Hospital and doctors held liable for medical negligence resulting in child's death, awarded Rs. 1 Crore compensation.

The Consumer Commission found Sankara Nethralaya and the doctors liable for gross medical negligence in a case involving the death of a child during surgery. The Commission awarded a total compensation of Rs. 1 Crore to the complainants, with Rs. 85 lakh to be paid by the hospital, Rs. 10 lakh by the anesthetist, and Rs. 5 lakh by the operating surgeon. An additional Rs. 1 lakh was awarded for litigation costs, with a 9% per annum interest for delayed payment.

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Issues Involved:
1. Alleged gross medical negligence and deficiency in service.
2. Jurisdiction of the Consumer Commission.
3. Examination and pre-operative assessment of the patient.
4. Administration of anesthesia and related procedures.
5. Timing and dosage of pre-medication.
6. Intubation and intra-operative care.
7. Post-operative care and communication with the complainants.
8. Vicarious liability of the hospital.
9. Quantum of compensation.

Issue-wise Detailed Analysis:

1. Alleged Gross Medical Negligence and Deficiency in Service:
The complainants, parents of the deceased child, alleged gross medical negligence and deficiency in service by Sankara Nethralaya and the doctors involved, which led to the death of their child during a squint correction surgery. The surgery was advised by Dr. S. Agarkar, and conducted by Dr. T.S. Surendran (OP-2) with anesthesia administered by Dr. R. Kanan (OP-3).

2. Jurisdiction of the Consumer Commission:
The Opposite Parties (OPs) raised a preliminary objection regarding the jurisdiction, arguing that the case required extensive and elaborate evidence suitable for a Civil Court. However, the Commission proceeded with the case under the Consumer Protection Act, 1986.

3. Examination and Pre-operative Assessment of the Patient:
The child was examined by Dr. S. Sujatha, who noticed a faint systolic murmur and chest wall abnormality, and referred the child to Cardiologist Dr. S. Bhaskaran. Dr. Bhaskaran, after further examination, declared the child fit for general anesthesia without recommending additional tests like ECG, ECHO, or X-ray. The Commission found this to be a failure in the duty of care, considering the child's congenital anomalies.

4. Administration of Anesthesia and Related Procedures:
The child was administered anesthesia by Dr. R. Kanan (OP-3). Halothane was used, which is known to cause bradycardia. The child was intubated after the administration of Scoline, which further precipitated bradycardia. The Commission noted that the anesthetist failed to recognize and manage the Oculocardiac Reflex (OCR), leading to the child's cardiac arrest.

5. Timing and Dosage of Pre-medication:
The complainants argued that Atropine, used to prevent bradycardia, was not administered at the correct dose or time. The Commission noted discrepancies in the records regarding the administration of Atropine and found that the child was not properly pre-medicated, contributing to the adverse outcome.

6. Intubation and Intra-operative Care:
The Commission observed that the first attempt at intubation failed, and the second attempt, following the administration of Scoline, led to severe bradycardia and cardiac arrest. The Commission found that the anesthetist should have cautioned the surgeon about the risks associated with Scoline in pediatric cases.

7. Post-operative Care and Communication with the Complainants:
The complainants were informed about the child's death two hours after the event, which the Commission found to be a delay. The discharge summary was vague and lacked details of the resuscitation efforts. The Commission noted that the hospital delayed providing the complete medical records to the complainants.

8. Vicarious Liability of the Hospital:
The Commission held Sankara Nethralaya vicariously liable for the negligence of its doctors. The hospital, being a reputable institution, was expected to ensure due and proper care by its staff.

9. Quantum of Compensation:
The Commission awarded a total compensation of Rs. 1 Crore to the complainants, considering the gross negligence and the fact that the complainants lost their only child. The compensation was divided as follows: Rs. 85 lakh to be paid by Sankara Nethralaya (OP-1), Rs. 10 lakh by the anesthetist Dr. R. Kanan (OP-3), and Rs. 5 lakh by the operating surgeon Dr. T.S. Surendran (OP-2). Additionally, Rs. 1 lakh was awarded towards the cost of litigation. The compensation amount was to be paid within six weeks, failing which it would carry an interest of 9% per annum until realization.

Conclusion:
The complaint was partly allowed, with the Commission finding the Opposite Parties liable for medical negligence and awarding compensation to the complainants.

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