M PUNDALIKA SHENOY (SINCE DEAD) Vs. RAMAIAH INSTITUTE OF CARDIOLOGY

JUDGEMENT

(1.) ONE Sri Pundalika Shenoy had filed this complaint against M/s. M.S. Ramaiah Institute of Cardiology and Gokula Education Foundation (Hospital) and its 3 Doctors praying for the direction to them to pay compensation of Rs. 19,82,853.00 along with interest @ 24% p.a. from the date of receipt of Notice dated 21.11.1996 and such other relief deemed fit. During the proceedings, the complainant died and his Legal Representative are brought in record. O.P. 3 Dr. Nityananda Shetty expired and deleted from the complaint under the Order dated 18.11.2004.

(2.) THE patient prior to the said operation, was working on the sales side headquartered at Bangalore and he was last employed as Sales Officer of M/s. Bharath Trading Company, Rajajinagar, Bangalore. He had put in 24 years of service involving vigorous travelling and canvassing for various products. He had been a very energetic person, after the implantation and operation conducted by the O.Ps., he has become a total recluse. He has been undergoing treatment regularly and he has advised to continue for indefinite period, but at the same time without much hope of improvement. The negligence and carelessness by O.Ps. has effected his health and mortality apart from depriving sources of livelihood. He cannot exert himself in any manner and has become burden to the family of wife and 2 young daughters, which has caused severe mental tension. He has to undergo Psychiatric treatment for Pschomatic Fobic disorder (still undergoing), caused on account of above facts. He has been advised to stay indoors till further advice, till he gets strength to move about. He requires the assistance of 3rd parties for his daily cores. This has caused serious apprehension whether he could lead normal life discharging marital obligations. He was earning Rs. 65,000 p.a. before he was hospitalized. He had bright future, but for the negligence of O.Ps., he would have not only continued to earn the said amount and would have gain more during the subsequent periods considering the normal increments, till the age of 60 years. He was likely to be promoted and would have earned considerably more amount than expected to be earned by him in the course of time. He has reasonably expected to leave beyond 60 years as generally, his family elders lived fairly longer period, and lived healthily. He would have been continued to be employed gainfully. His average gaining as per modest estimate to be Rs. 65,000 per year and making provisions for the increments, he would have earned not less than Rs. 1,10,000 on 60th year. In all, for the period from 1997 to 2009 (16 years) he would have earned not less than Rs. 12.50 lakhs. Considering all the above facts, the patient has claimed global sum of Rs. 19,82,853 as damages. The claim in the complaint is under 5 headsFor the reimbursement of charges and treatment, Rs. 1,05,000 in the O.P. Hospital, Rs. 44,520 Mallya Hospital Expenses, and loss due to earnings, 2/3 of Rs. 12,50,000 i.e., Rs. 8,33,333, and compensation for pain and agony and future medical expenses Rs. 10.00 lakh.

(3.) VERSION of O.Ps. 1 to 5 is that the facts and circumstances of the case requires elaborate oral and documentary evidence to decide the issues raised by the complainant, which is not suitable for adjudication in a time -bound proceedings under the Consumer Protection Act. It involves complicated questions of disputed facts in medical science and jurisprudence, which can be decided only after elaborate trial and scrutiny of various documents based on the expert opinion. This is a fit case to be decided by way of ordinary civil suit. They have admitted the complainant having admitted himself in the O.P. 1 Hospital with the complaint of pain in the left leg on 17.2.1996, and it was diagnosed as deep Venous Thrombosis of the left lower limb. He was in -patient from 17.2.1996 to 24.2.1996 and was discharged with the advice to take oral anti -coagulants. The fact of admission of the patient to a local hospital near his residence after he developed breathlessness at Vijayanagar and later on shifted to O.P. 1 Hospital on 21.5.1996 is admitted. The cause of breathlessness is on account of the complainant not following the medical advice at the time of discharge from the O.P. 1 Hospital at the first instance. The deceased complainant was admitted for the second time to the O.P. 1 Hospital on account of his utter carelessness, laches and negligence of not following the medical advice at the time of discharge from O.P. 1 Hospital. He developed breathlessness and also Haemoptysis. On observation, he had recurrent deep Venous Thrombosis and Pulmonary Embolism. Initial conservative treatment given was rest and elevation. He was started on heparin streptokinase and other resuscitative measures. In spite of this, he had recurrent episode of Pulmonary Embolism. After consultation and informing the complainant and his relatives about the advantages and disadvantages of the procedure of IVC Filter Implantation, besides the risks involved, the deceased was offered an insertion of IVC Filter Implantation to prevent fatal pulmonary embolism due to the recurrent attacks only as a life saving measure, and not as a cure in Deep Venous Thrombosis. Deceased consented for the said implantation offered by the O.Ps. and made part payment towards the cost and surgery for the said implantation, was performed on 30.5.1996. The IVC filter was inserted through the right internal jugular route, it is admitted. The process of implantation was projected on image intensifier. While performing the said procedure, deceased had cardiac tamponade and as an emergency was treated by the surgical exploration as it was the only chance of saving the deceased s life at that stage, it is a known complication during the said procedure and if not diagnosed in time and operated upon i.e., Median Sternotomy Operation, the deceased complainant would have ended up in fatality. The cardiac tamponade is rare one. After the operation sternotomy was closed using sternal wires and the patient had complete healed median sternotomy wound at the time of discharge on 12.6.1996. He was asked to follow up for the some time as the pain in the region of operation in the normal course would last from few weeks to a few months till the bone union takes place, at the time of discharge. Except for the hospital charges for the said implantation treatment collected from deceased complainant, they are not aware of any other expenses incurred by him. Rs. 1,05,000 mentioned is exorbitant and excessive. The complainant did not follow up any post operation treatment as advised and for reason best known to him and did not visit the hospital regularly after his discharge on 12.6.1996. There is no reason for the deceased complainant to doubt about the efficaciousness of the O.Ps. 3 to 5 since they are doctors of repute and the whole exercise in their efforts was done with due care and caution as a life saving measure with a bona fide intention to save the deceased complainant. In case of median sternotomy operation, the pain in the region may last for a few weeks to a few months. The post operative complications put forth in the complaint were not brought to their knowledge, besides no follow -up treatment was taken by the deceased complainant, as advised. After the sternotomy operation which was closed using sternal wire and the removal of the said wires is postponed for 8 -10 weeks to prevent sternotomy dehiscence failing which it will lead to yet another emergency. The operation at Mallya Hospital is as a result of negligence and lapses for not taking follow -up treatment regularly as advised to the deceased patient. The very fact that the complainant is still suffering and did not recover despite the treatment at Mallya Hospital, goes to show that the complications developed by the complainant are for the reasons beyond the control of the O.Ps., and the same are despite the best diligent efforts of the O.Ps. and maximum use of their knowledge, skill and expertise. The said post operative complications are unpredictable since medical science is empirical, and in the normal course none can foresee development of such complications since human body is complex and subjective. The suffering of the deceased complainant after discharge from Mallya Hospital cannot be attributed to the negligence of the O.Ps. in conducting the median sternotomy operation, which was done with due care and caution.