Eye hospital, surgeon get relief from medical negligence charges in lasik surgery case
No Medical Negligence
Chandigarh: Observing that a medical practitioner or hospital would be liable only where their conduct fell below the standards of a reasonably competent practitioner in their field, the State Consumer Disputes Redressal Commission, Punjab, recently exonerated an eye surgeon and hospital from the allegations of medical negligence while conducting Lasik Eye Surgery on a patient.
The case goes back to 2017 when the complainant approached the treating eye hospital. After examination, the treating doctor and hospital informed the complainant that his distance vision of the right eye was -2.00 and the left eye was -1.75 and accordingly, the patient was advised for standard LASIK operation. When the patient took a second opinion from another doctor, his problem was diagnosed as Myopia in both eyes, and he was advised to undergo the same operation.
Consequently, the patiet visited the first treating hospital and deposited money in advance for the surgery and tests. Meanwhile, the treating doctor suggested conducting Lasik with Custom Vue operation instead of standard Lasik operation, which would cost him more. However, the doctor and hospital told the complainant that under the said surgery, the light would not scatter in the eyes and also no blade is used. Accordingly, the patient/complainant agreed for Lasik with Custom vue operation. After the surgery, which cost Rs 59,000, the patient was discharged on the same day.
It was alleged by the complainant that the treating hospital and doctor took 2.5 hours for the surgery, and a blade was also used during it. When the complainant noticed that he was not able to see things properly, he approached the treating doctor, who assured him that after taking the prescribed medicines, his eyesight would be alright within 5-6 days. However, allegedly, even after 7-8 days, the problem still existed, and the light was also scattering in the patient's eyes. When the doctor was questioned again, the patient got a vague reason that before the surgery, the back light of his eyes was already very weak and therefore, he was not able to see properly.
Therefore, the complainant alleged that the act and conduct of the treating hospital and doctor were unprofessional and there was sheer negligence in performing the medical obligations.
Apart from this, the complainant also alleged that the bill provided to him was qua standard Lasik operation, even though the amount of Lasik with Custom vue was mentioned on the bill.
The complainant also submitted that later when visited another Eye Hospital, he was diagnosed -0.50 (cylindrical) each, which means that his problem had increased after the operation, as there was no cylindrical distance vision before the operation. It was also found that there was no such problem of weak backlight in the complainant's eyes, as told by the treating doctor. Therefore, alleging deficiency in service as well as medical negligence on the part of the treating hospital and doctor, the patient filed the consumer complaint and sought direction against the them to pay Rs.5,00,000/- as damages and compensation for causing damage to the eyes of the complainant and further to pay Rs.3,00,000/- for causing mental agony and harassment to him.
On the other hand, the treating doctor and hospital provided the details of the medical records of the patient and submitted that the complainant was clearly told that the said surgery would be done by using the Micro Keratome Moria Machine, which would make the corneal flap with a very fine blade.
They argued that even with the best possible efforts, if sometimes things go wrong in surgical operations or medical treatment, a doctor is not to be held negligent simply because something went wrong. It was contended that the treating doctor can be held liable for the negligence only when he falls below the standard of reasomably competent practitioner of his field.
Relying on medical literature and medical journals, the hospital and doctor submitted that in most cases, after Lasik surgery, the vision becomes stable and clear after six months of the surgery. Most of the symptoms which the patient experiences after the Lasik Eye Surgery disappear or are significantly reduced during the period of six months. However, the hospital and doctor claimed that the complainant became restless and impatient and consulted many other doctors immediately after the surgery.
It was also submitted that no eye surgeon/professional can visualise what would be the refractive status of the patient after the procedure. Therefore, there was no deficiency in service or medical negligence on the part of the treating hospital and doctor. Earlier, the District Commission had dismissed the complaint and challenging this, the complainant approached the State Consumer Court.
Observations by Consumer Court:
Regarding the allegations about the bill mentioning Standard Lasik Surgery, instead of Lasik with Custom vue, the State Consumer Court observed,
"The onus was on the appellant/complainant to prove his version by leading cogent evidence on record. But he failed to establish on record that standard Lasik treatment was given to the appellant/complainant instead of Lasik with custom vue surgery and they charged extra amount from him. It appears that the appellant/complainant has wrongly made up the case of deficiency in service on the part of the respondents/OPs while relying on the document of a third party i.e. ***Eye Hospital showing the cost as ‘with blade’ surgeries and ‘blade free’ surgeries, which is not applicable in the present case. Accordingly, we do not find any force in this contention raised by the appellant and the same is hereby rejected."
While considering the issue of medical negligence, the State Consumer Court referred to the submissions by the hospital and the doctor that most of the issues after Lasik Surgery disappear or are significantly reduced after six months.
However, noting that the consumer complaint was filed after 2.5 months from the date of surgery, the Commission noted, "As per above said medical literature in most of the cases, the vision becomes stable and clear at the period of sixth month, post operative visit to the doctor and most of the symptoms, which the patient experiences after the Lasik surgery disappear or are significantly reduced during the period of six months. In the present case, the appellant/complainant has filed the consumer complaint on 07.02.2018 i.e. after about 2½ months from the date of surgery conducted on 24.11.2017. Appellant/complainant should have regularly followed up after the Lasik eye surgery at least for a period of six months, as such like symptoms are disappeared or significantly reduced during that period. It is not the case of the appellant/complainant that the appellants/OPs have not performed the said procedure of ‘Lasik Laser Surgery’ as per the standard medical protocol. Negligence is an essential ingredient of the offence and if needs to be established, then it must be culpable or gross and not the negligence merely based upon an error of judgment."
Referring to the Supreme Court order in the case of Jacob Mathew, the Consumer Court noted that in this case, neither there was any error nor any specific allegation that the procedure adopted by the doctors was not as per medical protocol. Rather, the main dispute seemed to be of the amount charged by the treating hospital and doctor.
Therefore, the Commission held, "As such, we are of the considered opinion that there is no medical negligence on the part of the respondents/OPs while giving treatment to the appellant/complainant for the ailment suffered by him."
Accordingly, the State Consumer Court upheld the District Commission's order holding that there was no medical negligence and observed,
"In the light of the above discussion, we are of the opinion that a medical practitioner or hospital would be liable only where their conduct fell below the standards of a reasonably competent practitioner in their field. As such, we are of the considered opinion that no negligence can be attributed to the said doctors as well as the hospital as the doctors have performed their duties with reasonable skill and knowledge. As such, we do not find any force in the contentions raised by the appellant/complainant and the same is hereby rejected. The District Commission has rightly decided the case and there is no material infirmity and irregularity in the order of the District Commission. Finding no merit in this appeal filed by the appellant/complainant, the same is hereby dismissed & the order of the District Commission is upheld."
To view the order, click on the link below:
https://medicaldialogues.in/pdf_upload/punjab-scdrc-no-med-negligence-1-320361.pdf
