State Consumer Disputes Redressal Commission
Dr.Kuttikrishnan vs Sathi.C.P. on 19 October, 2011
Daily Order
Kerala State Consumer Disputes Redressal Commission Vazhuthacaud,Thiruvananthapuram First Appeal No. 691/2006 (Arisen out of Order Dated null in Case No. of District ) 1. Kuttikrishnan ENT Specialist,AKG Memorial Co -Operative Hospital,Kannur BEFORE: HONARABLE MR. SRI.M.V.VISWANATHAN PRESIDING MEMBER PRESENT: ORDER
KERALA STATE CONSUMER DISPUTES REDRESSAL COMMISSION VAZHUTHACAD, THIRUVANANTHAPURAM
APPEAL 691/2006
JUDGMENT DATED: 19..10..2011
PRESENT
SRI.M.V.VISWANATHAN : JUDICIAL MEMBER
Dr.Kuttikrishnan, : APPELLANT
ENT Specialist,
AKG Memorial Co-operative Hospital,
Kannur-2.
(By M.C.Suresh)
Vs.
1. Sathi.C.P.,, : RESPONDENTS
W/o Prasannan,
Kottakkan House,
Chalad, Kannur.
2. The Manager,
AKG Memorial Co-operative Hospital,
Kannur.
(By Adv.Thomas.M.Jacob, counsel for R1)
JUDGMENT
SRI.M.V.VISWANATHAN : JUDICIAL MEMBER The appellant is the 1st opposite party and respondents 1 and 2 are the complainant and the 2nd opposite party respectively in OP.263/02 on the file of CDRF, Kannur. The complaint therein was filed alleging medical negligence and deficiency in service on the part of the opposite parties in treating and administering medicines to the complainant while the complainant was treated in 2nd opposite party's AKG memorial Co-operative Hospital, Kannur. The opposite parties entered appearance and filed written version denying the alleged medical negligence and deficiency in service. The1st opposite party contended that the complainant was treated initially as an outpatient and treated as inpatient from 27.5.02 with utmost care and caution; that the complainant developed allergic reactions and she was treated with appropriate medications; that the complainant was referred to KMC hospital, Manipal on 31.5.02 at request. Thus, the 1st opposite party prayed for dismissal of the complainant filed against him. The 2nd opposite party AKG Memorial Hospital represented by its Manager filed separate written version adopting the contentions raised by the 1st opposite party and requested for dismissal of the complaint.
2. Before the Forum below the complainant was examined as PW1 and the doctor who treated the complainant at Kasturba Medical College Hospital, Manipal was examined as PW2; Exts A1 to A 94 documents were marked on the side of the complainant, Ext.X1 medical records produced from KMC hospital, Manipal was marked through PW2. The 1st opposite party was examined as DW1 and the 2nd opposite party as DW2; Exts.B1 and B2 documents were marked on the side of the opposite parties.
3. After hearing both parties and on appreciation of the evidence on record, the Forum below passed the impugned order dated 22nd March, 2006 allowing the complaint and directing the opposite parties to pay Rs.1,00,000/- as compensation with cost of Rs.5000/-. Hence the present appeal by the 1st opposite party Dr.Kuttikrishnan.
4. We heard both sides. The learned counsel for the appellant/1st opposite party submitted his arguments based on the grounds urged in the memorandum of the present appeal. He relied on the oral testimony of PW2 and submitted that the evidence of PW2 and X1 case sheet maintained at KMC Hospital, Manipal are sufficient to hold that there was no negligence or deficiency in service on the part of the opposite parties. He challenged the correctness of the findings made by the Forum below with respect to B1 case sheet . He also submitted argument notes in support of his oral submissions. On the other hand, the learned counsel for the 1st respondent/ complainant supported the impugned order passed by the Forum below and argued for the position that there was negligence and deficiency in service on the part of the opposite parties in treating the complainant. He also relied on the testimony of PW2. It is further submitted that issuance of Ext.A4 discharge summary from the 2nd opposite party hospital would show the deficiency in service on the part of the opposite parties. Thus, the 1st respondent prayed for dismissal of the present appeal. There was no representation for the 2nd respondent/2nd opposite party.
5. There can be no dispute that the 1st respondent/ complainant was treated from the 2nd opposite party, AKG Memorial Co-operative Hospital, Kannur from 3..5..02 and the said treatment was at the initial stage as outpatient under the 1st opposite party Dr.Kuttikrishnan. The aforesaid treatment was in connection with the ear problem and the said treatment continued from 27.5.02 as in-patient. The fact that the complainant had pain to her ear and surrounding area is admitted by the complainant herself. The aforesaid illness was diagonosed as otitis externa with cervical lymphademitis. The aforesaid treatment for infection to the ear was continued as outpatient and the said illness could not be cured. The complainant was admitted as inpatient from 27.5.02 for the aforesaid ear problem. The complainant was administered medicines such as penicillin injection, gentamycin, metrogyl and overran injections. The administration of the aforesaid medicines were not in dispute.
6. It is the case of the complainant that she developed drug reactions on account of wrongful application of the aforesaid medicines at the instance of the appellant/1st opposite party. Complainant had issued a lawyer notice(A1) dated 5.7.02 and it is after issuance of A1 lawyer notice the complainant in OP.263/02 was filed. In the aforesaid lawyer notice and in the written complaint it was alleged that the complainant was affected by stevens Johnson syndrome and the said complication was caused on account of reactions of medicine which was wrongly applied by the 1st opposite party Dr.Kuttikrishnan, ENT Specialist attached to the 2nd opposite party AKG Memorial Co-operative hospital, Kannur. It is to be noted that thee was no case in A1 lawyer notice or in the complaint in OP.263/02 that the aforesaid medicines were administered without giving test dose. But at the evidence stage, the complainant developed the case of failure on the part of the opposite parties in giving test dose before administering the penicillin injections. The aforesaid case developed by the complainant regarding failure to give test dose cannot be believed or accepted.
7. The mere fact that in Ext.B1 case sheet or in other medical records there is no mention of giving test dose before administering penicillin injection cannot be taken as a ground to hold that no test dose was given before administering penicillin injection to the complainant. It is to be noted that medicines were administered from KMC, Hospital, Manipal; but there is nothing in Ext.X1 case sheet produced from KMC Hospital, Manipal to show that test dose was given before administering medicines by way of injection. It is too much on the part of the complainant to depose that the opposite parties failed to give test dose before the administering penicillin injection and other injections. PW1 could not remember the details of the medicines administered to her while she was in 2nd opposite party hospital. It is deposed by PW1 that she is not remembering the procedure adopted by the doctor while treating her at 2nd opposite party's hospital. PW1 has also deposed that she is not in a position to remember the doctors who examined her at 2nd opposite party's hospital. If the complainant had such a case of failure to give test dose before administering penicillin and other injections, definitely she would have alleged the same in her lawyer notice and in the complaint in OP.263/02. So, the case of PW1 that medicines like penicillin injections were administered without giving test dose cannot be believed or accepted.
8. The complainant has alleged negligence on the part of the opposite parties in wrong application of medicines . But the complainant could not state the nature of the alleged wrong application of medicine or what medicine was wrongly applied by the 1st opposite party. In effect, the complainant failed to establish the alleged wrong application of medicine by the 1st opposite party. On the other hand, PW2 the expert doctor examined on the side of the complainant has deposed that there was nothing wrong with the medicines administered to the complainant. PW2 has not given any indication that there occurred any negligence in administering medicines to the complainant. The aforesaid case of wrong application of medicine cannot be believed or accepted.
9. It is the case of the complainant that she approached the 1st opposite party in the 2nd opposite party hospital with the complaint of ear problem and it ultimately resulted in causing drug reaction known as stevens Johnson syndrome, It is true that the evidence of PW2 and Ext.X1 case sheet maintained at KMC hospital, Manipal would show that the complainant developed the allergic reaction known as stevens Johnson syndrome. There can be no doubt about the fact that stevens Johnson syndrome is the allergic condition which can be caused due to drug reaction or due to the induction of any substance which is allergic to a particular person. It is true that the opposite parties could not detect exact cause or reason for the aforesaid allergic reaction. It is to be noted at this juncture that PW2, the doctor attached to KMC Hospital, Manipal who treated the complainant subsequently and improved her conditions could not give any reasonable explanation for the exact reason for the aforesaid allergic reaction known as stevens Johnson syndrome. The mere fact that the complainant can developed the aforesaid allergic reaction known as stevens Johnson syndrome cannot be taken as a ground to hold that the opposite parties were negligent in treating the complainant.
10. It is to be noted that the allergic reaction may cause due to the administration of any medicine which are prone to develop allergic condition. It may be correct to say that medicines Penicillin, gendamycin, imbecilic etc are very prone to induce allergic reaction. PW2 has categorically deposed that even after test dose the said medicine can also develop allergic reaction. Thus, it can very safely be concluded that the development of allergic reaction can be considered as a well known and accepted complication. It is true that such allergic reaction may not develop ordinarily; but in rare occasions such medicines can develop allergic reaction. It can be concluded that administration of medicines such as penicillin or gendamycin which caused allergic reaction cannot be taken as a ground to hold that the doctor who administered those medicines was at fault or negligent. The Forum below cannot be justified in holding that there was negligence or deficiency in service on the part of opposite parties in treating the complainant.
11. A careful analysis of the entire testimony of PW2 and Ext.X1 case sheet would make it clear that there is no medical negligence or deficiency in service on the part of the opposite parties in treating the complainant and that the allergic reaction known as stevens Johnson syndrome was not caused due to any negligence or deficiency in service. An appreciation of the entire evidence on record with the facts and circumstances of the case would make it clear that the Forum below failed to appreciate the evidence on record in its correct perspective. It can also be inferred that the impugned order was pronounced based on assumptions and presumptions and that the findings thereon are not supported by cogent and acceptable evidence. So, this State Commission have no hesitation to set aside the aforesaid findings and the conclusions thereon.
12. It is true that the opposite parties failed to maintain proper medical records. A perusal of Ext.B1 case sheet (medical records) would make it clear that the opposite parties failed to maintain proper medical records with respect to the treatment of the complainant in 2nd opposite party AKG Memorial Co-operative hospital, Kannur. It is true that there are over writings and corrections in Ext.B1 case sheet. But that cannot be taken as a ground to hold that Ext.B1 case sheet is a manipulated document. The very existence of the corrections and strikings, overwritings etc would show that Ext.B1 case sheet has been maintained by the 2nd opposite party's hospital in connection with the treatment of the complainant. It is to be noted that the complainant has no doubt about X1 case sheet of Kasturba hospital, Manipal. A perusal of X1 case sheet would show that there are corrections, over writings, etc in X1 case sheet also. So, the existence of corrections overwritings, different handwritings etc can not be taken as a ground to treat the medical records as one manipulated or concocted. Moreover, there is no rules or regulations prevailing as to how medical records are to be maintained. In the absence of any such stipulations, the opposite parties cannot be found deficient in maintaining proper case records.
13. There can be no doubt that Ext.A4 discharge card issued by the 2nd opposite party hospital is lacking in many aspects. PW2 has also deposed that discharge summary should contain the details of the medicines administered and also the details regarding diagnosis and procedures followed by that hospital which issued the discharge card. The discharge summary issued by KMC hospital, Manipal is also available in this case. The aforesaid discharge summary contains all the details with respect to the treatment given from that hospital. A study of A4 discharge card with that of the discharge summary of KMC would speak volumes about the failure on the part of the opposite parties in issuing a proper discharge summary to the complainant. The aforesaid failure can be treated as some sort of deficiency in service on the part of the opposite parties. But, there is nothing on record to show that the aforesaid deficiency in service in issuing A4 discharge card has resulted in any inconvenience or financial loss. PW2 has no case that due to the lack of details in A4 discharge summary he could not diagnose the disease of the complainant when she was admitted in KMC hospital, Manipal. It can be concluded that due to the said deficiency in service in issuing Ext.A4 discharge card no sort of difficulties, inconvenience or hindrance caused to the complainant in her treatment at KMC hospital, Manipal. It is not fair on the part of the Forum below in awarding compensation to the complainant for deficiency in service on the part of the opposite parties. Thus, in all respects the impugned order passed by the Forum below is liable to be quashed. The opposite parties 1 and 2 would not have been burdened with the liability to pay compensation to the complainant. So, the appeal preferred by the 1st opposite party in OP.263/02 is to be allowed and the complaint therein is to be dismissed.
In the result the appeal is allowed. The impugned order dated 22.3.06 passed by the CDRF, Kannur in OP 263/02 is set aside and the complaint therein is dismissed. As far as the present appeal is concerned, the parties are directed to suffer their respective costs.
M.V.VISWANATHAN : JUDICIAL MEMBER ps [HONARABLE MR. SRI.M.V.VISWANATHAN] PRESIDING MEMBER