K.K.UMMER vs JUBILEE MISSION HOSPITAL TRICHUR

THIS petition is riled under Section 12 of the Consumer Protection Act claiming a total compensation of Rs. 6 lakhs alleging medical negligence on the part of the opposite parties.

SHORTLY stated, the allegations in the complaint are as follows: The complainant was admitted to the first opposite party hospital on 2.2.1994 with recur- rent direct hernia and (L) Bulanocele. The second opposite party who is the surgeon attached to the first opposite party hospital performed an operation on the complainant for the ailments on 3.2.1994. The complainant was discharged from the hospital on 9.2.1994. Since during the later half of March, 1994 the complainant developed hardness and pain on the operated portion on both sides, he consulted the second opposite party. The second opposite party advised him that no medication is necessary and that the hardness and pain will disappear automatically. In the middle of April, 1994 the complainant developed acute pain at the pubic region and on the bones of his legs. He was not in a position to walk or even to move. He again went to the first opposite party hospital on 25.4.1994 and he was admitted to the hospital on 27.4.1994 and the second opposite party treated him by direct heating of the affected area. He also advised him to take some exercises and to walk. During this period it was admitted by the second opposite party during a discussion that he had put a surgical knot through the bone during the hernia operation and that might have caused infection of the bones of the pubic region. He also advised the complainant to prepare for an operation to remove the knot. On 12.5.1994 the complainant was transferred to Metropolitan Hospital, Trichur. Before that the second opposite party had brought Dr. Ramkumar of the Metropolitan Hospital to the bedside of the complainant for examination and consultation. The second opposite party told the complainant that the operation will be conducted by Dr. Ramkumar and he will also assist in the operation. At the Metropolitan Hospital Dr. Ramkumar diagnosed that the ailment of the complainant was Osteittis Pubic caused by infection of the bones at that area and that the infection was due to the hernia operation. Dr. Ramkumar conducted three operations at the pubic area of the complainant''s body on 13.5.1994, 6.6.1994 and 11.7.1994. After each operation the complainant was advised to walk and take exercises and the condition of the complainant deteriorated steadily. His pain became insufferable and he became totally disabled. He had to spend a huge sum of money towards his medical treatment. He was asked to undergo a number of tests and drains were inserted into his pubic region for draining out the serum through holes made by the purpose. On 15.8.1994 Dr. Ramkumar again conducted a minor operation to examine the infected area. The complainant''s leg was also put on traction. On 25.8.1994 he was discharged from the Metropolitan Hospital without getting any relief.

He was taken to the Medical College Hospital by his relatives, and he was examined by Dr. N.J. Mani, Professor of Orthopaedics and he was admitted there on 19.9.1994. Dr. Mani was also of the opinion that the cause of Osteitis Pubic with which the complainant was suffering was the hernia operation conducted in the first opposite party hospital. Under the treatment of Dr. M.J. Mani at the Kozhikode Medical College Hospital from 19.9.1994 to 19.11.1994 his condition improved to some extent. He was relieved of pain and could walk with difficulty, disabled permanently and even a slight strain on the legs causes pain. All the doctors expressed the opinion that the Osteitis Pubic was the result of the hernia operation conducted by the second opposite party. The complainant was a timber merchant who was having a monthly net income of about Rs. 5,000/- and he was unable to do any work connected with the business and was depending upon his relations for his daily needs. For the operation and treatment at the first opposite party hospital he was charged. The complainant was made to understand by the opposite parties that he will be relieved of the pain and that their services will be of the highest quality. But there was gross negligence on the part of the opposite parties. It is in those circumstances the complaint was filed claiming a total compensation of Rs. 6 lakhs under various heads.

A version was filed by opposite parties 1 and 2 denying allegations of medical negligence. It is also contended that the Jubilee Mission Hospital is a 700-bedded hospital with all basic departments and having 58 doctors, 130 qualified staff nurses, 90 sisters, 150 other staff and about 200 student nurses. In the version various treatments given to the complainant were also elaborately dealt with. It is also averred that on 25.3.1994 the complainant had complaints of backache alone. His wound was healed and repair was sound. For his complaint of backache Nacgel was prescribed and the complainant was directed to meet the Ortho Consultant. It was explained to the complainant that if the pain did not subside, he had to undergo an exploration and if it was found suture was the cause of pain, it was necessary to remove it. He was also told that this suture is taken as a standard procedure, for all hernia, close to the pubic bone, this suture was very important to perform a satisfactory repair. It was further averred that opposite parties were not aware of the nature of the treatment given to the complainant after 13.5.1994 and it was also stated that they were also not aware of the circumstances under which the complainant consulted Dr. Mani. It is also stated the actual cause of Osteitis Pubic is unknown and it may develop following surgical intervention. True Osteitis Pubic is non-infective and completely lacking in local or general signs of sepsis. There was absolutely no negligence on the part of the second opposite party and it is impossible to predict or prevent Osteitis Pubic as this complication is rare even in world literature. Finally it was contended that there was no deficiency on their part and the complaint is liable to be dismissed. On behalf of the complainant he was examined as PW 1 and PW 2. Dr. Mani who treated the complainant was also examined on commission as expert witness. Exts. P1 to P16 were also marked. On behalf of the second opposite party he was examined as RW 1 and Ext. Rl was marked. The complainant and both opposite parties also filed affidavits.

THE following points arise for consideration: 1. Whether the complication of Osteitis Pubic developed as a result of the negligent treatment and surgery conducted by file 2nd opposite party at the hospital of the first opposite party? 2. If so, what is the relief to which the complainant is entitled? 3. What is the order as to cost?

Point No. 1: In the affidavit filed by the complainant he averred in terms of the averments contained in the complaint. He was cross-examined by the Counsel for the opposite parties. Similarly the affidavit and evidence tendered by the second opposite party are also in terms of the averments in the version filed by them. The crucial evidence in the instant case has been tendered by Dr. N.J. Mani who was examined as PW 2. He was asked in the chief examination what is the Osteitis Pubic and he answered it is a condition affecting the pubic bone symphysis pubic and that the exact cause of it is not known. It is said that it can be due to an asceptic necrocia or it can be due to bacteria infection and can occur in various conditions like pregnancy, postpartum in athelets in any urological, gunocological and abdominal surgery. To a pointed question whether can it be caused as a result of surgical defect or indescretion, he answered not to his knowledge. He was also asked the question whether this condition can occur in a normal carefully done surgery and he answered it can occur. To a further question how it occurred, he answered nobody knows and there is no documentary evidence how this is caused. He has seen this Osteitis Pubic in hernia operations. It was also stated in any surgery there is a chance of infection and in hernia surgery there is chance of infection. In the cross-examination also he stated after surgical procedure anywhere near that area he has seen Osteitis Pubic. To his knowledge there is no documentary evidence of a test with which one identifies the patient who was going into Osteitis Pubic. To a question whether the Orthopaedics Principles and their applications by Samuel L. Turek M.D. is one of the standard text books on the subject he answered in the affirmative. Learned Counsel appearing for the opposite party brought to my notice the relevant passage in the above textbook, which reads as follows: "Osteitis Pubic is a painful condition about the symphysis pubic, usually developing after surgical trauma in adjacent areas, characterized by bony resorption about the symphysis and spontaneous reossification with subsidence of symptoms. Etiology: Symptoms develop within a few days or weeks after trauma usually surgical, about the lower pelvic region. In males, a suprapubic or retropubic prostatectomy most commonly antedates symptoms. In females pain often develops during the postpartum period, but the onset may occur during pregnancy or after extensive pelvic surgery. The actual cause is unknown. Infection has been blamed but local and general inflammatory signs are absent. Softening of the pelvic ligaments such as occurs during pregnancy suggests a predisposing factor. Local venous statis has been demonstrated. Damage to the venous plexus serving the pubic and ischium has been postulated and the resultant osserous hyperemia in turn causes local demineralisation",

IN the light of the evidence of the expert witness PW 2 and also the above observations in the text books, we are unable to say that the complication developed as a result of any negligence on the part of the opposite parties or their deficiency in service. The real cause is unknown and it is not possible to blame the opposite parties for the complications, which arose after surgery. We, therefore, hold that no deficiency on the part of the opposite parties is established.

THE foregoing discussion would show that the complainant is not entitled to get any relief. Accordingly the complaint is dismissed. We direct the parties to bear their respective costs. Complaint dismissed.