ROHINI DEVI vs H.S.CHUDAWAT

DR. H.S. Chudawat (Opposite Party No.1) runs an eye hospital under the name of "Alakh Ashish Eye Hospital" at Durga Marg, Ashok Nagar, Udaipur. Complainant Smt. Rohini Devi, aged 45 years, is wife of DR. Mohan Lai Paliwal, Managing Director, Krishna Chemicals, Udaipur.

COMPLAINANT Smt. Rohini Devi had catract in her right eye. She consulted opposite party No.1 on 10.10.90 who advised her to get intraocular lens implanted in her eye after operation for catract. On 24,10.90 herright eye was operated for cataract and after operation, intraccular les was implanted inside her right eye so that the complainant may be able to see without using spectacles. An amount of Rs. 1500/- was charged by opposite party No.1 as fees for this purpose. According to the complainant, the operation was not successful because th vision did not return normal for six months. Complainant had been contacting opposite party No.1 for check-up after every fortnight. On 22.3.91. it is alleged, the opposite party No.1 advised for getting a more costlier intraocular lens implanted in eye. It is alleged that opposite party No. 1 guaranteed that on re-implantation of the lens, her eye-vision would certainly become normal. On 1.4.91, opposite party No.1 re-operated the right eye of the complainant and another intraocuar lens was implanted in the eye after charging an amount of Rs. 3500/-. However, despite that vision of right eye of the complainant did not return. The complainant met opposite party No.1 several times with her husband and she was assured that vision would surely return. Ultimately, the complainant consulted a Senior Doctor in General Hospital and the latter advised her that the intraocular lens implanted by opposite party No.1 should be got removed otherwise considerable damage would result to her eye. Doctor of General Hospital also told that there was no vision in the eye in which dislocated lens is implanted. Her right eye was again operated on 7.1.92 in the General Hospital and the intraocular lens was removed from the eye.

The complainant has alleged that on account of mis-advise of opposite party No.1 and his incompetent and irresponsible service, she lost the vision of the right eye for ever despite being operated twice, opposite Party No.1 was insured under a professional indemnity insurance with opposite party No.2. On the basis of these averments, the complainant has claimed a total compensation of Rs. 9.5 lacs from the opposite parties as detailed in the relief clause of the complaint.

VERSION of opposite party No.1 is that after carrying out necessary investigations and treatment, the complainant was advised to get intraocular lens implanted in her right eye after expectance operation of cataract. The complainant was explained possible ecceptana and pros and cons of post-operation. After operation, intraocular lens of U.S.A. was implanted. It is denied that the complainant had guaranteed the return of vision and it is pleaded that no such guarantee can be given by Surgeon. After implantation of the lens, the complainant was advised to consult him if there was nonacceptability of the lens. On 23-3-91 the complainant and the husband contacted opposite party No.1 and told the latter of the vision problem of right eye. Opposite party No.1 reoperated the right eye and implanted another intraocular lens of U.S.A. make on 1.4.91. The complainant was also advised for follow up treatment. After beirg satisfied with the operation and re-implantation of the lens, the complainant paid its charges after one month on 1.5.91. Thereafter the complainant did not come to opposite party No.1 for any follow-up treatment and on 5.8.91 served upon the latter a notice. It is pleaded that even vision had returned after operation performed on 1.4.91. It is said that the eye hospital of opposite party No.1 has all the modern facilities according to International Standard and ethics. Eye-treatment is being performed under the supervision and guidance of Dr. L.P Agarwal, Founder Director of Dr. Rajendra Prasad Centre for Ophthalemic Sciences, New Delhi and Dr. P.N. Nagpal, famous eye surgeon. Opposite party No.1 was a fully qualified Surgeon. Operation was performed and intraocular lens was implanted with due care and skill by opposite party No.1 and there was no negligence on his part. It was the complainant who did not have follow-up checking and treatment. It was due. to complainant''s own negligence that membrane developed in the eye and if the complainant would have got timely treatment of the same, condition of the eye of the complainant could improve. It is admitted that opposite party No.1 was professionally insured with opposite party No. 2. Version was also filed by Oriental Insurance Company. Opposite party No. 2 has stated, that the complainant has not produced any documents showing the exact condition of her eye prior to the operation and what it was after operation. As per the report of the investigator Mr. R.K. Vashishta, the complainant never complained regarding her lost vision. Despite advise being given by the doctors to get the intraocular lens removed, the complainant did not comply with the advice of doctors of General Hospital for six months. Opposite party No.2 has also stated that it had accepted the risk to the extent of Rs. 3,75,000/- for any one claim and of Rs. 7,50,000/- for all claims during one period of insurance. Loss, if any, caused to the complainant was due to her own negligence and fault and the insurance policy did not cover such loss or damage.

THE complainant had ca tract in her both eyes. Catract in right eye was greater than in left eye. She consulted Dr. H.S. Chudawat and he advised operation and implantation of intraocular lens. In his affidavit Dr. H.S. Chudawat has deposed that:- "Limbal incision, Planned Extra Capsular ca tract extraction was done by disposable 26 G, needle cystitome by cane opening capsultomy under mannital and visilon. By Hydrodissection nucleous was delivered and remaining cortex irrigated out with mannual irrigating and aspiration canula. Posterior chamber intra-ocular implant was done and wound closed by 10/0 sutures."

Dr. H.S. Chudawat has further deposed that immediate post-operative period was uneventful, but later on the complainant developed thickening in the posterior capsule and again behaved as catract. Thickening in capsule was so much that surgical dissection was must. Complainant was advised second operation. In the second operation, under aseptic precautions, mannital and visilon, through Limbal incision intraocular lens was freed and removed and posterior capsulatomy was done. In the effort of providing best vision to the complainant, another intra-ocular lens made by U.S.A.I.O.E Company was implanted as per recommended procedure. According to opposite party No.1 immediate operative period was smooth, but for final visual gain, long term follow-up was required and depending upon the response, long term medication and/or surgical intervention was as important as the operation itself. The complainant was advised accordingly. But the complainant did not care to take appropriate post-operative treatment. Opposite party No. 1 has said that after the operation on 1.4.91, the complainant was asked that she must take follow-up action and precaution, because her physiology was developing membrane. She failed to take any follow-up action and precaution. Because of the developing of membrane, the lens implanted could be dislocated. Complainant had shown her eyes in R.N.T.M. Medical College & Hospital, Udaipur on 6.1.92. She complained pain in right eye and that she was unable to see with right eye. The bed-head ticket of R.N.T.M. Medical College & Hospital inter alia mentioned dislocated lens. The complainant had also earlier shown her eye in General Hospital, Udaipur on 22.7.91 and in the presentation corneal thickness is mentioned.

POSTERIOR capsular opacification is the most important and frequent complication following simple ECCE with or without intraocular lens. The cenile mature catract has a low incidence as compared to nuclear, cortical or posterior sub-capsular variety. POSTERIOR capsular opacification required either Ndi YAS la ser capsulatomy or surgical maneuvering.

A series of 32 cases with posteriorly dislocated intraocular lens were studied. In 30 cases, different methods of management were tried. Reporitioning was done in.19. exchange fora/c IDL in 8 and removal of IDL in 8 cases. All were seen in the first post-operative week. Visual activity of 20/40 or better was observed in 15 cases with repositioning, 6 cases of exchange and one case of removal. In the two cases without any treatment, the visual outcome was 20/25 and 20/300. It is noteworthy that operation of catract was done by the opposite party No.1 on 24.10.90 and intraocular lens was implanted. There is nothing to show that the complainant felt any pain or trouble for about five months. There is also nothing to show that the complainant took any post-operative treatment after 24.10.90 and before 22.3.91 i.e for about five months. It was only on 22.3.91 that the complainant again consulted opposite party No.1 and she was advised operation. Had there been any negligence in the operation or in the implantation of intraocular lens on 24.10.90, the complainant would not have got the second operation from opposite party No.1. The opposite party No.1 re-operated the right eye of the complainant on 1.4.91 and implanted another intraocular lens. Complainant took medicine as prescribed by opposite party No.1 upto June 1991. Thereafter on 22.7.91 she showed her eyes in General Hospital, Udaipur and corneal thickness was noticed. She got herself admitted in P.M.T Medical College, Udaipur on 6.1.92 and got removed the intraocular lens. From the above facts, it cannot be inferred that there was any want of due care and skill on the part of the opposite party No.1 in performing catract operation and implanting the lens. That, on the other hand, appears to be that the complainant did not take care to have follow-up treatment and check-up after operation and intraocular lens implantation. Had there been trouble soon after first operation, she would not have waited for five months in again getting re-operation on 1.4.91. After re-operation on 1.4.91, the in traocular lens was got removed and another lens was implanted and for nine months, the complainant did neither complain of trouble to the complainant and also did not get the intraocular lens removed. It thus clearly appears that the complainant had either no trouble after the implantation and re-implantation of intraocular lens or she was herself neglectful in the follow-up treatment. Want of due care and skill on the part of opposite party No.1 or negligence on his part has not at all been established by the complainant.

Complainant is, therefore, not entitled to claim any compensation from opposite party No.1 or from the Insurance Company (opposite party No.2) and the complaint deserves to be dismissed.

COMPLAINT filed by the complainant is hereby dismissed. Parties are left to bear their own costs of the complaint. COMPLAINT dismissed.