VIJAY DUTT Vs. R D NAGPAL

JUDGEMENT

(1.) No one ever knows what the outcome would have been had the other treatment modality been used. While everyone believes they know the recipe for their best personal series, no one knows what the best treatment would be for patients facing the dilemma. However, doctors cannot give a warranty of the perfection of their skill or a guarantee of cure. If the doctor has adopted the right course of treatment, if he is skilled and has worked with a method and manner best suited to the patient, he cannot be blamed for negligence if the patient is not totally cured. Thus, in the cases of Brain Aneurysms, it will be usually a conflicting issue, if the justification offered by surgeons to clip or having coil an aneurysm.

(2.) The Complainant Mr. Vijay Dutt, a healthy middle aged successful businessman of M/s Dutt & Company, resides at Indore. He was suffering from Migraine and was under treatment of a well-known Neuro-physician Dr. (Mrs.) Nadkarni at Indore. Since, his migraine continued despite medication, Dr.(Mrs.) Nadkarni advised him for CT scan of brain and higher investigations; which then, revealed Aneurysm in the right side of the brain. Thereafter, Dr. (Mrs.) Nadkarni advised the Complainant to undergo Angiography of the brain for the proper diagnosis and further management. Accordingly, on 30.03.2000, he visited the Jaslok Hospital and Research Centre Bombay (Mumbai) for consultation with the OP-1 Dr. Nagpal. The OP No. 1 and his fellow professional colleagues there, examined the Complainant. Thereafter, the OP-1 impressed upon the Complainant to get himself admitted in Jaslok Hospital (OP-2) for treatment and assured of best medical treatment for Aneurysm there. Believing those words of appraisal, on 23rd March, 2000 the Complainant (herein referred as "Patient") got himself admitted at OP-2 under the treatment of OP-1. Dr. Srinivas B. Desai, at Jaslok Hospital (the OP-2) conducted Cerebral Angiography along with CT Scan which confirmed the existence of Bilateral Middle Cerebral Artery (MCA) Aneurysm. Accordingly, the OP-1 advised and insisted the Complainant to undergo a surgery immediately or otherwise he would die soon, of rupture of aneurysm. Due to repeated emphasis by OP-1 about the sudden death, the Complainant was forced to agree for immediate surgery of aneurysm. The OP-1 and complainant discussed line of best available treatment for MCA aneurysms. Thereafter, to arrange the finances for the expensive surgical treatment, the patient went back to his hometown at Indore. On 02.05.2000, the patient got admitted to the OP No.-2 hospital under the treatment of OP No.-1. After a discussion again, about the method of treatment with OP-1, the patient, his wife and other accompanied family members expressed their willingness for the 'Coiling method' as their choice of the treatment. But, same request was blatantly turned down by the OP-1, and he insisted that he would perform the operation by employing the 'Clipping Method'. According to him, the Clipping Method has permanent cure as compared to the Coiling Method where relapse of Aneurysm occurs after a passage of time. Therefore, on such persuasion and insistence of OP Nos.-1 & 2, the Complainant was left with no option but to accept the Clipping Method. Hence, the Complainant literally signed the consent under coercion. On 03.05.2000, OP-1 performed the operation by the Clipping Method. Postoperatively, immediately, after ex-tubation, the patient noticed difficulty in his speech, and right hemi paresis with right side paralysis. Angiography study was performed immediately, which showed the non-filing of the middle cerebral artery beyond the clip. Thereafter, OP-1 re-operated upon the patient on the same day, removed the clip, and re-applied the same. Later on, the patient learnt that, at the time of the first surgical procedure, the OP -1 had wrongly clipped the MCA at the wrong place, therefore, it resulted in stoppage of the blood circulation to his brain, for almost three hours. It has led to impairment of speech and Right side paralysis. The Complainant was in a semi-coma condition for seven days, thereafter was kept in the Intensive Care Unit (ICU) for ten days, the next seven days in semi-ICU of the hospital(OP-2). The Complainant's hospitalization was for almost 40 days. After the discharge from the hospital, the Complainant was under constant medical treatment and supervision. He further incurred regular monthly expenses of Rs.4,000/- for physiotherapy, and Rs.1,500/- per month, for speech therapy. The Complainant produced opinion/reports from two doctors from Indore, Dr. Apoorva Pauranik, Consultant Neurologist and Dr. Sunil Athale, Neuro-Physician (Page No.182) and at (Page No. 183). Further, on 18.07.2000 the complainant consulted Dr. O.P. Bajpai of Indore, who advised him to undergo special physiotherapy treatment, abroad.

(3.) Complainant's main allegations on the OP No.-1 & 2, that they were guilty of medical negligence and deficiency in service as OP-1 applied wrongly the clip on the artery instead of the aneurysm. Due to such negligence, he suffered severe impairment of speech and Right sided paralysis. He incurred heavy medical expenses for operation, the physiotherapy, and speech therapy. He suffered mental agony. Therefore, the Complainant, Vijay Dutt filed this complaint through his wife Dr. Mrs. Veena Dutt seeking relief in the sum of Rs.52,46,199.80/- towards the reimbursement of expenditure, loss of earnings and damages. He also prayed for Rs.1,00,000/-, as lump sum amount towards future expenditure like medical treatment in India/abroad, domiciliary expenses etc.