KASTURBA MEDICAL COLLEGE HOSPITAL Vs. RUMA KUMAR

JUDGEMENT

(1.) This First Appeal has been filed by Kasturba Medical College Hospital & Others, Appellants herein and Opposite Parties before the Karnataka State Consumer Disputes Redressal Commission, Bangalore (hereinafter referred to as the State Commission) being aggrieved by the order of the State Commission, which had allowed the complaint of Mrs. Ruma Kumar, Respondent herein and Original Complainant before the State Commission, alleging medical negligence.

(2.) In her complaint before the State Commission, Respondent-Complainant, who was a teacher at the Bharatiya Vidya Bhavan Vidyalaya, Bangalore, contended that she approached Dr. Benjamin Joseph of Appellant-Hospital following complaints of stiff pain in both knee joints because of which she was finding it difficult to carry out her duties. After examination, Respondent-Complainant advised to undergo three surgeries, namely (i) right hip total replacement; (ii) total right knee replacement; and (iii) total left knee replacement. Respondent-Complainant got admitted to Appellant-Hospital on 17.10.1996 for total right hip replacement surgery and was operated on 22.10.1996 after being administered insulin to control blood sugar. However, soon after the surgery, she developed a bed sore. She was assured that being a diabetic, there would be delayed healing. She was discharged after being advised to undergo physiotherapy. Respondent-Complainant underwent the second surgery for total right knee replacement on 23.12.1998 and preliminary tests indicated that she was also suffering from hypertension, of which there was no previous history. Therefore, tablets were given to control hypertension and blood sugar although Respondent-Complainant specifically brought to the Doctor's notice that she was insulin dependent. However, this information was ignored and subsequently the surgery was undertaken although the blood sugar levels were not under control. Respondent-Complainant noted that fluid began to ooze from the scar on her back. However, the Doctors at Appellant-Hospital failed to take adequate care of the Respondent-Complainant and after the nurses changed the dressing and cleaned the scar, Respondent-Complainant was discharged on 06.01.1999 with advice to take antibiotics and do physiotherapy. The third surgery for total left knee replacement was undertaken on 03.02.1999 after preliminary investigations were carried out by nurses in a perfunctory and casual manner and again without taking due care to control her blood sugar levels. Following the surgery Respondent-Complainant developed severe pain in the operated area. Soon after, reddish coloured fluid was discharged from the operated area, to which the Doctors did not pay any heed. After 11 days when the bandage was removed, it was noted that the sutures at the top of the wound had broken resulting in discharge of the reddish coloured liquid, the skin had not united and the wound had not healed. Consequently a culture test was conducted which revealed that staphylococcus infection had set in at the site of the operation due to the unhygienic and unsafe condition at the operation theater. The wound was re-sutured and Respondent-Complainant was compulsorily discharged on 24.02.1999. When the Respondent-Complainant went back to Hyderabad, she found after 10 days that the sutures which had been put at Appellant-Hospital had again broken and the wound had not healed and, therefore, remnants of the stitches were removed and the scab that had developed on the operated area was sent for culture test, which indicated that staphylococcus infection persisted despite several antibiotics being prescribed by Appellant-Hospital. Respondent-Complainant also developed severe pain in the left knee apart from the oozing from the operation site and had great difficulty in banding the knee. On 14.04.1999 Respondent-Complainant was rushed to Apollo Hospital with swollen left knee and high fever and Doctors there informed her that the operation site had been severely infected and partial dislocation of the left knee had occurred. Respondent-Complainant had, therefore, to undergo an operation to remove the prosthesis after her blood sugar was controlled and the left knee was permanently fixed with Charley Compression Clamps. After two months of Respondent-Complainant's discharge from Apollo Hospital, it was noted that the right knee had also got similar infection and, therefore, the second prosthesis was also removed at Apollo Hospital and she was discharged after one month. Because of the botched surgery in Appellant-Hospital which could only be partially rectified in Apollo Hospital, Respondent-Complainant became disabled and physically immobilized and had to depend on others for her day-to-day activities. Being aggrieved by the medical negligence on the part of Appellant-Hospital and its Doctors, Respondent filed a complaint of medical negligence against them before the State Commission and listed the following deficiencies in service :

(3.) Appellants on being served filed written reply denying that there was any medical negligence in the treatment of Respondent-Complainant. It was inter alia stated that the Appellant-Hospital is a well-known institute of excellence and in the instant case all care and precautions were taken in respect of the medical treatment of the Respondent-Complainant at all times. It was denied that Respondent-Complainant was insulin dependent diabetic at the time of her first surgery. In fact, she had high blood sugar from the age of 14 years and she was controlling it through drugs and was not insulin dependent. Surgeries were conducted after taking due care and bringing her blood sugar as also hypertension under control before and during the second surgery. The insulin was started as a precautionary measure prior to the first surgery. Theater asepsis was meticulously maintained and it was fumigated and UV light sterilized on the evening before her total joint replacement surgery. All post-operative dressings were done by Resident Doctors using sterilized surgical gloves and mask and the prosthesis used were pre-sterilized. There was no problem in the fixation or alignment of the prosthesis at the time of surgery or post-operatively and the detailed and meticulously maintained records of the Appellant-Hospital are adequate proof of the same. The operation was conducted in hygienic condition but despite all precautions staphylococcus infection had set in which is common among patients of rheumatoid arthritis. However, Respondent-Complainant was cured in respect of this infection before being discharged. The subsequent complications which arose were after discharge of the Respondent-Complainant from the Appellant-Hospital in a satisfactory condition and the Appellant-Hospital cannot be held responsible for any subsequent problems that may have subsequently arisen because Respondent-Complainant did not heed the medical advice regarding the medication, treatment and follow ups.