M/S MANIPAL HOSPITAL BANGALORE Vs. ALFRED BENEDICT

JUDGEMENT

(1.) TWO cross -appeals are filed, namely, First Appeals No. 275 of 2007 and F.A.178 of 2008, have been filed by M/s Manipal Hospital Bangalore and Mr. Alfred Benedict and Anr. Opposite Party and Complainant respectively before the Karnataka State Consumer Redressal Commission, Bangalore (hereinafter referred to as the State Commission) challenging the order dated 05.04.2007 of that Commission. Since the facts and the parties in both first appeals are common/similar arising out of the same consumer dispute, it is proposed to dispose of these appeals by one common order by taking the facts from First Appeal No. 275 of 2007. The parties will be referred to in the manner in which they were referred to in the complaint i.e. Mr. Alfred Benedict and Anr. will be referred to as " Complainant " and the M/s Manipal Hospital Bangalore and ors as " Opposite Party. "

(2.) COMPLAINANTS took their two -year -old daughter who was suffering from cold and cough to opposite party No. 4 -doctor who advised them to admit her in opposite party No.1 -hospital. On admission she was taken to pediatric intensive care unit and diagnosed that she was suffering from cold and cough as well as from pneumonia. She was given intravenous fluids by inserting needle on the dorsal aspect of right wrist from Aug. 26, 2002 to Aug. 28, 2002: however, the baby developed gangrene initially in the finger tips which spread to the portion of the hand below wrist joint due to blockage of blood supply. The complainants further contend that on 29.08.2002 and 30.08.2002, OPs 2 to 4 conducted Angiogram and confirmed that there was complete blockage of blood supply to the right forearm. The Opposite parties conducted operation on the right forearm to restore blood supply but the same could not be restored and, eventually, the daughter of the complainant had to lose her right forearm. It is alleged that the complainants, thereafter, came to know that the needle was wrongly inserted into artery instead of vein due to which the blood supply was blocked. Thus, imputing the opposite parties of negligence and deficiency in service, complaint was filed before the State Commission praying compensation of Rs. 1,00,00,000/ - as the complainants ' daughter has to spend the rest of her life without the right forearm. 2. OPs contended that the gangrene of right forearm was due to septic shock. They contend that what happened to the patient in this case was a known complication and it 's not a case of negligence in any treatment given in their hospital. They deny that there was any negligence on the part of the OPs. They also deny liability to pay compensation.

(3.) OP -2 has admitted that at about 8.00 AM on 28.08.2002, the right index and little fingers of the patient were found to be cyanosed and swollen. However, they contend that it was noticed by the nursing staff and not by the Complainants. They further contended that at about 8.10 AM, Dr. Venkatesh on information saw the child followed by OP2 at 10.00 AM and cannula was removed. The patient was referred to the vascular surgeon Dr. Vasudeva Rao -OP No. 3, who examined the patient and advised elevation of the right forearm and infusion of heparin. It is contended that no surgery could be done because it was only the microvasculature that was affected. They further contend that OP3 decided to continue heparinisation and elevation of the limb. Doppler study showed presence of arterial pulsation till the level of wrist. On 29.08.2002, OP3 advised angiography and the same was done by Dr. Subhash Chandra, a consultant Invasive Cardiologist, which showed no flow beyond the brachial artery. OP No 3 contended that it was due to intense spasm of all the vessels and an aberrant right sub clavian artery; and that after injecting vasodilators (Pepaverine and Nitroprusside), some flow was seen in the radial and ulnar arteries and palmar arch and situation was duly explained to the Complainants by OP3. Fasciotomy was also done on 29.08.2002 which means opening up of the covering of the muscles of the arm in order to relieve pressure and to establish better blood supply. OPs, however, contend that there was no question of any situation for amputation. On 30.08.2002, the patient was seen by OPs 2 and OP -5 being a consultant pediatric surgeon; having gone through the records, advised to do Right Cervical Sympathetic Nerve Block was performed in consultation with Dr. Parameshwara, Consultant Anesthetist. Following this, there was improvement in the cold area of the upper arm, which became warm below the elbow. The procedure was repeated on 31.08.2002.The patient was managed conservatively till the line of demarcation became apparent. On 14.12.2002 the complainants had informed OP5 about the falling of the gangrene part. The patient was brought to OP5 who noticed that a little edge of bone was jutting out. The patient was readmitted on 16.12.2002 and dressing was done. Subsequently, the patient was regularly seen by OP5 and the wound was dressed regularly till it healed fully. The OPs contend that it was unfortunate that complications had taken place and the patient was being resuscitated for septic shock which could have been fatal.