Anasuyamma vs P RAGHUNANDAN

-AGGRIEVED by the order in CD No. 79 of 2000 on the file of District Forum, Ananthapur, opposite party preferred F. A. No. 880 of 2004. FA 879 of 2000 has been preferred by the complainants and since both these appeals arise from a common complaint they are being disposed of by a common order.

THE brief facts as set out in the complaint are that the deceased Anuradha is the wife of the first complainant and mother of the second complainant. The patient approached opposite party for terminating her pregnancy. Opposite party confirmed pregnancy and prescribed some medicines for termination. Since it was not successful opposite party fixed the operation on 1. 6. 2000 and the complainant brought all the medicines prescribed by the opposite party. The patient was taken into labour room and after 15 minutes opposite party informed the complainant that some complications have developed and advised them to take her to Manipal Hospital. First complainant arranged the vehicle and shifted the patient to Manipal but the patient was declared brought dead. The complainant requested the opposite party to give a copy of the case sheet but opposite party refused to give the case sheet and first complainant got issued a legal notice on 22. 4. 2000 requesting the opposite party to send a copy of the case sheet for which opposite party issued a reply but did not send the case sheet. Another notice was issued on 14. 6. 2000 after receipt of which opposite party sent a Xerox copy of the case sheet. The complainant submits that opposite party administered anaesthesia in high dosage and when the patient was being shifted to Bangalore opposite party did not arrange supplementary oxygen and ventilator and did not provide any medical assistance to the patient and was negligent in terminating the pregnancy of the patient which caused her death. Opposite party filed counter stating that there is a small inherent risk in the procedure of the MTP and this was duly explained to the complainant and her consent was also taken and that she took all necessary precautions and exercised her best diligence and there was no negligence on their behalf. The patient informed her that she had no history of allergy and she was not accustomed to oral contraceptives and that she has undergone caesarian during her first delivery. Opposite party first opted for local anaesthesia and prescribed Xylocaine. Opposite party also gave intradermal sensitivity test dose and also gave Tetanus Taxodic (TT) injection as a preventive measure after 10 minutes patient developed convulsions. Opposite party denies the allegations that Xylocaine was given in high dosage into intravascular system. Without post-mortem findings it is difficult to ascertain the cause of death and that the death may be because of any cause and therefore there is no negligence on their behalf.

Based on the evidence adduced i. e. , Exs. Al to A6 and Ex. B1 and pleadings put forward the District Forum allowed the complaint directing the opposite party to a pay a sum of Rs. 50,000 with interest at 9% per annum from the date of complaint till realization together with costs of Rs. 400.

AGGRIEVED by the said order the opposite party preferred appeal F. A. No. 880 of 2004 and the complainants preferred appeal F. A. No. 879 of 2004. The learned Counsel for the opposite party submitted that District Forum erred in holding that the opposite party did not provide ambulance with necessary facilities to transfer the patient to Bangalore and that opposite parties were negligent in administering anaesthesia in high dosage. The learned Counsel also contended that in the absence of post-mortem the reason for death cannot be ascertained and therefore negligence has not been established by the complainant.

THE learned Counsel for the complainants submitted that the opposite party is not approved under MTP Act, 1971 and that the opposite party failed to provide minimum medical assistance to the deceased in shifting process and that complications developed within 20 minutes because of anaesthesia over-dosage. We have gone through the material on record. It is not in dispute that the patient, late Anuradha approached opposite party on 16. 3. 2000 for MTP. It is also not in dispute that the patient developed complications immediately and she was advised to go to Manipal Hospital and that vehicle was arranged and she was brought dead to Manipal Hospital. According to the evidence of RW1, after administering Xylocaine, within 10 minutes the complainant suffered from convulsions and became unconscious. At about 3 p. m. the patient had fits. When heavy dose of local anaesthesia is administered to the patient, the earliest sign found in the patient will be contraction of muscles which was observed in the patient. The contention of the opposite party that the patient could be suffering from thrombosis due to pelvic inflammation is unsustainable on the ground that the doctor categorically admitted in her examination that the patient did not have any pelvic inflammatory and that she did not find the patient suffering from any disease when she examined her during 1st week of March 2000 and therefore the question of patient suffering from thrombosis due to pelvic inflammatory does not arise. We agree with the observation of the District Forum that the opposite party did not assist in providing an ambulance and also did not advise as to provision of proper facilities in the ambulance. Taking into consideration that the patient was taken in an open jeep when it was the moral and ethical duty of the doctor to have arranged for ambulance with proper oxygen facilities when the patient was in an unconscious state and had to travel a long distance to Bangalore, we are of the considered opinion that the opposite party was negligent in this aspect. The case sheet ought to have been provided and given to the patient when she was being transferred to another hospital. This was also not done by the opposite party which we find negligent. The exact line of treatment given because of which the patient expired has not been clearly established by the opposite party when it is her contention that it is not due to anaesthesia as alleged by the complainant. The principle of res ipsa loquitur can be applied here since the patient went into the operation theatre for a simple surgery like MTP and developed complications within 20 minutes which finally resulted in her death. It is also an admitted fact that the patient never suffered from any other diseases prior to the operation. However while the District Forum observed that there was clear deficiency of service and negligence by the opposite party awarded only an amount of Rs. 50,000 when the patient was a young mother leaving behind a minor of two years and husband who has lost her love and affection. For all these reasons we considered it a fit case to increase compensation of Rs. 50,000 to Rs. one lakh. Therefore the Appeal F. A. No. 880 of 2004 preferred by the opposite party is being dismissed while Appeal No. 879 of 2004 preferred by the complainant is being allowed partly and we raise the compensation awarded by the District Forum from Rs. 50,000 to Rs. one lakh while confirming the other aspects of the order of the District Forum.

IN the result F. A. No. 880 of 2004 is dismissed and F. A. No. 879 of 2004 is allowed increasing the compensation from Rs. 50,000 to Rs. one lakh while confirming the other aspects of the order of the District Forum. Time for compliance six weeks. Ordered accordingly.