New Delhi: The National Consumer Dispute Redressal Commission absolved an ophthalmologist who was held negligent by the State Consumer Dispute Redressal Commission and observed that the injury on the eyes leading to the blindness of the patient was caused due to dengue fever and not due to delay in attending the patient by the ophthalmologist.
The fact of the case is that the complainant, the patient had suffered from high grade fever and visited to Ahuja Hospital, Sanoli Road, Panipat. After check-up, the doctor immediately referred for higher centre in Delhi. The complainant then visited to the hospital and the was diagnosed with ‘dengue’ and was admitted in ‘Intensive Care Unit”’ of the hospital, where various tests were conducted. Test report showed “Dengue NS-1 Antigen” as negative. Due to negligent treatment in ICU, his ‘Platelet Count’ started falling and his visibility of the eyesight of both the eyes became very low. The complainant informed the attending doctors and nurses about his low visibility but they ignored it. In intervening night his condition had become very critical. In morning on the next day the senior doctor came, he advised for MRI and referred to Krystal MRI Scan & Diagnostic Centre-I, Paschim Enclave, Main Road, Neer Peera Garhi Chowk, New Delhi. MRI report showed “Subcutaneous edema in the bilateral eyelids with pathological of wall of optic globes”. The doctors, however, failed to control infection in eyes of the complainant. The complainant lost visibility and was referred for ‘All India Institute of Medical Sciences, New Delhi (AIIMS), informing the father of the complainant that he was unable to diagnose the reason of loss of visibility. He was admitted in ‘Dr. Rajendra Prasad Centre For Ophthalmic’ of AIIMS, where he remained admitted for a fortnight but could not get any effective result. The complainant took treatment from many hospitals but could not regain his visibility in any of the eye. The complainant alleged that due to gross negligence committed by the doctors of the hospital, the complainant permanently became blind. If the hospital was not competent to handle the condition of the complainant, they should not have admitted him in the hospital.
The hospital defended itself and said that the patient was brought to the hospital in a critical condition with history of fever since five days with chills and with rigors, passing of blood in urine(haematurial), pain in abdomen since 3-4 days, an episode of hematemesis 2 days and ghabrahat on sitting 2 days. General condition of the patient was very poor. On examination, he was diagnosed to have acute febrile illness with sever thrombocytopenia with bleeding diathesis, bleeding gums. He also had purpuric spots on legs. He was immediately admitted to ICU and examined Senior Consultant & Unit Head of the hospital. Gastrointestinal bleeding was suspected. Blood test report showed platelets count nil. Keeping in view of symptomatology and the reports in the outbreak of dengue fever, 4 platelet concentrate and one unit of platelet apheresis were transfused to the patient. As there was bleeding from multiple sites, two units of FFP were also given along with IV fluids and other supportive therapy. His reports revealed severe life threatening thrombocytopenia, haemo concentration, mildly deranged prothrombin time, positive dengue serology suggestive of secondary or tertiary dengue infection. He had polyserocytis (right pleural effusion), moderate ascites and gall bladder was edema. His clinical symptom atology and investigations were suggestive of dengue haemorrhage fever. During his admission in ICU, the patient was looked after by a qualified ICU Resident Doctor who was well versed with critical care and was constantly monitored and supervised by the treating consultants. In view of dengue outbreak, special care was given to the patient throughout his admission in the hospital. On the complaint of blurred vision, he was referred to Senior Consultant Ophthalmologist, whose impression was intra orbital/cerebral haemorrhage and advised CT Scan Head & Orbit axial + coronal cuts thin sections. CT scan was done and report came at10:00 hours on 06.10.2008, which revealed focal hypo-densities left front parietal region near the covexity and no evidence of intra cranial haemorrhage was seen. Neurologist was consulted and the case was reviewed by Senior Consultant Ophthalmologist also, who suspected impression of acute optic neuritis, vitereous haemorrhage due to haze, no view was possible in fundus examination. He advised for MRI orbit to rule out vitreous haemorrhage and demyelinating? optic neuropathy. MRI was done on 06.10.2008, which revealed multiple micro-bleeds in the bilateral fronto parietal subcortical and periventricular white matter and basal ganglia. There was a subcutaneous edema in the bilateral eyelids with pathological thickening of wall of optic globes. The patient was bleeding in vital organs like eyes. His platelets were maintained at more than 50000/min by platelet transfusion and his prothembin time was maintained by giving this Fresh Frozen Plasma. Ophthalmologist team reviewed the patient on 07.10.2008 and observed that the patient epithelial edema+epithelial deficit over cornea both eyes. The eyes also had chemosis. As there was no improvement in patient’s vision, he was referred to AIIMS for further management. The hospital further said that the State Commission sought for an expert opinion from Maulana Azad Medical College, New Delhi, who formed a Medical Board. The Medical Board examined the papers and stated that no medical negligence was committed at the hospital during treatment of the patient. The complainant also made a complaint against the hospital and the treating doctors before Delhi Medical Council, who had conducted an inquiry and after hearing the parties found that the treatment as given to the patient in the hospital was per Standard Protocol and no negligence has been committed. Though the hospital and ophthalmologist was not held negligent the State Consumer Dispute Redressal Commission held them negligent on the ground that there was delay of 12 hours in starting the treatment by the ophthalmologist.
The apex consumer court observed that the State Commission has illegally ignored the MRI report, expert opinions and not considered the medical literature. The apex consumer forum further observed that in the present case, the injury was caused to the patient due to dengue fever and not due to delay in attending by the ophthalmologist. In view of the aforesaid discussions, the order of State Commission was set aside by the apex consumer court.