Y.K.RAMA MURTHY vs L.P.NAGARAJAIAH

IN this complaint, under Section 17 r/w Section 12 of the Consumer Protection Act, 1986 the complainant has sought compensation in a sum of Rs. 3,01,331.50 with interest from the opposite party-Medical Practitioner. The opposite party is a Medical Practitioner having his clinic in KHB Colony, Basaveswaranagar, Bangalore. The opposite party is a family doctor of the family of the complainant.

IT is the case of the complainant that on 26.6.91, the complainant approached the opposite party for treatment of cough as he was suffering with it since 2 days. The opposite party examined the complainant, prescribed some tablets and also administered an injection to the right arm of the complainant. The medicine and the syringe used were of the opposite party clinic. IT is the further case of the complainant that within a few hours of injection pain started in the complainant''s right arm; the pain did not subside, it became acute, so the complainant again approached the opposite party at about 6.00 a.m. on 27.6.91 at his residence. The opposite party gave some tablets and rubbing ointment. Inspite of taking tablets, the pain did not subside. The arm began to swell. So the opposite party shifted the complainant to Mathru Nursing Home. Inspite of treatment given at Mathru Nursing Home, there was no improvement in the condition of the complainant. So he was shifted to St. John''s Medical College Hospital (SJMC Hospital), in the evening of 28.6.91. The complainant was admitted in the intensive care unit of SJMC Hospital and was in the said unit from 28.6.91 to 4.7.91. During the said period, his condition had become critical but subsequently the medicines given in the SJMC hospital, helped the complainant and he was discharged from the hospital on 18.8.91. Nextly it is the case of the complainant that the diagnoses at the SJMC Hospital was ''abscess due to injection and necrotising of the fasciatis''. There was an infection of the intramuscular tract. So skin grafting was also done there. The SJMC Hospital on investigation found that external bacteria''s have entered the body from the spot of injection. This was due to non hygienic and unsterilised conditions under which the respondent''s clinic runs. Unsterilised syringe and needles were used in the clinic which was responsible for necrotising fasciatis.

The complainant further averred that this was due to the gorss negligence committed by the opposite party in giving injection with unsteriled syringe and needle. The complainant, in consequence of which, suffered heavy loss and mental agony. The movement of the right arm has been restricted. The complainant, on the basis of these averments, sought compensation in a sum of Rs. 3,01,331.50 from the opposite party on various counts.

THE opposite party filed its version, admitted the fact that he was family doctor of the complainant''s family. THE opposite party also admitted that the complainant had come to his clinic, on 26.6.91, for the treatment of cough. THE opposite party on examining the complainant diagnosed it to be due to bad weather and prescribed some tablets and also administered the injection on the right arm. He has further stated that the injection given was betnosol injection as the complainant is allergic asthma patient. THE opposite party nextly averred that he had used disposable needle which the complainant had brought the tube and the needle from a shop. The opposite party denied the fact that the complainant after taking treatment on 26.6.91 had never approached him. The opposite party also denied the fact that it was he who shifted the complainant to Mathru Nursing Home. But the opposite party averred that he had called on the complainant while the complainant was in Mathru Nursing Home. It was a courtesy call. The opposite party came to know in the said nursing home that the complainant was suffering with cellulitis.

THE opposite party further averred that the external bacteria might have entered the body of the complainant due to his regular disease of allergic bronchitis. THE opposite party had never used the common needle for injection and as per his usual practice, he used only disposable syringe and needle. So in the case of the complainant also only disposable syringe and needle was used for giving the injection. THE opposite party on the basis of this averment, sought the complaint to be dismissed. During enquiry the complainant examined himself as C.W. 1, Dr. Nandakumar Jayaram, Medical Director, Mallya Hospital, was examined as C.W. 2 and the complainant also examined C.W. 3, Sri. Narayana Rao. The complainant got Exs. C 1 to C 35 marked in evidence. The opposite party examined himself as RW 1 and got one Dr. Krishnarajendra of Mathru Nursing Home, examined as R.W 2. We have heard the learned Counsel for the parties, perused the pleadings and material on record.

IT is not disputed that the opposite party. Medical Practitioner, gave an injection to the complainant on his right arm when the complainant had approached him in his clinic for treatment of cough. IT is also not disputed that the opposite party is a family doctor of the complainant. The complainant himself, in his evidence, has stated, thus: "The clinic of the opposite party is at a very short distance. Since about 10 years I am taking treatment with the opposite party. All our family members take the treatment with the opposite party. My mother was taking treatment for general complaints, I do not know the complaint which she had. Even my brother was taking treatment from the opposite party for certain general complaints. Opposite party Doctor, is our family doctor. The opposite party is a very busy practitioner. The opposite party Doctor as far as I know is Medical Consultant for Ashoka Hotel and BEL. I do not know to which other company he is working as medical consultant. I do not know how many patients every day come to the opposite party for treatment. I cannot say for how many times I had taken injections from the opposite party."

IT is also evident from the evidence of R.W.I. that he is a medical consultant for 13 institutions, that is, BEL, KEB, HMT, ISOR, MECON, Coffee Board, Central Silk Board, Central Government Employees Coordinate System, LIC, ITI and Indian Airlines and Karnataka Land Army.

THE grievance of the complainant is that the injection which the opposite party had given at about 9.00 a.m. on 26.6.91, to the right arm of the complainant, caused abscess, thereby syringe and needle of his clinic which caused abscess due to injection and necrotisicing of the fascia. The opposite party admitted the fact that an injection was given by him to the right arm of the complainant for his complaint of cough etc. But he stated that his usual practice is to make use of only disposable syringe and needle for giving injections and that the injection which was given to the complainant was also by the disposable syringe and needle which the complainant himself had brought.

The complainant has stated that within few hours of taking injection, pain became acute and so he went to the opposite party on 27.6.91 who removed him to the Mathru Nursing Home. The complainant, in this regard has in his complaint at para 3, averred thus: "3. Within a few hours of injection pain started in the complainant''s right arm beginning from the spot of injection. Pain did not subside but became acute. Therefore, again the respondent was consulted on 27.6.91 at 6.00 a.m. at his residence. He gave some more tablets and rubbing ointment. Inspite of the tablets the pain did not subside and arm began to swell. Therefore, the respondent shifted the complainant to Mathru Nursing Home which was close by to the respondent''s clinic."

THE complainant, in his evidence has in this regard, stated thus: "On the next day in the early morning I met the opposite party at his residence. THE opposite party gave me an ointment and a tablet, and told me that it would get subsidized. THEreafter the pain and swelling did not subside but it increased. In the evening of that day I was admitted in Mathru Nursing Home, Bangalore. Even there I did not get any relief."

THE version in the complaint, would go to show that it was the opposite party who removed the complainant to Mathru Nursing Home, but in his evidence, it was the complainant who got himself admitted in that nursing home. That is the evidence given by RW 2 Dr. Krishnarajendra, partner of Mathru Nursing Home, that the complainant was admitted in the nursing home who was accompanied by some of his relatives. THE complainant has further stated, thus: "Though I took that tablet but again the pain did not subside so I again went to the opposite party in the evening of that day. At that time the doctor-the opposite party gave one more injection. THE doctor gave the injection in the evening with the syringe and the needle of his shop. THEre was no pain by that injection."

THE complainant had even earlier taken injection from the opposite party and again on that day evening took one more injection from the opposite party, but that injection did not cause any pain or problem to the complainant. The complainant, with regard to the ailment which he suffered, has stated, thus: "I was treated for cellulitis at Mathru Nursing Home. I do not know the cause or the reason for the cellulitis."

''Cellulitis is an infection of the skin which has been described as under: ''Cellulitis, a bacterial infection of the skin and the tissues beneath it. Cellulitis is most commonly caused by streptococci bacteria, which enter the skin via a wound." The complainant himself has admitted, as referred above, that he was not aware of the cause or the reason for cellulitis. PW 2 Dr. Krishnarajendra has stated, thus: "When Ramamurthy came to our Nursing Home had cellulitis of the arm, that is, swelling of the arm and infection of the arm."

THEREFORE, it is clear that the ailment with which the complainant suffered was cellulitis and the complainant was not aware the cause or the reason for the same. In Bailey and Love''s Short Practice of Surgery, revised by Charles V Mann, R.C.G. Russell, at page 87, the ''cellulitis'' has been described, as under: "Cellulitis is inflammation spreading along the subcutaneous or a fascial plane often as the result of infection which strip progenies which has entered the tissue through an accidental wound, graze, or scratch, or following surgical incision. Unchecked, this may lead to septicaemia after a rapid spread within the tissues."

From this definition of cellulitis, it is clear that this infection may occur due to various reasons, Bacteria entering into tissues through an accidental wound, graze, or scratch, or following surgical incision. C.W. 2, Dr. Nandakumar Jayaram, had treated the complainant in SJMC Hospital, when he was admitted in the said hospital on 28.6.91. The final diagnosis made at SJMC Hospital, is injection abscess and necrotising fasciatis. CW 2 has in this regard, stated thus: "Final diagnosis made as per the records is injection abscess and necrotising fasciatis (i.e., spreading inflammation and damage of tissues)."

C.W. 2, has further stated, thus: "If the proper procedure is not followed while giving injection some bacteria may enter the body and cause abcess. Even if proper procedure is followed then also there is some possibility of bacteria entering and causing infection. Cellulitis and nectrotising fasciatis are both infective process. Cellulitis is spreading infection of sub-cutaneous tissues and another necrotising fasciatis is a spreading infection with damage to deeper structures, that is, fascia."

It is clear from the evidence of this witness that possibility of bacteria entering and causing infection even if proper procedure is followed is not ruled out. C.W. 2 has in this regard, further stated, thus: "It is true to suggest that without the knowledge or negligence of the doctor, bacteria entering the body and cause such infections. It is true to suggest that persons who are immulogical compromise are more prone to infections."

THIS evidence of CW 2, would make it clear that even without any negligence on the part of the medical practitioner, the bacteria may enter the body and cause damage.

IN the present case, as referred above, the complainant has stated that the opposite party gave injection to his arm with his own syringe and needle, that is, unsterile syringe and needle, few hours thereafter pain started at the sight of the injection. The opposite party has averred that he had used, in giving injection to the arm of the complainant, a disposable syringe and needle and the subsequent cellulitis caused to the complainant was not the result of injection given by him. Except this, the complainant has not placed any other material on record to attribute negligence to the opposite party in giving injection to the complainant.

The complainant has, of course, placed On record the material to show that swelling developed and infection took place. He was admitted to Mathru Nursing Home and subsequently the took treatment for a considerable time in SJMC Hospital, Bangalore, by that time cellulitis had taken the shape of necrotising of the fasciatis. ''Necrotising fasciatis'' is an acute life threatening infection of the super fascia and subcutaneous tissues caused by a variety of aerobic and unaerobic bacteria. The material which has come on record would go to show that there are number of reasons for causing cellulitis. As referred above, the complainant was unable to show the cause or the reason for the cellulitis and CW 2 has specifically stated that even on adopting proper procedure by the medical practitioner, there are possibilities of bacteria entering and causing infection.

THE Gujarat State Commission, while considering such of the facts in Consumer Education Research Society and Another v. Dr. Rotilal B. Patel and Others, reported in II (1994) CPJ page 342, held as under: "THE treatment given by the opponent No. 1 of giving injection of which prescription has been given to the complainant cannot be said to be non standard treatment. If the complainant was suffering from fever since long and when there is an epidemic giving of intra muscular injection cannot be said to be a non standard treatment. THEre are various reasons for infection. It is possible that it may be present when the treatment was given by Dr. Trivedi because infection was noticed on 25.7.87. It may be of origin of 10 days or origin of 4 days also but unless we know what treatment was given by Dr. Trivedi, we cannot jump to the conclusion that septicemia was the result of the injection given by the opponent No. 1. In any view of the matter, the heavy burden is cast upon the complainant to prove that septicemia was the result of either non standard treatment or negligence of the opponents and to our opinion the complainant has failed to establish this fact even though the qualified doctor was called as witness to whom this question could have been asked by the complainant."

Having regard to this material on record, it is very difficult to say that the opposite party had committed negligence in giving injection to the arm of the complainant. So having regard to this material, we are constrained to hold that the complainant failed to substantiate his claim that the opposite party committed deficiency in service in giving injection to the arm of the complainant. ORDER In the result, therefore, this complaint fails and it is dismissed. The parties are directed to pay and bear their own costs in this proceeding. Complaint dismissed.