VIJAYA NIRMALA Vs. UDHIYA @ UDHIYAKUMARI & 4 ORS ; SHARMILADEVI D/O KANNIAKUMAR; SUGANYA D/O KANNIAKUMAR; ASHOK NURSING HOME

JUDGEMENT

(1.) This instant revision petition under Section 21(b) of the Consumer Protection Act, 1986 is preferred by Dr. Vijaya Nirmala/petitioner/OP-specialized as an anesthetist. The other respondent No. 5/Dr. Rajendiram (OP 2) being a surgeon, who was also accused of negligence, has been absolved by the District Forum and the State Commission. The main allegation against the petitioner/OP 3 that she had administered drug, namely, thiopental, which was the cause of death of deceased-Kanniakumar.

(2.) The relevant brief facts for the disposal of the case are that on 2.7.2002, the patient-Kanniakumar, since deceased, (herein after referred as a patient) about 45 years of age, had complaints of Penile Pain and Dysuria and he consulted OP 2/Dr. Rajendiram at his clinic in Pondicherry. After series of laboratory tests, he was diagnosed as having VUJ-calculus of 3X2 mm and two large stones in Gall Bladder. Accordinlgy, he was advised for the surgery at OP 1-Ashok Nursing Home On 27.7.2002, the patient got admitted at OP 1. He was operated at 1.20 p.m. by induction of general Anesthesia (GA) with 250 mg. of Thiopental and 100 mg. of Scoline. The intubation was resorted, however, the tube could not pass through due to difficult airway, because of large leafy epiglottis and anteriorly placed Larynx. After the first unsuccessful attempt of intubation, again at 2.00 p.m. the petitioner adjusted the head of the patient and second attempt for intubation was made with the injection of Scoline 75 mg, Thiopental 100 mg. and Atropine 0.6 mg. Even the second attempt of intubation was failed. Therefore, the surgery was abandoned. To avoid laryngeal edema, Efcorlin 100 mg, Decadryl 8 mg was given. The patient's vitals were examined and to maintain ventilation, laryngeal mask airway introduced. The Oxygen Saturation was maintained. SPO2 was at 95%. At 3.30, the patient was fully recovered from the effect of anesthesia and the patient was shifted to Post Operqation Ward but at 4.00 p.m., the patient developed profound pulmonary edema. Hence, the patient was given Lasix 40 mg, Inj. Efcorlin 100 mg. and nibulisation was done. As the oxygen level was going down to secure the airway, Tracheostomy was performed and pulmonary edema was controlled for a while. The patient developed ST depression, Hypoxemia. NTG patch applied and the cardiologist was called. At 4.20 p.m. ST was 2.9 mm. BP dropped also. There was Bradycardia 36 per minute. The patient was resuscitated that point of time. The patient's relatives were called and explained about the situation. The cardiologist also examined the patient and advised to continue the same treatment. The resuscitation was done till 6.00 p.m. At 6.15 p.m. the patieint was declared dead. On the next day, i.e. 29.7.2002, post morem was performed. The biopsy report revealed extensive pulmonary edema with focal area of Broncopneumonia. The Chemical examination of viscera revealed 14.5 mcg of Thiopental in the blood. The final post mortem report of Forensic Medicine that the cause of death of the patient was due to Injection of Thiopental. Based on the final report dated 17.9.2002, wife of deceased alongwith her two minor children filed a complaint before the District Consumer Disputes Redressal Forum, Puducherry (in short, 'the State Commission') seeking compensation of Rs. 19 Lakhs.

(3.) The OPs resisted the complaint before the District Forum. The Chief Medical Officer, Department of Forensic Medicines was examined as an expert witness. He was not anesthetist and the post mortem report does not mention any inadvertent act of the anesthetist. Dr. M. Ravishankar, Professor and Head of the Department of Anesthesiology and CCU, JIPMER, Puducherry was examined as an expert witness. He deposed that the Thiopental dose was within normal limit and it was administered correctly and there was no negligence. It was further submitted that the complainant initiated simultaneously criminal prosecution against the petitioner from which she was acquitted. The complainant approached High Court through revision petition. The High Court sought an independent expert opinion from Dr. T. Venkatachalam, Professor, Deptt. Of Anesthesia, Madras Medical College & Hospital, Chennai. He deposed that the doses of administration of medicine was correct as per medical norm. Thus, the High Court upheld the acquittal.