Indian Kanoon - Search engine for Indian Law

Hence, the present appeals.

Contentions of the Parties

12. We have heard learned counsel for the parties, except respondent No.2/opposite party No.1, as none appeared on its behalf at the time of arguments. We have also carefully gone through the written arguments submitted on behalf of appellant/opposite party No.2 and respondent No.1/complainant and records of the case.

13. The written arguments submitted on behalf of appellant/opposite party No.2 are on the lines of the reply to the complaint filed by him before the District Commission as well as the grounds of appeal. The sum and substance of the oral and written arguments is that on 11.11.2017, the complainant had consulted him after being sent by the Emergency Medical Officer. After diagnosing the complainant with an old scar/Keloid on the right side of the dorsum of her nose, opposite party no.2 prescribed her prophylactic Antibiotics, Anti-inflammatory medications and also advised her to apply ointment over the scar/Keloid. She was asked to get an X-ray of the nasal bone. After seeing the X-ray, opposite Party No. 2 discussed the treatment options for Keloid on her nose. There are two possible ways of treating Keloids; one is surgical excision and the other is injecting the Keloid with a steroid. Surgical excision of Keloid may lead to scar formation or recurrence or disfigurement of the nose. Thus, injecting Keloid with triamcinolone is the first line of treatment and the same is considered to be standard medical protocol for treatment of Keloids. Triamcinolone comes with different brand names and the most common is 'Kenacort'; which is manufactured by Abbott. It is further contended that Keloids are raised overgrowths of scar tissue that occur at the site of skin injury. They occur where trauma, surgery, blisters, vaccinations, acne or body piercing have injured the skin. Less commonly, Keloids may form in places, where the skin has not a visible injury. Keloids differ from normal mature scars in composition and size. Some people are prone to Keloid formation and the same may develop them in several places. These are more common in young women, usually with pierced ears.

18. It is further contended that earlier, the complainant filed a complaint before District Commission, Barnala on 20.07.2018, in which she had referred to the Keloid/scar as a boil on the nose; whereas both boil and Keloid are different entities. The complainant has nowhere stated in the complaint as to what was required to be done and what was not done. She has vaguely stated that "the manufacturer of the said injection does not recommend for injection around/into the eye or certain parts of the nose due to risk for blindness or damage to the eye(s)."

22. It is further contended that the judgments relied upon by the complainant in support of her claim for enhancement of the claim do not support of her case and are distinguishable. Opposite Party No.2 also relied upon Medical Literature i.e. Scott-Brown's Otorhinolaryngology, Head and Neck Surgery Volume 3 Chapter 208 titled as "Keloids, Hypertrophic Scars and Scar Revision". As per page-2893 of this book under the heading "Intralesional Steroids", it is proved that the steroids are frequently used in the treatment of keloids and have shown response rate of 30%-100%. The use of intralesional steroids found that 88% of keloids demonstrated measurable improvement following treatment. It is mentioned in the said Book as follows:

Medical Negligence

41. It is an admitted fact that the complainant, who was suffering from a boil on her nose, had approached opposite party No.1-Hospital on 11.11.2017 and prescribed slip, Ex.C-1 (colly.) was issued after charging ₹10/-. Opposite party No.2-Dr. Gagandeep Tathgur checked-up her and prescribed some medicines and advised x-ray; which was got conducted by the complainant from Sanjha Aasra Charitable Health Care Centre on 15.11.2017. Then on 17.11.2017, she was subjected to treatment of keloid on the nose, which is clear from the medical record of opposite party No.1-Hospital, Ex.C-2 and Ex.C-3 (colly.). For treatment of keloid, multiple options are available, such as Elective Surgical Procedures, which include Lasik Surgery and CO2 Laser Resurfacing and Intralesional Steroid. The first thing was to understand, which technique was the best indicated in the present case. This was required to be ascertained before the procedure to be followed for treating the keloid. Mature keloid contains abnormally large collagen bundles, that look pale glassy pink in appearance on halmatoxlin and eoin staining. Keloid hypertrophic scar sometimes appears to be very similar in nature. It has not yet been determined, what results into their formation. However, there is difference between keloid and hypertrophic scars. The boil on the nose of the complainant was treated on 17.11.2017 by way of intralesional steroid i.e. Kenacort (Triamcinolone). As per the evidence on record, 0.5 ml. Triamcinolone was administered into the boil, technically known as keloid. Immediately after the administration, the complainant started complaining of headache and had about two episodes of vomiting and there was sudden loss of vision in her left eye. Immediately after giving injection of Kenacort (Triamcinolone) 17.11.2017 at Civil Hospital, Barnala, it was observed as under: