S Girija vs A Tulasi

THIS First Appeal has been filed by Smt.S. Girija, complainant before the State Commission and Appellant herein being aggrieved by the order of the State Consumer Disputes Redressal Commission, Hyderabad (hereinafter referred to as the ''State Commission '') which although accepting her complaint of medical negligence awarded lesser compensation of Rs.1 lakh. Dr.A. Tulasi, opposite party before the State Commission, is Respondent herein. FACTS Appellant approached the Respondent/doctor with complaints of severe pains during her menstrual period. After examination, Respondent advised her to undergo an abdominal hysterectomy for removal of uterus. She accordingly got admitted in the nursing home for the said surgery and paid the Respondent a package fee of Rs.20,000/- which included the cost of the surgery, post-operative care as also expenditure on medicines. The surgery was conducted on 19.11.2000 and Respondent informed the Appellant ''s spouse that the operation was successful. However, when the catheter was removed after 6 days of the surgery, it was noted that the urine kept on dripping and this fact was immediately brought to the notice of the Respondent. Appellant was thereafter referred to a Urology Specialist, Dr.Mohan Raju at Nellore on 24.11.2000 who after examining her opined that the urinary bladder had got punctured during the surgery and if the hole was minute it would have healed within a day or two. Since this problem continued, Dr.Mallikarjuna Rao, another urology specialist advised that Appellant be immediately shifted for surgery to Vijaya Hospital, Chennai. After preliminary tests there, a Cyptoscopy was conducted and the problem was diagnosed as Vasico Vaginal Fistula for which she was initially prescribed conservative treatment which included fixation of catheter-connected plastic bladders. The Appellant also consulted Dr.T.Gopal Rao, a Urologist in Hyderabad for a second opinion who opined that the Appellant ''s urinary bladder had got punctured on account of negligence of the Respondent while suturing the upper portion of the vagina during the hysterectomy and a surgery to repair the Vasico Vaginal Fistula was recommended. On 08.02.2001, a team of doctors at Vijaya Hospital in Chennai conducted this surgery and she was discharged on 19.02.2001 after which she had to take full bed rest for about 3 months and also be under regular medical supervision for another six weeks. She was declared finally cured only on 10.12.2001. During this period, she had to depend on others for all her daily requirements and suffered mental agony and huge financial expenditure on account of the negligence of the Respondent while conducting the hysterectomy surgery and puncturing her urinary bladder. Appellant therefore, filed a complaint before the State Commission on grounds of medical negligence and requested that the Respondent be directed to pay her Rs.2,67,137/- towards medical treatment and incidental expenses, Rs.6 lakhs towards mental agony with interest @ 18% per annum from 16.02.2001 till realization. Respondent on being served filed a rejoinder denying that there was any medical negligence and stated that the problem occurred because the patient did not cooperate and on the 6th day removed the catheter against medical advice. It was further stated that the Appellant had already undergone two caesarean sections and during the surgery, Respondent found that the bladder was very much adherent to the uterus which often occurs because of caesarean sections. The complication that occurred during the surgery is known to occur in respect of patients who have undergone previous surgeries and it was not because of any medical negligence on the part of the Respondent. The State Commission after hearing the parties and examining the evidence filed before it allowed the complaint by observing as follows: "In the present case the PWs.3 and 4 who are Specialists in Urology clearly stated in their affidavits that the hole in the urine bladder occurred due to the negligence of the doctor while conducting hysterectomy surgery. From the record we observe that the complainant was taken to Chennai and admitted in Madras Institute of Urology, Vijaya Hospital, Chennai on 26.11.2000 where after conducting preliminary tests the doctors have conducted "Cyptoscopy " operation on 29.11.2000 and diagnosed the problem as "Vasico Vaginal Fistula ". From the record it is also observed that a team of doctors in Vijaya Hospital, Chennai conducted surgery on the complainant on 8.2.2001 after she was examined by the Departments of Cardiology, Diabetes, Orals and Anesthesia. The Ex.A-8 discharge summary issued by Madras Institute of Urology under heading "Cystoscopy " it is clearly noted "P.V. done: through the scope able to see the finger entering the bladder " ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ...Due to the negligence on the part of the opposite party the complainant has suffered the problems of undergoing several clinical and diagnostic tests. Apart from that she has suffered pain and agony while undergoing hysterectomy surgery, cystoscopy and VVF surgery. "

THE State Commission directed the Respondent to pay Rs.1 lakh towards medical expenses and compensation within a period of six weeks failing which the said sum shall carry interest @ 9% per annum till the date of payment. Rs.3,000/- was awarded as litigation cost. This order was accepted by the Respondent who did not file an Appeal. THE present First Appeal has been filed by the Appellant for enhancement of the compensation. Counsel for both parties made oral submissions. Counsel for Appellant stated that following the hysterectomy because of the admitted negligence of the Respondent, she had to consult a number of doctors, undergo a Cyptoscopy and then a major surgery and even thereafter she was bed-ridden and totally dependent on others which would justify enhancement of the compensation. THE expenditure incurred on medicines alone was Rs.2,67,0000/- for which evidence was filed. Counsel for Respondent on the other hand stated that there was no case for enhanced compensation and the State Commission after taking into account the expenditure incurred and assessing the Appellant ''s contention of mental agony and harassment awarded a compensation of Rs.1 lakh which under the circumstances is not a lesser compensation. We have heard learned Counsel for both parties and have carefully gone through the evidence on record. In the first instance, we note that the Respondent has not filed an Appeal against the finding of medical negligence against him. Further, we have gone through the evidence filed by the Appellant on the expenditure incurred by her as also the undisputed fact that she had to undergo several tests and another major surgical procedure to repair the damage to her urinary bladder caused during a reasonably common surgery i.e. Hysterectomy. While we are of the view that the statement showing the medical and related expenditure incurred by the Appellant of Rs.2,67,137/- is on the higher side and is not supported by receipts, we find substance in the request of the Appellant that the compensation awarded to her is less than justified, keeping in view the expenditure incurred by her and the mental agony and suffering caused because of the puncturing of the urinary bladder. We are, therefore, of the view that this is a fit case where the compensation is enhanced from Rs.1 lakh to Rs.2,50,000/- taking into account the medical expenditure incurred as also compensation for mental agony and harassment. Respondent is therefore directed to pay the Appellant, Rs.2,50,000/- for medical expenses and compensation and Rs.3,000/- as litigation cost within a period of eight week from the date of receipt of this order failing which the entire amount will carry interest @ 9% per annum from the date of default till realization. Counsel for Respondent states that Rs.1 lakh has already been deposited by the Respondent before the State Commission. If that be so, this amount be adjusted against the compensation awarded to the Appellant by us and the balance be paid to the Appellant within the stipulated period.