National Consumer Disputes Redressal
Dr. Paramjit Singh Grewal vs Charanjit Singh Chawla on 19 October, 2006
NCDRC
NATIONAL CONSUMER DISPUTES REDRESSAL
COMMISSION
NEW DELHI
REVISION PETITION NO.1475
OF 2000
(From the order dated 25.5.2000 in F.A.
No.285/99 of the State Commission, Punjab)
1. Dr. Paramjit Singh Grewal, M.S.,
C/0 Grewal Hospital & Trauma Care Centre,
387, Green Avenue,
Amritsar ( Punjab)
2. Grewal Hospital & Trauma Care Centre,
387, Green Avenue,
Amritsar ( Punjab). Petitioner
V/s.
Charanjit Singh Chawla
@ Charanjit Singh
C/o S. Shumer Singh Chawla,
R/o H.M. 1094, Sector 3,
Ranjit Avenue,
Amritsar ( Punjab)
Respondent
BEFORE :
HONBLE MR. JUSTICE M.B. SHAH, PRESIDENT
MRS. RAJYALAKSHMI RAO, MEMBER
For the Petitioner Mr. Rajiv K. Garg, Advocate
For the Respondent Mr.
Tripal Singh, Advocate
Dated : 19th October, 2006
O R D E R
PER MRS.
RAJYALAKSHMI RAO, MEMBER This Revision Petition is filed by Dr. Paramjit Singh Grewal challenging the order dated 25.5.2000 passed by the State Commission, Punjab in Appeal No.285 of 1999 whereby the appeal of the Respondent herein, Shri Charanjit Singh Chawla, (Original Complainant) was allowed and the order of the District Forum, Amritsar dated 27.1.1999 dismissing the complaint was set aside.
Brief facts of the case are as follows :
The Respondent, Shri Charanjit Singh Chawla, while going on a scooter met with an accident at 9.30 p.m. on 26.1.1998 and approached the Revision Petitioner Dr. Paramjit Singh Grewal, an Orthopaedic Surgeon whose hospital was close by. He got the Respondent admitted in his hospital in the early hours on 27.1.1998.
The Petitioner recorded in his notes that there was tenderness and swelling of the right shoulder of the Respondent. After diagnosis and x-rays it was found that there is dislocation of right shoulder.
The Respondent was advised an open reduction of his right shoulder to which the Petitioner obtained the Respondents consent. The Doctor performed an operation of Open reduction under general anesthesia on 28.1.1998 and discharged the Respondent on 4.2.1998 and some medicines were prescribed. The Respondent was asked to come back on 9.2.1998 when the stitches were removed. The patient was asked to do some prescribed exercises of the elbow and he was allowed pendulum movements and was advised to come after two weeks.
However, the patient began complaining about continuing pain in the shoulder and met the Doctor on 13.2.1998, 18.2.1998, 2.3.1998 and on 16.3.1998. He was asked to come back after three weeks.
However, according to the Respondent, as the pain in the shoulder was persisting, he consulted in quick succession six other doctors during the period from 23.3.1998 to 27.4.1998. It is his version that the Revision Petitioner did not perform the operation in a professional manner and that the persisting pain was due to negligence in performing the operation. He further stated that an x-ray was taken on 16.3.1998 which showed that a chip of the head of humerus was lying separate; that the Revision Petitioner in a malafide manner recorded X-ray o.k.; that the separated chip was not put at the proper place while performing the operation and that the Petitioner is negligent in performing the operation.
Hence, the Respondent filed a complaint on 11.9.1998 before the Amritsar District Forum and claimed a compensation of Rs.3,80,000/- on various counts shown in the complaint.
The District Forum dismissed the complaint holding that there was no negligence or deficiency on the part of the opposite party. The Forum dismissed the complaint with costs of Rs.1,000/- to be paid by the Complainant to the opposite party. The appeal by the Complainant was, however allowed by the Punjab State Commission, which by its order dated 25th May, 2000, ordered the opposite party to pay compensation of Rs.1,05,000/-. The present revision petition is filed against the said order.
We have gone through the record and heard both the parties. The plea of the Petitioners is that on 27.1.1998 itself he tried a closed reduction of the shoulder and that he followed the standard procedure according to the medical texts. However, because of the nature of injury the closed reduction of the shoulder although was done did not work as head of humerus which was lying away could not be reduced into original position despite best efforts due to auxiliary nerve damage.
It is averred by the Learned Counsel for the Petitioner that an attempt was made at the time of operation to bring about the head which was lying entangled in the vital structure of the arms i.e. main nerves and blood vessels. However, it could not be reduced without endangering the main artery and the nerves of the arms. Due to excessive bleeding, further attempt of reduction was given up. As the post-operative period was uneventful and patient was progressing, he was discharged on 4.2.1998. After removing the stitches on 9.2.1998, the patient was advised to do some appropriate exercises of elbow and gentle movement of the shoulder. If these gentle exercises are not done, the shoulder would have got jammed and become immovable. Immediately after the operation on 28.1.1998 and subsequently on 9.2.1998 the patient was advised orally by the Petitioner that he could undergo at a later stage a shoulder replacement surgery. It is stated that after 16.3.1998 routine check-up was done, the Respondent never consulted him.
The Revision Petitioner finally submitted that he holds an M.S. degree in Orthopedics and that he was former Professor and Head of the Orthopedic Department, Medical College, Amritsar. He vehemently argued that the line of treatment followed by him was correct according to medical texts and established practice. In cases of bone dislocation, the first thing to be tried is the closed reduction and if it does not succeed, then an open reduction is to be done. If neither of these give relief, then a shoulder replacement has to be tried at a later stage and once again there is no guarantee that the shoulder replacement would help when there is Auxiliary Nerve damage.
Further, Learned Counsel for the Petitioner submitted that the injury which occurred at the time of the accident caused impalement of the nerves by bone fragment. The contention of the Respondent is that even though the chip of the head of humerus was lying separate the Petitioner recorded the x-ray o.k. . In response to this contention, the Learned Counsel for the Petitioner explained that by writing x-ray o.k. on the prescription slip on 16.3.1998 means that x-ray report was co-relating the clinical condition of the patient. It is further stated that he had written x-ray o.k. to reassure himself after seeing the x-ray whether it corroborated with his assessment. While admitting that there was a chip and non-reduction of the fractured bone, the Revision Petitioner clarified that he never told the Respondent that his condition was o.k. and he was completely treated. It was orally explained to him in clear terms that further treatment is necessary. The Revision Petitioner stated that he had acted with due diligence and with reasonable care in accordance with the principles of medical science.
The Respondent examined Dr. Avtar Singh as an expert witness on his behalf. In his cross-examination Dr. Avtar Singh has clearly stated that the treatment given and procedure adopted by the Revision Petitioner was in order and correct. He stated that there are certain things which cannot be diagnosed by just examining the patient before the operation and some decisions have to be taken during surgery alone. He further opined that the primary treatment of such fractures in open reduction and internal fixation during the initial stages and at later stages, options that can be considered are joint replacement and orthodesis.
It is pointed out that the Respondent has consulted various Doctors. The District Forum recorded that all the Doctors consulted by the Complainant have mentioned that the patient suffered from Auxiliary Nerve Injury. The Respondent consulted Dr. Naveen Talwar of Sir Ganga Ram Hospital and some Doctors of All India Institute of Medical Sciences, Delhi who opined that it was a case of dislocation of right shoulder and Auxiliary Nerve Injury which was caused at the time of accident and not due to the operation by the Petitioner and that the present position which exists is the known complication of such accident.
From the above discussion, all the Doctors who examined the Respondent opined that there was nerve injury and that the same was caused due to road accident and not because of the surgery performed by the Petitioner and hence, we have no reason to disbelieve the same.
In view of the above discussion, we agree that there is no material to hold that the Revision Petitioner was negligent in treating the Respondent.
However, before concluding we wish to state that the Revision Petitioner did not maintain a proper written record of the treatment given by him and a rationale for giving such treatment. Hence, to that extent there is deficiency in service.
For this we rely as the Revision Petitioner in his own admission has stated as under:
I informed the Complainant for the replacement of the shoulder when he could not get relief even after doing open reduction..I orally informed the Complainant about the replacement of the shoulder. It is not mentioned in the discharge card.
In view of the above admission of the Petitioner, we observe that it is high time that Doctors write correct notes in the operation record and discharge summary. These documents should be made available to the patient at any time without any hue and cry. When information is given orally, it becomes a matter of debate as to who is telling the truth. It is patients right to know how his case has been dealt with by the treating Doctor. It will also enable him to follow the treatment prescribed for future and, if required, sometimes, even to take a second opinion of an expert. It is the duty of the Doctor to state in the record all the details of the treatment given, medicines which are prescribed and the follow up advice, if any, and give it to the patient for his reference. Patient has a right to get the medical record pertaining to him and he cannot be denied the same when he paid the Doctor/Hospital for his treatment and hired the services.
In view of the above discussion, this Revision Petition is allowed. Impugned order passed by the State Commission is set aside. Order passed by the District Forum is restored.
However, Petitioner has to pay costs for not maintaining the proper record, which amounts to deficiency in service. The cost is quantified at Rs.10,000/- which shall be paid to the Respondent within four weeks from the date of receipt of this order.
J (M.B. SHAH) PRESIDENT ..
(RAJYALAKSHMI RAO) MEMBER P