठठी (Referral Card) यात डॉ.श्री एस.डी.हिवरे यांनी दिनांक-05/04/2011 रोजी 2.00 वाजता स्‍पष्‍टपणे नमुद केलेले आहे की, “The patient of Tubal  ligation was given i.v.taxim and immediately developed right index thumb & middle finger with c/o pain in 03 fingers (severe) followed by slow onset of cyanosis & loss of sensation in 3 fingers. Power in 3 fingers not lost? Redial nerve involvement expert advice & T/t.” यावरुन ही बाब नाकारता येत नाही की, तक्रारकर्तीला टॅक्‍झीम 1 ग्रॅम वजनाचे इंजेक्‍शन दिल्‍या नंतर तिला असहय वेदना झाल्‍यात व तिच्‍या उजव्‍या हातावर सुज येऊन पुढे उजव्‍या हाताचे बोटाचे मास गळून पडले. तसेच विरुध्‍दपक्ष क्रं-2 व क्रं 5 यांनी आपल्‍या उत्‍तरात असे नमुद केले आहे की, तक्रारकर्तीवर उपचार करताना कोणत्‍याही प्रकारची निष्‍काळजी केलेली नाही परंतु तक्रारकर्तीने दाखल केलेल्‍या रुग्‍णपत्रिकेचे अवलोकन केले असता दिनांक-05/04/2011 रोजी तेथील डॉक्‍टरांनी लिहिलेल्‍या मजकूरात तक्रारकर्तीला डाव्‍या हाताला दुखणे झालेले असून तिचे मधले बोट हिरवे निळे पडले व दुखायला लागले असे टॅक्‍झीम 1 ग्रॅमचे इंजेक्‍शन दिल्‍यामुळे घडले असे वैद्दकीय अधिकारी डॉ.श्री चिंचे यांनी नमुद केलेले आहे. यावरुन असे दिसून येते की, डॉक्‍टर किती काळजीपूर्वक तक्रारकर्तीवर उपचार करीत होते. तसेच त्‍यांनी आपल्‍या उत्‍तरामध्‍ये सुध्‍दा तक्रारकर्तीच्‍या डाव्‍या हाताला सुज आली व डाव्‍या हाताची बोटे हिरवी निळी पडून गळू लागली ही बाब खोटी असल्‍या बाबत नमुद केले म्‍हणजेच तक्रारकर्तीच्‍या केस पेपर्स मध्‍ये स्‍वतः नमुद केलेली बाब खोटी असल्‍याचा आरोप केलेला आहे. तसेच उजव्‍या हाता ऐवजी, डाव्‍या हाताचा उल्‍लेख करुन शासकीय वैद्दकीय महाविद्दालय नागपूर येथे पाठवितात यावरुन रुग्‍णांची ते किती काळजी व दक्षता घेतात ही बाब उघड होते. तसेच मा.सर्वोच्‍च न्‍यायालय, दिल्‍ली यांनी खालील दिलेल्‍या न्‍यायनिवाडयात आपले मत दिले-

         CIVIL APPEAL NO.-2641 OF 2010, Order Dated-08^th March, 2010- “V.Kishan Rao-Versus-Nikhil Super Specialty Hospital” या प्रकरणात मा.सर्वोच्‍च न्‍यायालयाने “Res Ipsa Loquitor” या तत्‍वाचे योग्‍य स्‍पष्‍टीकरण देऊन त्‍यात नमुद केले आहे की,  “Ordinarily the burden to prove negligence of the doctor lies on the Complainant.  But when this doctrine is applied the position is reversed.  The doctor has to prove that he was not negligent”.

             उपरोक्‍त मा.सर्वोच्‍च न्‍यायालयाने नमुद केलेले तत्‍व हे आमचे समोरील तक्रारी मध्‍ये तंतोतंत लागू पडते. आमचे समोरील तक्रारीमध्‍ये तक्रारकर्तीला टॅक्‍झीम 1 ग्रॅमचे इंजेक्‍शन तिचे उजव्‍या हाताला टोचल्‍या नंतर ताबडतोब सुज येऊन व असहय वेदना होऊन पुढे तिचे उजव्‍या हाताची बोटाचे मास गळून पडले, ही बाब नाकारता येत नाही. जर विरुध्‍दपक्षाचे असे म्‍हणणे असेल की त्‍यांनी तक्रारकर्तीवर वैद्दकीय उपचार करताना कोणताही निष्‍काळजीपणा केलेला नाही तर तसे सिध्‍द करण्‍याची संपूर्ण जबाबदारी ही विरुध्‍दपक्षांवर उपरोक्‍त मा.सर्वोच्‍च न्‍यायालयाने निकालपत्रात नमुद केलेल्‍या तत्‍वा प्रमाणे येते परंतु या तक्रारीमध्‍ये विरुध्‍दपक्षाने त्‍यांनी कोणताही निष्‍काळजीपणा केल्‍या नसल्‍या बाबतचा कोणताही पुरावा वा प्रतिज्ञालेख अभिलेखावर दाखल केलेला नाही. याउलट, तक्रारकर्तीने तिचे वैद्दकीय उपचाराचे संपूर्ण दस्‍तऐवज दाखल केलेले आहेत. तसेच तिचेवर कुटूंब नियोजनाची शस्‍त्रक्रिया करण्‍यापूर्वी, दिनांक-01/04/2011 रोजी सकाळी 7.30 वाजता स्‍त्री शस्‍त्रक्रिया वैद्दकीय अहवाल पत्रिका जी विरुध्‍दपक्षानी दाखल केलेली आहे, त्‍यामध्‍ये कॉलम नं.7 मध्‍ये मागील इतिहास या तपशिला मध्‍ये क्रं-1 ते 9 ज्‍यामध्‍ये एलर्जी, शस्‍त्रक्रिया, मनोविकार, फीट, हुदयविकार, अतिरिक्‍त दाब, काविळ, बाळंतपण घरी/दवाखान्‍यात, कान फुटणे/जखम इत्‍यादी आजार तिला नसल्‍याचे नोंदविण्‍यात आलेले आहे. यावरुन ही बाब सिध्‍द होते की, तक्रारकर्तीला कुटूंब नियोजन शस्‍त्रक्रिया करण्‍यापूर्वी कोणताही आजार किंवा शरिराला कोणतीही जखम नव्‍हती ही बाब सिध्‍द होते व सदरची घटना ही तक्रारकर्तीला रुग्‍णालयात भरती झाल्‍यावर टॅक्‍झीम 1 ग्रॅम इंजेक्‍शन टोचल्‍या नंतर उदभवलेली आहे, ही बाब सिध्‍द होते. तसेच मा.सर्वोच्‍च न्‍यायालयाने आपल्‍या उपरोक्‍त न्‍याय निवाडयात असेही नमुद केलेले आहे की, डॉक्‍टरांचे वैद्दकीय निष्‍काळजीपणामुळे एखादी घटना स्‍पष्‍ट दिसून येत असेल तर तेथे ग्राहक मंचाने वैद्दकीय तज्ञांचे मत मागविण्‍याची आवश्‍यकता नाही. आमचे समोरील तक्रारीत तक्रारकर्तीची उजव्‍या हाताची बोटे ही स्‍पष्‍टपणे गळल्‍याचे दिसून येत आहे व त्‍या बाबतचे छायाचित्र सुध्‍दा तक्रारकर्ती तर्फे प्रकरणात दाखल केलेले आहे.

08.    विरुध्‍दपक्ष क्रं 2 व क्रं 5 यांनी आपल्‍या उत्‍तरात असे नमुद केले आहे की, दिनांक-05/04/2011 रोजीचे घटने नंतर तक्रारकर्तीवर शासकीय वैद्दकीय महाविद्दालय, नागपूर येथे ज्‍या वैद्दकीय चाचण्‍या करण्‍यात आल्‍यात, त्‍या चाचण्‍यां मध्‍ये (Doppler Test) तिच्‍या शरिरा मध्‍ये कोणतीही अनियमितता दिसून येत नाही, तिच्‍या सर्व चाचण्‍या या “Negative” होत्‍या परंतु आपल्‍या या म्‍हणण्‍याचे पुष्‍टयर्थ त्‍यांनी चाचण्‍याचे कोणतेही दस्‍तऐवज दाखल केले नाहीत. या उलट, तक्रारकर्तीने तक्रारी सोबत दाखल केलेल्‍या दस्‍तऐवजाचे अवलोकन केले असता असे दिसून येते की, शासकीय वैद्दकीय महाविद्दालय,

नागपूर येथील दिनांक-19/04/2011 रोजीचे रुग्‍णपत्रिके मध्‍ये पुढील प्रकारे नमुद आहे-

           H/o-   bluish discoloration of right index, middle & thumb after receiving I.V. taxim & followed by slow onset of cyanosis & loss of sensation in these 3 fingers.

          C/o- Pain & loss of sensation of Rt.index & middle finger & thumb

          -Swelling is increasing.

         - Blackish discoloration at the tip of rt.index  and middle   finger.

         - loss of sensation in middle & index finger tip upto ½   inch.

      तसेच दिनांक-10/05/2011 रोजीचे दुपारी 12 वाजून 04 मिनिटानी शासकीय वैद्दकीय महाविद्दालय, नागपूर येथील युनिट हेड डॉ.ब्रजेश गुप्‍ता यांनी “SHORT CASE RECORD” मध्‍ये “CHIEF COMPLAINT” यात असे नमुद केले आहे की-

S/b ss ii

           Pt f/u c/o rt index & middle finger dry gangrene

           Pt h/o injection  taken on 5/3/2011 at Rural Health Katol in    right arm patient investigated rt ul Doppler wnl on 5/4/11 & 19/4/11 patent advice cvts opinion, cvts surgeon advice 2d- eeho & review 2^d echo wnl. Patient not f/o in cvts.

      आणि पुढे “Advice” यात पुढील प्रमाणे नमुद केलेले आहे-

f/u in plastic surgery for best of rehabilitation & further management of rt index & middle finger.

           f/u in cvts c 2^nd echo reports & further management review  sos

          cont c & d.

      या वरुन ही बाब सष्‍ट होते की, तक्रारकर्तीने झालेल्‍या घटने नंतरचे सर्व वैद्दकीय उपचार व वैद्दकीय चाचण्‍या या शासकीय वैद्दकीय महाविद्दालय, नागपूर येथील प्रमुख वैद्दकीय अधिकारी यांचे मार्गदर्शना खाली केलेल्‍या आहेत व त्‍यांनी दिलेल्‍या उपरोक्‍त दिलेल्‍या मतामध्‍ये तक्रारकर्तीच्‍या उजव्‍या हाताच्‍या बोटामध्‍ये  “dry gangrene” झाल्‍याचे निष्‍पन्‍न काढलेले आहे तसेच पुढे तिचे उजव्‍या हाताचे बोटांवर शस्‍त्रक्रिया करुन सडलेला भाग कापून त्‍यावर प्‍लॅस्‍टीक सर्जरी करण्‍याचे मत दिलेले आहे.

09.   विरुध्‍दपक्ष क्रं-2 व क्रं-5 यांनी आपल्‍या उत्‍तरात तक्रारकर्तीवर सदरची शस्‍त्रक्रिया झाली किंवा नाही या बद्दल ते अनभिज्ञ असल्‍याचे नमुद केले. परंतु तक्रारकर्तीने शासकीय वैद्दकीय महाविद्दालय, नागपूर येथील दिनांक-13/12/2011 ते 17/01/2012 या कालावधी मध्‍ये तिचे उजव्‍या हाताचे बोटांवरती शस्‍त्रक्रीया केली या बद्दल डिसचॉर्ज कॉडची प्रत दाखल केली, त्‍यामुळे ही बाब नाकारता येत नाही की, झालेल्‍या घटने नंतर तक्रारकर्तीच्‍या उजव्‍या हाताची बोटे सडल्‍यामुळे ती शस्‍त्रक्रियेने कापल्‍या शिवाय तिचे जवळ अन्‍य दुसरा कोणताही पर्याय उपलब्‍ध नव्‍हता.

10.    तक्रारकर्तीने तक्रारी सोबत पुराव्‍यार्थ दाखल केलेले शासकीय वैद्दकीय महाविद्दालय, नागपूर येथील सर्व तिचे वैद्दकीय उपचाराचे  आणि वैद्दकीय चाचण्‍यांचे दस्‍तऐवज पाहता मंचा तर्फे असा निष्‍कर्ष काढण्‍यात येतो की, ग्रामीण रुग्‍णालय, काटोल येथील तत्‍कालीन कार्यरत पारिचारीकेने तक्रारकर्तीचे उजव्‍या हाता मध्‍ये टॅक्‍झीम 1 ग्रॅमचे इंजेक्‍शन देताना योग्‍य ती काळजी न घेता ते इंजेक्‍शन चुकीच्‍या पध्‍दतीने तक्रारकर्तीला टोचले म्‍हणजेच सदरचे इंजेक्‍शन हे तक्रारकर्तीला I.V. (Intra vinous) द्दावयाचे होते परंतु विरुध्‍दपक्ष क्रं-5) पारिचारीकेने ते इंजेक्‍शन तिचे उजव्‍या हाताचे दंडाला थेट टोचले म्‍हणजे (Intra Muscular) दिले व त्‍यामुळेच तिला असहय वेदना सुरु झाल्‍यात, त्‍वरीत हातावर सुज आली आणि तिचे उजव्‍या हाताची बोटे सुन्‍न पडून हिरवी निळी दिसायला लागलीत.

   CIVIL APPEAL NO.-2641 OF 2010, Order Dated-08^th March, 2010- “V.Kishan Rao-Versus-Nikhil Super Specialty Hospital” या प्रकरणात मा.सर्वोच्‍च न्‍यायालयाने आपल्‍या निवाडयात पुढील दोन निवाडयांचा उल्‍लेख  केलेला आहे- “Where gangrene developed in the claimant's arm following an intramuscular injection [See Cavan v. Wilcox (1973) 44 D.L.R. (3d) 42];  When a patient underwent a radical mastoidectomy and suffered partial facial paralysis” [See Eady v. Tenderenda (1974) 51 D.L.R. (3d) 79, SCC];

        Where the defendant failed to diagnose a known complication of surgery on the patient's hand for Paget's disease[See Rietz v. Bruser (No.2) (1979) 1 W.W.R. 31, Man QB.];

11.     आणखी या ठिकाणी विशेष बाब नमुद करावीशी वाटते की, प्रस्‍तुत तक्रार मंचा समक्ष चालू असताना दरम्‍यानचे काळात तक्रारकर्तीचा अपघाती मृत्‍यू दिनांक-09/10/2014 रोजी झाला, तिचे मृत्‍यू नंतर तिचे पती व तिच्‍या अज्ञान दोन लहान मुलांची नावे या मंचाचे अभिलेखावर दिनांक-14.10.2015 रोजीचे मंचाचे आदेशा नुसार वारसदार म्‍हणून तक्रारीत समाविष्‍ट करण्‍यात आलीत.

12.   यातील विरुध्‍दपक्ष क्रं-3) डॉ.सचिन सदाशिवराव चिंचे, वैद्दकीय अधिकारी ग्रामीण रुग्‍णालय, काटोल  हे दिनांक-04/04/2011 व दिनांक-05/04/2011 रोजी शासकीय सुट्टीवर असल्‍या बाबत त्‍यांनी निवेदन केले व त्‍या संबधाने त्‍यांनी पुराव्‍या दाखलचा दस्‍तऐवज दाखल केलेला असल्‍यामुळे व त्‍या दस्‍तऐवजा मध्‍ये त्‍यांचे ठिकाणी डॉ. श्री हिवेरे वैद्दकीय अधिकारी यांचे नाव दर्शविले असल्‍याने विरुध्‍दपक्ष क्रं-3) डॉ.सचिन सदाशिवराव चिंचे, वैद्दकीय अधिकारी, ग्रामीण रुग्‍णालय, काटोल यांना या तक्रारीतून मुक्‍त करण्‍यात येते.

13.    विरुध्‍दपक्ष क्रं-4) डॉ.प्राजक्‍ता अमीतराव बंड, खाजगी वैद्दकीय डॉक्‍टर यांनी तक्रारकर्तीवर दिनांक-02/04/2011 रोजी ग्रामीण रुग्‍णालय, काटोल येथे कुटूंब नियोजनाची शस्‍त्रक्रीया केली व ती यशस्‍वीरित्‍या पार पाडली असल्‍याचे वैद्दकीय दस्‍तऐवजा वरुन दिसून येते, यामुळे विरुध्‍दपक्ष क्रं-4) यांना या तक्रारीतून मुक्‍त करण्‍यात येते. यातील विरुध्‍दपक्ष क्रं-3) डॉ.सचिन सदाशिवराव चिंचे, वैद्दकीय अधिकारी, ग्रामीण रुग्‍णालय, काटोल  हे दिनांक-04/04/2011 व दिनांक-05/04/2011 रोजी शासकीय सुट्टीवर असल्‍या बाबत त्‍यांनी निवेदन केले व त्‍या संबधाने त्‍यांनी पुराव्‍या दाखलचा दस्‍तऐवज दाखल केलेला असल्‍यामुळे व त्‍या दस्‍तऐवजा मध्‍ये त्‍यांचे ठिकाणी डॉ.              श्री हिवेरे वैद्दकीय अधिकारी यांचे नाव दर्शविले असल्‍याने विरुध्‍दपक्ष क्रं-3) डॉ.सचिन सदाशिवराव चिंचे, वैद्दकीय अधिकारी, ग्रामीण रुग्‍णालय, काटोल यांना या तक्रारीतून मुक्‍त करण्‍यात येते.

14.    वरील सर्व वस्‍तुस्थिती, उपलब्‍ध दस्‍तऐवजी पुरावा यावरुन विरुध्‍दपक्षा तर्फे तक्रारकर्तीची कुटूंब नियोजनाची शस्‍त्रक्रिया झाल्‍या नंतर चुकीचे पध्‍दतीने इंजेक्‍शन लावल्‍याने तिचे उजव्‍या हाताचे बोटांची हानी होऊन ती पुढे कापून टाकल्‍यामुळे तिला कायमस्‍वरुपी अंपगत्‍व आल्‍याने, तिला व तिच्‍या संपूर्ण कुटूंबाला मोठया प्रमाणावर शारिरीक, मानसिक व आर्थिक त्रास वेळोवेळी सहन करावा लागला, याचे मोजमाप पैशात करणे अशक्‍य आहे आणि तिची बोटे कापल्‍यामुळे तिच्‍या संपूर्ण कुटूंबाची अपमिरीत हानी झाली आहे आणि पुढे र्दुदैवाने तिचा अपघाती मृत्‍यू झालेला असल्‍याने तिची दोन्‍ही अज्ञान मुले व पती हे कायदेशीर वारसदार या नात्‍याने तिच्‍यावर विरुध्‍दपक्षाच्‍या चुकीच्‍या वैद्दकीय उपचाराने झालेल्‍या नुकसानी संबधाने विरुध्‍दपक्ष क्रं-1) महाराष्‍ट्र शासना तर्फे, उपसंचालक, महाराष्‍ट्र आरोग्‍य सेवा तसेच विरुध्‍दपक्ष  क्रं-2) डॉ.पकंज देवरावजी करांडे, वैद्दकीय अधिक्षक, ग्रामीण रुग्‍णालय काटोल आणि विरुध्‍दपक्ष क्रं-5) सौ.निशा रमेश गाडरे, (कु.निशा खवसे) पारिचारीका, ग्रामीण रुग्‍णालय काटोल यांचे  कडून नुकसान भरपाई मिळण्‍यास पात्र आहेत, असे मंचाचे मत आहे. 

15.   वरील सर्व वस्‍तुस्थितीचा विचार करुन, आम्‍ही, तक्रारीत  खालील प्रमाणे आदेश पारीत करीत आहोत-

                                      ::आदेश  ::

(01)     तक्रारकर्ती तर्फे तिचे कायेदशीर वारसदारानीं विरुध्‍दपक्षां विरुध्‍द केलेली तक्रार, विरुध्‍दपक्ष महाराष्‍ट्र शासन तर्फे, विरुध्‍दपक्ष क्रं-1) उपसंचालक, महाराष्‍ट्र आरोग्‍य सेवा तसेच विरुध्‍दपक्ष क्रं-2) डॉ.पकंज देवरावजी करांडे, वैद्दकीय अधिक्षक, ग्रामीण रुग्‍णालय काटोल आणि विरुध्‍दपक्ष क्रं-5) सौ.निशा रमेश गाडरे, (कु.निशा खवसे) पारिचारीका, ग्रामीण रुग्‍णालय काटोल यांचे विरुध्‍द वैयक्तिक आणि संयुक्तिक रित्‍या अंशतः मंजूर करण्‍यात येते.

(02)      विरुध्‍दपक्ष महाराष्‍ट्र शासन तर्फे विरुध्‍दपक्ष क्रं-1) उपसंचालक, महाराष्‍ट्र शासन आरोग्‍य सेवा तसेच विरुध्‍दपक्ष  क्रं-2) डॉ.पकंज देवरावजी करांडे, वैद्दकीय अधिक्षक, ग्रामीण रुग्‍णालय काटोल आणि विरुध्‍दपक्ष क्रं-5) सौ.निशा रमेश गाडरे, (कु.निशा खवसे) पारिचारीका, ग्रामीण रुग्‍णालय काटोल यांना आदेशित करण्‍यात येते की, त्‍यांनी  मृतक  तक्रारकर्तीचे  कायदेशीर  वारसदारांना,

           तक्रारकर्तीस झालेल्‍या शारिरीक हानी संबधात तसेच झालेल्‍या शारिरीक, मानसिक व आर्थिक त्रासा संबधात एकूण नुकसान भरपाई म्‍हणून रुपये-6,00,000/- (अक्षरी रुपये सहा लक्ष फक्‍त) आणि तक्रारखर्च म्‍हणून रुपये-10,000/- (अक्षरी रुपये दहा हजार फक्‍त) द्दावेत.

(03)     प्रबंधक, अतिरिक्‍त जिल्‍हा ग्राहक मंच, नागपूर यांना निर्देशित करण्‍यात येते की, विरुध्‍दपक्ष महाराष्‍ट्र शासन, आरोग्‍य सेवा तर्फे विरुध्‍दपक्ष क्रं-1), क्रं-2 आणि क्रं-5) यांचे कडून नुकसान भरपाई बाबत रुपये-6,00,000/- मंचात जमा केल्‍यावर त्‍यापैकी तक्रारकर्तीची अज्ञान मुले क्रं-2) कु.तनुष्‍का होमेश्‍वर फीसके आणि क्रं-3) पियुष होमेश्‍वर फीसके यांचे नावे ते सज्ञान होई पर्यंत प्रत्‍येकी रुपये-3,00,000/- या प्रमाणे राष्‍ट्रीयकृत बँकेत फीक्‍स मुदती ठेवी मध्‍ये  रक्‍कम गुंतविण्‍यात यावी.

(04)       विरुध्‍दपक्ष क्रं-3)  आणि विरुध्‍दपक्ष क्रं-4) यांना या तक्रारीतुन

           मुक्‍त करण्‍यात येते.

(05)       निकालपत्राच्‍या प्रमाणित प्रती सर्व पक्षकारांना निःशुल्‍क उपलब्‍ध करुन देण्‍यात याव्‍यात.

(06)      सदर आदेशाचे अनुपालन महाराष्‍ट्र शासना तर्फे विरुध्‍दपक्ष क्रं-1), क्रं-2) आणि विरुध्‍दपक्ष क्रं-5) यांनी वैयक्तिक आणि संयुक्तिकरित्‍या निकालपत्राची प्रमाणित प्रत प्राप्‍त झाल्‍याचे दिनांका पासून 30 दिवसांचे आत करावे.