B N GURUDEV Vs. N RAMANNA

JUDGEMENT

(1.) -THIS is a peculiar case wherein a Veterinary Surgeon has alleged medical negligence against a Consultant Orthopaedic Surgeon and others apart from the Chief Executive Officer of the Hospital. Case of the appellant:

(2.) THE case of the appellant is that he met with an accident on 13th April, 1992 at 5. 00 p. m. while riding a motor bicycle from Hubli to Haveri and sustained serious injuries resulting in fracture of the right leg. He went in an auto rickshaw to KMC Hospital, Hubli and got admitted in that hospital in the casualty ward and later on as an inpatient. A team of doctors conducted an emergency surgery on 14th April, 1992 and the doctors expressed a view that there was vascular insufficiency and hence advised the complainant to consult a Vascular Surgeon at Manipal Hospital, (hereinafter referred to as the hospital), Bangalore. He boarded a train on the same day at 8. 30 p. m. and arrived at Bangalore on 15th April, 1992 and was transported from the railway station to the Manipal Hospital by an ambulance provided by the Hospital. He was taken to the casualty, wherein history of the case was recorded and later on he was referred to an Orthopaedic Surgeon and a Cardio-thoracic Surgeon. After several tests, Dr. N. Ramanna, Consultant Orthopaedic Surgeon of the hospital conducted the surgery without obtaining his consent, though he was fully conscious. After recovery from anaesthesia on 16th April, 1992 the appellant was shocked to see that his right leg was amputated. He was treated carelessly without conducting the scientific tests and without taking the second opinion. He claimed a sum of Rs. 20 lakh towards pecuniary and non-pecuniary damages and mental agony etc. Case of the Respondent:

(3.) DR. Ramanna OP No. 1-Orthopaedic Surgeon has submitted his written version, which was adopted by Dr. Mohana Krishna and the authorities of the hospital. Dr. Ramanna has stated that as the complainant could not get compensation for his injuries under the provisions of Motor Vehicles Act, he has chosen the State Commission for obtaining compensation with an ulterior motive. He has stated that the doctors at the hospital after having a thorough discussion, decided to amputate the right leg of the complainant after obtaining the consent, if that was not done, the chances of complainant's survival would have been low. After amputation was done, various mandatory concessions were given to the complainant. OP No. 2- Dr. Shekhar Rao who is a qualified Cardio-thoracic and Vascular Surgeon has filed a separate statement. He submitted that as per the authoritative textbooks on Vascular Surgery, popliteal artery injury of the nature sustained by the appellant results in amputation more often than any other arterial injury. It has been scientifically established that beyond a period of 24 hours, after the initial injury, the possibility of salvaging a limb is only 20%. In fact, particularly in cases of knee dislocations, the amputation rate is as high as 86% unless the limb is revascularised within 8 hours of the injury, in case of extensive muscular necrosis urgent or immediate amputation is invariably recommended to avoid any risk of renal failure owing to circulating myoglobin released from necrotic muscles. If loss of sensation extends to the knee, extensive ischaemia of the underlying muscle groups results and an above the knee amputation is proceeded with on an emergent basis to avoid morbidity. It is against the above medico-surgical background that the complainant's injury and the prescribed surgical treatment must be examined and understood. ? order of the State Commission: