State Consumer Disputes Redressal Commission
Narinder Singh vs Harpreet Eye And Dental Care Centre & ... on 20 February, 2024
STATE CONSUMER DISPUTES REDRESSAL COMMISSION,
PUNJAB, CHANDIGARH.
Consumer Complaint No.47 of 2020
Date of institution : 03.02.2020
Reserved on : 25.01.2024
Date of Decision : 20.02.2024
Narinder Singh S/o Harbhajan Singh, Fatehpur, Fatehpur Kothi,
Hoshiarpur, Punjab
....Complainant
Versus
1. Harpreet Eye and Dental Care Centre through Dr. Nancy
Dhiman, 244-R, New Jawahar Nagar, Near City Hospital, Jalandhar
City, Punjab.
2. Dr. Nancy Dhiman, Harpreet Eye and Dental Care Centre, 244-
R, New Jawahar Nagar, Near City Hospital, Jalandhar City, Punjab.
3. The Oriental Insurance Company Limited, 4E/14 Azad Bhawan,
Jhandelwalan Ext., New Delhi, Delhi-110055
....Opposite Parties
Consumer Complaint under Section 17 of the
Consumer Protection Act, 1986.
Quorum:-
Hon'ble Mrs. Justice Daya Chaudhary, President
Ms. Simarjot Kaur, Member
1) Whether Reporters of the Newspapers may be allowed to see the Judgment? Yes/No
2) To be referred to the Reporters or not? Yes/No
3) Whether judgment should be reported in the Digest? Yes/No Present:-
For the complainant : Sh. Varun Bhardwaj, Advocate For Opposite Parties No.1&2: Sh.M.S. Khillan, Advocate For Opposite Party No.3 : Sh.B.S. Taunque, Advocate Consumer Complaint No.47 of 2020 2 SIMARJOT KAUR, MEMBER :
The Complainant has filed this Complaint against the opposite parties (hereinafter referred as OPs No.1 to 3) under Section 17 of the Consumer Protection Act, 1986 (for short 'the Act'). The Complainant has averred that on feeling pain in his second molar tooth on the left side, approached OPs No.1&2 on 11.09.2019, who are running Eye and Dental Care Clinic at Jawahar Nagar, Jalandhar. On the said day, the Complainant was asked to come on the next day. On 12.09.2019, OPs No.1&2 after examining the Complainant, informed him that his first and second molar needs to be removed and implants need to be put. The cost of Bi-cortical implants was quoted as Rs.50,000/-. On the same day, the Complainant deposited Rs.5,000/- as advance. OPs No.1&2 conducted the tests like OPG, Blood Test, Blood Sugar etc. of the Complainant. It was clear from said test reports that the Complainant was not diabetic. CBCT 3 dimensional test of the Complainant had not been conducted. Before starting treatment, anesthesia was administered. During treatment, OP No.2 informed the Complainant that in order to give proper treatment, his one more tooth needed to be removed. Complainant had no other option except to agree for the same as he did not know about the treatment required. Thus, three teeth of the Complainant had been removed at the time of insertion of Bicortical Implants. After treatment, when effect of anesthesia was wearing out, the complainant felt numbness/no sensation on his lips and lower jaw. The Complainant informed about the said problem to OP No.2, who Consumer Complaint No.47 of 2020 3 informed him that numbness would subside with medicines. On 13.09.2019, the Complainant felt severe pain in his jaw and head.
The Complainant informed his problem to OP No.2, who simply asked him to continue taking the medicines. On 13.09.2019, the Complainant paid Rs.30,000/- to OPs No.1&2. The Complainant did not get any relief from said pain and was unable to sleep in the night. Then the Complainant contacted OP No. 2 on phone and informed his problem but OP No.2 again asked him to continue with the medicines. When the Complainant approached OP No.2 on 16.09.2019, she asked him to get CBCT 3 Dimensional Test conducted in order to diagnose exact problem for his discomfort. In the said test, it was revealed that due to negligence of OPs No.1&2, the screws of the implant had entered into the Mental Nerve of the Complainant and damaged the same. After the said test report, OPs No.1&2 removed the implants of the Complainant. They treated him by giving various injections and medicines but no record of the same had been supplied to him. On 17.09.2019, the Complainant paid an amount of Rs. 15,000/- as the balance payment. Since he was not relieved of his pain, after taking medicines and injections, the Complainant tried to approach OP No.2. The OP No.2 did not meet him. Then he sent whatsapp messages as well as email to OP No.2 on 23.09.2019.
2. On 24.09.2019, Complainant visited PGIMER, Chandigarh with his pain and numbness in lower front tooth region and head. There he was informed that OPs No.1&2 had damaged her Consumer Complaint No.47 of 2020 4 Mental Nerve during treatment. The Doctor also informed him that for the said problem, there was no treatment available in India. On 09.10.2019, Complainant felt weakness and was unable to get out of his bed. The Complainant again contacted OP No.2 and informed about his position, who asked him to visit the Hospital. The Complainant met OP No.2, who after looking at his condition on 09.10.2019 alongwith his employee sent him in Ambulance to Dr. Sehgal's Cardiac and Diabetic Clinic, Jalandhar for check-up and conducted his blood sugar test, wherein it was found that the Complainant was suffering from diabetes. The said Doctor also informed him that due to use of strong medicines and injections given by OPs No.1&2, said diabetic problem had occurred. The Complainant sent an email to OP No.2 and informed about the wrong treatment given by her and resultantly he suffered severe pain. Thereafter, the Complainant got himself checked at AIIMS, Delhi on 15.10.2019. The Doctor after conducting X-ray diagnosed that his Mental Nerve had been damaged. Due to said damage, the Complainant had suffered pain and numbness in his lower jaw as well as temple region. The Doctor at AIIMS had prescribed him with some medicines and asked to come after one week. The Complainant again visited AIIMS, Delhi on 22.10.2019 where Doctor had confirmed that due to wrong treatment given by OPs No.1&2 damage to Mental Nerve/Paresthesia had been caused. Doctor at AIIMS had also informed that there was no treatment available in India for this problem. It was suggested to the Complainant to take the medicines as advised and to come for follow up. The Complainant had visited Consumer Complaint No.47 of 2020 5 AIIMS, Delhi on 30.10.2019 and 13.11.2019 and during this period his blood sugar test was done. On 16.12.2019, he was advised to get the opinion from Neurosurgeon, which was obtained on 14.01.2020 and it was found that during the Bicortical Implant Process on 12.09.2019, his Mental Nerve injury had occurred. Later the Complainant had also faced problem in his vision. He got himself checked on 27.11.2019 for the said problem at Akal Eye Hospital & Lasik Laser Centre, Jalandhar. The Doctor diagnosed Refractive error in both his eyes and cyst in lower lid in his right eye. This Doctor also informed him that said problem had occurred due to diabetes.
3. The Complainant had further pleaded that due to negligence of OPs No.1&2 in treating him, he had suffered with life time problems as he was not able to chew his food properly and was on liquid diet. He had a problem of continuous drooling from his mouth and had also suffered with the problem of numbness/no sensation. He is totally dependent upon his family to clean his face. His face has also been disfigured due to wrong treatment. He had spent huge amount on his treatment and had to travel to get his problem cured from different hospitals, which had occurred due to medical negligence of OPs No. 1 & 2.
4. Alleging the act of the opposite parties No.1&2 to be medical negligence as well as deficiency in service as OPs No.1&2 had not treated him with care & caution, his condition got aggravated. The Doctor had carried out the treatment without any diligence and negligence, the Complainant had suffered with the life Consumer Complaint No.47 of 2020 6 time problems. It was prayed in the Complaint that Opposite Parties be directed to pay Rs. 60,000/- as medical expenses so incurred by him with OPs No.1&2; Rs.25 lakh for further treatment/medicines expenses; Rs. 20 lakh on account of pain and suffering faced by him; Rs.25 lakh on account of mental torture, harassment, pain and suffering as well as Rs.1 lakh as litigation expenses; totaling Rs.71,60,000/-.
5. Upon issuance of notice in the complaint, the OP No.1 filed M.A. No. 1201 of 2020 for deletion of his name as OP No. 1 was the Proprietorship Firm and he had no role in the treatment given by OP No. 2 to the Complainant. The said application of OP No.1 was dismissed by this Commission vide order dated 28.08.2020.
6. OP No. 2 in its written statement had taken preliminary/legal objections stating that the Complainant had levelled wrong and concocted allegations upon OP No.2. The present complaint had been filed to extort money. The issue involved in the present complaint was of complex and complicated nature, which required detailed and elaborate evidence and needed examination and cross-examination of the parties. The proceedings under the Consumer Protection Act are summary in nature, hence, the present complaint deserves to be relegated to Civil Court or dismissed. The Complainant had left the treatment on 17.10.2019 on LAMA and had taken the advice of different Doctors/Hospitals. OP No.2 was well qualified in Dental field and had vast experience, holding good reputation in providing best dental treatment in and around Jalandhar. Consumer Complaint No.47 of 2020 7 The problem of the Complainant could be improved with time and there were no chances for lifelong disability or pain as portrayed by the Complainant for claiming damages. The treatment given by OP No.2 to the Complainant in brief was that on 12.09.2019, the Complainant had visited OP No.2 with the pain in 3rd quadrant molar region of the mouth. He was diagnosed with carious teeth and mobility (3rd Quadrant 7th no. Teeth), RCT treated tooth with faulty obturation (3rd Quadrant 6th no. teeth), which was treated somewhere else previously and impacted molar (3rd Quadrant 8th no. Teeth). On the same day, Intra-oral examination was done and the Complainant was advised to undergo CBCT but he had gone for alternative investigation technique i.e. OPG-Orthopantomogram for the panoramic view of the Jaw. On 13.09.2019, the Complainant had shown the said reports to the OP No.2. During conversation with OP No.2, the Complainant had been informed about the procedure of OPG/Bi-cortical implants including proximity of the 8th molar with inferior alveolar nerve canal and its complications. After understanding the same, the Complainant had signed the consent form. The required pre-procedure tests were conducted. Random Blood Glucose of the Complainant was done and it was found on higher side. The Implant procedure was done on 14.09.2019. Post- operative X-ray was also done to check the anchorage of the implants and the surgery was conducted smoothly. On 15.09.2019 when the Complainant had approached for follow up, he had told about the pain and numbness to the treating Doctor. He was informed that the pain was there as 3 teeth were extracted. It was a known Consumer Complaint No.47 of 2020 8 complication, which would improve with time. He was advised to continue with the medicines prescribed. On 16.09.2019, the Complainant had again approached with the same problem, he was advised to undergo for CBCT Diagnostic Test. Said CBCT report was discussed with the Complainant and to relieve him from any possibility of compression of the alveolar canal/nerve, the implants were removed under Local Anesthesia. No life-long problem had occurred in the case of the Complainant. The Complainant had started consulting different health institutions suddenly w.e.f. 26.09.2019 and thereafter on 01.10.2019 he had approached her for follow up. He informed about his pain and was advised the intervention of Maxillofacial Surgeon. He had refused to meet the said surgeon as he wanted to wait for sometime. On the asking of the Complainant, an Ambulance was also sent to his residence for pick- up. The Complainant had been heard, given consultation as well as proper attention and treatment. No medical negligence had occurred in the treatment.
7. On merits, it was averred that the Complainant was advised CBCT Test as pre-operative procedure but he had refused to go for it being costly one. He had gone for OPG test. Other tests like blood test, blood sugar tests were also done before starting the treatment. The said test had revealed that blood sugar level of the Complainant was beyond normal range, whereas on asking, the Complainant had refused that there was any history of diabetes. The OPG report of the Complainant showed course of inferior alveolar Consumer Complaint No.47 of 2020 9 nerve and its distance from teeth and magnification factor was mentioned for calculation of distances. Panoramic examination was a safe preoperative evaluation procedure for routine posterior mandibular implant placement. The said procedure had been followed upon the Complainant at preoperative stage. During the said procedure, intra operative live X-rays were done to check the progress of screws from various angles. These X-rays had helped her in putting implant screws. The Surgeon/OP No.2 was solely dependent upon the preoperative static radiological investigations and he was given extra care and caution during surgery. The Complainant was informed in advance about the extraction of impacted molar (38) as it was mandatory to provide the balance in the mouth for proper functioning of the teeth as the Complainant had deep bite and limited space in his mouth for chewing. Pain is subjective sensation. Some patients do not feel pain whereas others cry inspite of having given maximum anesthesia/pain killers. On 15.09.2019, the implants were found well placed, no oedema or swelling was seen. Neither any infection was found nor any discharge of pus was there. Pre-operative diagnosis had shown one root i.e. tooth no. 38 was almost intruding the inferior alveolar nerve so on extraction of such tooth even without putting implants some disturbance of inferior alveolar nerve could be possible. Bicortical implants were implanted, which were different from conventional implants. During the procedure of putting the implant, the Doctor had to work in precision of millimetres and she was away from the inferior alveolar nerve. But still it could get compressed indirectly by bone Consumer Complaint No.47 of 2020 10 expansion, by screws or even by blood clot. The problem which had occurred in the case of the Complainant was a routine complication and he was well informed in advance about the same. Recovery time in such like cases could vary from 3 to 12 months. He had signed the consent form after understanding the same.
8. In the present case there was no negligence on the part of operating Doctor. However, the PGI Doctor had mentioned that due to treatment of OP No.2, metal nerve of the Complainant had been damaged. It was also wrong to submit that there was no medical treatment available in India for the problem of the Complainant. It had also been averred that the Doctor had adopted the method duly approved as per medical practice. In case of some damage to the IANC, even then the only way out was to remove the implants as per medical literature, which was done in the present case without wasting any time. Had the pain was not subsided, the same could have been treated with Radio Frequency Ablation. Negligence means operating on wrong side, leaving instruments in any body part whereas no such incident had occurred in the case of the Complainant. The Complainant had claimed exorbitant amount in the Complaint as compensation. This case did not fall within the pecuniary jurisdiction of this Commission. It has been prayed that the Complaint be dismissed.
9. OP No. 3 in its written statement had raised a preliminary objections that the Complainant had claimed an amount of Rs.71,60,000/- whereas expenditure had incurred only Rs.60,000/- Consumer Complaint No.47 of 2020 11 but without giving any explanation for the same. The Complainant had levelled certain allegations upon OP No. 2 on the basis of diagnosis & treatment record of PGI, AIIMS and Akal Eye Hospital but he had not impleaded any one of them as party in the Complaint and had not tendered affidavit of any of the treating Doctors. None of the Doctors had alleged that during the dental surgery conducted by OP No.2, Mental Nerve of the Complainant had been damaged. The Complainant had previously suffered with the problem of diabetes but he had concealed this fact from OP No.2. No document had shown that after dental implant by OP No.2, the Complainant had suffered with the problem of diabetes. The complainant had failed to adduce any evidence to prove that due to dental implant procedure performed by OP No.2, the Mental Nerve of the complainant was damaged. The insurance policy of OP No.2 was governed by its terms and conditions and the maximum limit of the liability under the policy term was Rs. 10,00,000/-. It was neither a case of any deficiency in service nor any unfair trade practice on the part of OP No. 3. It was prayed that the Complaint be dismissed against it.
10. In his replication to the written statement of OP No.2, the Complainant had reiterated his version as mentioned in the Complaint. It was pleaded that due to negligence of OP No.2 the Complainant had suffered with problem of life time suffering. He was forced to knock the doors of this Hon'ble Commission for the redressal of his grievance. The medical record had clearly proved that OP No.2 was deficient and negligent in its dental treatment given to the Complainant. No expert opinion was required in the present Consumer Complaint No.47 of 2020 12 case as the medical record had clearly proved that the screws of the Bi-cortical implant had entered into the Mental Nerve of the Complainant. As a result thereof the same had been damaged. It was beyond imagination that once the Complainant had agreed to pay Rs.50,000/- for implant, he could have refused to get CBCT Test done for more amount of Rs.2,000/-. The Complainant had not been informed previously about any complications arising out of procedure of implant. The Complainant had to visit PGI and AIIMS as he was not relieved from pain by the medicines prescribed by OP No.2. The Complainant had claimed that the compensation be given as he had suffered pain and he had to spend huge amount on account of gross medical negligence committed by OP No.2 during implant.
11. The parties have led evidence in support of their respective versions by way of affidavits and documents.
12. Mr. Varun Bhardwaj, Advocate, learned counsel for the Complainant had argued on the same lines as per the detailed facts mentioned in the complaint and had alleged that due to the medical negligence and uncaring act of OP No.2, he had suffered from various problems, such as diabeties, was unable to chew his food properly, faced regular problem of drooling from his mouth, problem of numbness and loss of sensation. The Complainant had also presented himself during the course of arguments. It had been prayed that his complaint be allowed and compensation be awarded as prayed for.
Consumer Complaint No.47 of 2020 13
13. On the other hand, learned counsel for the OP Nos. 1&2-Mr. M.S. Khillan, Advocate had argued on the similar lines as mentioned in the written submissions. There was no reason of lifelong disability or pain and the problem of the Complainant. It had been argued that for the satisfaction of the Complainant, OP No. 2 had arranged Maxillofacial Surgeon for him but he has stated that he had learnt that natural recovery would take almost 6 months to recover. So, he wanted to wait for some time. He had stated that it was not a case of any medical negligence or carelessness during the treatment. The prayer has been made for dismissal of the Complaint.
14. Sh. B.S. Taunque, Advocate, learned counsel for the OP No.3 had argued that the insurance policy of OP No.2 was governed by its terms and conditions and maximum limit of the liability under the policy term was Rs. 10,00,000/-, if any negligence of OP No.2 was found. It had been argued that in the Complainant had demanded unnecessary exorbitant amount against the incurred expenses of Rs.50,000/- only and such type the Complaint be dismissed.
15. We have heard the arguments of learned counsel for the parties and have also carefully perused all the documents, medical literature and written arguments available on the file.
16. There is no dispute that the Complainant had approached OP No.2 with the problem of pain in his tooth. The sequence of dates and events is as under:-
i) The Complainant approached OP No.2 on 11.09.2019, he was asked to come on the next day.Consumer Complaint No.47 of 2020 14
ii) On 12.09.2019, after complete dental check-up of the Complainant, he was told that his first and second molar need to be removed and they have to be replaced by dental implants. The Complainant deposited Rs.5,000/- as advance. Certain tests like OPG, Blood Test, Blood Sugar of the Complainant were carried out. During the physical check-
up he was told that his one more tooth also needed to be removed. After giving consent, the procedure of putting of Bicortical implant was carried out by OP No.2. During the procedure, anesthesia was administered.
iii) On 13.09.2019, the Complainant felt severe pain in jaw and head. He was told to continue the medicines prescribed by OP No. 2. That day he deposited Rs.30,000/- more.
iv) On 16.09.2019, he was told to get his Cone-beam Computed Tomography Systems (CBCT) 3 Dimensional Test done. The OP No. 2 removed the implants of the Complainant.
v) On 17.09.2019, the Complainant deposited remaining amount of Rs.15,000/- with the OPs No.1&2.
vi) On 23.09.2019, the Complainant tried to meet OP No.2 but he could not meet her. Then he sent whatsapp messages and email to OP No.2.
vii) On 24.09.2019, the Complainant visited PGIMER, Chandigarh where he was diagnosed with 'Mental Nerve damage' and was prescribed medications. In the said report, there is a mention of CBCT showing Infraorbital Canal Injury due to perforation of previously placed and removed implants.
viii) On 09.10.2019, the Complainant again contacted OP No. 2, who referred him to Dr. Sehgal's Cardiac and Diabetic Clinic, where he was diagnosed with suffering from diabetes. He was prescribed medication by the said Doctor.
ix) On 15.10.2019, the Complainant went to AIIMS, Delhi where his Orthopantomography (OPG) was conducted and he was diagnosed with numbness in anterior lower region in the mouth i.e. the front part of the mouth.
x) He again went to AIIMS, Delhi on 22.10.2019 with the complaint of pain in left lower back jaw region. There the Consulting Doctor under history of patient had mentioned that extraction of 6,7,8 teeth was done under local anesthesia in a private clinic one month back and immediate Bicortical Implant placement. During implant placement, patient had Mental Nerve paresthesia. It has also been mentioned that there was no pus discharge.
xi) On 13.11.2019, again the Doctors mentioned Paresthesia of left Mental Nerve and medicines had been prescribed.
xii) On 16.12.2019, the Doctors advised him with an option for Neurosurgery opinion for left Mental Nerve Avulsion.
xiii) On 14.01.2020, the Complainant again went to AIIMS, Delhi where the Doctors recorded in the OPD slip regarding lower Mental Nerve injury, lower biotical implant placement during mandible during RCT of 6, 7, 8 molar teeth on 12.10.2019 outside. In the same slip, it had been mentioned that patient had been counselled about prognosis. Meaning thereby he was told about the treatment required for the said injury. Consumer Complaint No.47 of 2020 15
xiv) Later the Complainant faced problem in his vision and he was checked at Akal Eye Hospital & Lasik Centre, Jalandhar. In the medical notes of the said Hospital, it has been mentioned that he had 'refractive error in both eyes and cyst in lower Lid in Right Eye. The procedure for excision of right eye and use of glasses had been advised in the same prescription slip.
17. To match with the aforesaid sequence of events, we have perused corresponding documents in the case file, which are listed below:-
Date of Visit/ Documents details
correspondence
11.09.2019 Complainant approached OP No.2 with pain in his left side
second molar tooth.
12.09.2019 OP No. 2 examined the Complainant and diagnose:
(Ex.C-3) Carious teeth and mobility wrt 37
Rct treated tooth wrt 36
and Advised:
rehab with bicortical implants wrt 36 37
extraction wrt 38
Medicines for 10 days
Tab. Wysolone 20 mg
Tab. Enzomac
20 & 21.9.2019 (Ex.C-7), Whatsapp chat & letters between the Complainant and OP
(letter of Complainant) No.2 regarding pain
23.9.2019
24.9.2019 (Ex. C-9) PGIMER OPD Card
9.10.2019 (Ex. C-10) Another letter/email by the Complainant
9.10.2019 Dr. Sehgal's Cardiac and Diabetic Clinic
14.10.2019 (Ex. C-12) Another letter/email by the Complainant
Exs.C-13 to 18 AIIMS OPD Treatment
Exs. C-20 & 21 Akal Eye Hospital & Lasik Laser Centre, Jalandhar
Ex. C-22 Photographs
18. OP No.2 had also annexed treatment details of the Complainant with her written statement, which have also been perused. Such documents are listed below:-
Date of Visit/ Documents details
correspondence
12.09.2019 (Ex. OP-2/6) Clinical Notes
12.09.2019 (Ex. OP-2/7) X-ray 3rd Quadrant
Photographs
13.09.2019 Report OPG
Photographs of Teeth
13.9.2019 (Ex. OP-2/9) Clinical Notes
13.9.2019 (Ex. OP-2/10) Dental Implant Patient Information and Consent Form
13.9.2019 (Ex. OP-2/11) Clinical Notes
14.9.2019 (Ex. OP-2/12) Clinical Notes & X-ray (P.174-183)
Consumer Complaint No.47 of 2020 16
15.9.2019 (Ex. OP-2/13) Clinical Notes, X-ray (P.186-187) 16.9.2019 (Ex. OP-2/14) Clinical Notes 17.9.2019 (Ex. OP-2/15) Clinical Notes Ex. OP-2/16 Chats/Messages 23.9.2019 (Ex. OP-2/17) Clinical Notes (P.193) Ex. OP-2/17A Literature (Dental Injury Timeline) 24.9.2019 (Ex. OP-2/18) Clinical Notes (P.196) 26.9.2019 (Ex. OP-2/19) Clinical Notes (P.197) 1.10.2019 (Ex. OP-2/20) Clinical Notes (P.198) 9.10.2019 (Ex. OP-2/21) Clinical Notes (P.199) 17.10.2019 (Ex. OP- Clinical Notes (P.210) 2/24)
19. Now the issue for consideration before us on perusal of sequence of events and documents is as under:-
(1) Whether during the said treatment, there was any act of medical negligence?
(2) Whether in the treatment given by OP No. 2, the Complainant had suffered with life time pain, suffering and deformity of face?
(3) Whether any medical negligence is proved on the part of OP No.2?
(4) How much amount of compensation the Complainant is entitled for?
20. We have carefully perused the sequence of events, related documents, medical literature and heard the arguments raised by learned Counsel for the parties of both the sides. It has been alleged that the Complainant suffered from injury of Mental Nerve during the procedure of placing implants for his three teeth by OP No.2-Doctor, causing loss of sensation and facial deformity.
21. Before reaching any conclusion, it is important to understand the various medical terminologies used in the present Complaint. The Dental Implant Surgery is a procedure that replaces tooth roots with Metals, screw like posts and replaces Consumer Complaint No.47 of 2020 17 damaged or missing teeth with artificial teeth that look and function much like real ones. In the present case the Doctor had advised the patient to go for Bi-cortical implants. These type of implants are immediately loaded after fresh extraction and after obtaining the consent. This procedure was adopted by OP No.2. In the present case the Complainant had complained of pain and numbness and the said implants were removed. The removal of implants is the only option left to the Doctor if the patient is having severe pain and discomfort. It is also important to understand the definition of Mental Nerve and how it affects the anatomy of mouth and face. Mental Nerve in common terminology has been defined in medical literature as a sensory nerve of the face. Any damage to the nerve causes dysfunctions of inferior lip and teeth including numbness increased or decreased sensation, painful sensation or complete loss of sensation. During the removal of these implants by OP No.2, the Complainant had suffered from injury to the Mental Nerve.
22. It has been submitted during the course of arguments by OP No. 2 that no negligence could be attributed to her, if any injury had occurred to the Complainant, such type of injuries are unintentional and generally unsuspected and also no expert opinion had been tendered to prove that the damage to the nerve had been caused by the said procedure. The Complainant had failed to tender any affidavit/opinion from the treating Doctors of PGIMER, Chandigarh and AIIMS, Delhi, in support of his contention that due to Consumer Complaint No.47 of 2020 18 medical negligence of OP No.2, his Mental Nerve had been damaged. OP No. 2 had undertaken the procedure as per the medical literature.
23. The aforesaid submissions made by the Doctor/OP No. 2 cannot justify the suffering of the Complainant because of damage to the Mental Nerve. Though no affidavits have been tendered by the treating Doctors but in the medical notes of PGIMER, Chandigarh (Ex. C-9) and AIIMS, Delhi (Exs. C-15 & 17) it has clearly been mentioned/recorded that Paresthesia of Mental Nerve was caused by perforation during the procedure of putting implants. Paresthesia is an abnormal sensation, tingling or pricking caused chiefly by pressure or damage to peripheral nerves. Due to this diagnosis the treating Doctor at AIIMS had suggested 'Neurosurgery opinion for L Mental Nerve Avulsion'. Avulsion is a medical condition in which a part of body has been torn of or removed through either surgery or trauma. Thus, it is clearly established that the Complainant had suffered from complications which arose during the procedure of putting Bi-cortical implants. The OP No. 2- Doctor had also offered to get him treated with Maxillofacial surgery i.e. jaw surgery. Maxillofacial which is a surgical specialty focusing on reconstructive surgery of the face, facial trauma surgery, the oral cavity, head and neck, mouth and jaws. If the Doctor conducted the procedure correctly, why did she remove the implants in the first stage and later on offered to bear expenditure for the aforesaid surgery. It clearly emerges that negligence had Consumer Complaint No.47 of 2020 19 occurred during the extraction of teeth and procedure of putting the implants and the treating Doctor wanted to compensate the Complainant.
24. During the case of arguments, the Complainant had presented himself before us and his physical condition has also been observed. His complaint has been substantiated regarding deformity of face. The photographs of the Complainant have been shown to us of the period before and after the implant as tendered by him by way of evidence as Exs. C-22 & C-23, which clearly show the obvious changes in his face after insertion/removal of implant/deformity.
25. Besides the aforesaid discussion, the Complainant has lost his confidence, he remained agitated and restless as the negligence so caused by the OP No.2 had caused loss of sensation, pain and drooling from the mouth, which can be described as a natural reaction of any human being. It compelled him to go from pillar to post for diagnosis/treatment of his problem. He had also visited PGIMER, Chandigarh and AIIMS, New Delhi on numerous dates by spending lot of amount on his journeys which has been proved from the evidence as submitted by him i.e. tickets, bills and OPD slips of both the institutions. Both these institutions have diagnosed in clear terms that the said medical problem had occurred during the fixture of implants after extraction of his tooth.
26. It is also clear from the above discussion that the Doctors of both the reputed institutions i.e. PGIMER and AIIMS have held the same opinion that during the procedure of lodging of Bi-cortical Consumer Complaint No.47 of 2020 20 Implants, Mental Nerve of the Complainant had been damaged and subsequent problems like numbness/ no sensation on his lips and lower jaw had occurred. On numerous occasions OP No. 2 were unable to satisfy the Complainant when he tried to contact her, which has transpired from the whatsapp chats (Ex.C-7) and emails (Ex. C-8, 10, 12) sent to her.
27. It has been contended by the OP No. 2 that the Complainant had not sought any expert opinion regarding his medical condition. From the notes of two top most premier Medical Institutions of India, negligence of OP No.2 has been proved. The physical condition of the Complainant has been observed during the course of arguments when he himself remained present before us. We are of the view that his condition is so apparent and there is no need for seeking any expert opinion in this case.
28. The Complainant himself has alleged that the said procedure had affected his eyes too. The record and medical notes of Akal Eye Hospital & Lasik Laser Centre have been carefully perused. Nowhere in the said notes, it has been mentioned that his problem of Refractive Error or Cyst had occurred due to the dental implant procedure adopted by OP No.2. Hence, this ground of the Complainant is not proved on record that due to wrong implant, the problem of Refractive Error or Cyst had occurred in his both eyes.
29. The application of OP No.1 regarding deletion of his name from the array of party had already been dismissed vide order dated 28.08.2020.
Consumer Complaint No.47 of 2020 21
30. From the aforesaid discussion it has been proved on record and accordingly, it is held that OPs No.1&2 were negligent while conducting the procedure of the Complainant with Bi-cortical Dental Implant. In such circumstances, the Complainant requires further treatment to cure his medical problems and will have to incur expenses for the same. Therefore, in our considered opinion the Complainant is held entitled for the expenses incurred by him and also for further treatment/management. The preliminary objection raised by OP No.2 regarding the pecuniary jurisdiction is not sustainable as the case has to be considered as per the facts and circumstances of the Complainant and relief sought for which is due to the act of medical negligence on the part of the Doctor.
31. The Complainant has not stated specifically as to which surgery he has to undergo in foreign shores as raised by him during argument. We have researched regarding the surgery so required by the Complainant. It has been found that Maxillofacial surgery or any Neuro Surgery as required by the Complainant can take place in India itself. Therefore, we have assessed the compensation on that basis. The Complainant has sought the following reliefs in the complaint:-
(i) to pay Rs. 60,000/- as medical expenses incurred by him with OPs No.1&2;
(ii) Rs.25 lakh as further treatment/medicines expenses;
(iii) Rs. 20 lakh on account of pain and suffering faced by him;Consumer Complaint No.47 of 2020 22
(iv) Rs.25 lakh on account of mental torture, harassment, pain and suffering;
(v) Rs.1 lakh as litigation expenses; totaling Rs.71,60,000/-.
32. We are of the view that the compensation as prayed for by the Complainant is on the higher side. It is beyond doubt that he deserves compensation for future course of medical treatment action i.e. surgery for his problem, mental harassment and agony and pain as suffered by him while visiting different medical institutions. Besides he has also incurred expenses on litigation.
33. Accordingly, in view of the reasons and facts as mentioned above, we partly allow the Complaint by directing the OPs No.1&2 to refund an amount of Rs.60,000/- as spent by the Complainant on his treatment and also Rs.5,50,000/- as compensation for further future surgery; Rs. 3,00,000/- for suffering pain, mental harassment and agony and Rs. 50,000/- as litigation expenses. The OPs No. 1 & 2 are directed to comply with the order within a period of two months from the date of receipt of certified copy of the order, failing which the Complainant would be entitled for cost/penalty of Rs.50,000/-.
34. The OP No.2-Doctor had obtained Professional Insurance Policy from OP No. 3 to safeguard her from paying the amount of penalty from her own pocket when any mis-happening occurs during treatment and the liability is fixed upon her. Therefore, OP No.2 is at liberty to raise her claim with the said Insurance Company. Consumer Complaint No.47 of 2020 23
35. Since the main case has been disposed of, so all the pending miscellaneous applications, if any, are accordingly disposed of.
36. The complaint could not be decided within the stipulated period due to heavy pendency of Court cases.
(JUSTICE DAYA CHAUDHARY) PRESIDENT (SIMARJOT KAUR) MEMBER February 20, 2024 as