The Complainant took his 1year old daughter to the Opposite Parties (OP) /Petitioner hospital on 29.03.2005 with the complaints of since two days unable to open her left eye. The Doctor at Petitioner hospital examined the child as an out-patient and found the left eye had lid swelling with conjuctival congestion. There were multiple caterpillar hairs and it was inferior corneal epithelial defect. Under topical local anesthesia caterpillar hairs in upper tarsal conjunctiva in left eye were removed and antibiotic eye ointment applied and the eye was bandaged. Patient father was asked to bring the child for review the next day. But, the child brought to OPD on 31/03/2005 , and admitted as in patient on 1/4/2005 and discharged on 4/4/2005. The child was again brought for review on 26/4/2005 but the OP informed the complainant that child lost her vision in left eye.
Opposite Party (OP) denied the negligence on their part. OP contended that the complainant did not attend as per the doctor instructions for follow up. At the first instant the child was examined and treated on 29/3/2005 and called on very next day, but it was brought on 31/3/2005. Thereafter again, the child was advised for review on 12/4/2005 but child was brought on 26/4/2005 which on examination by the cornea specialist noted severe deterioration of left eye, there was corneal edema and anterior chamber, vitreous cavity showed severe fibrinous exudates suggestive of endophthalmitis due to migration of caterpillar hair posteriorly. The retina could not visualized, the ultrasound showed total retinal detachment. Such condition of child was informed to the complainant and advised to continue treatment by steroid eye drops and atropine ointment for 20 days. Child attended the OP for 4 times till 3/1/2006, thereafter stopped attending the OP hospital. Hence, OPs were confined to their stand as the treatment was in accordance with accepted medical practice and there was no negligence.
When the child attended the hospital on 29/3/2005 which was referred to Pediatric Ophthalmology Department, under local anesthesia caterpillar hairs in left upper tarsal conjunctiva were removed and antibiotic ointment applied and bandaged and called for review on next day ; but child was brought on 31.03.2005 on which the left eye developed corneal oedema; diagnosed that the anterior chamber showed fibrinous reaction to be due to the intraocular migration of the caterpillar hairs into the anterior segment; and hence admitted for treatment from 1/4/2005 to 4/4/2005. It was clear that there was no defect in the posterior segment of the eye. There was no movement of the caterpillar hair to the posterior segment till then. Hence, it was not a cause for vitritis or endophthalmitis by any migration of the caterpillar hairs posteriorly. It was admitted that if caterpillar hair enters an eye it is a complicated one; that if evidence hair enters the intraocular cavity, definitely it would cause loss of vision.
According to the expert falling of caterpillar hairs in the eye is a serious condition as the caterpillar hairs have fine spines and they have tendency to migrate to the cornea or sclera that produce inflammation in the eye and in rare cases might lead to the detachment of retina. Entering of caterpillar hair in to eye is scientifically termed as pthalmia Nodosa Normally pthalmia Nodosaincludes range of signs, range of symptoms including redness of the eye and watering to decreased vision and infection in the eye. On 29.03.2005 if ultrasound scan is performed in the Complainant baby the caterpillar hair that are present in interior portion of the eye, may be detected, and such treatment could be conducted by admitting the patient as in-patient, further it is a long course of treatment. The Opposite Party hospital if they have taken up the Complainant baby case seriously they could have saved her vision. It is admitted that pthalmia Nodosais a curable surgically by means of intro retinal surgery of which OP hospital failed to do so and not taken steps for further treatment. It is known that it is difficult to remove the caterpillar hair from the inner portion of the eye and which could be removed by Vitreo Retinal Surgery; that the petitioner doctor did not advise such kind of surgery. which amounts to deficiency in service and the medical negligence.
It is contented that every detail about the treatment is explained to the Complainant father, but there is no documentary evidence to that extent, it is also admitted by RW1 Dr. R.D. Ravindran, Chief Medical Officer, Aravind Eye Hospital in his Chief. OPs have not recorded the reason for retinal canal detachment in their hospital records. The court was aware that petitioner hospital is one of the renowned hospital in India, possess Research and a Post Graduate Ophthalmology Department, run by charitable trust. The OP doctors diagnosed the case but, despite knowing the seriousness and complication of the ailment, the petitioner has treated the child in a very casual manner. It was the duty of OP when the child presented herself first time for treatment on 29-03-2005 and diagnosed as existence of caterpillar hair in the eye, which would cause impairment of vision. OP merely removed the hairs in the anterior portion of the eye, applying eye ointment, bandaging the eye and called for review on next day. Such patient needs hospitalization for sustained and constant care and proper investigations as per expert evidence of CW 2 & 3.
Considering the evidence, the court is of considered opinion that being the seriousness of the ailment it was necessary to keep the child under constant care in the hospital till the ailment is completely cured off. But OP neglected it and treated the child in casual manner. The child on the first day of her presentation and discharging the child by clearing the exudates without confirming that the ailment was completely cured and the vision was normal that would certainly tantamount to negligence on the part of the OP. The discharge summary and hospital records lack many details of history and treatment given. It appears a careless approach by OP.
Held:
The principles of what constitutes medical negligence is now well established by number of judgments of this commission as also the Honle Supreme Court of India, including Jacob Mathew vs State of Punjab[(2005) 6 SSC 1] and in Indian Medical Association Vs V.P.Shantha [(1995) 6SSC 651]. One of the principles is that a medical practioner is expected to bring a reasonable degree of skill and knowledge and must also exercise a reasonable degree of care and caution in treating a patient. In the instant case, it is very clear from the facts stated in forgoing paragraphs that a reasonable degree of care was not taken by OP in treatment of the child left eye.
Therefore, the court is of considered opinion that there is deficiency in service and negligence in proper treatment which resulted in loss of vision in left eye of complainant. Hence, the court did not find any illegality in the orders pass by for below. While quantifying the compensation it is necessary to consider the age of the child, her father economic conditions. It is being a female child of 11 years as of now, lost her eye at the age of 1-1/2 years. Considering a tender age of child and her future, the court is of considered opinion that she should be compensated adequately. Therefore, the court confirmed the orders of fora below and impose additional punitive compensation of Rs.2, 00,000/- to be paid to the complainant.
(National Consumer Disputes Redressal Commission, New Delhi, Revision Petition No. 796 of 2013, Chairman, Aravind Eye Hospital vs. Minor Kanmani, decided on 18/9/2013)
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