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Judgment
Dr. S.M. Kantikar,Presiding Member
This Revision Petition has been filed under Section 21 of the Consumer Protection Act, 1986 against the Order dated 24.06.2019 in Appeal No. 456/2017, passed by the Maharashtra State Consumer Disputes Redressal Commission, Mumbai, Circuit Bench at Aurangabad(hereinafter referred to as the ‘State Commission’).
The Complainant Chandrashekhar Birle filed the Complaint before the District Forum, Latur for alleged medical negligence wherein heavy doses of Dexamethasone were advised by Dr. Sachin Chavan (OP-1) which caused damage to his vision.
The District Forum dismissed the Complaint and the First Appeal filed by the Complainant before the State Commission was dismissed and the Order of District forum was affirmed.
Being aggrieved the Petitioner/ Complainant filed the instant revision petition.
Heard the learned Counsel on both the sides, perused the treatment record, inter-alia Orders of both the Fora.
There was delay of 86 days in filing the instant revision petition. In the interest of justice and for fair adjudication on merit, the delay is condoned.
The case of complainant that, the OP-1 administered Dexamethasone wrongly for Conjunctivitis. It given in higher doses. After discharge from the hospital, he suffered loss of vision, dry eyes, irritation, and red eyes. He therefore on 07.04.2015 visited LV Prasad Eye Institute at Hyderabad. He came to know there about the negligence of OP-1.
On careful perusal of medical record revealed that the Complainant was suffering from mouth ulcers, discharge from both the lips and redness of the eyes. He was examined by the OP-1 who diagnosed it as oral ulcers with stomatitis also suspected Drug reaction. The Complainant was admitted in Chavan Hospital and treated from 22.01.2015 to 27.01.2015. During treatment administered IV fluids and injection Pentocid 40 , Dexa Inj. and antibiotic. The call was sent to skin specialist Dr.Kolhe, who visited the patient at 5.30 pm on 22.1.2015 and suspected Drug Eruptions , accordingly prescribed medicines. The patient was monitored whole night. On the next day Injection Oframax IV with 100 ml Normal Saline , IV Pantocid 40 and Inj Dexa 8 mg advised. The blood sugar level was monitored. On 24.1.2015 the dose of Dexa was tapered to 4 mg IV BD ( twice a day).
The chequered history of this matter that the Complainant gathered information from literature and also sought one opinion from Prof. of Ophthalmology, Govt. Medical College, Latur. According to the opinion steroid cannot be used if the patient was suffering from Conjunctivitis (Annex P-7 colly). Based on the complaint of Petitioner’s wife Vaishali dated 25.04.2016, the committee of doctors in Civil Hospital carried out an inquiry and submitted a report on 05.08.2017 stating that “there was no substance in the Complaint”. On 04.09.2017 she further made an application to the Deputy Director, Medical Service, Latur Division to re-investigate the matter, however, intelligently she concealed the previous enquiry report of the committee. Further, in 2016, he filed a Criminal Complaint before the Judicial Magistrate. Thereafter, the matter was travelled up to Hon’ble Supreme Court and finally the SLP (Crl) No. 3871 of 2019 was dismissed vide Order dtd. 03.05.2019.
On careful perusal of medical record it is evident that the OP-1 informed the Complainant on 22.01.2015 about the severity of oral ulcerations, redness of eyes as “mucopurulent conjunctivitis". The OP-1 prescribed injections containing Pentocid, Clavam and Dexa. For first two days (23.01.2015 and 24.01.2015) three injections of 2 ml of Dexa containing 4 mg per ml of Dexamethasone phosphate. Thereafter, the dose was reduced to two injections per day for 2 days and the patient was discharged on 27.01.2015. It was alleged that the patient after discharge continued to suffer from dry eyes, irritation and redness in the eyes and therefore, took further treatment at L.V. Prasad Eye Institute.
It is pertinent to note that on 22.01.2015, at 5:30 pm, Dr. A. P. Kolhe (Dermatologist) visited the patient. On examination, erythematous rashes over face, ulcerations and exfoliation in the oral cavity seen with mild congestion. Dr. Kolhe diagonosed it as ‘Drug eruption’ therefore, he further prescribed IV Inj. Dexa 2cc 8 hourly with antibiotic inj. Oframax 1gm IV TDS. The patient showed improvement and the same treatment was continued for two days and thereafter, dose of Dexa was tapered to 4 mg IV TDS. He was discharged and advised to follow up with Dr. Kohle and to seek Ophthalmologist’s opinion.
The record of LV Prasad Eye Institute, it clearly documented that the patient was suffering from ? Autoimmune Cicatricial pemphigoid, kerato conjunctivitis sicca, ? Sjogrens syndrome. The treatment of choice was steroid and accordingly, steroidal eye drops ‘Lotocheck’ and ‘Lotopred’ were prescribed. To know further, I have gone through the standard text book of Phamacology by Goodman-Gilman. It was noted that use of steroids is efficacious in treatment of wide variety of inflammatory dermatoses. However, due to long standing tropical/local use of steroid will cause Ocular diseases. In the instant case the steroid was administered systematically. Even for suspected drug induced skin reaction antihistaminic and steroids advised. As per the extract from Sharma’s Book of Pharmacology – Ocular effects:- Cataract and glaucoma are possible due to long use of glucocorticoids. It is to note that in the instant case steroid was used for very short period. From the text book of Pharmacology by Satoskar the Biological life of Dexa is 36 to 54 hours and short term therapy for 1 to 2 weeks with moderate dose is unlikely to produce any harmful effects. In the absence of specific contraindications, short course of high dose, systemic glucocorticoids also may be given for diseases that are not life – threatening The instant patient was given medicines for 5 days, so as to cause any harmful effects due to use of such medicine.
It is apparent from the record that Dr. Chavan (OP-1) is a qualified physician M.D. (Medicine). Based on clinical findings, he advised the dose of Dexamethasone in tapering doses for very short period. Moreover, at L.V.Prasad Eye Hospital he was diagnosed to be ? Autoimmune Cicatricial pemphigoid, kerato conjunctivitis sicca, ? Sjogrens syndrome which are the casues of loss of vision. There he was prescribed Lotepred (steroidal) eye drops for mucopurulent conjunctivitis. In my view the treatment given by OP-1 was neither wrong nor an excessive. It was for short period with proper doses and in tapering manner.
Based on the discussion above, there is no apparent error needs any interference in the Order of State Commission. The Revision Petition is dismissed. The parties to bear their own costs.