BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM

VAZHUTHACAUD, THIRUVANANTHAPURAM.

PRESENT

SRI. G. SIVAPRASAD : PRESIDENT

SMT. BEENAKUMARI. A : MEMBER

SMT. S.K.SREELA : MEMBER

C.C. No. 274/2006 Filed on 17.10.2006

Dated : 16.04.2010

Complainant:

Thomas Chacko, Bethel 86/A, Shanthi Nagar, Sreekariyam P.O, Thiruvananthapuram.

(appeared in person)

Opposite party:

The Managing Director, Sree Uthradam Thirunal Hospital, Pattom P.O, Thiruvananthapuram.

(By adv. R. Narayan)

This O.P having been heard on 27.02.2010, the Forum on 16.04.2010 delivered the following:

ORDER

SRI. G. SIVAPRASAD: PRESIDENT

The facts leading to the filing of the complaint are that complainant was admitted to S.U.T. Hospital following a severe chest pain on 16.04.2006, that he was advised a by-pass surgery and the operation was conducted on 21.04.2006, that he was kept in the Intensive Care Unit for 4 days out of the 9 days of the package, that after surgery he was unable to lie on the bed due to severe pain in the back side, buttocks, thighs and sides of the hands, elbows etc., that opposite party tried to hide the burn injury of these parts and told him that his body had a blanket allergy and very soon it will be O.K, that when pain increased, opposite party gave some water filled rubber hand gloves which were often bursting and the water inside the gloves spread over the wounds which increased the pain, that when severe pain sustained, opposite party gave him high dosage of sedative injunctions, pain killer tablets and antibiotics which caused his health too badly and he could not even sleep on those days and that only after removing from the ICU his relatives came to know the gravity of the serious burning injury and the oozing from the deep wounds consequent to the burning. It is submitted by the complainant that the grievousness of the burns on the back side was so serious that the doctors could discharge him only after 50 days from the hospital bed. Normally a patient after a by-pass surgery will be discharged within 9 days, but he was detained in the hospital for more than 50 days due to the burns, that of the utter negligence of the hospital. Though complainant was assured burn treatment free of cost by opposite party, instead of doing this, he was given an additional bill for Rs. 76,912/- on 09.06.2006 for the treatment of the burns that of their own negligence. When complainant refused to remit the said payment, opposite party allowed a discount and forced him to remit Rs. 28,944/-. Hence this complaint to direct opposite party to pay Rs. 5,00,000/- for the sufferings and torture, Rs. 1,00,000/- for mental agony due to negligence and misbehaviour of the hospital staff, Rs. 1,00,000/- for expenses to correct the skin disorders to the complainant along with refund of Rs. 28,944/- towards burn treatment and other reliefs.

Opposite party filed version contending that the opposite party hospital is one of the premier super specialty hospital at Thiruvananthapuram, that the complaint has been filed solely on an experimental basis just to harass and vex the opposite party, and that the best in medical care and treatment had been provided to the complainant, and that there was no medical negligence at any stage on the part of the opposite party. It is submitted by opposite party that complainant is a 54 years old gentleman with a long history of hypertension and 5 years history of coronary artery, that he was admitted in the opposite party hospital on 16.04.2006 with rest angina, that he had suffered acute heart attack. Earlier he had been treated at Kottayam Caritas Hospital. Subsequently he had coronary angiogram done in Lissie Hospital. He continued on medical treatment. Complainant went to the Medical College Hospital, Thiruvananthapuram wherein he underwent a repeat coronary angiogram in March 2006, which showed severe 2 vessel disease and he was advised coronary bypass surgery. Complainant had been advised surgery in March 2006 itself at the Medical College Hospital, Thiruvananthapuram. Opposite party conducted a very complicated surgery where 3 bypasses were done for the blocked arteries as scheduled on 21.04.2006. For 2 bypasses, blood vessels(veins) from the legs were used and the important LAD vessel, an artery on the chest was used. Surgery was done without any problems. The complainant was transferred to ICU on a ventilator as is the usual practice, that at about 1:45 a.m the next day when the nurses were giving skin care to the back, they first noticed a few small blisters, that immediately the matter was informed to the duty doctor and appropriate skin care and antiseptic ointment were applied in consultation with seniors. According to the usual practice, the complainant was weaned off the ventilator and he was totally free of it by 9:30 a.m. Complainant was conscious and he had oral fluids soon after. There was no complaint of any pain or discomfort over the back. The only complaint was gaseous distension of the abdomen in the afternoon for which he had antacids with relief. The blisters were initially though to be due to allergic reactions to thermal blanket used as some patients do get such blisters even on application of skin blisters. However, the blisters became bigger in the next day with peeling of skin. It was thought that the allergic reaction was aggravated by the heat, resulting in what appeared to be burns. The lesions were all superficial except the ones over the interscapular areas and the sacrum. They were appropriately managed with local antiseptics, dressings and later on with the involvement of a plastic surgeon. Complainant did not have an opportunity to complaint of pain. Though not deep, because the blisters enlarged and broke down, leaving large raw areas, it took some time for healing. During this period the patient was well looked after by the team consisting of doctors and nurses under the supervision of a plastic surgeon. The complainant was discharged when all the lesions were healed. Opposite party had shared the additional expenses by giving a discount of Rs. 47,968/- almost 50% of the additional expenses. At the time of discharge complainant and his relatives demanded th entire treatment should be free. Opposite party refused to meet this unjust demand. Opposite party believes that the present complaint is malafidely filed due to the opposite party's refusal in meeting the demand of the complainant to make the entire hospital bill free. There was no negligence, no deficiency of service or carelessness of any sort in the treatment given to the complainant. Hence opposite party prayed for dismissal of the complaint.

The points that arise for consideration are:-

1. Whether there is negligence and deficiency in service on the part of the opposite party in giving treatment to the complainant?

2. Whether the complainant is entitled to compensation? If so, at what quantum?

In support of the complaint, complainant has filed an affidavit of himself as PW1 in lieu of examination in chief and has marked Exts. P1 to P9. Complainant has been cross examined by the opposite party. One witness has been examined on the part of the complainant as PW2. In rebuttal Dr. S.K. Prabhu has been examined as DW1 and has marked Ext. D1 and has cross examined by the complainant. The administrative officer of the opposite party hospital has filed proof affidavit as DW2 and has marked Ext. D2. DW2 has been cross examined by the complainant. Opposite party's perfusion scientist has been examined as DW3.

Points (i) & (ii):- It has been the case of the complainant that on 16.04.2006 the complainant got himself admitted into SUT Hospital following a severe chest pain, that the complainant was advised a bypass surgery, the operation was conducted on 21.04.2006 and thereafter the complainant was transferred to Intensive Care Unit. It has also been the case of the complainant that after surgery, he was unable to lie on bed due to severe pain in the backside, buttocks, thighs and sides of the hands, elbows etc., that when complained the opposite party, they told his relatives that his body had a blanket allergy and very soon it will be O.K It is the contention of the complainant that when pain increased, opposite party gave some water filled rubber gloves which were often bursting and the water inside the gloves spread over the wounds that increased the pain, that when severe pain sustained, opposite party gave him high dosage of sedative injection, pain killer tablets and antibiotics which caused his health too badly and he could not even sleep on those days, that only after removing from the ICU his relatives came to know the gravity of the serious burning injury and the oozing from the deep wounds consequent to the burning, that the grievousness of the burns on the back side was so serious that the doctors could discharge him only after 50 days from the hospital bed, i.e, on 09.06.2006. It is the specific case of the complainant that after a bypass surgery in normal case a patient will be discharged within 9 days but in his case he was detained in the hospital more than 50 days due to the burns that of the negligence of the hospital. Further though the complainant was assured burn treatment free of cost by opposite party, instead doing this, complainant was given an additional bill for Rs. 76,912/- on 09.06.2006 for the treatment of the burns that of their own negligence. When complainant objected and refused to remit the payment, opposite party allowed a discount and forced him to remit Rs. 28,944/-.

It is the case of the opposite party that the complainant, a 54 year old gentleman, with a long history of hypertension and 6 years history of coronary artery was admitted in opposite party's hospital on 16.04.2006 with rest angina, that he had suffered an acute heart attack earlier, and had been treated at Kottayam Caritas Hospital and that subsequently he had coronary angiogram done in Lissie Hospital. He continued on medical treatment initially and he was restricted by his angina on exertion. The complainant went to the Medical College Hospital, Thiruvananthapuram, wherein he underwent coronary angiogram in March 2006, which showed severe 2 vessel disease and he was advised coronary bypass surgery. The pain at rest the complainant had on 16.04.2006 is a clear indication that medical treatment he had till date undergone had failed and that he required further intervention. A review of the complainant's coronary angiogram confirmed severe blocks in his heart vessels with 90% block in the beginning of his left anterior descending artery(LAD), the most important blood vessel for the heart. This meant that early coronary artery bypass surgery (CABG) is that most appropriate treatment, not only to control his symptoms, but also to improve his life expectancy. As such CABG was advised and after getting the consent and other preliminary preparations, surgery was done on 21.04.2006. It is contended by the opposite party that the surgery was done without any problems and the complainant was transferred to the ICU on a ventilator as is the usual practice, that at about 1.45 a.m the next day, when the nurses were giving skin care to the back, they first noticed a few small blisters, that on advice of senior doctor, appropriate skin care and antiseptic ointment were applied, that according to the usual practice, the complainant was weaned off the ventilator and he was totally free of it by 9.30 a.m, that complainant was conscious and he had oral fluids soon after, that there was no complaint of any pain or discomfort over the back, that the only complaint was gaseous distension of the abdomen in the afternoon for which he had antacids with relief. It is concluded by the opposite party that the blisters were initially though to be due to allergic reactions to a thermal blanket used, as some patients do get such blisters even on application of skin plasters. However, the blisters became bigger the next day with peeling of skin. It was though that the allergic reaction was aggravated by the heat, resulting in what appeared to be burns. The lesions were all superficial except the ones over the interscapular areas and the sacrum. They were appropriately managed with local antiseptics, dressings and later on with the involvement of plastic surgeon. Ext. D1 is the copy of discharge and operation note issued by the opposite party. As per Ext. D1 discharge summary (page 240) patient was admitted on 16.04.2006 and discharged on 09.06.2006. Diagnosis was CAD/systemic hypertension. Coronary Artery Bypass Graft X 3 on 21.04.2006. In the operation note (page 249 of Ext. D1) it is stated that Coronary Artery Bypass Graft X 3 (LIMA to LAD, SVG to OM2 and LPDA)was done on 20.04.2006.

Incision: Median Sternotomy. LIMA was harvested and had good flow.

Findings: Good LV Coronary anatomy as per angiography.

Perfusion Data:

Myocardial Protection : Cold Blood Cardioplegia.

Core Temp : 32^o C Oxygenator :

Cross Clamp min Bypass min

Graft Details :

LIMA to LAD (2 mm, good run off)

SVG to OM2 (1.5 mm, good run off)

SVG to LPDA (1.5 mm, good run off)

Off CPB : With ease in SR

Closure: Left plunal and mediastinal drains. Steel wires to Sternum. Vicryl to soft tissues and skin.

As regards course in the hospital as per discharge summary, in page 240 of Ext. D1 “After routine pre-operative evaluation the patient underwent CABG X3 (LIMA -LAD, SVG-OM2 LPDA) CPB on 21.04.2006. Post operative the patient developed dermal injury over the back probably secondary to thermal blanket. He was treated conservatively with dressing and antibiotics. At discharge he is asymptomatic and mobilised well and lesions have completely healed. In his cross examination complainant has deposed that his heart condition was serious when the bypass surgery was conducted and the heart operation at opposite party hospital on 21.04.2006 was successful. When asked “did you make any complaint with regard to the pain and discomfort in the back on the day of the surgery”, complainant said 'yes'. He further added that in the morning of 22.04.2006 he had no feeling of pain, since he was in anaesthetic condition. When asked “Do you believe that the mistake or defect in the machine caused you the alleged trouble, he deposed that “ I do not know, I was unconscious. I had burn due to somebody's mistake or machine's mistake”. According to opposite party, when the thermal blanket was used the patient developed allergic reaction due to his peculiar body temperature and skin nature, whereas complainant is of the view that the alleged trouble was not an allergic reaction.

Dr. S.K. Prabhu, Consultant Cardiac Surgey, of the opposite party hospital has filed his affidavit. In his proof affidavit, he has stated, the very complicated surgery where 3 bypasses were done for the blocked arteries was done as scheduled on 21.04.2006 itself. For 2 bypasses blood vessels (veins) from the legs were used and the important LAD vessel, an artery on the chest (internal mammary artery) was used. The surgery was done without any problems and the complainant was transferred to the ICU, on a ventilator as is the usual practice. At about 1.45 a.m on the next day when nurses were giving skin care to the back, they first noticed a few small blisters. Immediately the matter was informed to the duty doctor and appropriate skin care and antiseptic ointment were applied in the consultation with seniors. It is deposed by way of affidavit that the blisters were initially though to be due to allergic reactions to a thermal blanket used, as some patients do get such blisters even on application of skin plasters. However, the blisters became bigger the next day with peeling of skin, resulting in what appeared to be burns. The lesions were all superficial except the ones over the interscapular areas and the sacrum. These were slightly deeper but without involving any deeper tissues. They were appropriately managed with local antiseptics, dressings and later on with the involvement of a plastic surgeon. Because of the high quality of nursing care, the lesions were well looked after and the complainant did not have an opportunity to complaint of pain. Though not deep, because the blisters enlarged and broke down, leaving large raw areas, it took some time for healing. During this period, the patient was well looked after by the team consisting of doctors and nurses under the supervision of a plastic surgeon, the complainant was discharged when all the lesions were healed. DW1 has further deposed that the patient was not able to lie on bed on his back because of the discomfort of raw areas. He used to lie on his sides. The skin lesions would take time to heal. So it was only normal that the complainant had to have an extended stay at the hospital. DW1 doctor has been cross examined by the complainant. When asked DW1 about the technical feature of the thermal blanket, he has deposed that it is a specialized equipment used to rewarm the patient in open heart surgical cases, that during the surgery patient's body temperature is brought down to 28^o C to 32^o C to facilitate safe operative procedure on the heart, that at the end of the procedure, patient's body temperature needs to be restored and to help this a specialized equipment called thermal blanket is used. DW1 has explained further that the said equipment has got two parts-one is the blanket itself, which consists of small channel inside the blanket through which warm water is circulated, but the hot water never directly come in contact with the patient's body. The water is heated in another part of the equipment and in the part of the equipment there are temperature controls. The temperature can be set between 37^o C and 42^o C. It can never be got beyond 42^o C and that machine is equipped with an automatic cut off in case the temperature goes beyond 42^o C. DW2 has added that before starting to use this equipment, fresh water is put inside and at the end of the procedure, this water is discarded, that once the water is inside, we have no means of detecting the temperature of water inside the machine and we have to solely depend upon the automatic cut off of the machine.

The upper limit of the thermal blanket if not cut off automatically when it reaches 42^o C, whether it will cause burn (Q) “From my experience from 1999 onwards, we have never had such problems. If the temperature rises and unfortunately if it is not cut off, burns may be caused(A)”. Dr. S.K. Prabhu adds, in this case the temperature of the patient did not go beyond 37^o C. “Can you say how the burn has happened on the body of the complainant? (Q) Doctor has deposed that on the date of surgery, routine protocol was followed and there was no problem during the course of surgery and patient was shifted to post operative ICU. During the surgery, the patient is lying on his back and he lies on the thermal blanket and there will be a disposable cover for the thermal blanket and the patient is fully covered with drapes (cloth sheet). So there is no way of knowing what is happening on the patient's back. The patient was under anesthesia since he had undergone bypass surgery, he will remain on his berth he should not be moved until his condition stabilises. So even if any lesion on his back there is no way for us to detect that. So the next day when the staff turned him on his side to give back care, they noticed this lesion. When he came to know about this, initially preventive steps were applied on this blisters. Dr. S.K. Prabhu in his cross examination has deposed that using of this machinery is a part of the treatment as accepted by medical science. If there are no complications usually a patient who had undergone bypass surgery will be discharged after 7 days. In the case of the complainant, it took 51 days because skin lesion will take long time to heal. In his cross examination, doctor has deposed that body of the patient will be in contact with the thermal blanket only on the pressure areas. In a patient who is under anesthesia, the whole body will be touched the blanket. When asked that if it is an allergy, blisters would have been formed on the entire body touching the blanket, doctor deposed only touching area will be affected. For hygienic purpose, the disposal cover used in the blanket is disposed before using it on other patients. Doctor said, first, he thought it was allergic, then later only realised that it was burns. In his cross examination Dr. S.K. Prabhu said the burns on the complainant's body were not 3^rd degree burn. With regard to skin treatment also standardized procedure was adopted

Opposite party's administrative officer has been examined as DW2 and cross examined by the complainant. In his cross examination DW2 deposed that the treatment records Ext. D1 would give a detailed account of the complainant and attention given by the doctors and nursing staff. As regards overcharging, DW2 has denied it. DW2 has deposed that when treatment exceed the package days it is the normal practice of all hospitals to charge the patient as per schedule of charges for any services giving including room rent. But it has been the practice of this opposite party hospital to give considerable concession in such rare events. In this case also, opposite party had volunteered to give such concession because of prolonged hospital stay, though it happened not due to the fault of the opposite party as the complainant erroneously believes. This is just a goodwill measure. As regards machinery, DW2 has stated that he has no idea about the technicality of it. When complainant suggested that there is something wrong with the said machine, DW2 has denied it and added that the same machine has been used prior to and after the surgery of the complainant, no complaint has been reported so far as regards the said machine. In his reexamination DW2 has deposed that there is a biomedical engineering department in opposite party's hospital, which is well equipped and all equipments are under the control of qualified engineers in the said department. 100% working conditions of all machineries are to be assured by the said department and if any defect caused which will be rectified by the perfusion scientist. Perfusion scientist of the opposite party hospital has been examined as DW3. According to DW3, surgeon requires stand still blood free heart to operate. It is the perfusionist who looks after the patient's life during the bypass period. Heart lung machine and temperature control machine are the two equipments which are mainly required for the perfusionist to conduct a bypass surgery procedure. When he was asked about the use of that equipment DW3 deposed that after receiving the patient in the operation table anesthetist prepares the patient with peripheral arterial and central lines and incubate the patient by putting the nasal table, at the same time the perfusionist prepares the heart lung machine with proper tubing and accessories. DW3 added that when a patient is received, his normal temperature is 36.9 or 37, that when patient is received in the operation theater(OT), normally temperature of the OT would be between 22 & 25^o C, so patient's temperature also goes down before the main surgical intervention. In the instant case the patient's temperature was 34^o C and temperature readings of the patient during the course of surgery is recorded in page 235 of Ext. D1. According to DW3, the patient's surgery started at 11.41 a.m and bypass was off at 1.33 p.m, that perfusionsit cooled down the temperature of the patient to 29.7, so as to reduce the anabolic rate, that at the end of the surgery once the main procedure was over, temperature was slowly and steadily brought upto 36.9^o C and perfusionist's role finished at 1.33 p.m. According to DW3 if there is delay in raising the temperature to the normal level, perfusionist will loose the patient. DW3 has further added that today morning also they used the machine in dispute and they never found any defects therein so far. When asked him about the use of the machine whether manually or automatically, in his cross examination, DW3 said that the machine works manually since they have to switch on and set temperature and then they have to command the machine to start, then it will continuously work automatically, that there is a temperature cut off which works automatically. As regards the safety devices in the machine, DW3 said, the machine has inbuilt safely devices, the machine itself has a set up to cool as well as to warm and there is problem in it. DW3 in his cross examination has deposed that if there was any mistake on his part, the patient's life would have loosened or psychiatric problem would have arisen. As regards burns, he said he came to know it through this complaint.

We have heard the complainant in person as well as the learned counsel for the opposite party and gone through the entire materials available on record. There is no dispute on the point that complainant's heart condition was serious when the bypass surgery was conducted. There is no dispute on the point that the heart operation (bypass surgery) at opposite party's hospital on 21.04.2006 was successful. There is no dispute on the point that thereafter complainant had suffered pain due to burns on the back sides which resulted in his discharge after 50 days from the date of surgery instead of discharging after 9 days in the normal course. According to complainant, the aforesaid burn was due to negligence of the opposite party and due to prolonged stay for treatment of burns at opposite party hospital, he was given an additional bill for Rs. 76,912/- and when complainant refused to remit the payment he was given a discount and forced him to pay Rs. 28,944/-.

Thus in the facts and circumstances mentioned above, the question for consideration is whether the opposite party was negligent in performing the operation of the complainant.

Before proceeding further something should be said on “medical negligence”. Negligence is defined as a tort which is the breach of a legal duty to take care which results in damage, undesired by the opposite party to the complainant. It would comprise existence of a legal duty, breach of legal duty and damage caused by the breach.

Existence of legal duty:- Whenever a person approaches another trusting him to possess certain skill or special knowledge on a given problem and depends on him for service and dispensation of that skill, the second party is under an implied legal duty to exercise due deligence as is expected to act at least in such a manner as is expected in the ordinary course from his contemporaries. Failure on the part of such a person to do something which was incumbent upon him to do so, that which would be just and reasonable tantamounts to negligence. Every time a patient visits a doctor for treatment of his ailment he does not enter into any written contract, but there is a contract by implication and any lack of carelessness or proper care make the erring doctor liable for breach of professional duty.

Breach of legal duty: There is certainly a breach of legal duty if the person exercising the skill does something which an ordinary prudent man would not have done or fails to do that which an ordinary prudent man would have done in a similar situation. The standards are not supposed to be very high degree or a very low degree, but just the relative kind that is expected from an ordinary prudent man in the ordinary course of treatment.

Damage caused by the breach:- The wrong injury occasioned by such a negligence is liable to be compensated in terms of money and the courts apply the well settled principles for determination of the exact liquidated amount. In a complaint for damages on account of negligence the onus lies on the patient to prove that the doctor was negligent and the said negligence resulted in the injury which is complained to be compensated. Basically, medical negligence means such negligence resulting from the failure on the part of the doctor to act in accordance with medical standards or vogue which are being practiced by an ordinary and reasonably competent man practicing the same art. Once a doctor accepts a patient this principle became applicable. It may be stated here that to establish negligence on the part of the opposite party, the claimant must show (a) what is the standard care; (b) on the facts of the case, that opposite party's conduct fell below that standard; (c) that the same had resulted to some injury to the patient.

In the present case SUT Hospital is the opposite party. No allegation is levelled against the doctor who conducted the bypass surgery. On perusal of Ext. D1 treatment records it is seen the surgery was conducted by Dr. S.K. Prabhu. MS, FRCS (Edin) is the consultant Cardio Thoracic Surgery and that it could be assessed that he was having good knowledge and experience of branch of surgery. Complainant has no case that the doctors concerned had not exercised due deligence while performing the operation on 21.04.2006. No doubt, in this case after surgery, the complainant had suffered pain due to burns on the backside which resulted in prolonged stay in the hospital. In his cross examination Dr. S.K. Prabhu had given a detailed explanation. The thermal blanket is a specialized equipment used to rewarm the patient in open-heart surgery. During the surgery patient's body temperature is brought down to 28^o C to 32^o C to facilitate safe operative procedure on the heart. Dr. S.K. Prabhu has deposed further that there are temperature controls in the equipment, as such it can never get beyond 42^o C and that the said equipment is equipped with an automatic cut off in case the temperature goes beyond 42^o C. If the temperature rises and unfortunately if it is not cut off burn may be caused. In his cross examination Dr. S.K. Prabhu has deposed that in this case the temperature did not go above 37^o C. He has further deposed that using of this machinery is a part of the treatment accepted by medical science. There was no problem during the course of surgery and patient was shifted to the post operative ICU. He has further stated that during the surgery, the patient is lying on his back and he lies on the thermal blanket and there will be a disposable cover for this blanket and the patient is fully covered with drapes, so there is no way of knowing what is happening on the patient's back. The patient is under anesthesia. So even if any lesion on his back, there is no way for them to detect that. Next day of the operation when the staff turned him on his side to give back care, they noticed this lesion and doctor concerned came to know it only on the next morning, when he came for round, and initially preventive steps were applied on this blisters, antibiotics were given. Dr. S.K. Prabhu has further added that skin lesion will take long time to heal. That is why it took 51 days to discharge the patient. In the version it was specifically averred by the opposite party that blisters were probably due to an allergy, that allergy is the only reaction that happens to some patients, which gets aggravated by the heat of thermal blanket and that was caused only due to peculiar body composition and skin nature of the complainant. On the contrary in the matter of treatment, opposite party had proved by positive satisfactory evidence that they had taken reasonable care and caution in doing surgery of the complainant on 21.04.2006, to the best of their ability and knowledge of the subject and had acted in good faith in the interest of the health of the complainant. Complainant never adduced expert opinion to prove otherwise. Expert opinion is the basis for determining medical negligence. Complainant did not produce expert evidence to prove any negligence and deficiency in service on the part of the opposite party. In view of the above, we find opposite party is not guilty of medical negligence as long as they perform their duties and exercise ordinary degree of professional skill and competence. Complaint has no merits at all which deserves to be dismissed.

In the result, complaint is dismissed. Parties are directed to bear their costs.

A copy of this order as per the statutory requirements be forwarded to the parties free of charge and thereafter the file be consigned to the record room.

Dictated to the Confidential Assistant, transcribed by her, corrected by me and pronounced in the Open Forum, this the 16^th day of April 2010.

G. SIVAPRASAD,

President.

BEENAKUMARI. A : MEMBER

S.K. SREELA : MEMBER

jb

C.C. No. 274/2006

APPENDIX

I COMPLAINANT'S WITNESS :

PW1 - Thomas Chacko

PW2 - Jikey Chacko

II COMPLAINANT'S DOCUMENTS :

P1 - Photocopy of discharge summary

P2 - Photocopy of out-patient treatment card

P3 - Photocopy of the prescription of the ayurveda treatment.

P4 - Photocopy of prescription and treatment for the sprain and

swellings over limps and neck.

P5 - Photocopy of the prescription and treatment for keloid's

injections prior to a plastic surgery.

P6 - Photocopy of cash receipts (9 Numbers).

P7 - Photographs

P8 - Photographs of the present condition of the wounds

P9 - CD

III OPPOSITE PARTY'S WITNESS :

DW1 - S.K. Prabhu

DW2 - K. Haridas

DW3 - Venugopal

IV OPPOSITE PARTY'S DOCUMENTS :

D1 - Treatment records of complainant produced by opposite party.

D2 - Photocopy showing the technical details of the machine, with details of its manufacture.

PRESIDENT