M.P. BHANUMATHI PAEDIATRICIAN Vs. T.D. AUGUSTINE

JUDGEMENT

(1.) This first appeal has been filed by Dr. M.P. Bhanumati, Opposite Party before the Kerala State Consumer Disputes Redressal Commission, Thiruvananthapuram (hereinafter referred to as the State Commission) and Appellant herein being aggrieved by the order of State Commission which had allowed the appeal of medical negligence filed by Respondents against the Appellant.

(2.) Respondents No. 1 and 2, who are father and mother respectively of Respondent No.3 (hereinafter referred to as the Patient) had taken their son (Patient) aged about 8 years on 14.09.1995 to Appellant, who was a Paediatrician, for treatment as he was suffering from fever, rashes in the mouth and cough. After examining him, Appellant opined that several children had been suffering from a similar fever and she gave Patient an injection and two sample tablets to be given in the morning and evening. Respondents were also asked to purchase some medicines. Respondents were not told the names of the injected medicine or the sample tablets given by the Appellant. Despite this medication, Patient's condition deteriorated in the evening and he developed rashes all over the face and chest, followed by vomiting. Patient's eye also became infected with Conjunctivitis. He was, therefore, taken to Appellant next day on 15.09.1995 and Appellant again after examination stated that this was due to sultry climate and that the rashes would disappear within a few days. Because the condition of the Patient further worsened on 16.09.1995, Respondents took him to another Paediatrician at Iritty i.e. Dr. Devanand, who opined that the Patient was suffering from Meningo Cocciemia and should be taken to a hospital where expert doctors are available. Patient was, therefore, taken to Koyili Hospital, Kannur where he remained for about 4-5 hours, after which it was decided to take the Patient to Medical College Hospital, Kozhikode as per the advice of the doctors there. Patient was admitted to the Medical College Hospital, Kozhikode at 11.00 p.m. on 16.09.1995 and a Dermatologist, who subsequently examined him, diagnosed the disease as Stevens Johnson Syndrome, which usually occurs because of adverse reaction to a drug. The Dermatologist, therefore, advised Respondents to contact the Appellant to obtain details regarding the medicines administered to the Patient on 14.09.1995. Appellant after some hesitation finally wrote the names of the medicines and stated that she had treated the child on 13.09.1995 whereas the medicines were actually administered on 14.09.1995. The Doctors at the Medical College Hospital, Kozhikode informed Respondents that Appellant had not furnished the names of the actual medicines given to the Patient and had instead given the names of certain general medicines, which could not have caused the drug reaction. Although Respondents tried their best to ascertain the names of the actual medicines given but failed to do so. Patient remained in Medical College Hospital, Kozhikode till 09.10.1995, after which he was discharged for better specialized treatment for his eyes. He was subsequently given intensive treatment for his eyesight and other problems at Little Flower Hospital, Angamali and later at Christian Medical College Hospital, Vellore from 08.11.1995 to 08.12.1995. The doctors there stated that the Patient would live in a vegetative state and that there was no chance of his regaining his eyesight. Being aggrieved by the action of Appellant, who administered an injection and tablets to the Patient after which he developed a drug allergy leading to Stevens Johnson Syndrome, Respondents met the Appellant and requested for financial assistance for treatment of the Patient. According to the Respondents, Appellant admitted her mistake and stated that since she was insured with an Insurance Company to indemnify her for mistakes in her professional career, she would compensate them with Rs.6 Lakhs. However, she paid Respondents only a sum of Rs.1 Lakh in two installments of Rs.50,000/-. Respondent No.1 was also made to sign on some stamp papers. It was assured that the balance amount of Rs.5 Lakhs would be disbursed within six months. Despite this, no further payment was made. Being aggrieved, Respondents filed a complaint before the State Commission and requested that Appellant be directed to pay a compensation of Rs.15 Lakhs to Respondents for medical negligence and deficiency in service. Since Rs.1 Lakh had already been paid, the Appellant may be directed to pay the remaining amount of Rs.14 Lakhs to the Respondents.

(3.) Appellant on being served filed a written rejoinder denying the allegations of medical negligence. It was admitted that the Patient was brought to the Appellant's clinic, which is attached to her residence, on 14.09.1995 and on medical examination of the Patient, it was noted that he was running a temperature of 102OF, there was watering from both eyes and rashes in the mouth, which could have been due to infection. A provisional diagnosis of Viral Fever was made and 0.5 ml. of Injection Avil was given to the Patient to control the rashes in the mouth. Patient was also given 2 tablets of Avil to take 1/2 tablet twice daily, 6 tablets of Paracetamol to be taken thrice daily to control the Fever and a cough syrup for the dry cough. A prescription for an antibiotic Blumox to be purchased from outside was issued. Appellant received Rs.22/- being the cost of injection, medicines and consultation fee. Patient was advised to be brought for review after two days and to be given liquid diet. On 15.09.1995 Patient's fever had come down but there were some rashes in the body and Conjunctivitis was noticed. Since these did not warrant immediate hospitalization, Appellant gave injection B-Complex to control the lesions in the mouth and supportive therapy. Further, Gentamycin eyedrops were prescribed to control the eye infection. Respondents were advised that further investigations would be required if the rashes were not controlled. Thereafter Patient was never brought to the Appellant despite specific advice. It was denied that the medicines prescribed by Appellant caused Stevens Johnson Syndrome as the said disease takes at least one week after the administration of drugs to manifest itself whereas the Patient's condition was diagnosed by the Dermatologist as Stevens Johnson Syndrome within 4 days of the Patient being administered the medicines by Appellant. Further, as per medical literature on the subject, Stevens Johnson Syndrome can also occur in a Patient due to other causes/viruses. Appellant stated that there is no Hypersensitivity test in respect of oral medication. She had taken the precaution of ascertaining from Respondents whether Patient was allergic to any drug before prescribing the same. Appellant admitted that Respondents met her and being moved by the said plight of their son, purely on humanitarian and compassionate grounds and not as an admission of any medical negligence or deficiency in service and on persuasion by some local influential people, she agreed to pay Rs.3 Lakhs in terms of a written agreement dated 25.03.1996 voluntarily signed between the parties in the presence of witnesses.