2008(1) CPR 111(NC)
NATIONAL CONSUMER DISPUTES REDRESSAL COMMISSION, NEW DELHI
K.S. Gupta, Presiding Member and Dr. P.D. Shenoy, Member
Dr. B.N. Gurudev —Appellant
versus
Dr. N. Ramanna and Ors. —Respondents
First Appeal No. 783 of 2003
Decided on 3.10.2007

IMPORTANT POINT
The record clearly shows that appellant was not treated carelessly. He was treated by qualified doctors and his right leg was amputated by taking consent of patient’s educated wife to save the life of the patient.

Headnote:(i) Consumer Protection Act, 1986—21(a)(ii)—Appeal against dismissal of complainant of medical negligence by State Commission—Accident case—Injury in right leg—Necessitating amputation—Issue of informed consent—General consent for various tests and examinations given by educated wife and the patient, who was a veterniary doctor—No informed consent for amputation—Evidence showing that surgeon told need of amputation to the wife of patient who became swooned and taken to separate room for treatment—No denial to this episode—Amputation was done to save life of patient under emergency requirement—On this state of evidence whether it can he informed that consent was obtained before performing surgery?(Yes)

       Held: [Perusal of consent Form] clearly indicates that the consent was given by the wife of the patient who is an educated lady and she was staying along with him in the hospital for arteriogram examination, biopsy, transfusion or operation and for administration of anaesthesia as well as post mortem in the unfortunate event of death. She also gave the consent for Angeiogram, femoropopileteal embolectomy. Further after the surgery, the patient has given consent for wound inspection as well as for wound debridness.

       It is true that there is no separate specific consent for amputation of the right leg but it is clear from the affidavit of the operating surgeon that when the complainant’s wife was told about this and she swooned and hence, she was taken to a separate room for treatment. She has not filed any affidavit to deny this. After performing the arteriography when it was found that his limb had become non-viable and gangrene has set in, and the surgeon attending on him has no choice but to perform amputation to save the life of the patient as by that time it had become an emergency procedure. (Paras 30 and 31)

       (ii) Consumer Protection Act, 1986—Section 21(a)(ii)—Appeal against dismissal of complaint of medical negligence by State Commission—Accident case of a vaterniary doctor—Injury in right leg—Delayed arrival for treatment—It was found that limb became non-viable and gangrene had set in necessitating amputation—Amputation done by cardio thoracic surgeon performing vascular surgery—Whether a case of medical negligence?(No)

       Held: It is clear from the records and evidence placed before us that a Cardiovascular Surgeons are competent to perform vascular surgery. Off late there are super specialists performing only vascular surgery. However, vascular surgeons do not generally perform cardiac surgery. Patient himself decided to get discharged from the KMC Hospital, Hubli and got admitted to Manipal Hospital. He was conscious at the time of admission and he could have asked the hospital authorities whether there are any super specialist vascular surgeons handling only vascular surgery in the hospital before admission, which he had not done. This appears to be an after thought on the part of the complainant. (Para 32)

       (iii) Consumer Protection Act, 1986—Sections 21(a)(ii), 2(1)(g) and(o)—Appeal against dismissal of complaint by State Commission on medical negligence—Accident of a vaternity doctor—Grievous injury in right leg—Delayed arrival in Hospital—Limb not viable—Treating it as gangerene—General consent taken—But informed consent in writing for amputation not taken—Whether are material discrepancies?(No)—Whether amputation was necessary?(Yes)—No expert evidence by complainant—OP filed all medical records and cited medical tests in corroboration—Whether doctors and Hospital can be held negligent?(No)—AIR 1969 SC 128, Halsbury’s Law of England and(2005) 6 SCC 1 relied on—Appeal dismissed.

       Held: Complainant has neither filed any expert evidence nor he has submitted any extract of medical text corroborating his complaint to support his contention. Respondents have filed all medical records, which has not been denied by the complainant.

       Complainant was involved in an accident on 13th April, 1992 from while riding motor bicycle from Hubli to Haveri. He went by an auto rickshaw and got himself admitted in KMC Hospital, Hubli. As the condition did not improve, he traveled by train from Hubli to Bangalore and then went by Ambulance to Manipal Hospital, where he himself got admitted. As precious time was lost between the time of accident and the time he was admitted at Manipal Hospital, where x-rays were taken and arteriogram was performed. There was no possibility of reviving the right leg as gangrene has set in. To save the precious life of the Veterinary Orthopaedic Surgeon, a team of doctors came to an unanimous decision to amputate the right leg which was done in the two stages. Subsequently post-operative treatment was given to the patient/appellant at the same hospital. Appellant before us visited the hospital for 1½ years not only for post operative care but also for obtaining prosthetic leg and necessary advise.

       Hence we are not persuaded to hold that the doctors and the hospital were negligent in this case.

       Our view is fortified by the celebrated judgment of the Apex Court in Dr. Laxman Balkrishana Joshi v. Dr. Trimbak Bapu Godbole, AIR 1969, SC 128 while dealing with the question of medical negligence and duties of a doctor. (Paras 39, 40, 41 and 42)

       Held finally: In view of the above, we do not see any reason to interfere in the well reasoned order passed by the State Commission. Accordingly, this appeal is dismissed. However, there shall be no order as to costs. (Para 44)