No ophthalmologist consultation to in-patient for 5 days: TN Hospital slapped Rs 8 lakh Compensation

Karur: Holding negligence, the District Consumer Disputes Redressal Commission (DCDRC), Karur, has directed a Thanjavur-based hospital to pay Rs 8 lakh compensation to a patient, who lost complete visibility in his left eye. The commission noted that even though the patient remained admitted as an in-patient at the facility for 5 days, no Ophthalmologist visited the patient to examine the injury in his left eye and the hospital did not refer him to any other hospital on a priority basis as well.

Taking note of the medical record, the Consumer Court observed that the CT Craniofacial scan report identified that the Complainant sustained an Open left globe injury with vitreous hemorrhage. "...if this is a known complication, what steps have been taken during that period by the Opposite Party. In this case, the Opposite Party simply stated that the opinion of the Ophthalmologist is needed in the medical reports without taking any steps to provide treatment not even to examine the patient by the Ophthalmologist to the left eye of the Complainant for more than 5 days." 

The matter goes back to 2020 when the patient met with an accident and was brought to Meenakshi Mission Hospital Thanjavur for treatment. He was diagnosed with Zycomatic maxillary Complex fracture and laceration over the left upper and lower eyelid; he was admitted as an in-patient on 30.01.2020. 

Consequently, a plate was fixed during the surgery for the injury sustained from the ZMC fracture in the left eyelid maxillary area alone. However, he allegedly was not treated for the injury sustained in his left eye.

The complainant alleged that his left eye was severely injured, he could not see through his left eye and was suffering from severe pain. Even though the duty doctors and nurses assured him that he would be treated by an ophthalmologist, the hospital discharged him on 04.02.2020 without providing any treatment for the left eye, he said.

Due to severe pain in his left eye, he lost his visibility and thereafter on the same day, he consulted an Ophthalmologist Dr. Kumar. The doctor, after examining the patient, opined that his left eye had completely ruptured and he suffered with Ruptured Globe. Advising the patient to treat the same in a speciality Hospital, Dr. Kumar referred him to consult the doctors at Aravind Eye Hospital in Madurai, the complainant said.

Immediately, the patient got admitted to Aravind Eye Hospital, where the ophthalmologist opined that he had "Corneal Tear" in his left eye. They also opined that the patient had lost visibility in his left eye completely and partially in his right eye. To save the partial visibility in the right eye, they suggested the complainant undergo immediate surgery in his left eye. Accordingly, the complainant underwent surgery for Corneal Tear Repair and Wound exploration. The doctors from Aravind Eye Hospital allegedly told the complainant that he would not have lost his visibility and had the Corneal Tear if he had been treated properly at the early time of admission as soon as he met with the accident.

Alleging that he lost complete visibility in his left eye and partial visibility in his right eye, the complainant submitted that due to this, his entire routine life and earning power was lost and his future became at stake. Therefore, filing the consumer complaint he demanded compensation for deficiency in service and negligent treatment provided by the first treating hospital.

On the other hand, the hospital denied the allegations. It was submitted that the patient was examined by duty doctors and Abrasions over the left side forehead and both knee, Lacerations over the left upper and lower eyelid, and pain over the left hand were identified. Deciding that it was a case of Zycomatic Maxillary Complex Fracture, X-Ray, ECHO and CT Craniofacial were taken. The X-Ray revealed that the complainant sustained an M/ Clavicle fracture on his left hand and the CT Craniofacial revealed that Open Left Globe Injury with Viterous haemorrhage and the Lens was not made out. Since, it was case of Left Side Zycomatic Maxillary Complex Fracture, the Orthopaedic, Cardiologist and the Neurologist physicians were called.

They opined that the patient needed Ophthalmic surgery for his Left eye which sustained a ruptured open globe injury at a speciality hospital after retaining the ZMC fracture. The hospital alleged that the complainant was explained about the pros and cons of the surgery, state of affairs and his critical condition. It was further submitted that the surgery for ZMC fracture was done after obtaining consent for the same from the Complainant and his relatives.

Referring to the medical treatment process, the hospital highlighted that the doctor conducts the procedures one by one and stage by stage according to the patient's health condition. The hospital submitted that all the procedures could not be done at one sitting and therefore, the doctors initially planned to treat the ZMC fracture and Clavicle fracture in one sitting and treat the eye injury later.

It was pointed out that since there was much swelling in the Orbital region and the patient was unable to open the left eye, it was not possible to treat the patient's left eye without retaining the ZMC fracture. So the hospital treated the patient according to the severe condition of the Left side Orbital regain by surgical intervention for stabilizing the fracture at the site and did the procedures warranted one by one according to the medical line of practice. Therefore there is no unethical activity or medical negligence on the hospital's part, they said.

While considering the matter, the consumer court perused the records and found that the patient was brought to the Hospital on 29.01.2020 and discharged on 04.02.2020. During this period, various medical tests were taken including CT Craniofacial Scan where it was identified that the Complainant had sustained an Open left globe injury with vitreous haemorrhage and it was also found that the complainant remained admitted to the treating hospital for more than 5 days.

The Commission noted that from the date of admission to the date of discharge, no Ophthalmologist examined the patient and gave any essentially required treatment in time regarding the Open left globe injury with vitreous haemorrhage in the treating hospital. In fact, the hospital also admitted that there was no Ophthalmology department in the hospital.

At this outset, the Commission noted,

"...it is the duty of the Opposite party to refer the Complainant with all medical assistance including oxygen cylinders and other life saving drugs along with a medical attender to the superior hospitals through an Ambulance to treat the Complainant for all his ailments in one roof or otherwise the Opposite Party should have invited the Ophthalmologist from some other Speciality hospitals to give treatment to the injured left eye of the Complainant and till then the Opposite Party should have given the essentially required treatment to the Complainant. But the Opposite Party has failed to do so."

"The term “medical negligence means more than heedless or careless conduct, in omission or commission, it properly connotes the complex concept of duty, breach and damage thereby suffered the person to whom the duty was owing”. In this regard, the Opposite has completely omitted the Ophthalmology treatment to the left eye of the Complainant in which he had sustained injuries. The Opposite Party should have taken treatment to the injured left eye of the Complainant in first priority. But he had stated that ZMC surgery must be given 1st priority. However no expert opinion was produced in this regard to show the priority treatment," further noted the Commission.

Therefore, the consumer court concluded that the treating hospital carelessly omitted to provide Ophthalmology treatment to the Complainant till the end of his discharge and there was even no examination by the Ophthalmologist in respect of the left eye of the Complainant. Further, the Commission noted that the complainant lost his total vision in his left eye which amounts to permanent disability, which not only affects the Complainant but also his family.

Noting that the patient underwent surgery at the treating hospital without knowing the complication in the left eye since no examination was made by the Ophthalmologist, the Commission observed,

"As a treating doctor, the Opposite Party has to explain the reason for such complication in the left eye in the earlier stage when he was admitted in the Opposite Party Hospital itself, but he has not even taken step to examine the Complainant through an Ophthalmologist and he failed to do so. Even the failure of the proper medical treatment given is not amounting to deficiency and at the same time the failure to provide essentially required treatment is absolutely a negligence.No particulars have been mentioned in the medical records about the essentially required treatment which has been given to the Complainant regarding the Open left globe injury with vitreous hemorrhage."

The consumer court noted that the hospital treated the complainant for ZMC surgery and never for the complication in the left eye, which should have been treated first on a priority basis. Opining that there was medical negligence on the part of the treating hospital, the consumer court observed,

"There is no whisper in the medical record regarding the reasons for the loss of vision having set in the left eye and as per the CT Craniofacial scan report, if this is a known complication, what steps have been taken during that period by the Opposite Party. In this case, the Opposite Party simply stated that the opinion of the Ophthalmologist is needed in the medical reports without taking any steps to provide treatment not even to examine the patient by the Ophthalmologist to the left eye of the Complainant for more than 5 days. Hence, this Commission comes to a conclusion that there is a negligence as well as deficiency of service on the part of the Opposite Party in this regard and this points is answered accordingly."

Therefore, holding the treating hospital liable to pay compensation, the consumer court ordered, "In the result, the Complaint is partly allowed and the Opposite Party is directed to pay a sum of Rs.5,00,000/- as a compensation for the loss of eye due to the omission of treatment on the part of the Opposite Party and to pay a compensation of Rs.3,00,000/- for the mental agony caused to the Complainant by the Opposite Party due to the deficiency of service on the part of the Opposite Party and in toto the Opposite Party is directed to pay a compensation of Rs.8,00,000/-with interest at the rate of 9% p.a from 04.02.2020 on which date the Complainant was discharged from the hospital of the Opposite Party till the date of realization and to pay a sum of Rs.25,000/- towards the litigation expenses which carries no interest within one month from the date of the order and in other respects the Complaint is dismissed."

To view the order, click on the link below:

https://medicaldialogues.in/pdf_upload/consumer-court-rs-8-lakh-compensation-235059.pdf

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