Issues Discussed: • Qualification of Doctor for doing Operation • Bar of Limitation • Summary Trial and Speedy Disposal of Case • Issue of Referral

Issues Discussed: • Qualification of Doctor for doing Operation • Bar of Limitation • Summary Trial and Speedy Disposal of Case • Issue of Referral

Issue of applicability of ESMA, 1966 Issue of protection of Fundamental Rights of Citizens of India Impact of Health Services

Issues Discussed: • Duty of Junior Resident/Senior Resident • Standard of Medical Negligence • Issue of Vicarious Liability • Issue of Criminal vs. Civil Medical Negligence • Issue of criminal prosecution of Doctors • Issue of Preliminary Inquiry • P.M. Examination Report: Cause of Report • Issue of Inquiry Report of Expert Committee • Request for Inquiry by CMO: Non availability of Experts • Issue of Consent & Protocol

Issues Discussed: • What constitutes medical negligence? • Issue of Bald Allegations: vague and absurd allegations • Standard of Care • Use of Filthy Language and Defamatory Allegations: standard norms, Cause of Death: Natural • Duty of General Medical Practitioner, Family Doctor • Standard of care • Issue of Medical Record: Issue of Signatures • Issue of Professional Fees: • Case before NCDRC: Compensation Claimed: • Case Law

Following questions come for consideration of NCDRC Questions for Consideration: 1. Whether the Hospital is negligent in the Treatment of the Patient? and 2. Is there is any evidence on record to establish that during the second re-implantation the cotton gauze i.e. foreign body was left behind? 3. Whether this had led to the removal of the kidney of the Patient? 4. Whether the treating Doctor has exhibited reasonable degree of care and adhered to the normal practice of medical parlance? Issues discussed: Following issues have been discussed in this case: • Principle of res ipsa loquitur • Jointly and several liability • Issue of Standard of Care • Quality of Health Care and applicability of Bolitho test preferred to Bolam test • Professional Indemnity Insurance • Pecuniary Jurisdiction • Issue of Enhancement of Compensation • Principle of restitutio in integrum • Applicability of Doctrines related to Medical Negligence

Question for Consideration: 1. Whether the lens were opaque or not can be verified if it is an open lens and that at the time of cause of action preloaded lenses were not ordinarily used? 2. Whether the Treating Doctor could verify the opaqueness or otherwise of the lens, just prior to the surgery? 3. Whose duty to ensure quality, design and safety of IOL (Lense)? Manufacturer, Dealer or Treating Doctor 4. Whether the wrong IOL model or power has been pulled? 5. Who has to verify the quality of the lens, which includes the power and the suitability? Issues Discussed: • Duty of Cataract Surgeon (Standard Protocol) • Issue of quality, design and safety of Lens • Complainant’s daughter, who is also a Doctor • Decompensation of cornea • Issue of Contributory Negligence Post-Operative Capsular Opacificaiton (POCO) 1. Anterior Capsule Opacification (ACO) 2. Posterior Capsular Opacification (PCO)

Issues Discussed: • Optha case, cataract Surgery, Loss of Complete Vision • Expert Committee constituted by the SCDRC • NCDRC’s Directions for reconstitution of Expert Committee • What should be the composition of the Expert Committee? • Speaking Report by Expert Committee • Different Powers of COPRA/MCI Act

A brief perusal of the hospital treatment record shows that the patient was operated for Incision Hernia on 14th December, 2000, the preoperative instructions show that consent was taken, CBC was advised and the patient’s history of Vascular Bypass Surgery was clearly noted. The Complainant had no history of hypertension or tuberculosis, the blood pressure and pulse rate was normal, the random blood sugar which was taken was also normal. It was also noted that the patient was a known Diabetic and was on relevant medication. The operation was performed at 2:30 p.m. and lasted till 6:30 p.m. as per the operation notes. The patient was put on insulin and other antibiotics. The random blood sugar was tested at 8:00 p.m. was 91 mg and no insulin was advised. Next day on 15th December, 2000 the medical record show that there was mild pain in the abdomen the dressing was done and there was no soakage at 8:30 a.m., on the same day the patient was seen by one Dr. Lata and also by the duty doctor wherein he had mentioned that the patient had complained of pain. On the next day morning once again burning sensation in the left feet was recorded by the duty doctor and Doppler of the left Limb was advised. At 12 noon once again the patient was seen by the duty doctor, Dr Lata who mentioned at 4:00 p.m. that the Complainant is having burning sensation in both the limbs RBS was noted as 81 MG. Then on 16th December, 2000 once again there was noting of burning pain in the feet. Doppler, LT of the limbs was advised and the treatment record shows that there was continuous complaint of pain in the leg, at 7:30 a.m., at 3:30 p.m. and also in the evening the duty doctor had noted Dorsalis Pedis, weak of palpation. Again on 16th December, 2000 at 8:00 p.m. it was noted that the Complainant had burning pain in both the limbs which continued. Even on 17th December, 2008 at 7:30 a.m the dressing was done and the drain was removed and antibiotics were given thereafter at 9:00 a.m. it was noted that both the feet has Cyanosis with local temparature down Dorsalis Pedis week and the same was again noted at 4:15 p.m. The above operation notes clearly records that the Complainant was continuously complaining of pain and burning sensation in his legs right from the date of surgery till 17th December 2013 the fourth post-operative day. [Para 11]

The District Forum, after hearing the parties, allowed the complaint against the opposite parties no. 1, no. 2 and no. 4 and directed them to pay Rs. 5 lakh as compensation along with Rs.15000/- as litigation costs. [Para 5] Being aggrieved, the Military Hospital (O.P.No.2) filed First Appeal No. 52 of 2016, whereas the complainant filed First Appeal No. 91 of 2016 for enhancement of compensation, before the State Commission. The State Commission allowed the appeal filed by the Military Hospital (O.P.No.2) and dismissed the appeal filed by the complainant. Consequently, the consumer complaint filed before the District Forum was dismissed. [Para 6] Disposing Revision Petition NCDRC observed that thus, admittedly, at the time of admission to the Military Hospital, the patient was in a severally dehydrated state and, thus, the decision of the treating doctors to give IV supplements immediately cannot be said to be incorrect. In the meantime, the blood investigations were received in the night at 10.20 p.m., which clearly indicated diabetic ketoacidosis. Thereafter, the doctors treated the patient accordingly. This was neither negligence nor deficiency on the part of the hospital or the treating doctors. As written by the treating doctors in the medical record, the patient had undergone treatment for Pulmonary Tuberculosis with repeated infections. He was also suffering from severe emaciation. Thus, the treatment given by O.P.No.2 and No.3 (doctors) was proper under such facts and circumstances. Evidently, the doctors did their duty with care. [Para 12]