DISTRICT CONSUMER DISPUTES REDRESSAL FORUM PALAKKAD
Dated this the 11th day of January 2016
Present : Smt.Shiny.P.R. President
: Smt.Suma.K.P. Member Date of filing: 05/01/2014
(C.C.No.9/2014)
Santhakumari.
W/o.Vijayanarayanan,
Gokulam, Eralgyodath House,
Vettekkara Post,
Kadampazhipuram, Palakkad - Complainant
(By Adv.K.Dhananjayan)
Vs
1.The Manager / Medical Superintendent,
M/s.Vasan Eye Care Hospital,
Fort Maidan, No.18/888(7),
Chittur Road, Kunnathurmedu,
Palakkad – 678 013
2. Dr.Vinodkumar.T.
Working as Ophthalmic Surgeon,
M/s.Vasan Eye Care Hospital,
Fort Maidan,No.18/888(7),
Chittur Road, Kunnathurmedu,
Palakkad – 678 013 - Opposite parties
(By Adv.V.K.Venugopalan)
O R D E R
By Smt.Shiny.P.R. President.
Brief facts of complaint.
Complainant is a housewife and her husband was employed in BSNL, Palakkad. When the complainant began to feel the symptoms of poor eye sight to her left eye, she has approached the 1st opposite party hospital. 1st opposite party is one of the recognized branch of Vasan Eye Care Hospital Net work. 2nd opposite party is the doctor working in that hospital.
The doctor who was working as an ophthalmologist in 1st opposite party hospital has opined that the disease and cause of poor eye sight is due to cataract. She was admitted in the hospital on 19/1/2012 for cataract eye surgery. Then 2nd opposite party conducted the cataract surgery on the complainant’s left eye on 20/1/2012 in the 1st opposite party hospital and discharged on 20/1/2012. At the time of discharge the complainant was given with medical prescription and follow up treatment chart which has provided 40 days course of medicines to be followed. The complainant has followed all the post operative treatments and instruction given by 2nd opposite party. But even after two months after the surgery her eye sight has not at all improved. She was feeling tremendous discomfort just like formation and oozing of tears, blurring and reddening of eye, causing pain and itching and burning sensation in the eye.
Then the complainant has sought further evaluation and treatment at Trinity Eye Hospital, Palakkad. There she has met Dr.Mridula Sunil, the Ophthalmic Surgeon and she has further investigated the complainant. Dr.Mridula Sunil the ophthalmologist has suggested and opined that the reason of her poor eye sight and problems was due to the lack of care and non exercising of caution and prudence before conducting the cataract eye surgery to her left eye. The doctor further opined that opposite parties did not evaluate and taken necessary precaution to control her acute diabetic problem. The opposite parties deliberately ignored the obvious symptom of blood leakages for the reasons best known to them and that resulted in failure of the surgery conducted and the damage caused was irreversible. Doctor has given a CD showing the picture of the blood leakage. The blood vessel leakage was ignored by the 2nd opposite party and preceded for surgery without informing the complainant the impact and consequences of that. That has resulted in total failure of surgery and now the complainant is partially and permanently blind and her vision is reduced to 30%. She can see only things which are very near and can read only big letters kept very close. Later again the complainant approached another ophthalmologist Dr.Sasikumar, he also opined that the surgery ought not to have conducted in a situation where blood leakage in eye ball was there and the damage caused is permanent and irreversible.
Complainant submitted that all these mishaps have occurred only due to the non exercising of care, caution and required diligence throughout the treatment from the very inception of treatment, pre-operative period and post operative treatment. The deficiency of service is committed by opposite parties. The complainant is still continuing with her treatment though not sure of the result. Hence the complainant prays for an order directing opposite parties to pay a sum of Rs 10,00,000/- with future interest at the rate of 12 % p.a and cost of proceedings to the complainant.
Complaint was admitted and issued notice to opposite parties.
Opposite parties 1 and 2 filed their version contending the following:
The complainant came to the first opposite party hospital on 8/12/11 with complaints of blurring of vision in the left eye. She was a known diabetic since 10 years and was on treatment for the same. Her uncorrected visual acuity at that time was 6/24 (Right Eye) and 6/60 (Left eye) while the best corrected visual acuity was 6/9 p & N6 in Right eye and 6/9p & N24 in left eye. Anterior segment examination of both eyes showed an immature cataract in the left eye more than in the right eye. A dilated retinal examination showed a mild non proliferative diabetic retinopathy only. No CSME (clinically significant macular edema). Only few micro aneurysms were seen at the macula. Intra ocular pressure was 15mmHg in right eye and 14 mmHg in the left eye. On the basis of examination findings the complainant was advised a cataract surgery with an IOL implantation in left eye first. But as blood sugar level of the complainant was high (268mg % PPBS) she was referred to the diabetologist to control her diabetes mellitus.
On 16/01/2012 the complainant came up for a pre operative evaluation as advised blood test and a scan was done on the same day (RBS 205mg%) and the complainant was found fit for surgery and posted for surgery on 20/1/2012. There was absolutely no beading of retina then. The (FP) photograph taken will reveal the same. Opposite parties informed about the pros and cons of phaco emulsification with foldable intra ocular lens (IOL) implantation surgery and the complication involved in the surgical procedure. Then complainant voluntarily agreed and gave written informed consent for the surgery.
Under all aseptic care and precautions the second opposite party conducted left eye phaco emulsification with foldable IOL on 20/1/2012. Intra operative period was uneventful without any complication and her visual acuity had improved very well during the post operative period follow. Her visual acuity in the left eye improved from 6/60 to 6/12 (UCVA) uncorrected visual acuity, 6/9(BCVA) best corrected visual acuity. Near vision had also improved from N24 to N6. The complainant was asymptomatic in the post operative follow up except for occasional watering and foreign body sensation (which are seen once in a while in the diabetic patients especially if not under good control). As per the findings in her second post operative follow up visit, visual acuity and near vision were being maintained at the same levels. The complainant was advised diabetology consultation to check her blood sugar levels and to review after 2 weeks.
The complainant turned up for review only after 4 months. It was reported that the blood sugar levels were high and not under control. Hence the complainant was again advised to consult a diabetologist to bring down the blood sugar levels. During this visit also the BCVA 6/9 and near vision N6 in left eye. A retinal evaluation showed only a mild non proliferic diabetic retinopathy, no CSME. She was advised review, after consultation with her diabetologist, after 2 months. Instead she turned up only after 5 months ie.on 10/01/2013 which is 1 year after the surgery. This was the first time she had come with a history of a decrease in her vision in the left eye. Our Medical Director had seen the patient and on examination her visual acuity was found decreased and the anterior segment of the left eye was very clear and the implanted IOL was very well in position. A retinal evaluation of the left eye showed a possible central retinal vein occlusion which is a retinal condition seen in diabetic patients especially when under poor control. Hence it was only on 10/01/2013 that the complainant reported a decreased vision (vision left eye 6/60 NIG).
After cataract surgery the complainant had attained a very good improved vision 6/9 and N6 and maintained the same until one year and she was not on regular follow up and diabetic control as per advice. After evaluation on diabetic status and to come up for a review on 15/01/2013 to see the Vitreo Retinal surgeon (as expert on retinal diseases and its management). On 15/01/2013 she was seen by the vitreo retinal surgeon and her condition was diagnosed as proliferative diabetic retinopathy with macular had exudates and foveal hemorrhage in the left eye. She was advised FFA and OCT after metabolic control. But the complainant did not turn up and lost further follow up. As per investigation reports available her PPBS was 236mg% one month prior to this last visit. These aspects have been totally concealed by the complainant in the complaint.
She was informed about the cause of occasional watering and pain in the lid margins and during follow up visits strictly advised for diabetic control in consultation with diabetologist but the sequence of events and available investigation reports was that her diabetic level was not well under control as she was not regular in follow up and heedless to proper medical advice. Hence the diagnosed condition of proliferative diabetic retinopathy with macular had exudates and foveal hemorrhage in the left eye had occurred about one year after surgery is attributable to her diabetic disease condition and indifferent attitude and approach of the complainant to the medical advice.
There was no negligence or deficiency in service on the part of the opposite parties and they are not liable to compensate the complainant.
The opinion allegedly expressed by Dr.Mridula Sunil and Dr.Sasikumar, the ophthalmologists are unfounded and unsustainable.
There is no factual or medical basis for the complainant’s belief as alleged in the complaint and the second opposite party had conducted cataract surgery with due care and diligence and there was no shortcoming of deficiency in service on his part.
The complainant has approached the Forum by suppressing the facts regarding her diabetic condition and her failure to keep the diabetic condition under control in consultation with diabetologist and irregular follow up with the second opposite party. The complainant is not entitled to get any relief as prayed for in the complaint.
Complainant and opposite parties filed their respective chief affidavits. Exts.A1 to A6 is marked from the side of the complainant. Ext B1 is marked from the side of opposite parties. Complainant filed IA 206/14 to refer the matter to medical board. Opposite parties submitted no objection. Hence Application allowed and matter was referred to medical board. Report from Medical Board is marked as Ext C1
The following issues are considered
1. Whether there is deficiency in service on the part of opposite parties?
2.If so, what is the relief?
Issues 1 and 2
It is an admitted fact that complainant is a diabetic patient and is under treatment for the same. The entries in Ext B1 shows that complainant was a diabetic patient and after controlling sugar level, 2nd opposite party conducted surgery. On perusal of Ext B1, it is revealed that at the time of discharge the complainant was given with medical prescription and follow up treatment chart for a period of 40 days, a course of medicines to be followed. Then it is the duty of the complainant to control the sugar level and follow the instructions given by the opposite parties after surgery. Complainant did not produce any documents to show that she had conducted periodical check up of her sugar level and which was under control after surgery.
As per Ext.C1 report complainant’s anterior segment of the left eye was very clear and implanted IOL very well in position and patient reacting to light. Since there is no other contradictory evidence, we relied upon the opinion of the medical board and found that there was no negligence from the part of opposite parties. Another allegation of the complainant is that complainant is still continuing treatment for left eye. Nothing is produced to prove this allegation before the Forum
Complainant submitted that Dr.Mridula Sunil and Dr.Sasikumar the ophthalmologists suggested and opined that the reason of poor eye sight of left eye, after surgery is due to the lack of care and non exercising of caution and prudence before conducting the cataract eye surgery. In order to prove the allegations, complainant has not taken any steps to examine the Dr.Mridula Sunil and Dr.Sasikumar or other experts. The Hon’ble Supreme Court in Jacob Mathew V State of Punjab & another, III (2005) CPJ 9 (SC) held that a “professional may be held liable on one of two findings: either he was not possessed of requisite skill which he possessed to have possessed, or, he did not exercise reasonable competence in given case, the skill which he did possess.” In the present case complainant has not raised any dispute with regard to the qualification of 2nd opposite party doctor or adduced any evidence to prove that 2nd opposite party doctor conducted surgery without due diligence, care and caution. Moreover in Bolam’s case, Bolam V Frien Hospital Management Committee(1957)1 WLR 582, it was also held that a doctor is not negligent if he is acting in accordance with standard practice merely because there is a body of opinion who would take a contrary view.
In the above discussions we are of the view that 2nd opposite party treated the complainant with due diligence and care and there was no negligence or carelessness on his part. In the result we dismiss the complaint without cost. Pronounced in the open court on this the 11th day of January 2016.
Sd/-
Shiny.P.R.
President
Sd/-
Suma.K.P.
Member
Appendix
Exhibits marked on the side of complainant
Ext.A1 – Post OP drug schedule by the opposite party dt.20/1/12
Ext.A2 - Medicine prescription given by opposite party dt.26/1/12
Ext.A3 - Medicine prescription given by opposite party dt.20/2/12
Ext.A4 - Medicine prescription given by opposite party dt.7/4/12
Ext.A5 - Medicine prescription given by opposite party dt.15/8/12
Ext.A6 - Bill for the purchase of medicine given by the opposite party dt.10/1/2013
Exhibits marked on the side of opposite parties
Ext.B1 – Case sheet of Smt.Santhakumari maintained in the 1st opposite party
hospital
Report marked
C1 – Medical Report
Cost
No cost allowed.
