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10. The petitioner got admitted in the Urology Ward of Lourdes Hospital, Kochi on 06.06.2002 and the routine tests done were normal. He was subjected to ESWL treatment on 07.06.2002 (and not on 06.06.2002 as alleged). 2500 shock waves were given and the stone appeared to have been partially fragmented. The petitioner was discharged on the same day with medicines and pain killers and asked to report after one month for repeat x-ray and further treatment with ESWL. The petitioner reported to the OPD on 09.07.2002 and he had no symptoms at that time. Since he was not sure whether he had passed the stone fragments, the complainant was asked to take medicines for two more weeks and come for a repeat x-ray KUB.

11. The petitioner reported on 28.07.2002 to the casualty with pain right side of abdomen and got admitted in the Urology ward. Since, it was a Sunday; the Assistant Urologist examined the patient and prescribed medicines for alleviating pain. The 2nd respondent examined the patient on the next day and advised an x-ray KUB, which showed that the earlier stone had fragmented and only fragment of the size of 0.7 cm was remaining. This fragment had also descended to the ureter to a lower level (upper ureter). Since the petitioner had pain, he was subjected to one more sitting of ESWL (3000 shock waves) on 30.07.2002 and discharged on 31.07.2002. He was asked to take medicines for one more month and report after that.

12. The petitioner reported only on 10.09.2002 in the OPD and the x-ray KUB taken on that day showed that the stone had further become smaller and descended to a lower level in the ureter. Since the size of the stone was very small, he was advised to take only medicines and report after three months (if there were no symptoms) or earlier (if symptomatic). The patient did not visit the Hospital afterwards.

13. ESWL is a non-operative treatment of stones in the kidney and ureter and involves fragmentation of stones by passing electromagnetic waves from outside the body. There is no removal of stones as alleged. There is limitation to the number of shock waves that can be given in one sitting (maximum of 3000 shock waves). The smaller stone fragments will pass out through urine.

19. Ongoing through the record we find that the petitioner has no-where in his complaint specifically stated as to how the respondents are guilty of deficiency of service except for the fact that the he was not told that he may require second ESWL and that after the first ESWL he felt pain and he further learnt that the stone had not been completely removed from his system.

20. It is an admitted fact that the ESWL is an accepted method of treating kidney stones and as per the reply of the respondents before the District Forum the petitioner had opted for this method of treatment. The main advantage of this treatment is that a patient may be treated for kidneys stones without surgery. As a result, complications, hospitals stays, costs and recovery time are reduced. However, the stone fragments are occasionally left in the body and additional treatments are needed. It is also an accepted fact that some pain may occur when the fragments pass through the urinary tract to be dispelled with urine, which begins soon after treatment and may last up to four to eight weeks. Oral pain medication and drinking lots of water help to relieve symptoms. Sometimes, the stone is not completely shattered and additional treatments are required. In 70 to 90% of cases patient are found to be free of stones within three months of treatment. In the case of the petitioner it is an accepted fact that through the first ESWL had crushed the stone into fragments which had been expelled and only one fragment of the size of 0.77 cm was remaining. The fragment had also descended to the ureter to a lower level. Since the petitioner had pain, he was subjected to one more sitting of ESWL on 30.07.2002 and the patient was discharged on 31.07.2002. He was asked to take medicines for one month and report after that. Thereafter, the petitioner reported to the respondents on 10.09.2002 in the OPD and X-ray KUB taken on that day showed that the stone had further become smaller and descended to a lower level in the ureter. Since the size of the stone was very small, he was only advised to take medicines and report after three months or earlier, if required.