Tamil Nadu

North Chennai

CC/11/2020

Mrs.Meena - Complainant(s)

Versus

M/s.Hi Beam Diagnostic Research Foundations Pvt Ltd - Opp.Party(s)

M/s.C.Rekhakumari

21 Nov 2023

ORDER

                                                                     Complaint presented on : 31.12.2019

                                                                Date of disposal            : 21.11.2023

                                                                                  

DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION,

CHENNAI (NORTH)

@ 2ND Floor, T.N.P.S.C. Road, V.O.C. Nagar, Park Town, Chennai – 600 003.

 

PRESENT: THIRU. G. VINOBHA, M.A., B.L.           : PRESIDENT

                                         TMT. KAVITHA KANNAN, M.E.,         : MEMBER-I

                                         THIRU V. RAMAMURTHY, B.A., B.L., PGDLA : MEMBER-II

 

C.C. No.11/2020

DATED THIS TUESDAY THE 21ST  DAY OF NOVEMBER 2023

                                

Mrs.N.Meena,

W/o.Mr.Naresh Kumar,

No.210/212, C.B.Road, Oswal Garden,

‘C’ Block-402, Korrukkupet,

Chennai-600 021                                                           …..Complainant                                                                                                

 ..Vs..

  • .Hi Beam Diagnostic Research Foundations Pvt Ltd,

Represented by its Director,

Dr.Cynthia Dharshini Sugirtha,

No.53,Arathoon Road,

Royapuram, Chennai-600013.....Opposite Party

 

 

Counsel for Complainant                        : M/s.C.Rekhakumari and 2 others

Counsel for opposite party                        :M/s.V.Balaji and V.Yurendrakumar

 

 

ORDER

THIRU. V. RAMAMURTHY, B.A., B.L., PGDLA, MEMBER

This complaint has been filed by the complainant against the opposite party under section 12(1)(a) of the Consumer Protection Act, 1986 prays to pay the incurred medical and other miscellaneous expenses of Rs.70,000/- inclusive of physiotherapy charges and pay a sum of Rs.1,00,000/- towards the future treatment of the complainant and sum of Rs.10,00,000/- towards damages and mental agony.

 

1.THE COMPLAINT IN BRIEF:

          The  Complainant states that she is suffering from abdominal pain. She approached her general physician Dr.J.Deepali and Dr.Vinod kumar at Jayam Hospital chennai they recommended for ULTRA Sound scan but it was not adequate her pain for which complainant consult Dr.Vignesh  advised her to take CT Abdomen Scan. The complainant approached the opposite party on 17.09.2019 which is a Diagnostic Centre for CT Scan procedure. The complainant further states that neither the nurse nor the technicians were bothered to explain the procedure or the rare complications of the said contrast injection to her or to her husband. Once the needle was injected for test dose the complainant felt very uncomfortable and made noise her left hand got swollen from finger to elbow but no heed was given by the said nurse. Then a male technician came to inject the contrast through infusion pump she informed her pain but he ignored and started the procedure while injecting the solution burst out of her vein. The complainant states that she started vomiting and her hand swollen in full swing within the span of 2 minutes. The said contrast enhanced CT Scan was completed and the patient was sent home with the swelling in her hand and without providing first aid treatment. About four to five hours after the scan pain and swelling in her hands started increasing and the patient was forced to approach in M/s. Jayam Nursing Home. Conservative measures of treatment did not improve the symptoms. On further diagnosis of the hand showed a significant accumulation of contrast within the Extra-vascular space and acute compartment syndrome was diagnosed. She was admitted on 18.09.2019 for surgery where longitudinal incisions through the 2nd and 4th metacarpals and interosseus metacarpal spaces decompressed. Besides surgery the complainant was also advised to undergo physiotherapy and every day she had spent an additional amount of Rs.700/- per day and it continued for 15 days. Nearly 10 days she was unable to move her hand and literary she was under depression due to her immobility. The complainant represents that all the above incidents occurred due to the negligence of the opposite party by appointing such an inexperienced and inefficient nurse, technician in their diagnostic centre and the blatant dereliction of duty of the technician by wrongly injected the IV contrast in extra-vascular space due to their medical negligence. The complainant said as on date she spent about Rs.1,00,000/- towards the medical and other miscellaneous expenses out of which she got medical claim for Rs.30,076/- from her medi-claim insurance. Further till now the complainant is continuing her physiotherapy treatment and still on complete bed rest as unable to do any work and so the opposite party is liable to reimburse all those expenses as well as expensed for future treatment to the complainant. The complainant sent a legal notice dated 03.10.2019 to the opposite party through her advocate indicating the sufferings and mental agonies. Hence this complaint

2.WRITTEN VERSION FILED BY THE  OPPOSITE PARTY  IN BRIEF:

          The Opposite  party states that the complainant was admitted initially CT scan was taken. As advised by her physician another contrast enhanced CT scan was planned. The opposite party states that contrast media extravasation (CMEV) refers to the leakage of intravenously-administered contrast media from the normal intravascular compartment into surrounding soft tissues, it is well known complication of contrast enhanced CT Scanning. After CT scan plain was taken the needle of injection was inserted into the dorsum of complainant by the opposite party’s qualified nurse Rani. The complainant at that time did not complain of any pain. Because of the movement of the hand a few ml of the contrast material extravasated on the dorsum of the left hand of the complainant. The opposite party had proof through CT scan images that the maximum quantity of contrast material got injected into the vein. The Opposite party states that the management of extravasation includes nursing intervention and thermal application. The complainant was kept in the observation room and the radiologist Dr.Ganesh Balaji advised the nurse to keep the hand elevated and also advised ice pack application. Subsequently the complainant felt better and did not have any further vomiting. The complainant wanted to go home as felt better as radiologist told the complainant to report back if the swelling does not subside within 3 to 4 hours. The opposite party states that regarding the further increase of swelling the opposite party is not aware since the complainant did not report to opposite party inspite of the opposite party instructions to report in case of any swelling. The complainant was admitted only on 18.09.2019 in opposite party’s hospital. If the complainant reported to the opposite party when the swelling started increasing 4 hours after the injection with proper hand elevation and ice packs, acute compartment syndrome could have been avoided. Complainant intentionally not filed the entire discharge summary. Opposite party states that they have appointed experienced nurse and paramedical staff.

3. POINTS FOR CONSIDERATION:

1. Whether there is any negligence and deficiency in service on the part of the opposite party as alleged in the complaint?

2. Whether the complainant is entitled to the reliefs prayed in the complaint. If, so to what extent?

The complainant had filed proof affidavit, written arguments and  documents Ex.A1 to A5 were marked on the complainant’s side.  The Opposite parties had filed written version, proof affidavit, written arguments and documents Ex.B1 to B4 were marked on the opposite party side. Oral submission of learned counsel for opposite party also heard.

4. Point No.1:-

          The admitted fact of the complaint is that complainant on reference by Dr.J. Deepali of Jayam Nursing Home had approached the opposite party on 17.09.2019 for abdomen scan to find out the reason for  abdominal pain.  It is also an admitted fact that initially CT scan was taken and thereafter another contrast enhanced CT scan was planned and programmed. 

The complainant alleged that the nurse and technicians not bothered to explain the procedure or the rare complications of the contract injection to complainant or to her husband and carried the procedure.  It is further alleged that technicians could not identify the vein properly to infuse the needle for contrast study and once the needle was injected for test dose the complainant felt very uncomfortable and made noise and informed the nurse by saying its pricking.  Within no time the complainant left hand got swollen from finger to elbow but no heed was given by the said nurse and she left the room without considering about the pain incurred to the complainant.  Then the male technician who came to inject the contract through infusion pump also ignored the pain and started the procedure with infusion pump at very faster rate and while injecting, the solution burst out of her vein.  Thus, it clearly indicates that they had never bothered about the patient’s cry and pain.  The complainant further alleged that her situation had gone worse, and she started vomiting and her hand swollen in full swing within the span of 2 minutes.  The entire process happened within the span of 2 minutes.  On complaining about the swelling, it was informed by the opposite party that it will get subsidized in an hour and by that time the enhanced contract CT scan was completed and the complainant was sent home with the swelling in her hand and without providing first aid treatment for vomiting and swelling.  The complainant alleged that after 4 to 5 five hours of scan, the pain and swelling started increasing and the complainant was forced to approach the emergency department of M/s. Jayam Nursing Home and on physical examination it showed a pale, tense and swollen hand with blisters on the dorsal region and loss of sensation.  Capillary refill was increased and the complainant was unable to move her fingers and any attempt to do so was extremely painful.  Conservative measures of treatment did not improve the symptoms and on further diagnosis of the hand showed a significant accumulation of contrast within the extra vascular space and acute compartment syndrome was diagnosed.  The complainant was admitted on 18.09.2019 for surgery where longitudinal incisions through 2nd and 4th metacarpals and interosseus metacarpal spaces decompressed.  Fullness in Palmer aspect relieved. Decompression done on dorsal subcutaneous compartment of fore-arm and after adequate decompression bulky dressing done.  Volar POP slab applied.  The complainant alleged that besides surgery, she was advised to go for physiotherapy, and she had undergone mental harassment, depression due to immobility and all this happens due to the negligence and dereliction of duty of the opposite party.  On complainant side the discharge summary is marked as Ex.A1, Photographs of complainant showing injuries as Ex.A2, Reimbursement statement of the medical claim as Ex.A3, Legal notice as Ex.A4 and reply notice as Ex.A5.

On the other hand, the opposite party defended that complainant had abdominal pain for one month and vomiting for some times and pain has aggravated for past three days.  The opposite party contended that prior to taking CT scan the opposite party has clearly explained the risk of CT Scan / with contrast and the complainant having understood the same signed the informed consent on 17.09.2019.  The opposite party contended that the nurse Ms. Rani got seventeen years of experience and male technician Mr. Gambieeswaran.N got thirteen years’ experience.   The opposite party contended that Contrast media extravasation (CMEV) refers to the leakage of intravenously-administered contract media from the normal intravascular compartment into surrounding soft tissues; it is well-known complication of contract-enhanced CT Scanning.  After CT Scan plain was taken, the needle of injection was inserted into the dorsum of Complainant by the opposite party’s qualified nurse and at that time the complainant did not complain of any pain.  Then the contract injection was set through infusion pump.  The opposite party technician explained again the procedure to complainant and told her that she should report immediately if there is any pain during injection.  The opposite party further contended that the infusion pump was set as per protocol and infusion of the contrast was started at a standard rate.  Initially the complainant had no complaint and the maximum quantity of contrast was injected into the vein.  Suddenly the complainant vomited and during vomiting the complainant’s hand moved.  On noticing the complainant vomiting, the opposite party’s technician stopped the infusion pump. The opposite party contended that because of the movement of the hand by the complainant, a small quantity of the contrast material extravasated on the dorsum of the left hand of the complainant.  The opposite party further contended that maximum quantity of contrast material got injected and the images of kidneys which shows the contrast material excreted by the kidneys and thus only a small quantity got extravasated.  The opposite party contended that after the first sign of extravasation, management of extravasation with nursing intervention and thermal application as per protocol was carried out.  Thus the opposite party has given immediate treatment and the complainant was kept in observation room and the opposite party radiologist Dr.Ganesh Balaji saw the complainant and advised the nurse to keep the hand elevated, ice pack applied.  The complainant felt better and there was no vomiting and since the complainant wanted to go home she was sent to home with a advise to keep her hand elevated and continue to apply ice pack and also advised her to inform the opposite party if the swelling does not subside within 3 to 4 hours but the complainant never turned up thereafter.  The opposite party further contends that for such a small quantity of extravasation there is no possibility for acute compartment syndrome to develop if the complainant reported back to the opposite party when the swelling started increasing after 4 hours. If the complainant reported to the opposite party when the swelling started increasing 4 hours after the injection with proper hand elevation and ice packs, acute compartment syndrome could have been avoided.  Hence no negligence can be attributed against the opposite party.  On the opposite party side the Consent Form is marked as Ex.B1, CT Scan Report as Ex.B2, Academic Certificates of the Nursing Assitant and Technician as Ex.B3, CD of CT Scan as Ex.B4.

We have carefully gone through the averments and documents submitted on both sides and heard of the oral submission of the learned counsel of opposite party.  The opposite party contended that the complaint is bad for non-joinder of necessary party of Jayam Nursing Home.  Whereas the complainant has averred that Jayam Nursing Home has no role in the negligence of the opposite party and hence adding Jayam Nursing Home as party is unnecessary.  On perusal of Ex.B1, the complainant was referred to opposite party by Jayam Nursing Home for CT Scan and on further perusal of Ex.A1, Jayam Nursing Home had given treatment for Acute Compartment Syndrome Left Hand which arose after CT Contrast Scan.  Since the alleged incident of complaint was happened in between and further there was no role of activity for Jayam Nursing Home during that time and therefore the contention of the opposite party for non-joinder of Jayam Nursing Home as necessary party is not maintainable.

The opposite party contended that complainant had reported that she had abdominal pain for one month and vomiting for some times and pain has aggravated for the past three days.  On the other hand, the complainant disputed the contention of the opposite party stating that she was suffering from abdominal pain and not vomiting issue.  The complainant further states that actually she was suffering from vomiting only after the alleged procedure by the technician of the opposite party.   It is observed from Ex.B1, the patient details of the opposite party it is clearly indicated that as ABD pain 1 month, vomiting sometimes, 3 days over pain against complaints/history of illness.  But in the absence of any material evidence of past treatment records or case sheet we cannot conclude whether the complainant had vomiting issue or not prior to CT contrast scan.

The complainant alleged that CT plain scan was taken and thereafter the technicians programmed for another contrast enhanced CT scan and technicians were not bothered to explain the procedure or the rare complications of the said contrast injection to complainant or her husband.  The opposite party technicians carried on the procedure in order to obtain the contrast study but during the procedure, the technicians could not identify the vein properly, to infuse the needle for contrast study.  Further once the needle was injected for test dose the complainant felt very uncomfortable and made noise and it started pricking and within no time her left hand got swollen from finger to elbow and the same was informed to nurse who did not bother and left the room.  Afterwards a male technician came to inject the contrast through infusion pump and when the complainant was informing the pain to him, he also ignored the pain and started infusing the contrast at very faster rate and while injecting, the contrast solution burst out of her vein.  The complainant further alleges that situation had gone worse and she started vomiting and her hand swollen in full swing within the span of 2 minutes.  On complaining about the swelling, she was informed that it will get subsidized in an hour and by that time the said contrast enhanced CT scan was completed and she was advised to go home without any first aid treatment for vomiting and swelling.  On the other hand, the opposite party contended that prior to taking CT scan the opposite party had clearly explained the risk of the CT scan/with contrast and the complainant having understood the same and signed the informed consent on 17.09.2019 itself.  On perusal of Ex.B1, it is found that the complainant was informed about the risk of CT contrast scan and she will not hold Radiologist, Radiographer and other staff responsible for any untoward reaction occurring either immediately or after some delay and if any reaction occurs, she has to report to a hospital immediately.  Normally written consent used to be taken by hospitals or diagnostic centres from the patients or immediate relatives but how far they were informed in detail about the treatment or procedure test is a debatable issue and further there is no proof by the opposite party to show that the complainant was duly inform about the risk factors involved in the said procedure.  Just because consent was obtained in writing, the hospital or diagnostic centre cannot take it granted that they shall not be held responsible for any untoward incident happen.  In the present complaint the complainant alleged that the incidents as stated above occurred due to the negligence of the opposite party’s inexperienced and inefficient nurse, technician and their blatant dereliction of duty.  Whereas the opposite party contended that the nurse who attended the complainant was Ms. Rani has got seventeen years’ experience and the technician Mr. N. Gambieeswaran got thirteen years of experience and hence denied the allegation of the complainant.  On perusal of Ex.B3, the academic certificates of nurse and technician, it is observed that Mr. N.Gambieeswaran had passed first year of 3 years Diploma in Radiography Technology in the month of Jan. 2017 and from this it is inferred that he was supposed to complete his Diploma in Jan. 2019 only.  This incident happened in the month of Sep. 2019.  If at all he was qualified in Jan. 2019 then the experience gained by him was only 6 to 8 months and in such a case, he was not having experience of 12 years at the time of incident as contended by the opposite party.  On perusal of academic certificate of nurse Ms. Rani, it is observed that she had completed a short term certificate course in Fundamentals, MS-DOS, MS-WORD and MS-ACCESS held from Feb. 2002 to April 2002 which is a computer basics and from this it appears she is not a fully qualified nurse having 17 years of experience as contended by opposite party.  Hence it appears that opposite party had employed inexperienced technician and nursing assistant. Therefore, the contention of the opposite party that the risk was explained clearly to complainant before obtaining signature in consent form was not maintainable. 

The complainant alleged that nurse and technician never heed to the pain, cry and noise during the test dose and further ignored the swelling in left hand but proceeded injecting the contrast solution and completed the job at a faster rate which results bursting of her vein.  Whereas the opposite party in their averment contended that the needle of injection was inserted into the dorsum of complainant and at that time there was no complaint of any pain and afterwards the contrast injection was set through infusion pump and the technician again reminded to the complainant about the procedure.  The infusion of contrast was started at a standard rate and initially the complainant had no complaint, and the maximum quantity of contrast was injected into the vein and suddenly the complainant vomited and during the vomiting the complainant hand moved and immediately the technician stopped the infusion pump.  The opposite party further contended that because of the movement of the hand, only a small quantity of the contrast material extravasated on the dorsum of the left hand of the complainant.  Though the complainant admitted that she started vomiting during injection of contrast material but disputed that pricking, pain, swelling in left hand happened after vomiting.  The complainant contended that she reported the issues before injecting the contrast material but it was the opposite party’s staff ignored the same and continued the procedure.  It is quite normal whenever medicines are injected through veins to children, elderly persons they tend to move their hands without their knowledge and in general during sneeze, cough, vomit and it  is for the hospital or diagnostic centres to take adequate precautions to prevent the mobility of the hands and take after cause management to deal such situations but in the present case the opposite party failed to take such measures. In this instant complaint, complainant averred that the technician and nurse never heeded her pain, cry and swollen hand and inspite of reporting the same by the complainant, the opposite party’s technician and nurse continued their procedure.  As stated supra the opposite party have employed inexperienced technician and unqualified nurse and it appears that they have not handled the situation suitably or failed to report to the physician who was present at that time about the concerns of complainant during the injection of solution.  On perusal of Ex.B2, the Scan Report, no such issue was reported in the report and further no case sheet or notes or observations was filed by the opposite party which shows poor record maintenance by opposite party and in the absence of any such material evidence, we conclude that it is a clear negligence on the part of opposite party and therefore the contention of the opposite party is not sustainable.  However, the opposite party has admitted that a small quantity of contrast material got extravasated.

The complainant alleged that on complaining about the swelling, the opposite party had informed that it will get subsidized in an hour and she was sent to him without any first aid treatment for vomiting and swelling.  The opposite party on the contrary contends that Contrast media extravasation (CMEV) refers to the leakage of intravenously-administered contrast media from the normal intravascular compartment into surrounding soft tissues and it is well-known complication of contrast enhanced CT scanning.  The opposite party further contends that management of extravasation includes nursing intervention and thermal application and at the first stage of extravasation, with nursing intervention (i) administration of IV fluids stopped immediately and disconnect the IV tube from the cannula, (ii) Aspirate any remaining drug from the cannula, (iii) Administer drug-specific antidote and notify the physician, (iv) Local thermal treatments are used to decrease the site reaction and absorption of the infiltrate, (v) Local cooling (ice packs) aids in vasoconstriction, theoretically limiting the drug dispersion, (vi) Although clear benefit has not been demonstrated with thermal applications, it remains a stand supportive care, (vii) The recommended application schedule for both warm and cold applications is 15 to 20 minutes, every 4 hours, for 24 to 48 hours, (viii) Apply an ice pack to the affected area and elevate the affected extremity to reduce swelling and (ix) Keep the patient under observation for at least two hours.  The opposite party contends that they carried out the management as per protocol and further contends that risk factors can be classified under (a) Patient related factors (b) Procedure related factors (c) Product or Product related factors.  Further the opposite party contends that in this instant case the complainant’s vein was burst out and hence it is a case of patient related factor and the opposite had no role to play and in the case of procedure related factor a small complication arose that was attended properly that too due to shaking of hand by the complainant and in case of product or product related factors adequate choice of equipment is provided and hence there is no negligence on the part of the opposite party.  The opposite party further contended that complainant was given immediate treatment and was taken out of CT scan room and kept in observation room and the opposite party’s radiologist Dr. Ganesh Balaji saw the complainant and the advised the nurse to keep the hand elevated and also advised ice pack application.  Subsequently the complainant felt better and she did not have any further vomiting and when the complainant wanted to go home and she was allowed to go with a advise to keep her hand elevated and to continue applying ice pack at home.  The opposite party’s radiologist also advised the complainant to report back if the swelling does not subside within 3 to 4 hours but the complainant never turned up thereafter.  The learned counsel for opposite party during his oral submissions referred and relied a medical journal i.e. Journal of Education Evaluation for Health Professions by Prof. J. Educ Eval Health published on 10th August 2020 under Guidelines for the management of extravasation wherein under Introduction it is found that “Extravasation refers to the leakage of injected drugs from blood vessels causing damage to the surrounding tissues.  Common symptoms and signs of extravasation include pain, stinging or burning sensations and edema around the intravenous (IV) injection site.  In severe cases, extravasation may cause tissue dysfunction or physical defects, resulting in a delay of attempted treatment, patients’ distrust and numerous other issues.”It is also found that “the frequency of extravasation in adults is reported to be between 0.1% and 6%.  One of the risk factors under patient related factor is Vessels that may burst easily.  Under product related factors – Untrained or inexperienced staff, Multiple attempts at cannulation and High flow pressure.”Under management of extravasation various steps were recommended as stated in the early part of this paragraph and under Documentation it recommends “An incident of extravasation must be correctly documented and reported.  Documentation procedure may differ between treatment centres (documentation form); however, certain items are mandatory for patient safety and legal purposes: (1) patient name and number, (2) date and time of the extravasation, (3) name of the drug extravasated and the diluent used (if applicable), (4) signs and symptoms (also reported by the patient), (5) description of the IV access, (6) extravasation area (and the approximate amount of the drug extravasated), and (7) management steps  with time and date.”The learned counsel for opposite party in his oral submissions contended that adequate management of extravasation was taken care by the opposite party and in specific the opposite party’s radiologist Dr. Ganesh Balaji attended the complainant. On perusal of Ex.A5, Reply Notice wherein the opposite party had admitted that at the time of incident, the opposite party CT Scan centre was under the control of Radiologist Dr. Ganesh Balaji.  Whereas on perusal of Ex.B2, the Scan Report wherein it is found that the scan report was issued by one Dr.Anandakumar.V. Consultant Radiologist.  From the above, it appears that Dr.Anandakumr V was present at the time of incident and not Dr. Ganesh Balaji as contended by the opposite party.  The learned counsel for opposite party in his oral submissions relied on the medical journal stated supra and contended that opposite party had followed all the steps as recommended in the medical journal.  But it is observed that opposite party have not filed any documents of the extravasation management in support of their contention, which reveals that opposite party have totally failed to attend the complainant for extravasation of contrast material during the procedure and sent the complainant to home without any first aid/treatment.  It is found fromEx.B1, the declaration form on which the complainant consent was obtained by the opposite party wherein it is clearly mentioned that “If any reaction occurs, I will report to a hospital immediately”.  In this present complaint, even though the complainant had informed about the pain, swelling, bursting of vein due to the extravasation contrast material, which is an admitted fact by opposite party also, the opposite party failed to refer the complainant to a hospital.  On perusal of Ex.A1, the discharge summary, it is noticed that the complainant was diagnosed Acute Compartment Syndrome on Left Hand.  The complaints were stated “Pain and swelling in left hand since yesterday Patient underwent CT Scan abdomen for evaluation / Developed pain after IV contrast injection.”  Against local examination it is stated “Fullness of left hand both on dorsal and palmer aspects. Passive flexion of fingers are painful. SpO2 in fingertrips are 97-98% and Radial Pulse felt.”  Had the opposite party had taken proper steps immediately after occurrence of incident, the surgery could have been avoided.  From the observance of above discrepancies, we are of the concluded opinion that opposite party failed to attend the complainant and sent her home without first aid/treatment and the contention of the opposite party to the contrary is not proved. The above acts of the opposite party clearly amount to negligence and dereliction of duty during the procedure and after the procedure. 

The complainant alleged that after four to five hours the pain and swelling in her hands started increasing and the complainant was forced to approach the emergency department of M/s. Jayam Nursing Home at Old Washermanpet where the physical examination showed a pale, tense and swollen hand with blisters on the dorsal region and loss of sensation, capillary refill was increased and the patient was unable to move her fingers and any attempt to move so was extremely painful.  Conversative measures of treatments did not improve the symptoms.  On further diagnosis of the hand showed a significant accumulation of contrast within the extra-vascular space and acute compartment syndrome was diagnosed.  The complainant further contended that she was admitted on 18.09.2019 for surgery where longitudinal incisions through the 2nd and 4th metacarpals and interosseus metacarpal spaces decompressed.  Fullness in palmar aspect relieved.  Decompression done on dorsal subcutaneous compartment of fore-arm.  After adequate decompression bulky dressing was done and the complainant is continuing the treatment besides physiotherapy.  On the other hand, the opposite party contended that inspite of advice by Radiologist Dr. Ganesh Balaji the complainant did not turned up thereafter and therefore further increase of swelling is not aware.  The opposite party further contends that with such a small quantity of extravasation there is no possibility for acute compartment syndrome to develop. It is further contended that the complainant was admitted in the hospital on 18.09.2019 and if the complainant reported the same to opposite party when the swelling started increasing 4 hours after the injection with proper hand elevation and ice packs, acute compartment syndrome could have been avoided.  It is observed from the averment of the complainant that pain and swelling started increasing after 4 hours of scan and hence the complainant was forced to approach the emergency department of Jayam Nursing Home.  On perusal of Ex.A1, the complainant was admitted on 18.09.2019 at 12.25 p.m., surgery was on 18.09.2019 and discharged on 20.09.2019.  The complainant was diagnosed Acute Compartment Syndrome left and the nature of surgery was Decompression of dorsum of left hand and forearm.  From the above, it appears that complainant felt increasing of pain and swelling and approached the hospital who after examination conducted the surgery on 18.09.2019.  As stated in the previous paragraph the opposite party failed to take any steps for management of extravasation which resulted in Acute Compartment Syndrome.  Had the opposite party taken the complainant immediately to any hospital for further treatment Acute Compartment Syndrome could have been avoided which the opposite party failed.  Therefore, we are of the considered opinion that the contention of the opposite party for a small quantity of extravasation there is no possibility for acute compartment syndrome is not maintainable and it is the negligent and carelessness of the opposite party, the complainant had suffered with acute compartment syndrome for which she had to undergo surgery. 

Based on the observations from the above, this commission of the considered view that opposite party had employed inexperienced technician and unqualified nurse thereby caused negligence and deficiency in service in administering contrast material for CT Scan and further failed in the management of extravasation of contrast material with nursing and physician care and also failed to take the complainant to hospital for further treatment.  The above actions attributed for development of Acute Compartment Syndrome for which the complainant had to undergo surgery thereby caused damages and mental agony to complainant.  The complainant claimed that she is spent about Rs.1,00,000/- towards medical expenses out of which Rs.30,076 was reimbursed from mediclaim insurance and hence claimed Rs.70,000/- for the medical and other miscellaneous expenses incurred by the complainant but in the legal notice the complainant alleged that he is spent Rs.50,000/- towards medical expenses and considering the surgery undergone by the complainant in respect of acute compartment syndrome though there is no documents for the medical expenses incurred this commission is of the considered view that the complainant would have incurred Rs.50,000/- towards surgery and subsequent physiotherapy treatment and hence the opposite party is liable to pay the balance of Rs.20,000/- which was incurred by the complainant towards medical expenses. However, the complainant is entitled for compensation for the damages and mental agony and hence it is found that the opposite party has committed deficiency in service. Point No.1 is answered accordingly.

 

5. Point No.2.

            Based on findings given to the Point.No.1 for the negligence and deficiency in services committed by the opposite party, the complainant is entitled for Rs.20,000/- incurred towards medical expenses and Rs.2,00,000/-  towards compensation for damages and mental agony suffered by her and Rs.5,000/- towards cost of complaint.  Point no.2 answered accordingly.

          In the result the Complaint is partly allowed.  The Opposite Party is directed to pay Rs.20,000/- towards medical expenses incurred by her and also directed to pay Rs.2,00,000/- as compensation for damages and mental agony and Rs.5,000/- towards cost of complaint. The above amount shall be paid to the Complainant within two months from the date of receipt of the copy of this order, failing which the above said amount shall carry 9% interest from the date of order to till the date of payment. 

 

Dictated  by the Member II to the Steno-Typist taken down, transcribed and computerized by him, corrected by the President and pronounced by us in the open Commission on this the 21st day of November 2023.

 

MEMBER – I                   MEMBER II                      PRESIDENT

 

LIST OF DOCUMENTS MARKED ON THE SIDE OF THE COMPLAINANT:

Ex.A1

20.09.2019

Discharge Summary

Ex.A2

 

Photos of the complainant showing the injuries occurred due to the negligence of the opposite party

Ex.A3

 

Reimbursement statement of the medical claim insurance of the complainant

Ex.A4

03.10.2019

Legal notice issued by the complainant to the opposite party

Ex.A5

07.11.2019

Reply notice issued by the opposite party to the complainant

 

LIST OF DOCUMENTS MARKED ON THE SIDE OF OPPOSITE PARTY:

Ex.B1

17.09.2019

Consent Form

Ex.B2

17.09.2019

CT Scan Report

Ex.B3

 

Academic Certificates

Ex.B4

17.09.2019

CD of CT Scan

 

 

MEMBER – I               MEMBER-II                          PRESIDENT

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

CC.NO.110/2019, Dated:06.11.20203

Order Pronounced,

                   In the result the complaint is partly allowed, The opposite party is directed to pay a sum of Rs.25,000/-(Rupees Twenty Five Thousand only) to the complainant towards mental agony and loss sustained by the complainant. Further the opposite party is directed to remove the name of the complainant from the CIBIL records with adverse reference pertaining to the amount of Rs.8802.48/- within two months and also pay a sum of Rs. 5000/-(Rupees Five Thousand only) towards the cost of the complaint. The above amount shall be paid to the complainant within two months from the date of receipt of the copy of this order failing which the above said amount shall carry 9% interest from the date of this order to till the date of payment.

 

 

 

 

 

 

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5.0 (615)

Bhanu Pratap

Featured Recomended
Highly recommended!

Experties

Consumer Court | Cheque Bounce | Civil Cases | Criminal Cases | Matrimonial Disputes

Phone Number

7982270319

Dedicated team of best lawyers for all your legal queries. Our lawyers can help you for you Consumer Court related cases at very affordable fee.