A.KUMAR vs HINDU MISSION HOSPITAL

COMPLAINANT was working as a helper. In the course of his employment, he was involved in an accident where an iron rotation motor fell on his right leg below the knee resulting in fracture of the same. The COMPLAINANT was taken to the Hindu Mission Hospital at Tambaram. The COMPLAINANT''s case is that at that time, the staff nurse intersed the needles in the artery while administering I.V. fluid in the right wrist portion and as a result of which the blood started gushing up the tube and this is clearly negligence and inefficiency and on account of the same, the COMPLAINANT''s two fingers and right index finger became necrotic and gangrene set in as a result of which they had to be removed. Therefore, claiming compensation the complaint had been laid.

THE Lower Forum dismissed the complaint and aggrieved by the same, the present appeal is preferred by the complainant. The complainant has stated in the complaint as follows: The staff nurse inserted the needles, probably not in the veins but in the arteries at the right wrist portion, as a result of which, instead of glucose dripping from the tube, blood started gushing up the tube. Therefore, from this very statement made in the complaint, it is obvious that the complainant is not sure as to what happened and he is only guessing that the staff nurse had probably inserted the needle while administering the I.V. fluid in the artery instead of in the veins. It is really an unfortunate case where the complainant had lost two of his fingers and a right thumb. But, because of that fact, one cannot find the opposite party guilty unless we have some materials to conclude that there has been deficiency and negligence on the part of the opposite party. The complainant admits that he was admitted for the fracture of his leg and the fracture was treated properly and that he was cured and there was fusion of the fractured bones in the right leg within four weeks and the complainant has been able to walk. Therefore, he has no grievance as against the opposite party with regard to the treatment given to him for the fracture sustained by him and from the very allegations made in the complaint, we find that he has been satisfied with the treatment and that the fracture had become all right with the fusion of bones taking place and the complainant now being in a position to walk.

In their version, the opposite party has stated that at the time when the complainant was admitted the complainant was in a state of shock on account of the accident, he was complaining of severe pain below the right knee and that he was highly restless and fidgety. Therefore, the Doctors had to first calm him down before starting any treatment for his injured leg. It is seen from the version as well as from the case sheet that he was administered certain injections intravenously and the patient was made ready for administration of I.V. drips. It is stated that at the time as the patient was highly restless and fidgety and was in a state of shock, it was quite difficult to find the vein in the wrist area, more so, because the artery is in closed proximity to the vein in the wrist area. According to them, unless the hand is kept motionless, it will be difficult to locate the vein. Therefore, while trying the probe for a vein, there was counter puncturing of the other blood vessels resulting in extra vasation of blood and on account of the extra-vasation of I.V. fluids, oedema of the right hand was set in. Thereafter, the placement of the needle was changed. From the records as well as from the version, we find that they took all anti-oedema measures. Necessary medication was also given. The hand was kept in an elevated position but in spite of it, some discolouration of the skin at the tip of the thumb and index finger of the right hand was noticed for which treatment was also given. They would say that the complainant''s case is, minimal Arteriospasm had set in and there was a mild discolouration of the skin. The records further establish that necessary precautions and care were taken to prevent loss of a major portion of the palm. It is also seen that on 19.6.1998, the line of demarcation of the right hand of the thumb and index finger had been drawn and thus the entire hand excepting the tip of the thumb and index finger had been saved.

THE complainant was discharged on 2.7.1998 with instructions to visit the hospital on the alternate day for dressing as dressing was absolutely essential so as to arrest infection. THE complainant does not say that he meticulously followed the advice by reporting on the alternate day. But, he was re-admitted on 12.10.1998 when assessment of vascularity was done. THE line of demarcation was found to be distinct and was just distal to the I.P. joint in the thumb and at the PIP joint of the index finger. As it became advisable to remove necrotic portions with a view to stop the spreading of infection, with the consent of the complainant on 13.10.1998 the necrotic portions were removed. In the version filed by the opposite party, it is stated as follows: "The opposite party submits that the complainant was got ready for I.V. drips. It was extremely difficult in finding the vein since the patient was extremely restless. At this juncture it is necessary to mention that in the wrist area the artery is in close proximity to the vein. It is, therefore, fairly tricky to locate the vein though this is easily possible if the hand is kept motionless. In the instant case, the complainant was suffering from shock and was, therefore, restless. As a result while probing for a vein there was a counter puncturing of the other blood vessels thereby resulting in extra-vasation. "Extra-vasation" means a flow of fluid outside the blood vessels on account of counter puncturing of the blood vessels. The opposite party submits that on account of the extra-vasation of I.V. fluids oedema of the right hand set in. Immediately the placement of the needle was changed."

Thus they have admitted clearly that instead of piercing the vein they had pricked the artery which was in close proximity to the vein. While they admit that it is fairly tricky to locate the vein, it is not known how and why they happened to pierce the artery. The complainant was then in shock. It is stated that he was restless. In such a condition, it is all the more necessary for the opposite party to have taken sufficient care and caution. They ought to have seen to it that his hand is kept motionless before starting the complainant on I.V. drips. It should have been supervised by a doctor especially when it is stated that it is tricky to locate the vein where the artery is in close proximity to the vein. This they have failed to do. Whether it was done by the nurse or the doctor, it has been done without taking basic precaution with the result that the artery was punctured leading to extra-vasation and resulting in oedema. This oedema had to be treated by the opposite party. They of course took the necessary steps to treat it by administering necessary medicines. But even according to them, as stated in paragraph 8, in spite of all the measures, mild discoloration of the skin at the tip of the thumb and index finger of the right hand took place and it was on account of the veinous oedema coupled Arteriospasm of right radial artery. It is also admitted in paragraph 8 that Arteriospasm in nature''s way of preventing excessive blood loss resulting from the puncture of the artery and in the case of the complainant minimal Arteriospasm had set in and there was a mild discolouration of the skin and later the steps taken to improve the blood did not succeed. Anti-oedema measures were very effective though it helped to bring down swelling. The final analysis was that amputation had to be done to remove the necrotic portions. Thus in fine, we find that the complainant has lost his thumb and index finger which are the most essential parts of the hand. And it was the right hand. This definitely would affect the complainant''s prospects of making his livelihood. He cannot grip or hold anything with his right hand. The complainant is admittedly a worker who was engaged as a helper. Therefore, for such a person, the use of the right thumb and right index finger is quite essential. From the very version it is clear that on account of the wrong insertion of the needles for administration of I.V. fluids, a puncture was made in the artery as a result of which oedema had set in and to prevent further infection and gangrenous condition the index finger and thumb were removed. Thus, from the version, we find a clear admission of negligence. They have failed to take necessary care and caution before administering I.V. fluids. They have been careless in administering it with the result the artery nearby was injured. As a result of the injury to the artery, the impairment has been caused to the complainant. Thus, we find that there is deficiency in service as much as the opposite party has failed to exercise reasonable care and caution and have further failed to exercise the necessary skill and standard of care and there was failure in observing the standard of care as a result of which the complainant has lost his index finger and thumb.

NOW, coming to the damages, the complainant has claimed a sum of Rs. 4,90,000. The complainant submits that he lost Rs. 4,50,000 by way of loss of earning. Excepting the complainant''s assertion, there is no other material. Of course, there is some physical disability and the Government Hospital has issued a certificate stating that the disability is about 35%. But the disability is not of such a nature that the complainant will not be in a position to do some work. Of course, there is disability caused by the negligence of the opposite party. As to the earnings of the complainant, we have so materials much less of acceptable nature. It is also not known whether the complainant was having work on all the thirty days of a month, and what was the wages he was receiving. Therefore, considering all these circumstances and the physical and mental agony suffered by the complainant, we would fix a sum of Rs. 1 lakh as a reasonable compensation to be paid to the complainant. In the result, this appeal is allowed. The order of the lower Forum is set aside. There will be a direction to the opposite party to pay a sum of Rs. 1 lakh as compensation to the complainant. In the circumstances, parties are directed to bear their own costs. Appeal allowed