M J JOSEPH Vs. P J JOHN

JUDGEMENT

(1.) Complaint by the husband, children and in-laws of late Mrs. Annamma. The complainants seek for compensation for the death of Annamma on the allegation of negligence and deficiency of service by the first opposite party-doctor who according to the complainant is an employee of the second opposite party hospital.

(2.) The allegations in brief are : That on 13.10.1997 while deceased Annamma was cooking she tasted a piece of meat which got stuck in her throat as a result of which she felt discomfort and pain, and she was taken to the second opposite party hospital whereafter examination by the duty doctor and having taken X-ray, she was examined by the first opposite party, the E. N. T. Surgeon, and oesophaguscopy and removal of foreign body under general anaesthesia was done on the next day, i. e. , on 14.10.1997 at about 8.30 a. m. Foreign body was visualised at 38 cms. down, since the meat piece was too large to be negotiated and taken out it was dislodged to the stomach which was 2 cms. lower. Thereafter, she was given antibiotic and anti-inflammatory drugs and was removed to the post operative recovery room where she continued till about 5.30 p. m. Thereafter, she was removed to the room. She was again examined by the first opposite party at 8.45 p. m. and she was attended by him on the 15th, 16th and 17th during his morning rounds. On 17.10.1997 first opposite party discharged Annamma with advice to continue medicines and report back after 5 days. The allegation is, the discharge was inspite of the fact that Annamma had considerable discomfort and weakness at that time. On reaching home the discomfort increased and she vomited during night. On the next morning, i. e. , on 18.10.1997 she was taken to the Nirmala Hospital, Kambilikandom, where she was examined and advised to be taken to a specialised hospital for expert treatment. Though she was taken to the second opposite party hospital, first opposite party doctor was not available and the call duty physician examined her, but they refused to treat her and, therefore, she was rushed to the Medical Trust Hospital, Ernakulam, where she underwent treatment in the Thorasic Surgery Department and ultimately she expired on 30.10.1997 at 4.30 a. m. The complainants allege that the death of Annamma was due to the lack of proficiency, expertise, professional incompetence and negligence of the first opposite party which would constitute negligence as well as deficiency of service as per the Consumer Protection Act, 1986 (for short the 'act' ). The allegation is, the cause of death was oesophagal leak and complications due to the same, there was massive right pleural effussion into the lungs at the time when she was admitted in the Medical Trust Hospital. By introduction of right based intercostal tube 1.600 ml. of purulent fluid was drained from her on 19.10.1997. Inspite of draining process continued unabated, there was no progress and finally she died on 30.10.1997. Perforation in the above context should have been caused by the process of dislodging the meat piece into the stomach by the first opposite party and the first opposite party failed to detect the leak while she was in the second opposite party-hospital. The first opposite party is not professionally efficient as he held himself out; he is not competent to manage such a situation. Therefore, the complainants claim that they are entitled to compensation on different heads mentioned in the complaint.

(3.) The opposite parties in their version denied the allegations except that the deceased Mrs. Annamma was brought to the second opposite party-hospital at 9.25 p. m. on 13.10.1997 with a history of difficulty on account of swallowing meat piece, at about 11.30 a. m. X-ray was taken and the first opposite party examined her. No foreign body could be visualised. The X-ray did not show any prevertebral widening and thereupon, the patient and her relatives were advised about the necessity of an oesophaguscopy. Meat piece with bone was visualised at about 38 cms. down from the mouth as it could not be negotiated, the same was dislodged into the stomach with care and caution and the first opposite party carefully examined the oesophagus for perforation which could happen with that type of foreign body but he could not find any symptom of perforation. After operation the patient was continuously monitored and she was fed by Ryle's tube feeding after 4 p. m. and she was administered antibiotics and anti-inflammatory drugs. There was no problem with the patient while she was in the observation room and thereafter, she was removed to the post operative ward at 5.30 p. m. At 8.45 p. m. she was seen by the first opposite party and watched for vital signs on 15th, 16th and 17th; she was not having any problem for 24 hours even after oral feeding. There was no clinical evidence of any perforation and she was discharged with instructions to take medicines and to report after 5 days for review. On 18.10.1997 at 9.55 p. m. she was again brought to the hospital with complaint of discomfort and cough. She was examined by the duty doctor and found that air entry on the right side was diminished. Emergency medicines were administered. Being Saturday night, first opposite party was not in Station, and hence the duty doctor John Joseph referred her to the Medical Trust Hospital where there are better facilities. If at all there was any injury or perforation that could have been only on account of swallowing meat piece with bone. When she was in the hospital inspite of thorough examination no perforation could be visualised. The statement that she was having discomfort and weakness at the time of discharge is false and they denied that there was negligence or deficiency of service on their part. They wanted dismissal of the complaint.