SHANTHI vs Dean Govt General Hospital Chennai

THE complainants case is as follows: She had headache and vomiting. She was treated in the hospital of the opposite party where she was an in -patient for 20 days. They failed to give proper treatment to the complainant. They stated that she was in a coma stage. They advised the complainants husband to take her away from the hospital and arrange for her treatment elsewhere. Because of the negligence in giving timely treatment, she lost her eyesight and became paralytic. When the complainant consulted a Neurologist by name Dr. Baskar, he has advised her to go to Sankara Nethralaya where she is now taking treatment. The complainant has spent more than a lakh of rupees as a result of the negligence of the opposite party in treating her. They have failed to give her proper medical advice. They have not done proper diagnosis. She had thus suffered at the hands of the opposite party. She has lost her vision in her eyes on account of the act of the opposite party and, therefore, she claims a compensation of Rs. 20,00,000.

IN the version filed by the opposite party, it is stated as follows: The complainant was admitted in the hospital of the opposite party on 18.1.1998. She was referred from S.R.M.C. She was taken care of from the date of her admission to the date of her discharge. The discharge was against medical advice. She was properly investigated for her complaints of headache and vomiting and seizure L.P. Cerebrospinal fluid analysis was done twice on 21.1.1998 and 25.1.1998. Urgent C.T. Scan of brain was taken on 24.1.1998. Basal cistern was seen. X -ray of chest was taken. ECG was also taken. Blood investigation, Biochemical investigation were done. She was attended to by qualified Physician and Neurologist from the day of admission till discharge against medical advice. The complainant was also treated by Opthalmologist/Neurologist/Neurosurgeons/Physicians. The allegation that the opposite party failed to give proper treatment is false. The complainant was conscious throughout her stay in the hospital. The complainant was given best treatment for ''Retro Balbar Neuritis'' diagnosed at the hospital, with Inj. Methyl Prednisolone and natural history of Retro Balbar Neuritis blindness due to optic atrophy. It is not true to say that there was any negligence in giving treatment and that she lost her sight due to the negligence of the opposite party. The opposite party is not aware of the treatment said to have been taken by the complainant elsewhere. The complainant was treated in I.M.C.U. from 24.1.1998 to 3.2.1998. She got herself discharged against medical advice. She was carefully treated in I.M.C.U. by Physicians, Neurologist round -the -clock. The complainant and her husband were explained about the illness of complainant. The complainants husband has signed consent for treatment and discharged her against medical advice. The loss of vision in both eyes is the sequlae of Retro Balbar Neuritis and it was treated very well with injection Methyl Prednisolone with help of Neurologist and Ophthalmologist while she was in the hospital of the opposite party. The complainant did not pay any fee for treatment. Hence the provisions of the Act will not apply. The claim for compensation in a sum of Rs. 20,00,000 is exaggerated. Hence the opposite party prays that the complaint be dismissed with cost. The points for consideration are - (1) Whether there is any deficiency in service as alleged? and (2) To what compensation the complainant is entitled to?

POINTS : The complainant was admitted in the hospital of the opposite party on 18.1.1998 and she left the hospital of the opposite party on 6.2.1998. In the complaint, she has stated in paragraph 4 that at the time when she was admitted, she had complaints of headache, vomiting. The allegations made in the complaint are that she was not given proper treatment on the ground that she was in a coma state. She was advised to go elsewhere for treatment and that on account of their negligence to give timely treatment, she lost vision in both the eyes and became paralytic. It is also stated in paragraph 6 that there was no proper diagnosis. In the notice given to the opposite party, it is stated that the Doctors failed to give proper treatment on the ground that she was in coma stage. It is further stated in the notice that because of failure to give proper treatment, she lost her eyesight and also became paralytic.

IT is to be pointed out that the complainant has not examined any expert in support of her case. She ought to have examined an expert to say that what should have been the diagnosis arrived at on the basis of the tests carried out and what was the nature of treatment that should have been given and how and in what manner the opposite party failed to adhere to the standard of practice in treating her. Therefore, the complainant is not in a position to point out how and in what manner there has been deficiency in service on the part of the opposite party. That is why we pointed out to the complaint where it is stated that they had not given proper treatment stating that she was in coma stage. While so, now, it is stated that because of L.P. Cerebrospinal fluid analysis was done twice, she had become paralytic. It is not the case put forward in the notice or complaint. Nor anything is mentioned about spinal fluid has been taken on two occasions. Further, the husband has given consent for the spinal fluid puncture on 18.1.1998, the date of admission. Therefore, the contention of the complainants husband who represented her in the proceeding that on account of the negligence act of the opposite party in taking spinal fluid from the complainant on two occasions she had become paralytic is unacceptable. Further, the case sheet reveals that L.P. was done under strict aseptic precaution and 2% xylocaine was infiltrated on 21.1.1998 and 3 ml. of CSF was collected. P.W. 1 has stated in the course of chief examination that in January 1998 she had headache and she was admitted as in -patient and that a scan was taken and it was stated that it was normal. She states that at the time when the fluid from the spinal cord was taken for the first time she lost sensation in her right leg and arm and that when it was taken for the second time she lost her eyesight. As already pointed out, such a case is not stated either in the notice or in the complaint. It is further stated by her that they put her on rhyles tube forcibly as a result of which she began to bleed and at the time she was given some pills and after consuming the pill she lost her senses and was in a comatose for a period of three months. This is also not stated anywhere in the notice or in the complaint. In the cross -examination, she states that she left the hospital of the opposite party which their consent whereas from the case sheet, we find that it has been against their advice. She admits in the course of cross -examination that all necessary tests were done and that she was in the I.C.U. from 24.1.1998 to 3.2.1998. She admits that after she was discharged from the hospital of the opposite party, she did not go back again for treatment. It is also stated by her that she has not produced any record to show that she became hemiphlegic because of the act of the opposite party in taking spinal fluid on two occasions. The functions of her right limbs are normal. For she appeared before this Commission and walked to witness stand. She also signed the deposition with her own hand. Therefore, her contention that she lost the use of right arm and right leg cannot be accepted at all.

R .W. 1 is Dr. Vijayaraghavan. He has deposed on the basis of records maintained by the opposite party. From Ex. B1 which is the case sheet, it is stated by him that, on examination it was found that she had symptoms of brain fever. Therefore, fluid from spinal cord was taken and she was given necessary treatment to combat the brain fever. Since the fever did not subside again fluid was taken and she was shifted to I.C.U. where C.T. Scan was taken and a Neurologist examined her. At that time, according to the Doctor the patient complained that her vision was diminishing. Therefore, the Ophthalmologist was called in and she tested her and gave necessary treatment. He would further say that after carrying the necessary tests, they came to the conclusion that the complainant was affected with brain T.B. Therefore, she was given treatment and on account of the treatment given to her, her life was saved. It is further stated by him that the complication of loss of vision was the result of the Tuberculous Meningitis with Retro and that the said complication which has resulted from Tuberculous Meningitis with Retro could not be prevented in spite of their best treatment. He further states that she was advised that she had to remain in hospital and to take treatment for longer period, but they insisted upon being discharged and, therefore, she was allowed to leave the hospital. According to the Doctor, in spite of their best treatment the loss of vision which is the complication or effect of the attack of Tuberculous Meningitis with Retro could not be prevented. He further asserts that the complainant was never in a comatose stage while she was in the hospital.

IT is to be pointed out that in the complaint it is stated that she was refused proper treatment on the ground that she was in coma stage. On the other hand, we find from the records, Ex. B1 that at no point of time she ever lapsed into coma. Conveniently, now in her evidence, she states that after the insertion of rhyles tube forcibly when she complained of pains, to relieve of her pain, she was given some pills and after consumption of pill she had become unconscious for three months. Such a case is not set out in the complaint or in the notice. According to the Doctor, because of the seriousness of the disease namely Tuberculous Meningitis with Retro, she was in a drowsy condition and that she was never in comatose stage. He further states that if the complainant had continued the treatment in the hospital per -haps her vision would have improved and that the loss of vision was not on account of any deficiency in service on their part or wrong treatment but it is an inevitable and unexpected complication of the disease she was suffering i.e., Tuberculous Meningitis with Retro. In the course of cross -examination, he has stated that a term of doctors attended upon her and treated her while she was in the hospital. He denied the suggestion that without proper diagnosis she was treated. He asserts that necessary tests were carried out and the treatment indicated in the circumstances was given to her. In the course of cross -examination, it was suggested to the doctor that when the spinal fluid was taken for the first time she lost the use of right limbs. But, whereas that is not the evidence of P.W. 1 nor it is the case set out in the complaint. In fact, in the complaint, nothing is mentioned about the spinal fluid being taken. He further states that it was not a common headache with which she was suffering. If really, it was a common headache and vomiting, definitely the complainant who claims that she was at that time employed elsewhere could not have rushed to the opposite partys hospital and got herself admitted. She would have gone to some other doctor nearby and would have taken treatment if that was only a common headache. R.W. 1 further states that only after the extraction of fluid for the second time from the spinal cord, they could confirm it that she was suffering from Tuberculous Meningitis with Retro. He denies the suggestion that spinal fluid was taken by staff nurse. He says that it was done only by the doctor and it will not be even done by trainee doctors. A suggestion was made to him that because of the wrong procedure adopted in taking the spinal fluid, she lost her vision and movement of the right limbs. But the complainants case is that she lost her vision when she was in I.C.U. and after she was given some pill for relieving the pain, she suffered when rhyles tube was inserted. The other suggestion made to him was that without even ascertaining the proper cause they pre -concluded it as that it was a case of T.B. and treated her and, therefore, the consequences have arisen. But, on the other hand, a perusal of the case sheet would show that they carried out the necessary tests and got it confirmed as Tuberculous Meningitis with Retro only after the L.P. Cerebrospinal fluid was tested for the second time. According to him on 25.1.1998 the second L.P. Cerebrospinal fluid analysis was done and only on that day they had it confirmed that she was suffering from Tuberculous Meningitis with Retro. He further states that the brain fever can be caused either because of Tuberculosis or any other cause. According to him, on 18th on the date of admission she could not be treated on the basis that she was suffering from Tuberculous Meningitis with Retro because at that time they were not sure whether she was suffering from Tuberculous Meningitis with Retro or Bucear Neuritis or Meningo Encephalopathy, Immune, Infective. He further states that because of the impact of the disease she was suffering from, certain consequences such as loss of vision had followed and it could not be foreseen or prevented.

THEREFORE , an analysis of the materials placed before this Commission would show that the complainants case that there was negligence and deficiency in service cannot at all be accepted. On the other hand, from the records produced, we find that the complainant was taken care of well by the opposite party and necessary treatment was given and that the loss of vision followed as a result of the serious nature of the ailment she was suffering from and that it was an unexpected or perhaps an inevitable result or complication of the ailment she was suffering from and it was not on account of any negligence on the part of the opposite party and, therefore, there is no deficiency in service at all. Hence, it follows that the complaint deserves to be dismissed.

IN the result, this complaint is dismissed but in the circumstances without cost. Complaint dismissed. ===========================================================================