Dr. Anumalla Satyanarayana Vs. K. Shankar - Court Judgment

Dr. (Mrs.) Mamata Lakshmanna, Member:

1. This appeal is preferred by opposite party Dr. Anumalla Satyanarayana aggrieved by the order dated 17.10.1997 in O.P. No. 287/1994 on the file of the District Forum, Nizamabad directing him to pay to Sri K. Shankar, respondent/complainant, Rs. 18,000/- towards medical expenses incurred by him and Rs. 30,000/- towards damages for his permanent disability (amputation of right leg) and Rs. 1,000/- towards costs of the complaint. Parties are referred to as in the O.P.

2. The case in brief is as follows : The complainant was suffering from pain in the right leg below knee due to exertion. As such he approached the opposite party for treatment on 2.7.1994. After examining he was admitted by the opposite party in his nursing home for 6 days but as the condition went on deteriorating, he on his own left the nursing home, went to Hyderabad and was admitted in Apollo Hospital on 8.7.1994. After the investigations, doctors at Apollo Hospital diagnosed that gangrene had settled in his right leg and it had to be amputated upto thigh level immediately as it was a danger to his life. On the consent of the complainant his right leg was amputated upto thigh i.e. just above the knee on 9.7.1994. After treatment he was discharged from hospital on 13.7.1994. After return, he lodged a complaint with the District Forum on 26.9.1994 accusing the opposite party for not treating him properly and attributing negligence in not preventing gangrene by proper treatment at an early stage so that his leg would not have been amputated.

3. The opposite party in his counter disputed the claim said that the complainant did not come under the definition of ‘consumer under Section 2(d) of the Consumer Protection Act, 1986 and hence the complaint should be dismissed. He also mentioned that he treated the complainant without charging any fee as he was brought by one Jagadeshwar, who worked in the medical shop on his premises. He stated that the complainant had pain in his right leg for the last four years and it had aggravated since last 45 days. The opposite party treated the patient only as out-patient and gave prescription free of cost on humanitarian grounds. When the complainant came to him on 2.7.1994, he was advised by opposite party to stop smoking and drinking and was explained the details of the prognosis of his case and was cautioned that unless he followed the treatment scrupulously he would lose his right leg. On 4.7.1994 the complainant came again and the opposite party prescribed him anti-diabetic drugs and also diet control so that his blood sugar could be controlled. The complainant was told that his restricted diet should not include rice, sugar, sweets, fruits, etc. After three days on 7.7.1994 the complainant got his urine examined. There was 1% sugar in the urine and on enquiry the opposite party learnt that the complainant was not able to stop smoking or drinking as advised and that he was not following the advice of his doctor which amounted to negligence on his part. On this visit the complainant did not report any aggravation of pain and, therefore, the opposite party concluded that the medicines prescribed by him were effective. He denied that the complainant was ever admitted as in-patient in “Satyasai Orthopaedic Nursing Home” which was run by him. He also stated that the doctors of Apollo Hospital did not mention that gangrene developed due to improper treatment during the last 6 days i.e. from 2.7.1994 to 7.7.1994. He refuted the charge that the leg had to be amputated due to his negligence and improper treatment by him. Gangrene would have developed if the complainant had neglected to follow the medical advice as given by him and about which he had already warned. He also denied that the complainant was earning Rs. 3,000/- per month through his business of selling goats and sheep and working as butcher. Since the complainant did not loose his leg due to his negligence, he was in no way responsible for the complainants disability or loss of income and therefore the complainant was not entitled to any compensation from him. The medicines prescribed by him were to halt the progress of the disease. There could be many reasons for grangrene developing and once it starts it could spread within hours.

4. In his cross-examination the opposite party stated that the complainant was brought to him by Jagadeshwar who had a medical shop on the premises. However subsequently he was not on cordial terms with Jagadeshwar by 20.10.1995 when the cross-examination was conducted. Jagadeshwar used to give lesser quantity of medicines prescribed by him and also charged full amount from the patients and on complaints from his patients he was warned. Jagadeshwar also mentioned in his cross-examination that he was no more running the medical shop nor going to the nursing home though earlier after disposing the medicines in the medical shop, he used to even help the opposite party in his clinic as a ward boy though without any payment. The appellant/opposite party mentioned that on 3.6.1994 one DSP Mr. S.P. Naidu was treated as in-patient and as such his name was there in the register (Ex. B1) submitted by him to the District Forum. Had the complainant been treated as in-patient the register would have mentioned his name also.

5. In the cross-examination of the complainant and his witness, they stated that the complainant was kept in bed immobile for 6 days with traction on his right leg after his admission in the nursing home of the opposite party. The opposite party and the complainant both mention that the complainant went to the opposite party on the recommendation of one Jagadeshwar, who was employed in the medical shop. The complainant presented Exhibits A1 to A8 and the opposite party Ex. B1. Ex. A1 dated 2.7.1994 was accepted by both the parties. It shows the medicines prescribed by the opposite party. The opposite party subsequently explained in detail why each of these medicines were prescribed. There is a second endorsement on the same Exhibit on 4.7.1994 by the opposite party. However, there is no receipt regarding payment of Rs. 1,000/- on admission on 2.7.1994 to the nursing home as claimed. Ex. A4 is the urine test report dated 7.7.1994 which shows Fasting Sugar nil, Post-lunch urine sugar 1%. All these were not denied by the opposite party. According to the complainant these tests were conducted while he was admitted in the nursing home and according to the opposite party these show the days when the complainant came to him for consultation. Ex. B1, said to be the admission register for the patients, is in fact in the form of a book containing consent forms. The District Forum therefore did not accept Ex. B1 as in-patient register. Ex. B1 contains the consent of the patient for investigation, treatment, plaster management under anaesthesia, etc. It also contains the particulars in the patients own handwriting about the ailments he was suffering from or causes if any for fractures, etc., that it was not a medico legal case. In this register there is no mention of the name of the complainant on the dates he was supposed to have been admitted in the said nursing home, most probably because no surgery was done. Exs. A2 and A5 are the receipts given by the Apollo Hospital for Rs. 9,000/- and Rs. 5,899/- respectively. Ex. A3 is the discharge summary of Apollo Hospital after his leg was amputated. Under “History of Present Illness” it says :

“A 52-year old male a known diabetic on irregular treatment has been having pain in the right leg on exertion since 4 years. History of intermittent claudication + pain increasing Swelling + No history of cough/SOB/chest pain.”

Exs. A6, A7 and A8 are X-rays which were taken at the clinic of the opposite party and denied by him as that of the patient/respondent.

6. Now the points for consideration are firstly, whether the opposite party was responsible for not treating the complainant properly when he was under his charge from 2.7.1994 to 7.7.1994 and could proper treatment have prevented the amputation of his right leg on 9.7.1994; and whether in case the complainant lost his right leg due to the negligence of the opposite party, is the complainant entitled for any compensation and if so, to what extent The contention of the opposite party that he treated the patient without charging any fee and hence he was not liable for paying any compensation is not valid because he admitted that he was running a private nursing home where patients were being treated on payment. Even if in this particular case he had not taken any fee, that did not exonerate him from the liability.

7. The complainant went for treatment to the opposite partys nursing home on 2.7.1994 as he complained of “pain in the right leg below the knee due to exertion”. There he was treated till 7.7.1994 and whether he was an in-patient or out-patient the opposite party did not deny the fact that he was under his treatment. On 8.7.1994 the complainant was admitted in Apollo Hospital at Hyderabad. According to the complainant, after all the investigations the doctors in the Apollo Hospital told him that due to negligence and improper treatment for 6 days initially gangrene was formed, and there was danger to his life unless the leg was amputated upto thigh immediately. Therefore, Dr. Jayaram Chander Pingle operated and amputated his right leg upto thigh i.e., just above the knee. Since the leg was amputated the complainant became permanently disabled. Apart from this disability, the complainant had to incur heavy expenditure, loss of earning and mental agony. The opposite party diagnosed that the complainant was suffering from `Thrombo Angitis obliterans” which pertains to the blood vessels in regard to flow of blood and treated him accordingly. The opposite party advised diet control orally which was not denied by the complainant. But while following all the instructions of the opposite party under his treatment, the pain was aggravated and the complainant on his own discontinued the treatment and came to Hyderabad. In other words, those last ten days prior to coming to Hyderabad and getting admitted in Apollo Hospital were crucial and the fact that the leg had to be amputated due to gangrene established that there was negligence on the part of the opposite party. If the opposite party could not give relief to the complainant or suspected that gangrene could set in (as he admits having warned the complainant) he should have referred him to a vascular specialist instead of continuing to treat himself.

8. We, therefore, are of the view that in the present case, the opposite party continued to treat the complainant according to his own diagnosis, though the complainant complained of no relief. The opposite party neither consulted another specialist nor referred the complainant to another hospital/specialist though he was a known diabetic. The opposite party admitted that in his condition, gangrene could set in any time. Which actually was diagnosed to be so on the very next day when the respondent was admitted in Apollo Hospital and his right leg was amputated on 9.7.1994. Loosing the leg must have been a traumatic experience apart from the inconvenience and expenditure involved. It has also meant loss of earning by the bread winner complainant.

9. We, therefore, uphold the order of the District Forum. The appeal stands rejected.

Appeal rejected.