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& SRI S. BHUJANGA RAO, MEMBER   THIS THE THIRTIETH DAY OF DECEMBER TWO THOUSAND THIRTEEN   ORAL ORDER:

(Per Sri T. Ashok Kumar, Member)   ***  
1) This is an appeal preferred by the opposite parties 1 and 2 as against the order in C.C. No. 56/2010 on the file of Dist. Forum II, Krishna Vijayawada. For convenience sake, the parties as arrayed in the complaint are referred to hereunder.
 
2) The case of the complainant in brief is that complainant No. 1 a heart patient (hereinafter called as patient) has been referred to by Op1 to Op2 with a history of Pace Maker Syndrome (Syncope) as he had earlier undergone pacemaker implantation at Op1 hospital. On 12.8.2008 he was admitted to Op2 hospital. On 18.8.2008 after necessary investigations Op.3 performed operation to implant a new pacemaker by removing the existing pacemaker on the patient for which Op5 paid Rs. 80,000/-. The patient was kept in the same hospital as in-patient as advised by Op3 doctor for better management of the patient and to monitor post-operative complications if any.
 

3) Op1 filed counter resisting the complaint and OP. 2 adopted the same. According to Op.1 the complainant had long history of heart block. He approached Op2 in the year 2004 after receiving treatment from a local Neuro Hospital for seizures and convulsions. He was found to have bradycardia with a complete congenital heart block. He was not responding to deep stimuli, exhibited shallow breathing. ECG report revealed bradycardia. A temporary pace maker was implanted and the patient was stabilized. Necessity of implanting a permanent pace maker was explained to the parents. In October, 2004 a Permanent pace maker was successfully implanted. The patient and their family members did not adhere to the medical advice. In August, 2008 a new pace maker implantation was suggested as there was complete heart block. An emergency temporary pacemaker was implanted by the cardiologist. The old permanent pacemaker showed fractured circuit (lead) at the left clavicular area. Echocardiography revealed severe left ventricular dysfunction and left ventricle clot. The patient intubated and mechanically ventilated and simultaneously started I.V. fluids. Utmost care was taken while implanting the pacemaker. The development of numbness and pain in the leg of the patient was due to complete heart block and severe left ventricular dysfunction that led to ischemia of right lower limb due to showering of clots from left ventricle into systemic circulation. It has happened in spite of heparinisation and anticoagulation. The thromboembotolic pneumonia of right leg was due to said Ischemia and not due to any negligence on their behalf. The complainant did not state specifically as to what was required to be done and what they ought to have done. The patient was discharged after amputation of his right leg. Unfortunate condition of the patients congenital heart problem and its complications are not due to any medical negligence either on the part of treating doctors or the hospitals.

The case of the complainants is that the patient approached the second Opp party hospital on 12.8.208 for treatment on the ground that he was experiencing repeated health problems.

There is no dispute that third party is a consulting doctor at Ops hospital. He examined the first complainant patient and diagnosed him to have Pace maker syndrome, in such circumstances, on 12.8.2008 the first complainant patient was admitted in the hospital of second opposite party and after due investigations on 18.04.2008, 3rd OP performed operation and implanted a new Pace maker to the first complainant by removing the existing Pace maker for which 5th opposite party trust paid Rs.80,000/- to the second opposite party. Since third opposite party advised to keep the first complainant patient in the same hospital as inpatient for better management of the patient and also to monitor post-operative complications if any the first complainant continued to stay in the said hospital as in patient. Thereafter, third opposites party consultant doctor had been to abroad i.e. U.K., on 22.08.2008 and returned to India on 05.09.2008. Thus, safely it can be said that in between the said dates ie for about two weeks OP.3 did not treat or attend on the first complainant. The said OP. 3 who is examined as DW.1 has admitted that any Pace maker implantation required not more than two or three days hospitalization but as the first complainant patient developed Limbeschemia his hospitalization was extended. However, the complainants did not allege any deficient service on the part of OPs hospital or the third opposite party that there was defect in implantation of the Pace maker. Merely because Pace maker worth of Rs.40,000/- was donated or sponsored by the first opposite party in the year 2004, it is in no way helpful for the contesting Ops to say that they did not render any deficient service to the first complainant in this case which ultimately led for amputation of his right lower limb on account of eschemia.

18. Op.1 is the main hospital and Op.2 is its branch and in view of the discussion made supra certainly it has to be held that Ops 1 and 2 rendered deficient service to the first complainant in treating him in connection with eschemia which is a known peril after implantation and pace maker which ultimately led to the amputation of right leg of first complainant. In the circumstances of the case, refund of Rs.30,000/- paid towards amputation charges with interest thereon @ 9% pa from 15.09.2008 till payment directing Ops 1 and 2 jointly and severally to pay the same to the first complainant so also costs of Rs.3,000/- needs no interference. On account of amputation of right leg at the age of 20 years the first complainant permanent disabled and he is unable to work and earn as before. The fact that the was suffering from heart ailment since 2004 is a mitigating circumstance in favour of the Ops to some extent. There is no dependable evidence on record form the side of the complainants with regard to his avocation and income. In view of the said age of 20 years of the first complainant, multiplier 16 under the M.V. Act is applicable for computation of compensation for the said permanent disability of the first complainant and as there is no dependable evidence as to avocation and income of the first complainant and as he took treatment under Arogyasri which indicates his income was meagre his income on some guess work is taken as Rs.3,000/- per month which comes to Rs.36,000/- per annum and if the said amount is multiplied with 16, the total loss of his earnings on account of such permanent disability comes to Rs.5,76,000/- and thus amount of Rs.8 lakhs awarded to the first complainant towards compensation has to be scaled down to Rs.5,76,000/- Payable with interest there on 9% pa from the date of complaint ie. 29.7.2009 till payment. The District Forum did not award any compensation to the complainants 2 and 3, so also, for life long support to their son as prayed for. So also, to refund Rs.80,000/- fee paid by OP.5 to the 2nd opposite party towards implantation of pace maker and no cross appeal in the said context has been preferred nor any case was made out for such reliefs. Thus, in view of the above discussion, point is answered mostly in favour of the complainants modifying the order of the District Forum directing Ops 1 and 2 to pay jointly and severally Rs.30,000/- towards refund of amputation charges with interest thereon at the rate of 9% pa from 15.09.2008 till payment and also a sum of Rs.5,76,00/- towards compensation with interest @ 9% pa from the date of complaint ie 29.07.2009 till payment and also costs of Rs.3,000/- to the first complainant and the remaining order stands set aside.