National Consumer Disputes Redressal
S.P. Aggarwal, vs The Sanjay Gandhi Post Graduate ... on 31 March, 2010
NATIONAL CONSUMER DISPUTES REDRESSAL COMMISSION NATIONAL CONSUMER DISPUTES REDRESSAL COMMISSION NEW DELHI FIRST APPEAL NO. 478 OF 2005 (Against the order dated 03.10.2005 in C.C No.119/SC /96 of the U.P. State Consumer Disputes Redressal Commission, Lucknow) S.P. Aggarwal, S/o D.P. Aggarwal, Sandeep Enterprises Appellant Main Market, Dhangarhi, Nepal versus The Sanjay Gandhi Post Graduate Institute of Medical Sciences, Rae Bareli Road, Respondent Lucknow Through its Director BEFORE: HONBLE MR. JUSTICE R.C. JAIN, PRESIDING MEMBER HONBLE MR. ANUPAM DASGUPTA, MEMBER For the Appellant Mr. Abhindra Maheshwari, Advocate For the Respondent NEMO Dated, the 31st day of March 2010 ORDER
PER JUSTICE R.C. JAIN, PRESIDING MEMBER Aggrieved by the dismissal of his complaint no.
119/SC /96 by the Uttar Pradesh State Consumer Redressal Commission, Lucknow (in short, the State Commission) vide its order dated 03.10.05, the original complainant has filed the present appeal.
2. The facts and circumstances leading to the complaint and then the present appeal are that the complainant was admitted on 26.07.1996 to Sanjay Gandhi Post Graduate Institute, Lucknow (to be referred to as the hospital) for the treatment of acute duodenal papillary ulcer. The ultrasonographic examination of the complainant was conducted and thereafter he was advised to undergo (contrast) CT scan on 01.08.1996. As a prelude to the said test, he was to be intravenously injected 10 ampoules of ionic contrast medium (Urograffin 76%). When, in order to inject the said dye, the nurse inserted a cannula in the left wrist of the complainant, he felt unbearable pain and cried out loudly. The nurse did not take any notice of the same; rather, she asked the complainant to remain silent. According to the complainant, when the nurse injected the first ampoule of the contrast dye through the cannula, the complainant again felt severe pain. Even the dye could not be fully injected and almost 50% of the dye came out of the needle. At the time of injecting the second ampoule, again the complainant felt severe pain and nearly 60% of the dye came out. The same thing happened when the third ampoule was injected. The complainant did not allow the fourth ampoule to be injected and stood up in protest. On hearing the cries of the complainant, a doctor came and, after inspecting the needle which had been inserted in the left wrist of the complainant, he took out the needle from the wrist and inserted the cannula in the right hand dorsum of the patient through which the remaining six ampoules were injected. The complainant continued to feel severe pain and swelling in his left wrist which remained uncured. Though, as per the record of the hospital, he was purportedly discharged on 05.08.1996, in fact, he was discharged on 10.08.1996 only, with the assurance that his left hand would be alright after 15-20 days. Since the condition of the left hand and forearm of the complainant actually deteriorated during the subsequent period, he again visited the respondent hospital on 28.08.1996 with the complaint of more severe pain and swelling in the forearm. Dr. V.A. Saraswat, the gastro-intestinal (GI) specialist who was attending on him, advised that he would be alright in a few days. Again on 04.09.1996, the complainant visited the hospital with the complaint of unabated and unbearable pain and only then Dr. Saraswat referred him to one Dr. Adarsh Kumar of K.K. Hospital, Lucknow for his opinion, treatment and management. He contacted the said doctor and thereafter some other doctors. He even got conducted electro nerve conduction test at the Electro Neuro Diagnostic Centre, New Delhi but ultimately, there was no relief and the complainants left forearm became totally disabled.
3. According to the complainant, the insertion of the cannula in his left wrist was done in a grossly improper, negligent and careless manner by inexperienced para-medical staff, as a result of which the contrast dye could not be injected into the vein and the drug accumulated in a serous cavity which ultimately led to a diagnosis of carpal tunnel syndrome (L) hand, first resulting in acute pain and swelling of the left wrist and then in its permanent disability. The complainant claimed a total compensation of Rs.18 lakh towards pecuniary and non-pecuniary damages and injury to him.
4. The complaint was resisted by the respondent-hospital though it did not dispute the factum of admission of the complainant to the hospital as also the treatment and diagnostic investigation given to him, including CT scan test on 01.08.1996. It was sought to be explained that the cannula was inserted in the left wrist of the complainant by an experienced nurse and there was no complaint of pain or swelling till the time two ampoules of ionic contrast medium were injected through the said cannula. The complainant complained of the pain, etc., at the time of injecting the third ampoule and, therefore, the cannula was removed from the left wrist and was placed on the dorsal side of the right hand. It was denied that there was any negligence or deficiency in the said process but it was admitted that the complainant was referred to certain outside hospital as he continued to have the complaint of swelling and pain in his left wrist/hand.
5. In order to substantiate his case, the complainant filed his own affidavit besides placing reliance on a number of documents relating to his treatment at the respondent hospital, K.K. Hospital, Lucknow and the test reports of the Electro Neuro Diagnostic Centre at New Delhi. The hospital was content with filing the affidavit of Dr. Kartar Singh in support of its defence plea. The State Commission, on consideration of the respective pleas and the evidence and material produced on behalf of the parties, dismissed the complaint by holding that there was no negligence or insufficiency of service on the part of the hospital in giving treatment to the complainant. In doing so, the State Commission largely went by the version given by Dr. Kartar Singh in his affidavit and discarded the affidavit filed by the complainant primarily on the ground that his affidavit was very short and not in accordance with law, i.e., provisions contained in Order XIX CPC. It would also appear that in reaching the said finding, the State Commission was largely guided by the assertions on behalf of the respondent-hospital that it had given the best treatment and possible help to the complainant inasmuch as he was provided consultation and advice whenever sought by him to the maximum possible extent by the doctors of the said hospital.
6. We have heard Mr. Abhindra Maheshwari, learned counsel representing the appellant but had not the advantage of hearing the say of the respondent hospital as none appeared to argue the matter on behalf of respondent hospital at the time of hearing of the appeal, though the hospital was earlier represented through counsel.
7. Learned counsel for the appellant would assail the impugned order and findings of the State Commission as erroneous on the ground that it is not based on correct and proper appreciation of the facts and circumstances, evidence and material produced on record. In this connection, his first submission is that the State Commission has erroneously discarded the affidavit of the complainant on a mere technical ground that the said affidavit was not in conformity with the provisions of Order XIX CPC, which could not be strictly applied to the proceedings under the provisions of Consumer Protection Act, 1986. We see merit in this contention because the proceedings under the Consumer Protection Act are required to be dealt with in a summary manner and, therefore, the provisions of the Code of Civil Procedure, except and so far as they have been specifically applied in relation to these proceedings, will have no application. The State Commission has taken a hyper-technical view in rejecting the said affidavit on the ground that it has not been prepared and filed in accordance with the provisions of the Code of Civil Procedure and the 13 annexures filed along with the affidavit are not dealt with in detail in the said affidavit. It is pertinent to note that the annexures filed by the complainant were only the record of treatment and medical reports and possibly no doubt could be raised about the existence or genuineness of the said documents. The affidavit and the documents filed by the complainant were entitled to due consideration and the State Commission ought to have taken a view based on the intrinsic value of this relevant and important evidence.
8. We may also note that during the pendency of the appeal before this Commission, the appellant moved an application seeking permission to file additional evidence on record in the shape of affidavit of the complainant and report of a medical expert. Consequently, a detailed affidavit of the complainant dated 07.03.2007 running into ten pages has been filed. In this affidavit, the complainant has reiterated the instances of omission and commission on the part of the staff of the respondent hospital in giving treatment to him, more particularly in regard to the insertion of cannula in his left wrist and the injection of ionic contrast medium through the said cannula. In paragraphs no.7, 8 and 12 of the said affidavit, the complainant has stated as under:
7. I state that the gross negligent attitude and careless behaviour of doctors of Sanjay Gandhi Post Graduate Institute, Lucknow started on the date when the deponent/complainant was brought to CT Scan unit because there were 10 injections which were required to be injected in intravenous to the deponent/complainant before getting the CT Scan and for this purpose one nurse came to patient i.e., deponent/complainant hereto and inserted one needle in the wrist vein of the complainant so that all the ten injections could be injected through this needle. It is important to point out here that when the said sister/nurse was inserting the needle in the wrist vein of the deponent/complainant, he made a complaint of severe pain which was unbearable at that moment and he cried loudly. The deponent also requested the nurse that he is suffering severe pain because of penetration of this needle and it may be possible that this needle is wrongly placed in the vein of the complainant, but the nurse along with the staff of Sanjay Gandhi Post Graduate Institute, who were attending to the deponent at that time scolded the deponent in a very harsh and rude manner and asked him to remain silent stating that it was their job and that they knew how to insert the needle in the vein. When the said nurse inserted the first injection through that needle, the deponent/complainant cried again because he was feeling at that time that some knife like thing is being penetrated in the vein of complainant and it is also relevant to point out here that almost 50% of the medicine injected through the injection came out of the vein measuring thereby that the said needle was wrongly placed and the injection could not be inserted in the vein but without caring for the said fact the said nurse again inserted second injection through that needle. The deponent again cried loudly because of severe pain and more than 60% of the liquid injection came out and the appellant/complainant again made complaint regarding this pain. But the staff of said hospital held the hands and legs of the deponent and the said nurse inserted third injection in a like manner and again more than 80% liquid injection came out and they repeated this procedure for inserting 4th injection in the manner stated herein above. Then the deponent cried loudly and rescued himself from the grip of staff of hospital and stood up and informed that he is not in a position to take this treatment in this manner. The doctor who was attending to the deponent/complainant came to the deponent after hearing his cry and saw the position of the patient and also inspected the needle which had been inserted in a wrist vein of the deponent. The doctor took out that needle from the wrist of the patient and injected the rest of the 6 injections himself in the right hand of the deponent/complainant and when doctor himself injected these 6 injections in the right hand of the deponent/complainant, no complaint of the pain was made by the deponent/complainant to the doctor but the deponent requested the doctor concerned that he has been suffering severe pain in his left hand and showed the doctor his left hand in which apparent swelling was visible. Despite knowing everything the doctor told the deponent/complainant that it happens sometime, and, therefore, he should not worry.
8. I state that it is code of conduct for the doctors to ensure that all the drips/1V cannula must be put by doctor on duty only assisted by the nurse and in the instant case the drip was inserted made by the sister in a most negligent manner indicated in detail hereinabove, which was patently wrong, careless and unwarranted.
12. I state that in the aforesaid letter, it was specifically indicated that the case of the complainant is a case of accidental injection of urograffin left hand palmer aspect. Though the deponent /complainant approached Dr. Adarsh Kumar of K.K. Hospital, Lucknow but he could not get any relief from his pain. The deponent/complainant is also annexing herewith outdoor receipt of K.K. Hospital dated 4.9.96. A true and correct copy of outdoor receipt is exhibited as Exh. PW-1/2.
9. Apart from the said deposition, the counsel for the appellant has invited our attention to a reference letter dated 04.09.1996 issued by the doctor concerned (Pool Officer, CVTS) to Dr. Adarsh Kumar, MS, MCh of K.K. Hospital, in which there is a clear mention of the kind of complication which occurred in the left hand of the complainant due to the said episode of improper insertion of cannula.
A case of accidental injection of urograffin Lt. Hand palmar aspect. Now c/o Pain and swelling Lt. Hand. ? Carpal Tunnel Syndrome. Kindly evaluate and advice.
10. It would appear that the above-named doctor at K.K. Hospital examined the complainant on the same day (04.09.1996) and he found as under:
FTC Ampullar ulcer (SGPGI) 20 day old Volkmanns Ischaemia L hand (intermediate phase) Swelling tnt L hand Sensory examn
-
Sens nt M (L) ulnar area incl. Tempt. Jt.
Secy
-
Diminished L median
-
(N) M auto zone of (L) radial
-
Tinels test at base of (L) mg and little (illegible)
-
Notes:- Ulnar Gr I
- Medianic Gr III (illegible) [Emphasis supplied]
11. On 06.09.1996, the complainant was referred by Dr. V.A. Saraswat to Dr. S. Pradhan, Neurologist with the following notes:
Mr. S. P. Aggarwal underwent CT Scan for evaluation of ulcer on ampulla of Vater and massive GI bleed. GI bleed and ulcer have resolved; however, inadvertent extravasation of contrast during CT scan has resulted in severe edema and soft tissue swelling of (L) hand. He probably has (L) carpal tunnel syndrome and is severely symptomatic. Please evaluate him and consider for NCV and EMG (L) hand. Likely to need surgical release for carpal tunnel syndrome.
? N/surgery.
12 (a) The complainant consulted one Dr. Pradeep Sharma, Consultant Orthopaedic Surgeon at Holy Family Hospital at New Delhi on 08.09.1996. The said doctor observed as under:
Dated:
8.9.96 Contracture left hand and Median and ulnar NV compression. 25 days old as a result of extravasations of drug (urograffin).
Whitish palm at neck now.
All fingers and thumbs contracted with sensory deficits of median and ulnar nerves.
Suggest Urgent EMG Lt. Median/Ulnar Nvs.
12 (b) As advised by Dr. Sharma, the complainant underwent nerve conduction tests at the Electro Neuro Diagnostic Centre, New Delhi on 09.09.1996 and the results of the said examination were as under:
ELECTRODIAGNOSIS I) NERVE CONDUCTION STUDY
1.
No motor or sensory response by stimulating left ulnar nerve at wrist.
2. Low amplitude (only 800 mv) CMAP in left APB with low NCV of 23 m/s in left median nerve with absent sensory potentials.
3. Low CMAP of 2.5 mv in left extensor indicts with 50 m/s NCV in left radial nerve with low amplitude sensory potential in left radial nerve.
II) ELECTROMYOGRAPHY
1. Severe denervation activity in left FDP, FCU, ADM (Ulnar innervated) with only a few unit recruited in FDP and FCU, but nil in ADM.
2. Moderate denervation in Pronator teres, FDS, APB (median innervated) with only a few units in them.
3. Minimal denervation in radial innervated muscles with fair amount of motor unit activity.
4. Normal left biceps, triceps.
III) IMPRESSION FINDINGS REVEAL SEVERE AXONAL DEGENERATION IN LEFT ULNAR AND MEDIAN (ULNAR >> MEDIAN) IN FOREARM AND HAND (with evidence of continuity in median nerve, but not in ulnar nerve) LIKELY TO BE DUE TO ISCHAEMIC EFFECT ON MEDIAN, ULNAR NERVES ALONG WITH THEIR MUSCLES IN FOREARM AND HAND.
[NOTE: CMAP: Compound Muscle Action Potential. Denervation: Loss of nerve supply. Pronator teres:
The pronator teres is a muscle of the human body (located mainly in the forearm) that, along with the pronator quadratus muscle, serves to pronate the forearm (turning it so the palm faces posteriorly).
12 (c) On re-examination of the complainant the next day after the suggested EMG tests, etc., had been done, Dr. Sharma further observed as under:
Dated: 9.9.96 Volkmann Ischemic contracture Lt forearm and hand with contractions of wrist and fingers.
Median and ulnar NV involved in the Dehaene contracture.
No evidence of carpal tunnel syndrome.
Does not (illegible) any decompressive surgery at present.
Adv. Use Lt. Ext. attach.
Gentle paraffin wax left wrist with stretching exercise (sic) left const. And (sic). Contract, examine galvanise (illegible) ulnar and median NV & extension physiotherapy + splintage of hand (illegible) and wrist. [Emphasis supplied] 13 (a) A further examination of the complainants medical record at the OP Institute would bring out that after his discharge, the complainant went as an out-patient to the OP Institute on 28.08.1996. He was examined at the gastro-intestinal out patient department (OPD) where the attending Senior Resident referred him to one Dr. S.K. Agarwal of the cardio vascular thoracic surgery (CVTS) OPD. The undated observations and advice of the CVTS Doctor were as under:
Pt (patient) seen. It seems to be post-inflammatory (illegible) setting in. The radial and ulnar and also the capillary filling is (sic) normal. But as the injection was on ventral aspect of wrist, he should be put on conservative tt (treatment) and reviewed after 15 days.
(b) On the same day, the complainant was also referred to the Senior Resident, Neurology. The latter recorded, Hyposthesia in ulnar distribution, seems to be due to nerve irritation by .. (illegible) and advised some routine medicines.
(c) On 30.08.1996, the complainant went to the orthopaedic OPD of the OP Institute, where he was advised to undergo, inter alia, cold fomentation also physiotherapy of left hand in addition to certain medication.
(d) As already noticed, he was referred by Dr. Saraswat of the OP Institute to Dr. S. Pradhan of the neurology department on 06.09.1996.
(e) Of the same date, however, there is on record a copy of an OPD card referring the complainant to Plastic Surgery Department (Head Surgeon) of KGMC (King George Medical College, a Government medical college, probably attached to the OP Institute) with the following observations:
A case of suspected (illegible) contracture with carpal tunnel syndrome L hand following contrast (illegible) which inadvertently got extravasated. For urgent surgery. [Emphasis supplied].
(f) It is thus clear that during the post-discharge consultations/examinations of the complainant by various doctors of the OP institute, firm diagnosis of the continuing severe problems in the complainants left hand and forearm did not emerge. This was clearly because further diagnostic tests were neither advised nor conducted by any Department of the OP Institute during the last few days of August 1996. In fact, the complainant was made to run from one doctor to another. Thus, on 28.08.1996, there were two sets of references and corresponding observations/diagnoses by the CVTS and the Neurology Departments and apparently two different lines of treatment. On 30.08.1996, a third line of treatment was advised by the Orthopaedics Department. On 04.09.1996, the complainant had already been referred to Dr. Adarsh Kumar of K. K. Hospital, Lucknow (a private hospital) for evaluation and advice, on the suspicion of carpal tunnel syndrome. As already noticed above, on 04.09.1996 itself Dr. Kumar had diagnosed the complainants condition as Volkmanns Ischaemia (Intermediate Phase). Yet, on 06.09.1996, Dr. Saraswat of the GI Department of the OP Institute again thought it fit to refer the complainant to Dr. Pradhan of the Neurology Department for examination and advice, suspecting the same carpal tunnel syndrome. To our further wonderment, we notice that on the same day, i.e., 06.09.1996, some Senior Resident (Department unclear) of the OP Institute straightaway referred the complainant to the Head of Plastic Surgery for urgent surgery.
(g) What, therefore, emerges clearly is that the continuing complaints of severe pain and swelling in the left hand and fore arm of the complainant were due entirely to the extravasation that he suffered as long ago as on 01.08.1996. However, no diagnostic tests were considered necessary to determine the diagnosis and further treatment of the complainants problems during the period 28.08 04.09.1996. It was only after the complainant was examined, on reference from the OP institute by Dr. Adarsh Kumar of K.K. Hospital on 04.09.1996 that a firm diagnosis of Volkmanns Ischaemia was made. This was confirmed by Dr. Pradeep Sharma of the Holy Family Hospital, New Delhi on 09.09.1996, after he had advised nerve conductions tests on 08.09.1996. On 09.09.1996, Dr. Sharma also clearly recorded that there was no evidence of carpal tunnel syndrome.
(h) For better appreciation of the medical terms used in the diagnosis of the complainants problems, we would refer to reliable medical literature available on the Internet:
On extravasation, the website of the National Extravasation Information Society of the U.K. (http://www.extravasation.org.uk/home.html) states: Extravasation injury usually refers to the damage caused by leakage of solutions from the vein to the surrounding tissue spaces during intravenous administration. Once an extravasation has occurred, damage can continue for months and involve nerves, tendons and joints. If treatment is delayed, surgical debridement, skin grafting, and even amputation may be the unfortunate consequences. The website goes on to describe the various treatments that are used for dealing with extravasation injuries, depending upon the situation.
On Volkmann's ischaemic contracture, the website of the National Institute of Health of the USA (http://www.nlm.nih.gov/medlineplus/ency/article/001221.htm) states:
Volkmann's contracture is a deformity of the hand, fingers, and wrist caused by injury to the muscles of the forearm.
Volkmann's contracture occurs when there is a lack of blood flow (ischaemia) to the forearm. This usually occurs when there is increased pressure due to swelling, a condition called compartment syndrome.
Trauma to the arm, including a crush injury or fracture, can lead to swelling that compresses blood vessels and can decrease blood flow to the arm. A prolonged decrease in blood flow will injure the nerves and muscles, causing them to shorten and become stiff (scarred).
When the muscle shortens, it pulls on the joint at the end of the muscle just as it would if it were normally contracted, but because it is stiff the joint remains bent and cannot straighten. This condition is called a contracture.
In Volkmann's contracture, the muscles of the forearm are severely injured, resulting in contracture deformities of the fingers, hand, and wrist.
The hallmark symptom is pain that does not improve with rest or non-sedating pain medications, and will continue to get worse with time. If the pressure is allowed to persist, there will be decreased sensation, weakness, and paleness of the skin.
If there is a forearm or elbow fracture, you should use a sling or splint to keep the area still and raise the arm above heart level. This helps prevent further injury and excessive swelling.
The best treatment is early surgery to release the pressure in the forearm before any permanent injury to the muscles and nerves occurs. Reconstructive surgery to lengthen and sometimes transfer muscles is necessary to try to regain some hand function.
14 (i) The conspectus of facts reflected by the complainants medical records, particularly, the OPD records of the OP Institute, would firmly establish that (i) though the complainant suffered severe extravasation on 01.08.1996 at the OP Institute, its gravity was sought to be collectively minimised by the Doctors and paramedics concerned;
(ii) consequently, there was no mention in the discharge certificate of any medical advice for proper follow-up/treatment of the continuing problems of pain and swelling in the left hand and forearm of the complainant as a result of which the initial complications got aggravated, leading soon to Volkmanns Ischemia; and (iii) during the week of 28.08 04.09.1996 when the complainant went back as an OPD patient to the OP Institute, the doctors there sought advice/opinions of various medical disciplines without any attempt at a sensible co-ordination, which led to varying medical advice being tendered by different disciplines, without any firm diagnosis based on appropriate tests, leave alone any treatment. It was only after he consulted Dr. Kumar at K. K. Hospital on 04.09.1996 that his condition was diagnosed as Volkmanns Ischaemia (and not carpal tunnel syndrome) which was confirmed when he underwent nerve conduction tests on the advice of Dr. Sharma of the Holy Family Hospital at New Delhi.
(ii) An attempt has been made on behalf of the OP Institute to explain the said complications on the premise that the cannula was inserted by trained and experienced paramedical staff and there could be no negligence in conducting the said procedure. In fact, it has been claimed that the complainant came to the Radiology Department of the OP Institute with a cannula in his wrist already in position. However, the fact of extravasation has been clearly admitted, though with the qualifying phrase of inadvertent, by any number of the attending doctors in their inter-disciplinary references. Hence, the extravasation and the resultant injury to the complainants left hand and forearm are established facts. More important is the failure of the OP Institute to take due cognisance of the injury caused due to extravasation and initiate appropriate steps to treat the ensuing problems faced by the complainant. This is clearly evidenced by complete silence of the Discharge Summary recorded by the OP Institute on this score.
(iii) Even when the complainant went back to the OP Institute as an OPD patient with the continuing complaints relating to his left hand and forearm, the doctors concerned merely sought advice from one Department or the other, without any attempt at coordinated action for a firm diagnosis and treating the complainant on the basis thereof.
(iv) Going by the examination of the complainant by Dr. Vineet Suri of Apollo Hospital, New Delhi based on X-ray examination suggesting erosive Arthropathy (and the Radiologist mentioning Rheumatoid Arthritis as a possibility), the State Commission observed that there was possibility of the complainant suffering from Rheumatoid Arthritis and held the view that swelling and acute pain might have been due to the said latter disease. We have already noticed the firm diagnosis of Volkmanns Ischaemia by two successive doctors, immediately prior to the above-mentioned x-ray report. Moreover, the subsequent reference to Rheumatoid Arthritis in the Radiologists report is only as a possibility. Thus, there is no escape from the conclusion that the State Commission has overlooked these relevant and important pieces of evidence in its consideration while recording the finding and has entirely based its findings on the plea taken by the OP Institute through the affidavit of Dr. Kartar Singh. It would further appear that instead of examining the question as to whether the complications suffered by the complainant were due to the extravasation and whether the complainant was treated with due care for the said complications, the State Commission has focussed its entire attention on the overall conduct of the OP Institute and the doctors and paramedical staff employed therein in treating the complainant for his main ailment of acute ulcer. Assuming that the OP Institute and its doctors did well in giving proper treatment to the complainant for the main ailment of ulcer, it would not set off the damage done to the left hand and forearm of the complainant due to the collective negligence of the OP Institute in timely diagnosis of the complication suffered by the complainant due to extravasation. The fact remains that the complainant has suffered permanent disability of his left hand.
15. The extent of permanent disability for which the complainant should be compensated by the respondent Institute has, however, not been established by means of cogent evidence, such as disability certificate issued by any medical officer/board authorised to issue such certificate. All the same, it is established beyond doubt that the complainant has suffered some kind of permanent disability in his left hand and forearm. The complainant has claimed a total compensation of about Rs.18 lakh on account of loss of business, treatment, etc., but he has failed to file any cogent proof to establish the extent of such loss or expenses incurred on the treatment. However, considering the bare description of the nature and extent of the permanent disability suffered by the complainant in the medical records of his diagnosis and treatment at the K. K. Hospital and Holy Family Hospital, caused by the negligent act of the staff and doctors of the respondent Institute, we are of the view that a lumpsum compensation of Rs.1,00,000/- should be awarded to the complainant. In view of the fact that several doctors and paramedical staff of the respondent Institute were involved, it is the respondent Institute which has to be held vicariously liable to compensate the complainant to the above extent.
17. In the result, the appeal is partly allowed and the impugned order of the State Commission is set aside. Consequently, the complaint is also partly allowed and the respondent Institute is called upon to pay a lumpsum compensation of Rs. one lakh to the complainant/appellant within a period of six weeks from the date of receipt of this order, failing which the amount of compensation shall carry interest @ 12% per annum.
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[R.C. JAIN, J] PRESIDING MEMBER .......Sd/-................
[ANUPAM DASGUPTA] MEMBER A/Court3