16. In our case even before the 3rd opposite party doctor conducted the Mastoidectomy surgery on the complainant on 07.01.1998 she was suffering from conductive hearing loss of both ears as could be seen from the Audiometric Report under Ex.B1 series dated 20.12.1997. Hence, the 3rd opposite party had conducted proper procedure called Mastoidectomy under general aneasthesia. Perusal of medical literature shows that the Mastoidectomy is a surgical procedure that removes deceased mastoid air cells and this procedure can also be used to remove a abnormal growth of the ear known as a cholesteatoma. There are three types namely simple mastoidectomy, redical mastoidectomy and modified radical mastoidectomy.
17. Invariably in all literature it is asserted that this procedure Mastoidectomy is not common and patients suffering from the said conditions should be treated with anti-biotic and steroid and if this cannot cure the conditions then only the surgery should be resorted to. But in our case the complainant was not only suffering from infection but there was tympanic perforation which cannot be cured by medication alone and hence the doctor had correctly resorted to surgery namely Mastoidectomy. The complainant cannot cite any literature to the effect that some other procedure should have been adopted or the procedure adopted by the 3rd opposite party doctor was not a standard procedure.
18. A perusal of Ex.A1 and Ex.B1 series shows that the surgery was conducted on the complainant on 07.01.1998 and she was discharged on 13.01.1998 with advice to come for review. It reveals that the complainant had come for review before the 2nd opposite party hospital on 27.01.1998 and she was prescribed some medicines. But on 27.01.1998 when the complainant came for review she did not complain of any complications to the doctor who attended on her and hence there was no entry regarding any such complaint in Ex.A1 case sheet for the day 27.01.1998. Ex.A1 and Ex.B1 series would show that she developed some facial pharalysis on the 2nd post operative day for which treatment was given to her. From the medical literature stated supra it can be seen that the facial paralysis is the complication in such condition namely CSOM. In our case facial paralysis developed on the 2nd post operative day. Further facial paralysis is a known complication in the procedure called Mastoidectomy. Further a perusal of the literature would reveal that if the infected cells are not removed it is more likely that the infection might spread to the brain which would create severe complications. Hence adoption of the procedure called mastoidectomy for treating the condition by the 3rd opposite party doctor cannot be said to be negligent act and in the facts and circumstances of this case that was the correct procedure.
19. Further from the written version of the opposite parties and the proof affidavit of the opposite parties it can be seen that after discharge from the 2nd opposite party hospital on 13.01.1998 the complainant came for review on 27.01.1998 and thereafter she did not come for review. If at all there were severe complications due to the surgery conducted by the 3rd opposite party doctor the complainant should have frequently gone for review before the same doctor but that was not done by the complainant and no reason is forthcoming from the complainant for the same. Further when all the facilities were available in the 2nd opposite party hospital the complainant had on her own approached various other hospitals for the alleged complications and the opposite parties were not aware as to what where the procedures done in those hospitals. Hence we are of the view that no negligence could be attributed to the 3rd opposite party doctor in the matter of diagnosing and treating the complainant for her condition.
20. But as regards the consent for conducting mastoidectomy on the complainant on 07.01.1998 we are of the view that no proper and informed consent was obtained either from the complainant or from her husband even though as admitted by the 3rd opposite party the mastoidectomy surgery conducted on the complainant was an elective one. Further the complainant was not in a critical condition so as not in a fit condition to give any consent. Inspite of these circumstances the 3rd opposite party had not obtained the informed consent from the complainant for the purpose of conducting mastoidectomy procedure on her. If we peruse Ex.B1 case sheet it is found as follows;
“vdf;F kaf;f kUe;J nfhLj;J MgNurd; nra;a rk;kjk;”
21. But this consent was not obtained in the prescribed format. From this consent it cannot be taken that the 3rd opposite party doctor had narrated the condition with which the complainant was suffering and the kinds of treatment that could be given for that condition and what would be the complications if that treatment was not given and what would be the post operative complications in the event of conduction of surgery and what was the type of procedure proposed to be conducted on her. Hence we have no hesitation to hold that the so called consent letter found in Ex.B1 series cannot satisfy and fulfill the requirements to make it an informed consent. Hence though the 3rd opposite party doctor was not negligent in the diagnosis and actual treatment for the condition still conducting the surgery without obtaining a proper and informed consent from the complainant would be against medical ethics as propounded by the Medical Council of India and such practice has been repeatedly deprecated by the Hon’ble National Commission and Hon’ble Supreme Court of India.
22. In the light of the discussions held above we hold that there was medical negligence on the part of the 3rd opposite party in the matter of not obtaining a informed and valid consent for conducting mastoidectomy procedure on the complainant and hence there was deficiency in service on the part of the opposite parties and we answer this point accordingly.
23. Point No.1:- The learned District Forum has held that the complaint was barred by limitation. The complainant was admitted in the 2nd opposite party hospital on 06.01.1998 and a procedure called mastoidectomy was conducted on the complainant by the 3rd opposite party doctor on 07.01.1998 and the complaint was discharged from the 2nd opposite party hospital on 13.01.1998. The complainant in his complaint in para 2 would aver as “the complainant after discharge developed loss of sensation on the surgical part of the face. Accompanied with swelling and inability to close her left eye, in the result the eye become immobile. Though the post operative complication were brought to the notice of the doctor of the 2nd opposite party during the review period. The complainant was advised that during course of time the recovery would be in full and normal in the operated portion.”
24. The complainant would further aver that on 27.01.1998 as her condition became worse she consulted a Doctor in Vijiya Health Centre who referred her to Madras Neuro Diagnosis Research Centre where some tests were done and the doctor advised the complainant to consult the doctors at Dr.Agarwal Eye Hospital Ltd., and accordingly the complainant had consulted in the said hospital and after some tests in the said Dr.Agarwal Eye Hospital. The complainant had again visited the 2nd opposite party hospital and got treatment from the 3rd opposite party doctor but there was no improvement and hence she went to another hospital by name Apollo Hospital, Chennai on 10.12.1998 where, after taking some tests she was admitted on 15.12.1998 and some surgery was conducted on her for the condition facial weakness on the left side and was discharged on 18.12.1998 and another surgery was done on her on 26.07.1999 and thereafter the complainant had approached another hospital by name Rajan Eye Care Hospital for treatment of inability to close the left eye and some procedure was done there on 13.07.1999 and the case summary was given to her on 30.07.2001.
25. From the above it can be seen that after discharge from the 2nd opposite party hospital the complainant had continued to have treatment in various other hospitals till 30.07.2001. In the complaint in para 9 the complainant stated as “The complainant came to know about the negligent operation performed by 2nd and 3rd opposite parties when she was discgarged at Rajan Eye Clinic, on 30.07.2001 thereafter she was advised to file the Writ Petition before the Hon’ble High Court of Madras, Chennai in W.P.No.9029 of 2003 and the Hon’ble High Court by its orders dated 20.01.2005 was pleased to dismiss the writ petition and directed the petitioner to move the appropriate forum for appropriate relief, hence the present complaint is well within the limitation as per the order, hence question of latches does not arise,”
26. From the above pleadings it emerges that the complainant had come to a definite conclusion on 30.07.2001 that all the complications developed in her, resulting in loss of vision, loss of sensation and loss of hearing were due to medical negligence exhibited by the 3rd opposite party doctor when he conducted procedure on her on 07.01.1998. Hence even assuming that the cause of action continued from the date of discharge namely on 13.01.1998 till 30.07.2001 on which date the complainant came to the definite conclusion regarding medical negligence committed by the 3rd opposite party doctor still the complainant should have filed the complaint within two years from 30.07.2001 i.e. on or before 31.07.2003. But this complaint was filed only on 07.11.2005 i.e. well beyond the period of limitation i.e. on or before 31.07.2003. For this the learned counsel for the complainant would submit that the complainant had filed a writ petition in W.P.No.9029/2003 before the Hon’ble High Court of Madras, Chennai and the same was disposed of by an order dated 20.01.2005 dismissing the writ petition as withdrawn with liberty to move any appropriate forum for appropriate relief. Hence the period during which W.P.9029/2003 was pending before the Hon’ble High Court of Madras should be excluded from computing the period of limitation and if so excluded the complaint filed on 07.11.2005 was within time.
27. It is trite law that as per Sec.14 of the Limitation Act, 1963 the period during which the proceedings bonafide initiated by a party was pending before a wrong forum could be excluded from the period of limitation. In our case there is no pleading and there is no evidence specifically to the effect that the complainant had bonafide filed the writ potion before the Hon’ble High Court. Even assuming that the complainant had bonafide filed and prosecuted the W.P. before the Hon’ble High Court still the complainant had not pleaded and proved when he had filed the said WP so as to calculate the period of pendency of that WP. Hence, it is not possible to calculate the period of pendency of the WP for the purpose of excluding the said period from the limitation period. Because, the date of disposal of the Writ Petition alone is found in the complaint as 20.01.2005. Further it can be seen that the limitation for filing the complaint in our case started running from 30.07.2001. Even assuming that the WP was filed on the first working day in the year 2003 viz. 02.01.2003 (because the number of WP is WP.No.9029/2003) it has to be held that the WP was filed after 17 months from the date on which the limitation started running viz. 30.07.2001. Hence 17 months time in the limitation of period of 2 years was over even when the WP was filed. The WP was disposed off on 20.01.2005. A further limitation period of 7 months only was available to the complainant from 21.01.2005. If so the complaint should have been filed within 7 months from 21.01.2005 i.e. on or before 21.08.2005. Unfortunately, the complaint in our case was filed only on 07.11.2005 i.e. after a delay of 77 days. These 77 days of delay has not been explained by the complainant. It is pertinent to note that no separate petition under Sec.24A of the Consumer Protection Act, 1986 was filed in this case nor was any specific pleading explaining the said delay. Simply because the Hon’ble High Court of Madras had granted liberty to the complainant at the time of dismissing the WP to approach the appropriate forum for relief it does not mean that the complainant need not explain the delay over and above the period of pendency of WP. The liberty given by the Hon’ble High Court would only protect the complainant from the doctrine of Resjudicata.
28. Based on the discussions held above, we hold that the complaint is barred by limitation as held by the learned District Forum and we answer this point accordingly.
29. Point No.3:- Though we have held while answering point No.2 that there was deficiency in service due to medical negligence on the part of the opposite parties still the complainant is not entitled to any relief as we have held in point no.1 that the complaint was barred by limitation. Hence, we hold that the complainant is not entitled to any relief and this point is answered accordingly.
In the result, this appeal is dismissed. No order as to costs.
S.M.LATHA MAHESWARI K. BASKARAN,
MEMBER PRESIDING JUDICIAL MEMBER.
INDEX; - YES/No
Bsd/e/JM/Orders