I MANIMEGALAI Vs. STEEL AUTHORITY OF INDIA LTD

JUDGEMENT

(1.) This Complaint has been filed by the wife of deceased P. Rangangam and their children. The deceased P. Rangangam was working in the office of opposite party Nos.1 and 2 from 2.2.1981 and was entitled for medical facilities under the conditions of service. The deceased had stomach pain on 17.6.1995 at 7 a.m. and he got himself admitted in the hospital of opposite party Nos.l, 2 at 10.10. a.m. The Complainant reached the hospital and found that hernia operation of the deceased had already begun without even informing the family members and without obtaining consent from any one of them. The deceased was in the operation theatre till 3 p.m., when he was declared dead. In the certificate issued by the Hospital authorities it was stated that the deceased had expired due to illness. According to the Complainant, the deceased died only because of excess anaesthesia given by opposite party No. 4 Dr.Vineeta Dwivedi. It was further stated that the excess anaesthesia cannot be given when the patient's stomach was full which is fatal to life. The deceased had full stomach and anaesthesia given to him had adverse effect. The Hospital authority did not conduct post-mortem of the deceased. It is further submitted that there was no emergency warranting to conduct hernia operation which is otherwise minor ailment and can never lead to death. According to Complainant, death was caused due to negligence in handling the operation and the death had resulted only because of excess anaesthesia given by opposite party No.4. The Complainant has given the salary statement to which the deceased would be entitled and has claimed total compensation of Rs. 40 lacs.

(2.) Reply was filed by opposite party No. 1 wherein it was contended that the treatment given to the deceased was totally free of charge and the service rendered does not fall within the definition of service under Section 2(1)(o); that opposite party No. 1 runs a well equipped hospital for the benefit of its employees as a welfare measure and the employees and their dependents are provided totally free medical service as per service rules and the employees of the opposite party do not contribute for the same. On merits, it is contended that the deceased came to casualty where the medical officer examined him. The examination revealed swelling in umbilical area with pain. It was diagnosed that the deceased was suffering from Non Reducible Obstructed Para Umbilical Hernia. The deceased was admitted at about 8 a.m. when the then Chief Medical Officer had also examined him. The deceased was seen by Dr. Vineeta Dwivedi, Senior Medical Officer (Anaesthesia) and thereafter all routine medical investigations were carried out. The deceased had given his consent for surgery in the prescribed form. The medical condition of the deceased required emergency surgery and since Hospital surgeon was not available, Dr.C.Ganesan, a reputed freelance surgeon in Salem was immediately requisitioned for surgery. He had examined the deceased at 9.30 a.m. and the deceased was shifted to operation theatre. Under General Anaesthesia, Herniotomy and repair of abdominal wall were done in the surgery. The operation was over at about 10.30 a.m. and the patient recovered fully about 10.45 a.m. and he was responding to verbal commands and his reflexes and vital parameters were normal The patient was brought to recovery room. He developed Hypoxia and the patient was administered 100% oxygen and intermittent pressure ventilation was also given. The patient suffered cardiac arrest once but he was revived fully with immediate treatment. A reputed cardiologist from Salem town was immediately requisitioned to treat the patient. The cardiologist from Salem Town arrived and examined the patient. The patient suffered from cardiac arrest again and in spite of best efforts, the patient suffered third bout of cardiac arrest. Defibrillation was done by DC shock and medication was given. The deceased could not be revived after the third cardiac arrest and he was declared dead at about 3 p.m. It has also been stated in the reply that contents of stomach of the deceased were aspirated before the operation took place and the allegation of the Complainant that anaesthesia was administered to the patient when the stomach was full is false and denied. In reply, past history of the deceased having suffered from Para Umbical hernia in the year 1993-94 has been given. The Complainant was repeatedly advised to undergo surgery. It is further stated that the deceased was chronic smoker and there is distinct possibility that hypoxia suffered was due to compressed state of his lungs and his obese stature.

(3.) Opposite party No. 4 Dr. Vineeta Dwivedi also filed affidavit in reply wherein it was pointed out that petitioner was chain smoker (30 cigarettes a day) was advised surgery of para umbilical hernia in 1993-94. The deceased had suffered attack, which in medical terms is commonly known as "Strangulated Hernia". If the same is not immediately operated, it can lead to gangrene of the bowel or the intestines. During pre-anaesthetist check up it was found that patient was full stomach. However, he had been taken for emergency operation because of acute pain and he was administered Metoclopramide. This medicine is administered to those patients who are full stomach and who have to undergo surgery. This helps in cleaning the stomach and prevents vomiting. Routine tests were carried out which were normal. It was during pre-anaesthetist check up it was found that patient was excessive smoker. It has been proved by extensive research that during and after surgery, smokers may suffer from hypoxia, due to many reasons, which in normal terms is lack of oxygen. Since the patient was a chronic smoker, hence after operation pre-emptively the patient was put on oxygen support. In spite of the above precaution taken with the patent, he suffered from hypoxia between 11 a.m. to 12 noon. The deceased suffered from cardiac arrest. At that time, Dr.Jaipal, an expert external Cardiologist was rushed to the hospital to attend the patient. In fact, another anaesthetist namely Dr. Elango was also requested to be present to monitor the patient. Besides this, Dr. C. Ganesan was also present attending to the patient besides opposite party No. 4. At about 3 p.m. on the same day the deceased suffered another cardiac arrest and could not be revived in spite of steps taken and the patient expired. The deceased was diagnosed to be suffering from pulmonary plethora which is a state of poor lung compliance and he was advised to stop smoking way back in July 1990. It has been admitted that deceased was having full stomach. However, as per the practice and correct procedure, first Ryle's Tube and suction of the stomach was carried out to reduce chances of aspiration of the stomach. In this manner, the stomach was practically emptied and only thereafter medication was administered upon the patient by opposite party No. 4.