Delay in Eye surgery after accident: Consumer forum absolves hospital, ophthalmologists of negligence
Kerala: Upholding the expert opinion in the case, the Consumer Dispute Redressal Commission, Kannur has dismissed medical negligence charges against an eye hospital and 2 ophthalmologists. The doctors had treated the patient who suffered the penetration of a metal tool into his right eye and lost the eye in the treatment process.
In his complaint, the patient had alleged that there was a delay in treatment and gross negligence on part of the doctors and the hospital and as a result, the infection spread through his eye and he lost his vision of the right eye. However, the committee refused to accept that the patient lost his right eye due to the deficiency of the authorities and observed that the patient was properly treated with topical and systemic antibiotics.
The case goes back to the year 2008 when the patient, a mechanic by profession suffered an injury while he was working. A tiny part of the metal tool got broken and penetrated into his right eye. He immediately went to an eye care Hospital, Kannur. The doctor in that hospital advised him that better treatment is required since there was a metallic foreign body penetration.
Therefore, he went to the concerned hospital and the ophthalmologist there diagnosed that the injury was simple in nature and he applied some medicine, dressed the eye, and let the patient go home. However, after reaching home, the patient felt severe pain in the eye and started vomiting. On the same day, he again went to the hospital. Since the doctor was not available in the hospital, he went to the doctor's residence and got examined in the morning. From there, the patient was examined by another ophthalmologist and he was admitted to the hospital.
Due to the continuous vomiting, the patient was shifted to another hospital but he had to be again transferred to the hospital and after that, the doctor referred the patient to Amrita Institute of Medical Science, Ernakulam.
The patient alleged that due to the delay, he had suffered a severe infection and the doctors at the other facility were constrained to do surgery for removal of the right eye of the complainant. It has been further alleged by the complainant that since the doctor treated him initially without due care and caution and without considering the gravity of the injury, he lost his vision of the right eye.
The counsel for the complainant contended that it was the duty of the hospital and the doctor to examine the patient and decide what treatment was to be given and there was gross negligence on the part of hospitals and doctors. The complainant submitted that due to loss of vision, he cannot do his mechanic work. He had to spend over Rs.1,00,000/- at AIMC Ernakulam for treatment. Hence, he filed a complaint seeking Rs 11 lakh as compensation from the hospital and doctors.
The counsel for the hospital and the doctors denied the allegations stating that the complainant had a history of sustaining an injury to his right eye two days prior to the date of consultation and also he took treatment for the injury from another eye hospital at Kannur and came to the hospital with complaints of severe pain, watering and reduces right eye with defective vision.
They further submitted that ocular examination revealed "lid oedema with partial-thickness corneal wound and severe iritis" and fundal examination showed no view. So the treating ophthalmologist sought the expert opinion of a senior consultant. Suspecting intraocular foreign body(IOFB), the doctors informed the complainant and explained that he required a B scan and X ray orbit for detailed evaluation and for a conclusive diagnosis but as the facility was not available in the facility he was referred to a higher centreDel.
It was also contended that considering the seriousness, emergency treatment was given with topical antibiotics and anti-inflammatory drugs and applied pad and bandage. However, the complainant instead of going to the higher centre came back to the hospital the same night with complaints of pain, headache and vomiting. Since the hospital has only daycare facilities, the duty sister sent the patient to the residence of the doctor who had also diagnosed IOFB with panopthalmitis and informed the complainant and his bystanders that immediate attention of a retinal surgeon was required and since the patient was too sick to travel, they insisted for treatment at the hospital. He was started on IV fluids and IVAugmentin and IV magnamycine, antibiotics to avoid septicemia and cerebral infection.
The hospital and the doctors further contended that the fact that the complainant sustained an injury to the right eye on 4/12/2008 was not correct and from the records submitted by the complainant, it could be seen that the patient was referred from Oommen eye care hospital Kannur to Vasan eye care hospital from where some medicines were prescribed and the complainant subsequently attended the hospital and the patient had suppressed the facts regarding the treatment to cook up his own story. The patient was given emergency first aid treatment to prevent further deterioration and was specifically instructed to go to a higher centre for expert management, the counsel submitted.
After considering the submissions, this Forum forwarded the complaint to DMO to refer the matter to a competent doctor/committee of doctors specialized in the field relating to submit a report regarding the alleged medical negligence.
Following the report, the commission observed that as per the expert opinion of a senior consultant, "Suspecting intra ocular foreign body (IOFB), the complainant was informed and explained that he required B scan and X ray orbit to rule out the possibility of having 10FB." Since the facilities such as X ray orbit and B scan were not available in the hospital at that time, the patient was advised to go to either to attend any higher centre at Kozhikode. Hence, the hospital and the doctors were right in referring the patient.
Moreover, the commission also noticed that the patient was started on several fluids and antibiotics to avoid septicemia and cerebral infection. On the next day morning, he was referred to AIMS Hospital Kochi and thus pleaded that there is no deficiency in service or professional negligence on their part.
The commission further noted that the complainant did not admit that the injury happened 2 days before consulting the doctor and he also did not mention that he was first referred to another Eye Hospital from where some medicines were prescribed. "Hence, the facts stated by the complainant in his defeat that he immediately after the injury on his right eye approached the eye hospital could not be appreciated in his favour", stated the commission.
The counsel for the petitioner referred to a decision of Hon'ble National Consumer Disputes Redressal Commission 2008(20 CPR (NC) 399 in which the Hon'ble National Commission held that the doctor has been negligent and deficiency in service to the extent that he did not follow and adopt an adequate normal procedure of obtaining the required test reports before arriving at a diagnosis. However, the commission stated, "Here it can be seen that the patient on the first day itself advised to take X ray orbit and B scan and given the choice of going to higher centers for further management."
Observing that topical antibiotic and anti-inflammatory drugs were administered to avoid septicemia and cerebral infection, the court stated
So we could not come to a conclusion that Ops 1&2 did not follow and adopt adequate normal procedure before arriving at a diagnosis. So the decision produced from the complainant's side cannot be taken into account. The law is that if a medical practitioner is acted in accordance with the practice accepted by the profession he cannot be hold negligent.
The commission also considered the expert's committee's opinion that 'The complainant was treated with topical and systemic antibiotics and referred to AIMS, Kochi on the next day itself for expert management and as per the available documents, the complainant has received proper treatment and primafacie there is no obvious negligence".
Finally, the commission dismissed the plea stating,
"The expert committee did not find the Ops guilty of committing medical negligence. Since the opinion of the Expert Committee is available on record, we have to go by the Expert committee report unless there are good enough reasons to disagree with the expert committee report. We cannot substantiate our own views over that of specialists because we are not expert in medical science."
To view the order, click on the following link:
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