'Blatant Medical Negligence': Supreme Court Directs Surgeon To Pay Rs 3.5 Lakh To Patient Who Developed Infection After Cataract Operation

The Supreme Court restored the findings of the State Consumer Commission of Maharashtra which found that the present Respondent, an eye surgeon, had failed to diagnose and also further failed to take corrective steps after the Appellant developed an infection and abscess following a cataract operation. 

A bench of Justices Vikram Nath and PB Varale held that this amounted to medical negligence and overruled the finding of the National Consumer Disputes Redressal Commission (NCDRC) that there was no negligence.

"It was a blatant result of medical negligence by the respondent in post-operative care wherein corrective steps could have been taken, if the most reasonable and basic skills which were expected from the respondent-doctor, were applied," the Court held.

The Respondent is now directed to pay compensation of Rs.3,50,000 to the Appellant within 2 months, failing which the amount shall carry an interest of 12% per annum from the date of the judgment till its realisation.

Facts of the case

The present Appellant is the original complainant, who had developed a cataract in his right eye and had approached the Respondent, an eye surgeon at his clinic in Pune on January 11, 1999. After examination, the Respondent advised an operation to remove a cataract in the right eye. Thereafter, the operation was performed and the Appellant was discharged on the same night. 

On January 20, 1999, the Appellant visited the Respondent's doctor with a complaint of severe pain in the operated eye and headache. Thereafter, the Respondent changed the bandage of the operated eye, prescribed medicines along with eye drops and gave black glasses.

On his visit again for a checkup, the Appellant complained of intense pain in the operated eye. When the Respondent removed the bandage and examined the right eye, the Appellant could not even open his eye because of sticky fluid oozing out of his eyes. Still, the Respondent assured the Appellant that the operation was successful. The bandages were replaced and certain painkillers and eye drops were prescribed. However, the Appellant was rushed to the hospital again on January 25 where he was prescribed certain medicines and painkiller tablets. 

As per the Appellant, the condition of his eye has worsened and the pain became unbearable as a result of which he went to the doctor again on January 26. Again the Respondent told the Appellant that his eye was in good condition and he was again called for a checkup the next day.

On January 27, the Respondent cleaned the Appellant's eye with cotton and when the Appellant complained that he was unable to see anything, he was reassured that the vision would be restored to normal in a few days. He was advised to conduct the Blood Sugar Level test, which came out to be normal.

On January 27, the Appellant visited another doctor, who referred him to another eye specialist. The eye specialist opinionated that the operated eye was completely damaged. He was informed that if it is not removed in time, it may lead to further damage to the brain. The Appellant again sought a third medical opinion and contacted another doctor, who also gave an opinion that there was a septic infection in the operated eye which had led to complete damage and had to be removed. 

The Appellant was finally admitted to the Military Hospital where he was diagnosed with endophthalmitis. The operation was performed and the hospital succeeded in retaining the eyeball for cosmetic purposes but the Appellant lost his complete vision for the right eye. 

Before District Consumer Forum and State Consumer Commission 

Aggrieved about the loss of vision, money spent on doctor visits and the operation, the Appellant sent a legal notice to the Respondent for willful medical negligence and claimed Rs.10,00,000. Subsequently, the Appellant preferred a complaint before the District Consumer Forum, Pune, for medical negligence and prayed for a compensation of Rs.3,50,000.

However, the District Consumer Forum dismissed his Appellant's complaint on the grounds that he had not filed any expert evidence or affidavit of Doctors of Military Hospital. Thus, he failed to prove that the Respondent was negligent.

Aggrieved, the Appellant preferred an appeal before the State Consumer Commission of Maharashtra, which on November 26, 2015, partly allowed the Appellant's appeal and set aside the District Forum's order. It was concluded that the complainant had developed an infection after the operation of the cataract and the Respondent miserably failed to diagnose it and take the correct steps, which pointed out a clear-cut case of medical negligence. 

During the hearing before the State Commission, an expert opinion of an ophthalmologist was called by the Appellant's Counsel, which opined in favour of the Appellant. 

The Respondent was directed to pay a compensation of Rs.3,50,000 within a year, failing which the amount would carry an interest of 12% per annum. It also found that the doctor filed his reply without any case papers and the said case papers were filed only at the appellant stage to corroborate the written version.

Even the written revision had contradictions as the alleged original case papers had no entry of trauma which is alleged in the written version by the Respondent that since the Appellant had changed the bandages on his own, the same caused trauma.

Before NCDRC

Aggrieved by the said order, the Respondent preferred the Revision Petition before the NCDRC.

Appellant also aggrieved by the fact that the State Commission did not allow for the claim for special damages for the sufferings and mental agony preferred Revision Petition. Both revision petitions were heard together and were disposed of by a common order dated November 20, 2018. 

The NCDRC came to the conclusion that the Appellant had on his own changed the dressing of the operated eye which caused the displacement of the lens and the infection appears to be traumatic in nature. It was held that the development of endophthalmitis was due to traumatic injury and cannot be attributed to any fault or deficiency on the part of the Respondent during the cataract surgery.

Against the dismissal of the Revision, the instant appeal was filed before the Supreme Court. 

What did the Supreme Court observe?

The Supreme Court found the Respondent-doctor negligent in his diagnosing the Respondent's eye. It held: "Given the medical opinion reproduced above and the fact that the appellant made five visits to the respondent-doctor in a week's period while consistently complaining of immense pain in the operated eye, headache and lack of vision while the respondent kept reassuring him that the operation was successful and he would recover his vision eventually, whereas all the three other doctors who the appellant visited on 27.01.1999 opined that the appellant was suffering from endophthalmitis which has led to complete damage of the eye, it becomes evident that the respondent-doctor was negligent in his diagnosing the respondent's eye. It becomes clear that the respondent failed to detect the infection and clear the same in time despite several complaints by the appellant."

The Court also took notice of the medical opinion rendered before the State Commission by an ophthalmologist in which it was stated that oozing of pus after operation is not a usual occurrence. In cases where there is small amount of white discharge from the eye post-operation, it usually disappears within 48 hours.

It was further opined that oozing of pus after a cataract operation indicates the presence of infection in the operated eye which needs to be treated aggressively, both locally and systematically, to prevent further spread of infection.

It said: "With regard to the diagnosis of endophthalmitis after a cataract surgery, pain in the operated eye and no regaining of vision following operation were considered to be the two most important symptoms – a complaint that was consistently made by the appellant herein in his multiple visits to the respondent post-operation."

The Court found that the infection was diagnosed by the three doctors, but it was too late by then and the Appellant had to undergone evisceration of his right eye leading to loss of vision. . 

It was also held that no credible reliance can be put on the Respondent's written version which was not supported by enough evidence. 

Case Details: BHERULAL BHIMAJI OSWAL(D) BY LRs v. MADHUSUDAN N.KUMBHARE., ARISING OUT OF SLP (C.) NOS.11716-11717 OF 2019

Citation : 2024 LiveLaw (SC) 1044

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