A.SAIBABA GOUD vs L.THOMAS

AGGRIEVED by the order in O.P. No. 843/1994 (C.D. No. 843/1994) dated 7.9.1998 passed by the District Consumer Forum-I, Hyderabad the opposite party filed this appeal.

THE case of the complainant is that she consulted the opposite party on 27.5.1994 for treatment of her eye, who on examination advised her to join Geeta Nursing Home, Secunderabad for intra ocular lens implantation. He conducted the operation on 31.5.1994 and she developed severe pain in the operated right eye, but the opposite party was negligent to examine her and brushed aside her complaint as post operative pain. Not only that she was discharged forcibly on 2.6.1994 from the Nursing Home merely prescribing some pain killers like Combiflam, etc. However, the complainant appeared before the opposite party again on 6.6.1994 with a complaint of unbearable pain. He again disposed of her by merely prescribing some pain killers without bestowing any attention to the real problem which arose out of defective surgery, want of care and diligence. As there was no relief for her problem she consulted Dr. K. Ravi Kumar Reddy on 7.6.1994, who diagnosed the problem as post operative endopthalmitis and referred her to Dr. T.P. Das, Retinal Surgeon, L.V. Prasad Eye Institute where her right eye was operated and the I.O. lens implanted by the opposite party was explanted under vitrectomy by Dr. Ajit Babu and she was discharged on 17.6.1994 after getting cure and relief. However, though the pain was relieved, the sight which was deteriorated after the operation could not be improved, and she lost her vision in the right eye. THE loss of her eye sight in the right eye was the result of negligent and careless acts of the opposite party in maternity home which was not properly equipped to perform eye surgery. Due to loss of sight she had fallen and sustained injuries. She was treated at NIMS for her fracture for a period of 1 months. THE opposite party is responsible for this incident because her fall was due to imperfect operation done by the opposite party. She got a legal notice issued on 5.7.1994 to the opposite party which was replied with untenable allegations. She filed the complaint claiming a compensation of Rs. 1,00,000/- for the loss of sight and a further sum of Rs. 25,000/- as compensation for mental agony and suffering. In the counter filed by the opposite party it is admitted that the complainant was admitted in the nursing home on 30.5.1994 and surgery was performed on 31.5.1994. The operation was successful and necessary precautions to avoid any post operative complications were also taken. She was discharged on 2.6.1994 in normal condition. Three days later she returned and complained of pain. After due examination pain killers were prescribed to provide relief. He has not shown any negligence or lack of care at any stage of the treatment and so he is not responsible for deterioration in vision or pain or other complications. The complainant filed her affidavit by way of evidence and marked Exs. A-1 to A-21. The opposite party filed counter affidavit by way of his evidence.

On the basis of the material available on record the District Forum came to the conclusion that there is deficiency in service and accordingly directed the opposite party to pay a sum of Rs. 50,000/- towards compensation for the loss of vision in her right eye as well as mental agony and suffering undergone by her. It is this order that is questioned in this appeal.

THE fact that the opposite party conducted cataract operation to her right eye on 31.5.1994 and implanted I.O. (Intra Ocular) lens is admitted. THE case of the complainant is that when she complained of pain in her operated eye the opposite party brushed aside her complaint as post operative pain. On his advise the complainant was discharged forcibly on 2.6.1994 even though she was suffering from pain. She approached the opposite party again on 6.6.1994 with a complaint of severe pain but he merely prescribed some pain killers without bestowing attention to the real problem. THErefore, she consulted Dr. K. Ravi Kumar Reddy on 7.6.1994 who diagnosed the problem as post operative care endopthalmitis and advised her to undergo emergency vitrectomy. It was accordingly performed in L.V. Prasad Eye Institute and the I.O. lens implanted by the opposite party were explanted on 7.6.1994. She got the relief from pain but she could not regain sight which was deteriorated after the operation and the vision in her right eye was totally lost. She attributes that the loss of her vision was a result of negligent and careless act of the opposite party. She issued a registered notice under Ex. A-19 with all these details claiming compensation of a sum of Rs. 1,00,000/- for causing loss of sight and a further sum of Rs. 25,000/- for mental agony and suffering. A look at the said notice shows that the complainant was discharged on 2.6.1994 forcibly though she was complaining severe pain in the operated eye. THE opposite party brushed aside her complaint as a post operative pain merely prescribing some pain killers and usual medicines. In the reply notice, Ex. A-20 it is stated that the allegation that she developed pain and she was administered pain killers during her stay at the nursing home is totally incorrect and the patient was discharged on 2.6.1994 after due compliance with the necessary formalities and ensuring that her condition was normal. It is curious to note that it is not mentioned in the said notice as to what treatment was given and what medicines were administered even though there is a specific allegation in the complainant''s notice that she was given merely pain killers. As already seen the complainant has alleged in the said notice as well as in the complaint that she was suffering from severe pain in her right operated eye. In the reply notice it is merely stated that her condition was normal. So the question is, whether the condition of the complainant was normal on 2.6.1994 ? She appeared before the opposite party admittedly on 6.6.1994 with a complaint of severe pain. We have to see whether she has developed pain after discharge from the nursing home on 2.6.1994 or whether the pain continued from 2.6.1994 onwards and whether she was forcibly discharged. In the reply notice the opposite party as already seen did not state as to what treatment was given during the post operative period before discharge. The complainant states that she appeared before the opposite party on 6.6.1994 with a swollen eye complaining of acute and unbearable pain. In the reply notice the opposite party states that any complications which the complainant had developed are totally unconnected to the treatment and surgery performed by him. As the complainant re-appeared before the opposite party on 6.6.1994 with a swollen eye we are of the opinion that this complication is not unconnected with the surgery conducted by him. Further the discharge card shows that the opposite party party prescribed the following medicines : 1. Betanif Tab 2. Daonil Tab 3. Glyciphage 4. Septran D.S. 5. Betanosal Eye Drops He has not stated either in his reply affidavit or in the counter as to what post operative treatment he has given to the complainant. There is no material to show whether he has noted blood sugar level of the complainant before the operation to avoid any complication when the complainant approached him again. On 6.6.1994 he prescribed the following medicines without admitting her and conducting necessary tests for the complication that set in : (A) Atrisolow Eye Drops (B) Megaphin, and (C) Combiflam. Instead he neglected his duty to admit her and examine her thoroughly to find out the cause for which complications arose. Instead he prescribed these medicines mechanically without application of mind. This in our view is certainly a deficiency in service. This view of ours gains support from the fact that what could not be diagnosed on 6.6.1994 was diagnosed by another doctor on 7.6.1994 as endopthalmitis. The referral letter, Ex. A-6 written by Dr. K. Ravi Kumar Reddy clearly establishes this. This development had not grown all of a sudden within one day. In our view it was there on 6.6.1994 which could not be detected by the opposite party. It must have been earlier also when she was discharged on 2.6.1994 against her wish. The discharge was hastened and was forced on 2.6.1994 even though the complainant was complaining of pain without bestowing any attention for the said complaint. Therefore, we are of the view that the opposite party is liable for deficiency in service. It is stated by the complainant that as her problem was diagnosed as endopthalmitis on 7.6.1994 she got herself admitted in L.V. Prasad Eye Institute where emergency vitrectomy was performed on that day at 10.10 p.m. The complainant states that she is relieved of the pain but she lost the vision and the I.O. lens implanted by the opposite party were explanted. In spite of vitrectomy she lost vision in the operated eye. She, therefore, rightly attributes her loss of vision in the eye due to the deficiency in service rendered by the opposite party. In British Journal of South Asia Edition Vol. I, January 1998, John P. Whitcher states that even though endopthalmitis is a rare combination of cataract surgery its treatment continues to be a frustrating problem leading frequently to disastrous visual results. While analysing the reasons he states firstly that poor visual outcomes may be due to severe intraocular infection, secondly the size of the inoculum of the infecting organism; and the third and most important is the time lapse between the onset of symptoms and clinical diagnoses and the initiation of aggressive appropriate therapy. He states further as follows : "The faintest suspicion that the patient is developing endopthalmitis should lead to the immediate institution of a standardised diagnostic and treatment protocol such as the one described by Okhravi and colleagues in this issue."

Therefore, the treatment the opposite party should have given is to examine the problem of the complainant and diagnose the same as endopthalmitis which he failed to do. When the prognosis is not done in the initial stages the inevitable disastrous result would follow as it happened in this case. On the basis of the factual matrix placed before the District Forum it is more than clear that the opposite party failed to diagnose the problem correctly as endopthalmitis which is a complication of the surgery performed by him and due to his failure to prognosis the disease the complainant had paid a heavy price and lost total vision in her operated eye. Therefore, we have no hesitation to agree with the view taken by the District Forum in coming to the conclusion that the opposite party has failed to diagnose the problem of the complainant which resulted in the loss of her sight in the right eye. Under these circumstances the District Forum rightly in our view awarded the sum of Rs. 50,000/- for the loss of the vision in the right eye and also for pain and suffering caused to the complainant.

THE appeal, therefore, fails and is accordingly dismissed with costs of Rs. 2,000/-. Time for payment of costs Rs. 2,000/- 6 (six) weeks. THE amount lying in deposit can be with drawn by the complainant. Appeal dismissed.