State Consumer Disputes Redressal Commission
Mangayarkarasi, W/O Gunasekaran, vs Union Of India, Government Of ... on 3 February, 2012
BEFORE THE STATE CONSUMER DISPUTES REDRESSAL COMMISSION AT PUDUCHERRY BEFORE THE STATE CONSUMER DISPUTES REDRESSAL COMMISSION AT PUDUCHERRY Friday, the 3rd day of February, 2012 Dispute No.2/2006 Mangayarkarasi, W/o Gunasekaran, No.16, Pillaiyar Koil Street, Kombakkam, Puducherry-10. Complainant Vs. 1.
Union of India, Government of Pondicherry, Rep. by its Chief Secretary to Government of Pondicherry.
2. Dr.S.Mohankumar, M.S., M.CH., Consultant, Plastic Surgeon, Specialist in Surgery Grade-II, Government General Hospital, Pondicherry, 240, Lal Bahadur Shastri Street, (Near Kamban Kalai Arangam), Pondicherry-1.
3. The Secretary to Government.
Department of Health & Family Welfare Services, Government of Pondicherry, Chief Secretariat, Pondicherry.
4. The Director, Department of Health & Family Welfare Services, Government of Puducherry.,
5. Resident Medical Officer, Government General Hospital, Pondicherry. . Opposite Parties BEFORE:
HONBLE JUSTICE THIRU J.A.K.SAMPATHKUMAR PRESIDENT TMT. K.K.RITHA, MEMBER-I THIRU K.ELUMALAI, MEMBER-II FOR THE COMPLAINANT:
Dr.V.Suresh, Advocate, Chennai and Thiru G.Balasundaram, Advocate, Puducherry.
FOR THE OPPOSITE PARTIES:
Thiru M.V.Vaithilingam, Government Pleader, Puducherry.
- for Opposite Parties No.1,3,4 &5.
Tvl, T.Murugesan, P.Rabindran and K.Ranganathan, Advocates, Puducherry - for O.P.No.2 O R D E R (By Tmt.K.K.Ritha, M.A., M.H.R., B.L., Member) The complaint is against the opposite parties seeking compensation for medical negligence
2. The brief facts of the case are as follows:
The complainant Mrs. G.Mangayarkarasi, an auto rickshaw driver plying it for her livelihood, was treated for the thyroid problem by Dr.Mohan Kumar, opposite party No.2 in his private clinic. The said opposite party No.2 received a sum of Rs.10,000/- from the complainant since the same operation would cost about Rs.20,000/- in a private clinic and advised her to undergo thyroid surgery at Govt. General Hospital, Puducherry (O.P.5) where O.P.No.2 is employed. No receipt was issued for the payment as it is the usual practice.
3. The thyroid surgery was conducted at the Govt. General Hospital on 4.03.2003 under the supervision of opposite party No.2 and discharged the complaint on 10.03.2003. After the surgery, the complainant complained of pain in her throat, vocal cord to O.P.No.2 for which, he advised her to wait for some weeks for the internal wounds to heel and recover her voice. Since she was suffering from severe pain in her throat, she could not speak properly also because of breathing problem. She attended Govt. General Hospital, Pondicherry as an out-patient in the initial stage, but on the advice of O.P.No.2, she regularly attended his private clinic.
The Opposite party No.2 treated her with medicine and reassured that she would recover from all her health problems gradually. During her numerous visits, the 2nd O.P. failed to review her condition to ameliorate her sufferings. The prescription given by O.P.No.2 on 15.03.2003 (Ex.C4) would show that the complainant was suffering from breathlessness and other complications.
4. During the treatment period, since the complainant conceived, she attended Govt. Maternity Hospital, Puducherry and the treating Doctors prescribed medicines to her by taking note of her thyroid surgery she had undergone. The complainant and her husband reposed confidence on O.P.No.2 and never felt the necessity to obtain medical opinion from another doctor. Since there was no improvement in her health condition even after a year, the complainant on 16.08.2004 went to JIPMER Hospital and for the first time she came to know the nature of surgery done on her which was sub total thyrodectomy. During the sub total thyrodectomy surgery some nerves had damaged permanently and to relieve her from difficulty, she underwent tracheotomy on 27.08.2004 from JIPMER Hospital. By this tracheotomy procedure a Jackson metal tracheotomy tube of size 32 was inserted and she has to be with that tube throughout her life, which requires regular treatment to clean the tubes and ensure that she should not contract with any infection. According to the complainant, there was negligence in the post-operative treatment by way of both medical and psychological advice given to her. Due to O.P.2s negligence, the complainant is dragged to a life of seclusion, unable to bring up her child with permanent metal pipe in her throat.
5. The complainant appealed to the Government of Puducherry for monetary assistance which was granted for her treatment in Apollo Hospital, Chennai. An enquiry was ordered by the Govt. of Puducherry for which the complainant appeared before the designated enquiry officer on 19.01.2005, who was biased in his enquiry and the result of the enquiry was not known to the complainant
6. On 24.03.2005, a legal notice was issued by the complainant to the opposite parties . To this, the O.P.No.2 alone replied on 11.04.2005 denying negligence and deficiency in service.
7. Even after surgery at JIPMER Hospital, the complainants health condition did not improve. She consulted doctors at Arupadaiveedu Medical College Hospital, Puducherry and doctors at PIMS Hospital, Puducherry. Since she continued to have acute pain, she approached Apollo Hospital, Chennai and was treated from 23.06.2005 to 26.06.2005. On 24.06.2005, fibreoptic laryngoscope was performed with confirmed bilateral abductor palsy of vocal cords. Since her TSH was high and her condition was irreversible she was advised not to go for further surgery.
8. Hence, the complainant prays to compensate her by the opposite parties for the damage, injuries, mental agony undergone by her to a tune of Rs.37,00,000/[.
9. The reply version of Dr.Mohankumar (O.P.No.2) is as follows:
Dr.Mohan Kumar,O.P.2 is working as a surgeon in Government General Hospital, Puducherry. The complainant was admitted in the hospital on 01.03.2003 and had undergone surgery for thyroid problem on 04.03.2003. It is not true that he suggested to the complainant to undergo the surgery in a private clinic which would cost Rs.20,000/- and therefore he undertook to perform the surgery at O.P.No.5 hospital and received Rs.10,000/- for the said operation. The complainant has not visited O.P.No.2s clinic numerous times with the complaint of severe pain in her throat and improper speech. It is not true that the complainants complaint was not taken up seriously and make any attempt to review her condition or prescribe medical tests. Also it is not true that the complainant was continuously taking treatment from the 2nd opposite party after the surgery was done at Govt. Hospital, Puducherry or met him during her pregnancy period. Further, it is not true that he did not inform the complainant about sub total thyroidectomy to be performed on her and the danger inherent in the surgery.
The present condition of the complainant is not the direct consequence of the thyroid surgery performed by the 2nd opposite party in the Govt. Hospital, Puducherry, but due to complainants slackness in taking proper post-operative care and later complications after surgery undergone in JIPMER Hospital.
10. Further, the complaint is barred by limitation since the complaint was filed after a lapse of nearly three years from the date of surgery done on 04.03.2003 from Govt. Hospital, Puducherry and not shown any sufficient ground for non-filing of the complaint within the limitation period of two years. Moreover, the treatment given by the 2nd opposite party is free of charge in Govt. Hospital, Puducherry. The complainant is not a consumer and the service rendered by the opposite parties are not coming under deficiency in service and therefore, the complaint is not maintainable on this ground and liable to be dismissed.
11. The complainant herself had directly attended the Govt. Hospital, Puducherry for her health problem but not on the advice and instructions of 2nd opposite party. On 01.03.2003, a thorough check-up was made,and the complainant was operated for thyroid on 04.03.2003 and discharged on 10.03.2003. The sutures were removed and her speech was recorded normal. The complainant did not complaint of any pain. Further, during intra-operative and post-operative period, the said operation was smooth and no remark of any kind of suffering noted by the visiting duty doctors. The biopsy report is Hashimoto Thyroiditis, which is an auto immune disorder. It is a generalized immunity disorder and progressive in nature affecting any/all the systems of the human body.
12. After the operation, the complainant met 2nd opposite party only on two occasions in his clinic, but not on numerous occasions as alleged by the complainant. The 2nd opposite party prescribed medicines for respiratory infection and general health and then the complainant failed to come for follow up treatment on the prescribed dates. Moreover, the 2nd opposite party is a qualified doctor having M.S., M.Ch. degree working as a Specialist Grade-II in general surgery unit in Govt. Hospital, Puducherry for the past 19 years selected for the post of Specialist in Surgery and Head of Surgical Unit in Department of Surgery.
13. The complainant was operated only after getting consent from her and her husband. She was discharged after the wound had completely healed and sutures removed. The complainant had no complaint of any difficulty in speech or breathing. The complainant had approached JIPMER Hospital only after a lapse of about one and half years from the date of the said operation and in the meantime, she became pregnant and delivered a male baby. This shows that she was in good physical condition and delivered the child without any stress. The JIPMER hospital records show that the nerve palsy was due to acute respiratory infection and it has nothing to do with the operation done at Govt.
Hospital, Puducherry. At the same time, O.P.No.2 was not aware of the continuous treatment taken by the complainant at JIPMER Hospital, Arupadai Veedu Medical College, PIMS Hospital and Apollo Hospital, Chennai. The compensation granted by the Government of Puducherry was only on humanitarian grounds and cannot be construed as for any negligence of the 2nd O.P. It is not true to say that the enquiry ordered by the Government was biased. Moreover, the complainant is a money minded person and it is clear from the claim of Rs.15.00 lakhs as compensation mentioned in her lawyers notice but in the complaint claiming a sum of Rs.37.00 lakhs. The allegation put forth by the complainant is to make a false claim and to defame O.P.2 when there is no deficiency in service and negligence on his part.
Thus, the 2nd opposite party prays to dismiss the complaint with cost in the interest of justice.
14. The counter version filed by the 5th O.P. and adopted by Opposite Parties 1, 3 and 4 reads as follows:
They are not necessary parties and deny all the allegations made by the complainant. The O.P.2 is a qualified doctor having experience for more than ten years and he took all precautionary steps for treating the complainant. An enquiry was conducted by Dr.K.Nandakumar, explained the treatment given by 2nd opposite party and advised her to take further treatment, but, the complainant never came forward to take treatment from Government Hospital, Puducherry periodically. The treatment taken by the complainant from other Institutions will not amount to deficiency in service on the part of O.P.No.2, unless it is proved by expert opinion. There is no justification given for the quantum of compensation claimed by the complainant and that the allegations are baseless and vexatious. Further, the Govt. Hospital, Puducherry is well equipped with modern machineries and new technologies are adopted and recruited only qualified experts well experienced and the doctors are taking good efforts for treating the patients. Therefore, there was no medical negligence on their part and prayed to dismiss the complaint.
15. After deliberations, the following issues are framed to decide the case on hand:
1. Whether the complainant is a consumer or not? and whether the complaint is barred by limitation?
2. Whether the complainant was consulting O.P.No.2, Dr.Mohan Kumar at No.240, Lal Bahadur Street, Puducherry for thyroid problem before getting treatment at G.H. on 25.01.2003 for preliminary investigations?
3. Whether the complainant was advised by O.P.No.2 while consulting him, to get treatment/medical investigations at G.H., Puducherry in January, 2003?
4. Whether the complainant was getting treatment/medical examination from 25.01.2003 to 01.03.2003 from Dr.Mohankumar, as out-patient at G.H. Puducherry?
5. Whether the complainant was admitted on 01.03.2003 in G.H., Puducherry for thyroid surgery in Ward No.22 on the advice of O.P.No.2, Dr.Mohan Kumar?
6. When E.N.T. Specialists were available on 01.03.2003 in G.H., Puducherry, is it not necessary to perform thyroid surgery only after consulting other E.N.T. specialists?
7. Is it necessary that as per prescribed tests, Fine Needle Aspiration Cytology (FNAC) ought to have been done prior to deciding the nature of thyroid surgery?
8. After post-operation period between 11.03.2003 till January, 2004 whether the complainant continued to meet O.P.No.2 in his clinic for further treatment and advice and informing him about the problem of breathlessness post surgery and other problems?
9. Whether the complainant was referred by Govt, Maternity Hospital, Puducherry to the physicians in G.H., Puducherry on 27.09.2003 (Ex.C10) to give his opinion about the nature of medicines mainly to be given to the complainant/patient as on Tab Eltroxin?
10. Is it true that thyroid tests conducted on 28.07.2003 (Ex.C6) would reveal that T4 is below normal range and TSH was abnormal? If so, what would be the implications for not giving treatment in this regard?
11. Is it true that on 15.03.2003 thyroductomy specimen biopsy record (Ex.C5) indicate that the complainant had Hashimoto Auto Immune Thyroid Disorder and that O.P.No.2 knew about this? If so, what is the consequence of not treating such Hashimoto Auto Immune Disorder?
12. When the complainant become critically ill requiring emergency surgery due to negligence of O.P.No.2 and doctors of O.P.No.5 Govt.
Hospital in not addressing progressive complications and not consulting available E.N.T. specialists about the treatment to prevent further progression of complications in the post surgery period.
Are the doctors liable for the consequences of not addressing progressive complications due to Hashimoto disease and auto immune disease?
13. Is it true whether the complainant was in critical condition when she was operated at JIPMER Hospital for emergency tracheotomy?
14. Is it true whether the problem suffered by the complainant was due to her own carelessness, negligence in not taking prescribed medicines and not coming for follow up action?
15. Whether the non-examination of medical expert is fatal to the complainant?
16. Whether O.P.No.5 Govt. Hospital after surgery of the complainant and after obtaining opinion on biopsy sample (Ex.C5) had given any discharge summary to the complainant? If not given, will it not amount to deficiency in service?
17. Whether the complainant is entitled for remedy as prayed for?
16. ISSUE No.1:
Medical Services are covered under the definition of service . Service includes rendering of consultation, diagnosis and treatment both medical and surgical, Indian Medical Association Vs. V.P.Shantha (1995) Supreme Court 272.
The contention of opposite parties in respect of limitation for filing the present complaint has been taken as preliminary point by this Commission and rendered finding ,over-ruled the contention of the opposite parties while sustaining the claim of the complainant vide order dated 04.01.2007. There was no appeal filed against the said order. The Order dated 04.01.2007 has become final. Therefore, the complaint is not barred by limitation. Hence, this issue is answered against the opposite parties.
17. ISSUE No.2:
The case record of the complainant, Ex.R17 shows that the complainant attended Unit-III, Ward 22 Surgery O.P.D. on 25.01.2003 under the care of Dr. Mohankumar (O.P.No.2). Again, the complainant attended O.P.2s unit on 29.01.2003, 05.02.2003, 19.02.2003 and on 01.03.2003, and she was admitted in the hospital for the surgery held on 04.03.2003. Also Investigation Forms, dt.19.02.2003 for U.S.G. Thyroid tests, T3 T4 and TSH were conducted by 2nd opposite party in Unit-III of Government Hospital, Puducherry for the complainant as an out-patient.
18. From the case record Ex.R17, it is evident that Preliminary medical investigations were conducted by Dr.Mohankumar (O.P.No.2) for the preparations of complainants surgery. Even after the discharge from G.H., Puducherry on 10.03.2003 (Ex.C2) the very next day, i.e. on 11.03.2003,the complainant visited O.P.No.2s clinic and the latter prescribed medicines under Ex.C3.
19. Dr.Mohankumar (O.P.No.2) in his Chief Examination has stated that .the complainant herself directly attended the G.H., Puducherry for her condition, but not on my advice and instructions. The complainant was admitted in G.H., Puducherry after thorough physical examination, laboratory investigation and pre-anesthetic evaluation on 01.03.2003 for surgery.
20. Again, Dr.Mohankumar, O.P.No.2, deposed at Page 9 of the deposition that .at the time of the incident, I was not running any private clinic at all. I deny that I have received any amount from the complainant. Only in the interest of the patient, I have performed the operation in Government Hospital in general ward at free of cost at the request of the complainant Further O.P.2 deposed that I was having only private consulting room and I have shifted it from that place about three and half years before
21. From the above deposition of O.P.No.2, it is clear that he was running a private clinic which he termed as private consulting room. The chain of incidents, i.e. the complainant attending O.P.D. in O.P.No.2s Unit on 25.01.2003, 29.01.2003, 05.02.2003, 19.02.2003 admission in the hospital on 01.03.2003 and for all medical investigations prior to the surgery held on 04.03.2003 would show that the complainant was not a stranger to 2nd opposite party contrary to what he has stated in his chief examination .that the complainant herself had directly attended the G.H., Pondicherry for her condition, but not on my advice and instructions
22.It is a dubious statement made by the 2nd opposite party that at the time of incident, I was not running any private clinic.. I was having only a private consulting room. Even in a private consulting room consultations can be given to the patients. Thus, 2nd opposite partys denial that the complainant attended the G.H., Puducherry directly and not consulted him in his private clinic is nothing but a falsehood which has adverse effect on the credibility of the very deposition made before this Commission.
23. From the facts of the case, Exs.R17, Ex.C3, deposition of O.P.2, CW1 and CW2, it is well established that the complainant was 2nd opposite partys patient prior to attending the O.P.D. at the G.H., Puducherry on 25.01.2003. Therefore, this issue is decided in favour of the complainant and against the 2nd opposite party.
24. ISSUE No.3:
It is proved in issue No.2 that the complainant attended Dr.Mohan kumar (O.P.2s) clinic prior to attending O.P.D. in G.H., Puducherry on 25.01.2003. Also, Ex.R17, the case record of the complainant shows that the investigation form dt.29.01.2003 for USG Thyroid Test, T3, T4 and TSH tests were conducted by 2nd opposite party in Unit-III, Government Hospital, Puducherry as an out-patient.
25. The complainant and her husband deposed before this Commission as CW1 and CW2 stating that the 2nd opposite party demanded Rs.20,000/-, but, they paid Rs.10,000/- for arranging complainants surgery at the G.H., Puducherry. The common practice is that for the fees paid by the patients in private clinic for consultation, the treating doctors do not tender any receipt and the patients never demand for the same. It is purely on good relationship between the doctors and the patients attending the clinics. It is needless to make an attempt to accept or refute whether Rs.10,000/- was the actual amount paid by the complainant to 2nd opposite party for arranging for surgery at G.H., Puducherry, when there is no documentary evidence before this Commission. While weighing the evidence of both sides and also from the conduct of O.P.2 and his dubious statement as mentioned above, we are inclined to accept that O.P.No.2 did receive Rs.10,000/- from the complainant to perform the said operation at G.H., Puducherry.
26. Ex.R17 dated 25.01.2003 and 29.01.2003 shows that medical investigations were done for the complainant in Unit-III of the O.P.D. under the care of 2nd opposite party and subsequently also on 05.02.2003 and 29.02.2003. Hence, this issue is decided in the affirmative in favour of the complainant.
27. ISSUE No.4:
The case record Ex.R17 shows that the complainant attended Unit-III Ward No.22, Surgery O.P.D. on 25.01.2003 under the care of Dr.Mohankumar, O.P.2. Again, the complainant attended the same O.P.D. on 29.01.2003, 05.02.2003, 19.02.2003 and on 01.03.2003, she was admitted for the surgery held on 04.03.2003. Investigation requisition forms dt.29,01,2003 for USG Thyroid Tests T3, T4 and TSH were conducted for the complainant as an out-patient by 2nd opposite party in his Unit-III. From the case record Ex.R17, it is evident that preliminary investigations were done by 2nd opposite party for the preparations of the complainants surgery. Hence, this issue is decided in the affirmative in favour of the complainant.
The following particulars would clearly show that the complainant was Dr.Mohankumar O.P.2s patient in G.H., Puducherry S.No. Date of Document Particulars Consulting Physician 01 25.01.2003 (Ex.R17) Attended Unit III, Ward 22 at G.H., Puducherry as an outpatient Dr.S.Mohankumar, O.P.2 02 29.01.2003 (Ex.R17) Attended Unit III, Ward 22 at G.H., Puducherry as an outpatient O.P.2
03. 19.02.2003 (Ex.R17) Attended Unit III, Ward 22 at G.H., Puducherry as an outpatient O.P.2
04. 01.03.2003 (Ex.R17) Admitted in G.H., Puducherry for surgery
--
05. 04.03.2003 (ExR17) Operation notes sub-total thyroidectomy done O.P.2
06. D.O.A. 01.03.2003 D.o.D 10.03.2003 (Ex.C2) Follow up card G.H., Puducherry O.P.2 07 DOD 10.03.2003 (Ex.C2) G.H., Puducherry Clinical History and investigations shown Estimated Normal T3 1.43 0.7 2.0 T4 7.57 55 135 TSH 5.62 0.12 4.05 O.P.2,
28. ISSUE No.5:
On 01.03.2003 Ex.R17 shows that the complainant was admitted in the G.H., Puducherry for thyroid surgery in Ward No.22 under the supervision of 2nd opposite party. Hence, from the case record Ex.R17, it is obvious that the complainant was an in-patient under 2nd opposite partys surgery Ward at G.H., Puducherry. Hence, this issue is decided in the affirmative in favour of the complainanat.
29. ISSUE No.6:
The questions put forth by complainants counsel and the deposition of O.P.No.2 are as follows:
Q: Have you consulted the ENT Specialist or H.O.D. before performing operation to the complainant?
A: Since the operations are generally done by General Surgeons only if necessary, used to consult ENT specialists or HOD and I already told that ENT surgeons do not do this operation as a routine.
Q: I put it to you that because you have not consulted the ENT specialists or HOD, this complication has occurred.
A: No, I deny the suggestion.
Q: Whether thyrodectomy is a major or minor operation?
A: It is a major operation Q: I put it to you since you are not an ENT specialist and have not consulted HOD and because of that the complainant has developed the complications?
A: The patient did not have any complication during or after surgery. We need not consult the ENT specialists because they are not doing these operations routinely. It comes under ENT department operations.
Q: Whether thyrodectomy came under ENT or general surgery?
A: In our hospital, it is coming under general surgery.
Q: Thyroid occur in which region?
A: It occurs in throat region.
Q: I suggest you that it is an ENT problem and you are saying it is not a throat problem.
A: No it is a thyroid problem
30. Further, the above deposition of 2nd opposite party asserted that as a General Surgeon, he is competent to perform thyroid surgery as a routine and since the complainant did not have any complication during or after surgery, there was no necessity to consult an ENT specialist.
31. The above assertion of 2nd opposite party is negated by the deposition of Dr.S.Gopalakrishnan, Professor of ENT, JIPMER, Puducherry as:
Q: Would it be correct to say that ENT surgeries are specialist surgery and that where surgeons are involved in surgery they would seek Experts opinion both pre-operative and post-operative and particularly if complications set in?
A: It is usually the protocol before thyroid surgery. The assessment of vocal cord function is done usually by the ENT specialists and post-operatively if any defect in the voice production is noticed.
Q: What is the medical protocol in cases of any respiratory difficulty following thyroid surgery?
A: The usual protocol for difficulty in breathing following thyroid surgery involves assessment of vocal cord function as well as the potency of the trachea (wind pipe).
Q: Would it be correct to say that the treatment given at the earliest point of time would help the patient and also prevent further growth of the complications?
A: Yes. Generally.
32. Dr.S.Gopalakrishnan, ENT specialist and HOD in JIPMER in his deposition put forth that the protocol before thyroid surgery is the assessment of vocal cord function which is usually done by the ENT specialists and post-operatively, if any defect in the voice production is noticed. Whenever there is difficulty in breathing following thyroid surgery, the assessment of vocal cord function and potency of trachea are made. Also, treatment should be given at the earliest point of time to help the patient to prevent further growth of complications.
33. In this case, even though thyrodectomy is a major operation, the 2nd opposite party failed to follow the protocol of seeking experts opinion before or after the surgery. Moreover, Ex.C4, dt.15.03.2003 2nd opposite partys medical slip, shows that the complainant was suffering from breathlessness. At this point of time, 2nd opposite party could have given her proper treatment which is the earliest point of time, would have helped the patient and also prevent further growth of complications as put forth by the Expert in his deposition at Page No.5.
Hence, this issue is decided against the 2nd opposite party.
34. ISSUE No.7:
The 2nd opposite party deposed that two types of tests are conducted. 1) assessment of patient for fitness for surgery and 2) test for confirmation of diagnosis. In the case sheet, Ex.R17 produced by the opposite parties, there is no trace of fine needle aspiration cytology test conducted by O.P.2. Hence, it can be inferred that fine needle aspiration cytology (FNAC) test was not conducted prior to the surgery by O.P.2. Only after surgery, the biopsy test done on 15.03.2003 (Ex.C5) revealed the disease of the complainant as Hashimotos which is progressive in nature.
35. It is a serious lapse on the part of the 2nd opposite party for not having conducted FNAC test pre-operatively for the complainant. Hence, this issue is decided against the 2nd opposite party.
36. ISSUE No.8:
The 2nd opposite party in his deposition at Page No.9 has said she never consulted me after the surgery, except once to thank me that she will be grateful till the end of her life. This statement of 2nd opposite party is disproved by the available documents Exs.C3, C4 and C7, dated 11.03.2003, 15.03.2003 and 22.07.2003 respectively, which are the medical prescriptions of 2nd opposite party wherein medicines were prescribed to the complainant in his private clinic on three occasions. In Ex.C3, on 11.03.2003, the 2nd opposite party prescribed three types of tablets to be taken twice daily for a week. It is pertinent to point out that the complainant visited his clinic on the fourth day, i.e. on 15.03.2003 Ex.C4 instead of completing the medicines for a week (Ex.C3) which is a clear indication that the complainants health was in jeopardy after the surgery. There is a note in the prescription made by O.P.2 that the complainant complaint of breathlessness and prescribed Eltroxin tabs.
37. On 15.03.2003, Ex.c5 biopsy report revealed that the complainant was suffering from Auto Immune Thyroiditis - probably Hashimotos and on 19.07.2003, her TSH was 100 against the normal level of 0.12 4.05.
38. Again on 22.07.2003, Ex.C7, the complainant visited O.P.2s private clinic and again prescribed medicines
39. From the above Exs.C3, C4 and C7, it is found that the complainant continued to meet O.P.2 in his private clinic since she had breathlessness and other problems after the surgery and her health condition was not stable.
40. Therefore, this issue is decided accordingly in favour of the complainant and against the 2nd opposite party.
41 ISSUE No.9:By Ex.C10, dt.09.08.2003, the complainant who attended Maternity Hospital, Puducherry for her pregnancy, was referred to the physician in G.H., Puducherry, i.e. O.P.2 on 27.09.2003, since she had undergone sub-total thyroidectomy surgery and to give his opinion about Eltroxin tablet for treating her. In Govt.
Maternity Hospital medical slip, it is mentioned that the patient was on Eltroxin tab and sub-total Thyroidectomy was done 5 months back. It is observed that all the medical slips, namely, Primary Health Centre, Murungapakkam, Ex.C8, Govt. Maternity Hospital, Puducherry, Ex.C9, Ex.C10 and Ex.C11 and D.D. Public Health (Ex,C13) had invariably mentioned that the complainant had undergone Sub-Total Thyroidectomy and she was on Eltroxin The D.D. Public Health noted ..Patient should take - Tab Eltroxin as patient complains of fatique
42. Thus, the treating Doctors at Government Maternity Hospital and D.D. Public Health had confirmed that the complainant was taking tablets Eltroxin daily. Also, it is observed that the Doctors of the above said Institutions have sought for the opinion of the physician at the G.H., Puducherry who conducted the surgery to the complainant, namely, 2nd opposite party regarding tab Eltroxin in order to give treatment to her during pregnancy period. There is no medical document produced by the opposite parties to show whether there was any proper advice/opinion given by the 2nd opposite party in this regard. In the absence of rendering any opinion in response to Government Maternity Hospital, Puducherry and D.D. Public Health, an adverse inference has to be drawn against the opposite parties. Hence, this issue is answered in favour of the complainant and against the opposite parties.
43. Issue No.10:
The thyroid test conducted on 28.07.2003 Ex.C6 reveals the range of T4 as 31.3 as against 55 135 and Thyroid Stimulating Harmone (TSH) as 100 as against 0.12 4.05. At the time of discharge on 10.03.2003, Ex.C2, her T4 was 75.7 and TSH 5.62. Again, on 26.06.2005, Ex.C33, her TSH was 260. We can trace out the range of TSH level as 5.62, 100 and 260 respectively as against the normal range of 0.12 4.05 which was on 10.03.2003, 28.07.2003 and 26.05.2005 respectively.
44. Ex.C6, the thyroid test result with TSH level 100, was not in the medical records, Exs.R17 and 18 filed by the opposite parties. Dr.Gopalakrishnan deposed that the level of TSH of the complainant as 100 was not shown to him and added that the patient should receive Medical Suppressive Therapy.
45. During the period from 10.03.2003 to 28.07.2003, the complainant was under the care of 2nd opposite party vide Ex.C2 to C6. The estimate level of T4 and TSH of the complainant were not within the normal level which shows an alarming difference in the result.
46. Since the 2nd opposite party had not rendered proper treatment, the complainant was subjected to pain and sufferings, led to the onset of Bilateral Palsy which is a life threatening situation and finally, she had to undergo emergency Tracheotomy surgery at JIPMER in August, 2004.
47, The thyroid test result Ex.C6 is a vital proof to exhibit the lacunae in not rendering proper and timely treatment to the complainant. At the most, O.P.2 could have referred her to an ENT specialist or any higher Institution to safeguard her health. We can observe that though the complainant clung on the Doctor, O.P.2 with full faith and trust in his treatment, O.P.2 had failed to treat her with all seriousness. It is apparent from Ex.C5 and Ex.C6, the complacency and casual attitude of 2nd opposite party in treating the patient resulting to a major complicated problem. Hence, this issue is decided against the opposite parties.
48. ISSUE No.11:
The biopsy report of the complainant, Ex.C5, dt.15.03.2003, indicates that the complainant had Auto Immune Thyroiditis probably Hashimotos. The test was conducted at G.H., Puducherry, Ex.C5 and O.P.2 was unit in-charge. On the same day, 15.03.2003, Ex.C4, the complainant attended O.P.2s private clinic, prescribed medicines and noted complaint of breathlessness in his prescription. Further, O.P.No.2 in his chief examination has stated that the biopsy report of the complainant is Hashimotoss Thyroiditis which is an Auto Immune Disorder. It is a generalized immunity disorder and progressive in nature affecting any/all systems of the human body
49. From O.P.2s above statement, it is clear that Hashimotos is an immunity disorder and progressive in nature which affects any or all systems of the body. When these symptoms were known to O.P.No.2 through biopsy report, Ex.C5, then, how the Doctor has failed to take care of the seriousness of the disease and treated accordingly. This slackness on the part of O.P.No.2 made the life of the complainant at stake which is deplorable. Hence, this issue is decided against the opposite parties.
50. I SSUE No.12:
The complainants biopsy report as auto immune thyroiditis probably Hashimotos was conducted on15.03.2003 from G.H., Puducherry under the care of O.P.2 as unit in-charge. Again, on 28.07.2003, Ex.C6, T3, T4 and TSH tests were held and found T4 range 31.3 as against 55 135, and TSH level 100 as against 0.17 4.05 with an alarming difference from the normal range. Even though there were great variations in T4 and TSH, the complainant was not subjected to consult an ENT specialist who was very much available in G.H., Puducherry at that time. Since Hashimotos, an auto immune disease is progressive in nature, it was of paramount importance to give her proper treatment to prevent the deterioration of her health.
51. It is observed that the 2nd opposite party and Doctors of O.P.5 have failed to conduct FNAC (Fine Needle Aspiration Cytology) test as there is no document produced in this regard. If at all this test, which is vital in this case was held pre-operatively, the Doctors of Opposite parties would have come to the conclusion that the complainant was suffering from Hashimotos. The biopsy test on 15.03.2003, Ex.C5, revealed the actual disease of the complainant as Hashimotos with progressive complications of health was known actually to the opposite parties after the performance of surgery on 04.03.2003. Even after coming to light what is the actual condition of the complainant, not much heed was paid to arrest the progression of the disease further, as there is no evidence or document produced by the opposite parties before this Commission in this regard.
52. The T3, T4 and TSH tests conducted on 10.03.2003, Ex.C2, at the time of discharge of the complainant after surgery indicates that her TSH level as 5.62 as against the normal 0.17 4.05, which is normal.
Again, after four and half months, i.e. on 19.07.2003 (Ex.C6), T4 very low range as 31.3 against 55 135 and an increase of TSH 100 as against the normal range of 0.17 - 4.05. The TSH 5.62 on 10.03.2003 which becomes 100 which is normal.
53. During the above said four and half month, the complainant continued to be O.P.2s patient attending his private clinic and tests were done at G.H., Puducherry vide Exs.C2, C3, C4, C5, C6 and C7. The TSH level on 10.03.2003 at the time of discharge itself was not normal. She was not given proper treatment to prevent the deterioration of her health.
54. The O.P.2 and the Doctors of O.P.5 failed to conduct FNAC (Fine Needle Aspiration Cytology) test and no document was produced by the opposite parties in this regard. If this test was held pre-operatively, the doctors of opposite parties would have come to the conclusion that the complainant was suffering from Hashimotos only after the biopsy test on 15.03.2003 and after the surgery on 04.03.2003, revealed the actual disease of the complainant as Hashimotos which is a progressive complication of health. Since she was not given the right treatment to arrest or further progression of such symptoms, the TSH result in four and half months revealed appalling abnormal. Thus, the act of 2nd opposite party and Doctors of O.P.5 manifest serious lapse on their part in dealing with the patient as that of the complainants complications without much seriousness. Hence, this issue is answered against the opposite parties.
55. ISSUE No.13:
Dr.Gopalakrishnans deposition revealed that the complainant was in a critical condition when she was operated in JIPMER Hospital for an emergency tracheotomy. The complainant was brought to the hospital for respiratory difficulties associated with noisy breathing. The Doctor further deposed that the surgery was in an emergency situation wherein the patient was with noisy and difficulty in breathing due to paralysis of both sides of vocal cord resulting in near total laryngeal obstruction. Since the surgery was conducted under emergency situation, the Doctor didnt have time to look for the operative status and only examination was done before tracheotomy which reveals Bilateral Vocal cord Abductor Paralysis.
56. From the deposition of Dr.Gopalakrishnan, it is evident that the complainant underwent tracheotomy from JIPMER hospital under a grave situation in order to save her life.
Hence, this issue is decided against the opposite parties.
57. ISSUE No.14:
The sequence of events below would show that the complainant continued to be O.P.2s patient post-operatively from 11.03.2003 Ex.C3 and further treatment from other hospitals.
S.No Date of Document Particulars Consulting Physician 01 11.03.2003 (Ex.C3) Prescribed three types of tablet To be taken twice daily for a week O.P.s private clinic 02 15.03.2003 Ex.C4 Again prescribed tablet and syrup to be taken twice daily O.P.2s private clinic (OP2 noted complaint of breathlessness 03 15.03.2003 (Ex.C5) Biopsy report as Auto Immune Thyroiditis -
probably Hashimotos ( Hashimotos was known on 15.03.2003 itself) G.H., Puducherry under Unit III incharge Dr.Mohankumar (O.P.2) 04 19.07.2003 (Ex.C6) Result on 28.07.2003 G.H., Puducherry O.P.D. Estimated Normal T3 0.71 0.7 2.0 T4 31.3 55-135 TSH 100 0.12 4.05 O.P.2s Unit III, G..H., Puducherry
05. 22.07.2003 (Ex.C7) Prescribed tablets O.P.2s private clinic
06. 31.07.2003 (Ex.C8) Primary Health Centre, Murungapakkam Doctor at P.H.C. Murungapakkam
07. 09.08.2003 (Ex.C.10) Sub-Total Thyroidectomy done five months back, referred to G.H., Puducherry for opinion for usage of Tab. Eltroxin Govt.. Maternity Hospital, Puducherry referred the complainant on 27.9.2003 to the physician at G.H., Puducherry (O.P.2), who has conducted the surgery --- for opinion
08. 16.08.2004 (Ex.C14) Emergency Tracheotomy done in ENT Ward JIPMER, Puducherry
09. 16.08.2004 (Ex.C16 & C17) Department of Pathology, Lab investigations, ENT O.P.D. JIPMER, Puducherry
10. 26.06.2005 (Ex.C33) ENT Unit Discharge Summary Apollo Hospital, Chennai
58. From the above series of visits made by the complainant to O.P.2 and other hospitals mentioned above is an indication that she continued her treatment post-operatively. Hence, this issue is answered against the opposite parties.
59. I SSUE No.15:
The role of a medical Expert in medical negligence cases is usually sought to highlight the particular case. There is no hard and fast rule that each case should be saddled with Expert opinion to prove whether there is negligence or not. The fulcrum of the case depends upon the documents, oral evidence, facts and circumstances of the particular case. If the parties prove medical negligence beyond any reasonable doubt from the available facts, then, the role of Experts opinion is only addition to the evidence already available on record.
60. In the present case, though the complainant has not examined any medical expert, but has brought out the sequence of events of the case with facts and supporting documents to prove the case of medical negligence in a vivid manner.
61. The learned counsel for the opposite parties relied on the following decisions:
1.
V.Kishan Ravo Vs. Nikhil Super Speciality Hospital (2010 (5) S.C. Page 513
2. Sethuraman Subramanian Iyer Vs. Triveni Nursing Home & Another (1998 CPJ Page 110 (NC)
3. Dr.Harkanwaljit Singh Saini V. Gurbax Singh & another I 2003 CPJ 153 (NC) 4 N.S.Sahota Vs. New Ruby Hospital & Others ( II (2000) CPH Page 345 SCDRC, Chandigarh, Punjab stating that the complaint has to fail due to non-examination of Expert to prove medical negligence.
62. The facts on hand are totally different to the facts concerned in the above said rulings. We have already held that the complainant has brought out sequence of medical negligence of the case with facts and supporting documents to prove the medical negligence in a vivid manner. Even if an Experts opinion is rendered, it is only an addition to the proved facts of medical negligence in this regard. Therefore, we are of the considered view that the said decisions are not applicable to the facts on hand. Hence, this commission is of the considered opinion that there is no infirmity in deciding the case without the assistance of medical Expert. Hence, this issue is decided against the opposite parties and in favour of the complainant.
63. ISSUE No.16:
From the documents, Exs.R17 and R18, produced before this Commission by the opposite parties, it is seen that the opposite parties had failed to submit the Discharge Summary of the complainant at the time of discharge on 10.03.2003. Also, the vital document, the biopsy report, Ex.C5, is also not produced before this Commission. This document highlighted the actual health problem of the complainant that she was suffering from Hashimotos. Again, the Govt. Maternity Hospital, Ex.C10, the complainant was referred to the physician in G.H. Puducherry, i.e. O.P.2 who had done the surgery for the complainant, to give his opinion about the usage of tab Eltroxin. The opinion of O.P.2 /G.H. physician in this aspect was not produced before this Commission to confront the claim of the complainant Again, D.D. Public Health, has sought for the opinion as to the continuity of tab Eltroxin since the patient was complaining of fatique. For this also, no opinion was rendered by the 2nd opposite party.
64. The above fact has also been reiterated in Dr.Gopalakrishnans deposition, I have no first hand knowledge about the follow up treatment after thyroid surgery, neither the patient had any record for the same when she got admitted in JIPMER.
65. It is to be noted that when a patient is discharged from the hospital a Discharge Summary of the patient is to be given with all details of the surgery for future follow up which is mandatory. In this case, only the follow up card Ex.C2 was given to the complainant, but not the Discharge Summary. No explanation was offered on the side of the opposite parties for not giving the vital document for follow up action
66. Concealment of such vital document by the opposite parties before this Commission exposes their negligence/deficiency in service in conducting the said operation to the complainant.
67. Had they produced the said discharge summary, it would adversely affect the case of the opposite parties and prove the medical negligence in favour of the complainant. That is the reason why the opposite parties have not produced the discharge summary and other connected medical records before this Commission. The non production of the said documents by the opposite parties before this Commission amounts to dereliction of duty and deficiency in service on their part. Hence, this issue is answered against the opposite parties and in favour of the complainant.
68. ISSUE No.17:
The complainant in her lawyers notice, dt.28.03.2005 made a claim of Rs.15,00,000/- whereas, in her complaint filed before this Commission on 22.12.2005, she has been claiming a sum of Rs.37,00,000/- as compensation, which O.P.No.2 alleged her as a money-minded person.
69. It is well settled that if a consumer sustained any loss or damage actually, he is entitled to compensate. Padmanab Dash Vs. Divisional Railway Manager, S.E.Railway, 1994 (I) CPR 77.
70. Compensation is to be given for loss or injury suffered by a consumer due to the negligence of opposite parties, S.K.Lokhotia Vs. National Insurance Company Limited, 1994 (I) CPR 43.
71. For the award of compensation, a consumer has not only to show deficiency in service but also the negligence of the opposite party and without proving negligence, there cannot be any award Director, Himachal Institute of Engineering & Technology Vs. Anil Kumar Gupta 1994 (I) CPR 182.
72. In Consumer cases, compensation is commensurate with the loss, damage or injury suffered by the consumer and not otherwise. Moreover, consumer court is not the place where a consumer can satiate as a profit earning place. A consumer is entitled just for the extent of loss or injury suffered/undergone by him through the acts of opposite parties.
73. To sum up, instead of giving a new lease of life to the complainant after the thyroid surgery, she was left with a hole in her throat with an external device for her survival and she has to endure with it throughout her life. Hence, the opposite parties are liable for deficiency in service and negligence for causing loss, injury and mental agony to the complainant.
Hence deficiency in service and negligence on the part of the opposite parties are proved and the complainant is entitled for compensation.
74. The complainants prayer for compensation are as follows:
1) a sum of Rs.16,00,000/- for carelessness,
2) a sum of Rs.5,00,000/- for pain and sufferings,
3) a sum of Rs.5,00,000/- for disablement,
4) a sum of Rs.5,00,000/- for further medical treatment,
5) a sum of Rs.1,00,000/- for love and affection,
6) a sum of Rs.5,00,000/- towards loss of income In total, the complainant prayed for a sum of Rs.37,00,000/- towards compensation and cost for the proceedings.
75. For the complainants prayer for loss of income, this Commission has calculated and fixed in the following manner:
76. The complainant has stated that she is an auto driver by profession and was earning more than Rs.200/- per day. Since she is unable to make a livelihood due to the present health condition, this Commission is of the view the she has to be compensated for the loss of income suffered by her after the surgery in 2003.
77. The complainant was aged 32 years at the time of surgery. If we take her earning capacity up to the age of 60, her income can be calculated for a period of 28 years. So, if we calculate her income approximately as Rs.6,000/- per month, her annual income comes to Rs.72,000/-. Accordingly for a period of 28 years, it comes to Rs. 20,16,000/-.
78. Since the complainant has prayed for Rs.5,00,000/- towards loss of income, we are constrained to consider only Rs.5,00,000/- as loss of income caused to the complainant.
79. Since the complainant has to live her life with the metal tube in her throat and the present state of hers is irreversible, this Commission sustains her prayer for disablement and awards Rs.5,00,000/- accordingly.
80. For negligence and deficiency in service of the opposite parties, this Commission is restricting to Rs.2,00,000/- instead of the complainants prayer for Rs.5,00,000/- since she is suitably awarded for loss of income and disablement.
81. The complainant is entitled for a sum of Rs.20,000/- towards the cost of this proceedings
82. The complainants other prayer at Sl. No.2, 4 and 5 cannot be entertained and no compensation is awarded in this regard.
83. Thus, opposite parties are jointly and severally liable to pay to the complainant-
1) A sum of Rs.5,00,000/- (Rupees Five-Lakh only) towards loss of income
2) A sum of Rs.5,00,000/- (Rupees Five-Lakh only) for disablement
3) A sum of Rs.2,00,000/- (Rupees Two Lakh only) for negligence and deficiency in service.
4) A sum of Rs.20,000/- (Rupees Twenty-Thousand only) towards costs.
Thus, the complaint is party allowed and party dismissed.
Dated this the 3rd day of February, 2012 (J.A.K.SAMPATHKUMAR) PRESIDENT (K.K.RITHA) MEMBER (K.ELUMALAI) MEMBER LIST OF COMPLAINANTS WITNESSES:
CW1 Tmt.G.Mangayarkarasi, Complainant filed Chief examination affidavit on 10.01.2008 and further examined on 27.03.2008,& 28.03.2008 CW2 Gunasekaran, complainants husband, examined on 24.09.2008, & 12.11.2008 CW3 Dr.S.Gopalakrishnan, Head of Department, ENT, JIPMER Hospital, Puducherry LIST OF COMPLAINANTS EXHIBITS:
Ex.C1 Xerox copy of Driving Licence issued to the complainant, by Assistant Licensing Authority, Pondiherry to drive LMV Autorickshaw, marked through CW1 Ex.C2 - Xerox copy of Follow up card, issued by Department of Surgery, G.H., Pondicherry to the complainant (DOD 10.03.2003), marked through CW1 Ex.C3
- Xerox copy of prescription, dt.11.03.2003 by O.P.2 to complainant, marked through CW1 Ex.C4
- Xerox copy of prescription, dt.15.03.2003 by O.P.2 to complainant, marked through CW1 Ex.C5
- Xerox copy of Duplicate Biopsy Report, dt.15.03.2003, issued by Dept. of Pathology, G.H., Pondicherry in respect of complainant, marked through CW1 Ex.C6 Xerox Copy of Investigation Requisition Form of G.H., Pondicherry in respect of complainant marked through CW1 Ex.C7 Xerox copy of Prescription dt.22.07.2003 by O.P.2 to complainant, marked through CW1 Ex.C8 Xerox copy of O.P.D. slip in respect of complainant, issued by P.H.C., Murungapakkam, Pondicherry, marked through CW1 Ex.C9 Xerox copy of prescription, dt.9.8.2003 by Govt. Maternity Hospital, Pondicherry to the complainant, marked through CW1 Ex.C10- Xerox copy of prescription and advice, dt.9.8.2003 by Govt. Maternity Hospital, Pondicherry to the complainant, marked through CW1 Ex.C11- Xerox copy of Discharge Slip, issued by Govt. Maternity Hospital, Pondicherry with DOD 31.12.2003, marked through CW1 Ex.C12- Xerox copy of Investigation Requisition Form, dt.03.01.2004 by G.H., Pondicherry in respect of complainant, marked through CW1 Ex.C13- Xerox copy of O.P.D. slip, dt.9.4.2004 issued by P.H.C., Murungapakkam to complainant, marked through CW1 Ex.C14- Xerox copy of Out-Patient Case Record dt.16.08.2004 in respect of complainant, issued by JIPMER Hospital, Pondicherry, marked through CW1 Ex.C15- Xerox copy of Discharge Summary, dt.27.8.2004 in respect of complainant, issued by JIPMER hospital, Pondicherry marked through CW1 Ex.C16- Xerox copy of Requisition for Lab. Investigations of Department of Pathology, JIPMER Hospital, Pondicherry, dt.16.08.2004 in respect of complainant, marked through CW1 Ex.C17- Xerox copy of Xerox copy of Requisition for Lab. Investigations of Department of Pathology, JIPMER Hospital, Pondicherry, dt.16.08.2004 in respect of complainant, marked through CW1 Ex.C18-Xerox copy of Out-patient record, dt.7/12 (year not mentioned) in respect of complainant, issued by Aarupadai Veedu Medical College & Hospital, Pondicherry, marked through CW1.
Ex.C19- Xerox copy of representation, dt.13.12.2004 of complainant to His Excellency Lt. Governor, Pondicherry, marked through CW1.
Ex.C20-Xerox copy of I.D.Note, dt.15.12.2004 by L.G. Secretariat to Secretary (Health) Pondicherry seeking detailed report regarding the complainants case, marked through CW1.
Ex.C21-xerox copy of letter from L.G. Secretariat, dt.29.12.2004 to the complainant informing the grant of Rs.5,000/- from L.Gs Welfare Fund, marked through CW1.
Ex.C22- copy of representation, dt.10.01.2005 by the complainant to Medical Superintendent, G.H. Pondicherry, marked through CW1.
Ex.C23- Xerox copy of notice, dt.11.1.2003 by 5th O.P. to the complainant to appear for an enquiry, marked through CW1.
Ex.C24- Xerox copy of discharge summary, dt 18.03.2005 issued by Pondicherry Institute of Medical Sciences, Puducherry to the complainant, marked through CW1.
Ex.C25- Xerox copy of investigation requisition form dt.23.3.2005 by JIPMER Hospital in respect of complainant, marked through CW1.
Ex.C26- Xerox copy of representation, dt.24.03.2005 by the complainant to Mr.K.Lakshminarayanan, M.L.A., marked through CW1.
Ex.C27 xerox copy of prescription,dt.5.4.2005 by Dr.M.Prabhakaran, Apollo Hospital, Chennai to the complainant, marked through CW1.
Ex.C28- Xerox copy of certificate, dt.5.4.2005, issued by Apollo Hospital, Chennai to the complainant, marked through CW1.
Ex.C29 Xerox copy of Reply Notice, dt.11.04.2005 by O.P.2s lawyer to complainants lawyer, marked through CW1.
Ex.C30 - Xerox copy of letter, dt.17.6.2005 by J.A.O., Pondicherry Medical Relief Society for Poor, Govt. of Pondicherry granting relief to the complainant marked through CW1.
Ex.C31
- Xerox copy of Demand Draft for Rs.37,500/-, dt.17.06.2005 in favour of Apollo Hospital, Chennai, marked through CW1 Ex.C32- Xerox copy of Report of Department of Bio-Chemistry, Apollo Hospital, Chennai in respect of complainant, marked through CW1 Ex.C33- Xerox copy of Discharge Summary, dt.26.6.2005, issued by Apollo Hospitals, Chennai to complainant, marked through CW1 Ex.C34- Xerox copy of in-patient bill, dt.26.6.2005, issued by Apollo Hospitals, Chennai to complainant, marked through CW1 LIST OF OPPOSITE PARTIES WITNESSES:
RW1 Dr.S.Mohankumar, 2nd Opposite Party filed chief examination affidavit on 17.12.2008 and cross-examined on 04.02.2009 LIST OF OPPOSITE PARTIES EXHIBITS:
Ex.R1 - Xerox copy of Medical Registration Certificate, dt.28.05.1986, issued by Tamilnadu Medical Council to O.P.2, marked through RW1 Ex.R2 - Xerox copy of Degree of Bachelor of Medicine and Surgery, dt.20.09.1986, issued by Madras University to O.P.2, marked through RW1 Ex.R3 - Xerox copy of appointment order, dt.28.12.87, issued by Department of Health & Welfare, Govt. of Pondicherry to O.P.2, marked through RW1 Ex.R4 - Xerox copy of G.O.Ms.No.98, dt.30.12.88, issued by Government of Pondicherry appointing O.P.2 on regular basis, marked through RW1 Ex.R5 - Xerox copy of Degree of Master of Surgery (M.S.), dt.27.2.1993, issued by the Tamilnadu Dr.M.G.R. Medical University, Chennai to O.P.2, marked through RW1 Ex.R6 - Xerox copy of Additional Qualification Registration Certificate, dt.
20.01.1994, issued by Tamilnadu Medical Council, to O.P.2, marked through RW1 Ex.R7 - Xerox copy of Memorandum, dt.27.7.1995, issued by Health and Welfare Department (Health, Govt.
of Pondicherry to O.P.2, marked through RW1 Ex.R8 - Xerox copy of Degree of Master of Chirugh, dt.23.3.1998, issued by the Tamilnadu Dr.MGR Medical University to O.P.2, marked through RW1 Ex.R9 - Xerox copy of Certificate of Award, dt.23.03.1998, issued by the Tamilnadu Dr.MGR Medical University to O.P.2, marked through RW1 Ex.R10
- Xerox copy of Certificate of Award, dt.23.3.1998 for the performance in M.Ch., Plastic Surgery, issued by the Tamilnadu Dr.MGR Medical University to O.P.2, marked through RW1 Ex.R11 Xerox copy of Additional Qualification Registration Certificate, dt.24.7.98, issued by the Tamilnadu Medical Council, Chennai to O.P.2, marked through RW1.
Ex.R12 Xerox copy of Life Member Certificate, dt.2.11.2001, issued by Indian Medical Association, New Delhi to O.P.2, marked through RW1 Ex.R13 Xerox copy of No Objection Certificate, dt. 18.6.2007, issued by Directorate of Health and Family Welfare Services, Govt. of Puducherry to O.P.2 to present his research paper in the 14th International Confederation for Plastic surgery, marked throughRW1.
Ex.R14 Xerox copy of Order, dt.5.10.2007 of IGGH&RI, Govt. of Puducherry promoting O.P.2 as Specialist Grade-II, marked through RW1.
Ex.R15 Copy of legal notice, dt.28.3.2005, issued by complainants lawyer to O.P.2, marked throughRW1.
Ex.R16 Copy of reply notice, dt.11.4.2005, issued by O.P.2s lawyer to complainants lawyer, marked throughRW1.
Ex.R17 Xerox copy of In-Patient Case Record of complainant (in-patient No.6828, date of admission 1/3/03), issued by Government General Hospital, Puducherry, marked through RW1 Ex.R18 Xerox copy of Obstetrics Admission Sheet of Govt. Maternity Hospital, Pondicherry in respect of complainant, dt.30/12 (year not mentioned) marked through RW1.
Ex.R19 Xerox copy of Obstetrics Admission Sheet of Govt. Maternity Hospital, Pondicherry in respect of complainant, dt.9.1.2004 marked through RW1.
(JUSTICE J.A.K.SAMPATHKUMAR) PRESIDENT (K.K.RITHA) MEMBER-I (K.ELUMALAI) MEMBER-II