National Consumer Disputes Redressal
Consumer Protection Council, ... vs Lifeline Hospital on 26 August, 2022
NATIONAL CONSUMER DISPUTES REDRESSAL COMMISSION NEW DELHI CONSUMER CASE NO. 12 OF 2008 1. CONSUMER PROTECTION COUNCIL, TAMILNADU 2, RMS BLDG, THILLAINAGAR MAIN ROAD, TIRUCHIRAPPALLI - 18. 2. M. K. Vaidyanathan 3, Dr. Radhakrishnan Nagar 2nd Street, Thiruvanmiyur, Chennai - 41 ...........Complainant(s) Versus 1. LIFELINE HOSPITAL REP. BY ITS MANAGING DIRECTOR, 5/639, OLD MAHABALIPURAM ROAD, PERUNGUDI CHENNAI - 96. 2. Dr. J.S. Rajkumar S/o. Dr. Shankaran, 47/3 New Avadi Road, Kilpauk, Chennai - 10. ...........Opp.Party(s)
BEFORE: HON'BLE DR. S.M. KANTIKAR,PRESIDING MEMBER HON'BLE MR. BINOY KUMAR,MEMBER
For the Complainant : For the Opp.Party :
Dated : 26 Aug 2022 ORDER
Appeared at the time of arguments
For the Complainants : Mr. S. Pushpavanam, in person
For the Opposite Parties : Mr. Sukumar Pattjoshi, Sr. Advocate with
Mr. Jitin Singhola, Advocate
Mr. Pravesh Bahuguna, Advocate
Dr. Raj Kumar, in person
Pronounced on: 26th August 2022
ORDER
DR. S.M. KANTIKAR, PRESIDING MEMBER
1. The instant Complaint was filed under Section 21 of the Consumer Protection Act, 1986 by the Registered Voluntary Consumer Organisation (Consumer Protection Council, Tamil Nadu) - Complainant No. 1 on behalf of M.K. Vaidyanathan - Complainant No. 2 for alleged medical negligence of the treating doctor and the hospital, causing death of his son, Vignesh.
2. The facts stated in the Complaint are that Mr. Vignesh, about 20 years, young MBA student (since deceased, hereinafter referred to as the "patient"), son of Mr. MK Vaidyanathan (Complainant No. 2) met Dr. J. S. Rajkumar (OP-2) in a gathering who assured his obesity treatment by Bariatric Surgery. The OP-2 assured to do the surgery without any complications at Lifeline Hospital, Chennai (for short 'Hospital'-OP-1) and he would lose about 50 Kg weight in 3-6 months and thereafter another 40 Kgs. The package of treatment was given Rs.3.25/- lakh. It was informed that the surgery was to be done in two steps i.e. 'Sleeve Gastrectomy' and then 'Duodenal Switch'. The OP-2 explained about the side effects and risks, gave the warning that the patient had to eat in smaller quantity of food at more frequent intervals.
3. Accordingly, on 24.03.2006 the OP-2 examined the patient and confirmed his Bio-Mass Index (BMI) as 64/65 and categorised the patient under super obese category. The OP-2 started on diet supplements called Optifast. The patient was admitted to Lifeline Hospital, Chennai on 04.04.2006 and the OP-2 performed the laparoscopic 'Sleeve Gastrectomy' on 05.04.2006. After the surgery, the OP-2 told the patient's father that the second procedure 'Duodenal Switch' was not necessary. On 06.04.2006 the patient was shifted to ward. On 08.04.2006, in the morning, patient complained severe abdominal pain. It was alleged that the OP-2 after examination told that there was a fluid collection in the abdomen and advised in the evening to perform an emergency short procedure (45 minutes) to remove the collection; but later on it was learnt that he had performed a regular surgery (exploratory laparotomy) by opening patient's abdomen. After 3- 4 days, the OP-2 informed the Complainant No.2 about the leak in the abdomen, therefore the patient was put on ventilator for better recovery. On 11.04.2006, the OP-2 informed the Complainant that patient developed septic shock and started injection Xigris costing about Rs. 2.5 lakh per injection. On 16.04.2006 further 'Cansidas' a medicine for the fungal infection was started. It was further alleged that, a film shooting was going on in the hospital premises on 17.04.2006 with hundreds of people polluting the entire atmosphere. The construction activity was also raising dust from the columns. It was alleged that due to prolonged ventilation, the OP-2 performed tracheostomy on 21.04.2006 and on the next day the patient was shifted to isolation ICU. On 25.04.2006, the OP-2 informed the patient's father and relatives that a leak was found and that the patient was having a 'Gastric Fistula'. Thus moping was needed for fast recovery. After 2 hours of the procedure, the OP-2 informed the patient's father that a third surgery for stomach removal might be necessary. Therefore, the Complainant alleged that the previous two surgeries were failure. The OP-2 referred the patient to Dr. Surendran at Apollo Hospital on 26.04.2006 only after paying total amount paid was Rs.27 lakhs while the package promised was for Rs. 3.25 lakhs. It was alleged that, the Complainant No. 2 came to know about the life-threatening infection from the doctors only on 26.04.2006, after admission to Apollo Hospital. Being aggrieved the father of the deceased filed the Consumer Complaint through Consumer Protection Council, Tamil Nadu against both the OPs and prayed compensation of Rs. 5 Crores plus Rs. 1 crore as punitive damages and Rs.50,000 to each Complainant towards cost of litigation.
4. The Opposite Parties filed their written version and denied the allegations of negligence. They have raised preliminary objections on maintainability as the prayer of complainant was exaggerated only to create jurisdiction for filing this complaint before this Commission. Apollo Hospital was not made a necessary party. The Complainant also initiated proceedings before Tamil Nadu Medical Council, Police authority but both absolved the Opposite Party(ies) of any negligence. The surgery was performed on written informed consent. In their reply OPs narrated the details of treatment given to the patient (stated in para 7 below). They have filed the copy of entire medical record. The OP-2 stated that he was ready to face an enquiry from expert bodies like Obesity Surgery Society of India (OSSI) and Indian Association of Gastro Intestinal Endosurgeons (IAGES). The patient was treated as per the standard of practice and there was no deficiency in service.
5. We have heard the arguments from the learned Counsel for both the sides. Perused the material on record, inter alia, the Medical Record and gave our thoughtful consideration. The authorised representative of the complainant and the learned counsel for OPs reiterated their facts and evidence.
Arguments on behalf of the Complainant:
6. The authorised representative Mr. S. Pushpavanam, the Secretary of Consumer Protection Council, Tamilnadu argued on behalf of Complainants. He reiterated the facts. He submitted that, this case pertains to wrong classification, negligence and defective Bariatric surgery on a young boy. The OP-2 misled the patient who believed that the operation would get rid him of obesity and avoid future risks. The patient was wrongly classified under Super obese category; but on the basis of BMI 64/65, weight 195 kg he ought to have been classified as Super Super obese. The mode of treatment changes as per the category of obesity. As per medical literature Bariatric surgery should be done when other nonsurgical methods failed and if life-threatening situation. In the instant case, the patient was normal before surgery, without any threat to his life.
Arguments from the Opposite Parties:
7. The learned Counsel for the Opposite Parties reiterated their reply and contents of their evidence. He submitted that, previously the patient took non-surgical treatment at R.K. Nature's Centre in Coimbatore, it is evident from the evidence of patient's mother before the trial court. He further argued that to facilitate to take expert opinion, the hospital issued original medical records on 16.05.2006 to R. K. Ramanathan on written request. He further argued that Methylene Blue test to detect leak after surgery was conducted. In present days it is not mandatory and hardly practiced by the Bariatric Surgeon. The Complainant manipulated / tempered the documents D-7 & P-23 by editing original contents electronically. It was detected by the forensic expert. He further argued that Dr. Surendran of Apollo Hospital was an interested party in the instant case and was not a Bariatric surgeon said to be an expert. The external drain put on 11.04.2006 was present still the time of discharge. Regarding the film shooting and construction work the Learned Counsel submitted that it was in the different area and the hospital premises and the O.T./ICU were not involved. Dr. Rajkumar (OP-2) is a well-qualified and experienced. He performed more than 100 surgeries before the instant case. He had adequate experience and expertise. The Tamil Nadu Medical Council (TNMC) and the committee constituted by the Director of Medical Education (DME) of three experts did not hold the OP-2 for medical negligence.
8. The learned Counsel for OPs relied upon following citations and medical literature:
Citations:
1. C.P. Sreekumar (Dr.), MS (Ortho) vs. S. Ramanujum[1]
2. V. Kishan Rao vs. Nikhil Super Speciality Hospital & Anr.[2]
3. Kusum Sharma and Ors. vs. Batra Hospital and Medical Research Centre & Ors.[3] Medical literature:
1. Article on Laparoscopic Sleeve Gastrectomy for the Super-Super-Obese.
2. Article on The Birmingham experience of high pressure methylene blue dye test during primary and provisional bariatric surgery.
3. Article on Routine Intraoperative leak testing for sleeve gastrectomy.
4. Copy of Article on Effects of intraoperative leak testing on postoperative leak-related outcomes after primary bariatric surgery.
5. Article on Intraoperative leak testing has no correlation with leak after laparoscopic sleeve gastrectomy.
Observations and Discussion:-
9. The allegations of the Complainant in nutshell are that the Opposite Parties failed to categorise the patient's obesity, eligibility for surgery, negligently prescribed the dietary supplement 'Optifast', the hospital hygiene was lost due to commercial venture by allowing film shooting in the same floor where operation theatres were located and the dusty construction activity. Some other allegations like medical record was fabricated, no pre-operative assessment and the OP-2 was not qualified and inexperienced.
10. On careful perusal of the medical record, the OP-2 made a pre-operative diagnosis as "Super obesity". On 05/04/2006 the "Laparoscopic - Sleeve Gastrectormy" performed. Intraoperative methylene blue test revealed no leakage. Surgery was completed at 7 pm and patient recovered well from anesthesia at 07:40 pm. He was extubated and shifted to ICU for further management. On the next day the patient was shifted to ward. The patient on 07/04/2006 complained of abdominal pain. The ultrasonography (USG) revealed no free fluid or no dilated bowel loops. The patient passed flatus / motion on 08/04/2006. At 6 pm, the intensity of pain increased and patient was febrile. USG was repeated at 07:30 pm which revealed fluid in both iliac fossa and pelvis. Therefore, a high risk informed consent was taken from the patient's mother for prolonged ventilatory support. The perforation was suspected and a laparotomy for closure of it was planned. After taking informed consent from patient's mother was taken surgery was conducted. A perforation was identified in the upper most end of stapled line of the stomach. It was closed with interrupted 2.0 vicryl stiches and omental onlay patch kept over it. Complete peritoneal lavage was given and drain tube was kept in hypochondrium. After the surgery, patient was shifted to ICU and was put on ventilator CMV mode. The collection from drain was recorded periodically in the case sheet. The patient was reviewed by various consultants like the intensivist, cardiologist, pulmonologist and nephrologist at regular intervals.
11. Thereafter, on 21/04/2006, tracheostomy was done and the patient was put on ventilator. The patient continued to have intermittent fever. The Culture and Sensitivity (C/S) tests were done form specimens collected from the ET tube (replaced twice) and Foley's urinary catheter. The patient was given appropriate antibiotics and medicines. The C/S of Central vein line tip did not show any organism. Further swab from ET tube for C/S twice showed Candida (patient's own flora). Patient's attenders were regularly appraised about patient's conditions. The medical record revealed us that, after 2nd surgery the patient showed steady improvement till 17th post-operative day (25.04.2006) but in the evening, the patient developed again a leak on the same side i.e. feature of gastric fistula, Therefore, the patient's parents were suggested about 3rd surgery for emergency exploratory laparotomy with a possible Gastrectomy (removal of stomach), but they in writing refused for consent and decided to shift the patient to other hospital. On 26.04.2006, they took discharge against medical advice (DAMA) at 5.10 am from OP-1 hospital and shifted to Apollo Hspital at 7 am. At the time of discharge the patient was conscious and hemodynamically stable. The doctors there were of the opinion that due to severe infection another surgery would be fatal. Unfortunately, in the same evening the patient suddenly became cyanosed, developed bradycardia and at 5.45 pm suffered a cardiac arrest. In spite of Cardio-Pulmonary Resuscitation (CPR) the patient could not be revived and declared dead at 07:00 pm. In our considered view, the emergency total Gastrectomy could have saved the life of patient. The Apollo Hospital gave the cause of death as "Morbid Obesity Explorative Laparotomy on 08.04.2006 (done elsewhere) Post-operative Gastric fistula / sepsis"
12. It is pertinent note that, the trial court after expediently looking into the method of selection of "sleeve gastrectomy" concluded that it was the simple and less complex procedure rather than other procedures and therefore held that, there was no wrong committed in selection of this procedure in bariatric surgery. It also noted that "intra-operative methylene blue test was done, but no leak was detected". As per literatures in our view, methylene blue test after surgery is not mandatory and now hardly being practiced by Bariatric surgeons. The allegation of not issuing medical record is not acceptable the Medical Superintendent issued the original record and obtained signature of Mr. Ramnathan. After shifting to Apollo Hospital, the necessary emergency surgery was not performed. The cause of death given as by Apollo Hospital was Post-operative Gastric fistula / sepsis, therefore postmortem was not done.
13. From the credentials on record, we find Dr. J. S. Rajkumar (OP-2) is a well-qualified, competent and experienced laparoscopic surgeon undergone special training on Bariatric surgery. He was one of the first to start bariatric surgery in the country. He was a visiting and teaching faculty in Sri Ramachandra Medical College at Chennai. Some opinions from best of the bariatric surgeons in India ruled out negligence on part of OP-2 doctor during surgery.The TNMC and the committee of DME of 3 experts concluded that there was no negligence. On the question of hospital hygiene, we do not find any relevance to the construction activity and film shooting. In that case the other patients also had suffered such infection, but it is not evident. The routine sterilization protocol by OT/ICU by swab cultures records was maintained. We note that construction work was going on and a cinema shooting was held on 17.04.2006 in the hospital premises. However, from the record it is evident that it was not nearer to the ICU or OT block.
14. Moreover, Optifast is not a medicine, but a very low calorie dietary supplement. It has no significant role for weight reduction in super obese patients and not mandatory to take for 6-9 weeks in super obese patients with BMI> 60.
15. As per the literature and standard books on Bariatric Surgery there are different classification method/schemes of obesity. The article on 'Body Mass Index', published by International Federation for the Surgery of Obesity and Metabolic disorders (IFSO) which classifies anyone with BMI>50 kg/m as super obese without any upper limit. The OP-2 followed the above classification. The complainant herein classified the patient by different method as Super - super obesity for BMI > 60 kg/m². Overall, it was only a subset of super obesity. Thus we do not see that OP-2 had committed any error and classified the patient as Super Obesity and it was not medical negligence. In our view, the choice of bariatric surgery to be performed is based on the BMI value rather than the scheme of classification[4]. It is also well established that bariatric surgery to be performed in two stages for those with BMI more than 60 kg/m². It was to avoid the high morbidity and mortality associated as with single stage operation. Hence, it was decided to perform initial Sleeve gastrectomy as the primary step and around 6- 12 months it is followed by the laparoscopic biliopancreatic diversion. It was a routine procedure done per operatively.
16. It should be borne in mind that the treatment package includes methylene blue test. However, in case for the repeat methylene blue test done post operatively, it was to be charged and reflected in the list of consumables. Therefore, the allegation of complainant about Methylene blue test was not done, is not acceptable to us.
Discussion on Expert Opinions:
17. We have gone through few expert opinions on record. The Expert Opinion sought by this commission from AIIMS dated 07.03.2008 was issued by Dr. T.K. Chattopadhyay -Prof. and Head of Department of G.I. Surgery who did not affirm any apparent negligence of the OP-2.
18. Opinion of Dr. T. S. Shanmugam - Professor, Dept. of Gen. & GI surgery, PSG Hospitals.
According to him for Super Obese individuals, the ideal procedure is staged operations. The first operation would be a simple restricted procedure like Sleeve Gastrectomy or Gastric Banding and the patient after losing sufficient weight, if he needs further weight loss, he can go for the second stage i.e Gastric Bypass (or) Duodenal Switch. In instant case after preoperative cardiac assessment and fitness given by anaesthetist, the OP-2 performed the ideal procedure of Sleeve Gastrectomy. He further pointed out that In India, CT Scan facility especially for obese patients is not available, therefore Ultrasound is normally used. Accoring to him the OP-2 performed surgery and treated the complications as per standards. Dr. T. S. Shanmugum has gone through the opinion of Dr. T. K. Chattopadhyay and expressed that any opinion on a case of Bariatric Surgery should only be given by a surgeon who has done Bariatric Surgeries.
19. Opinion of Dr. Muzzapar Lakadwala [The Chief, Dept. of Minimally Invasive and Bariatric Surgery, Saifee Hospital & Consultant Laproscopic surgeon at Lilavati Hospital at Mumbai] opined that the patient took non-surgical treatment for weight loss, but it was not helpful. The patient's was more than 175 kg and BMI - 67 kg/m². Due to failure of conservative method for weight reduction, bariatric surgery was the indication. In the instant case laparoscopic sleeve gastrectomy was the correct choice. He further opined that the surgery was performed after the clearance from cardiologist, intensivist and the anaesthetist. The surgical procedure was correct and intraoperative leak was check by methylene blue which showed no evidence of leak. The drain tubes were placed. He also commented that CT scan table can't accommodate such obese patient; therefore USG was done on 3rd post-operative day, which revealed an intra-abdominal collection which was highly suggestive of a leak. Therefore, the next step would be to take the patient up for diagnostic laparoscopy or an exploratory laparotomy at the earliest. The OP-2 had done in the instant case. It is normal practice in GI surgery with a morbid patient to perform tracheostomy up to 2 weeks as it was done in this case.
20. There was no obvious evidence of intra-abdominal sepsis. The cause of fever was investigated on daily basis by USG study, chest X rays, blood cultures, endotracheal cultures, blood counts. The Specialists including an infectious disease specialist, opined that the fever was only due to candida (fungus) grown in the endotracheal tube. Accordingly, antifungal treatment was given and the fever responded. Dr. Lakadwala opined that the line of treatment followed throughout was in line with normal procedure followed in a patient with a leak post sleeve gastrectomy. Bariatric Surgery like any other major surgery carries a small bit definite risk of death and it is unfortunate that this happened to this patient.
21. Opinion of the Association of Surgeons of India (ASI) Dr. Suresh Vasishta, the President of ASI, opined that the patient with staple line leaks, that are over sewn, will often develop re-leaks between 1 to 2 weeks. It has what had happened to the instant patient. Subsequently, developed gastric fistula and the patient was recommended a re-exploration to wash out, and/either Gastrectomy, and the patient would almost certainly be alive. But, the relatives of patient refused the suggestion of OP-2 for re-exploration, which resulted in a progressive deterioration. The OP-2 carried out extensive range of investigations to find the cause of sepsis like blood culture, urine culture, central line tip, endotracheal tube tip and USG etc. Despite the efforts the gastric fistula inevitably occurred, which should have been treated or explored immediately would have saved patient's life. Unfortunately, it was left untreated due to the DAMA discharge.
22. Opinion of Dr. Manoj Kumar, AIIMS, Patna According to him all the efforts were made to find out the cause of the sepsis. The culture samples from ETT, Blood and urine were sent. The USG was repeated. Despite all these measures, as the doctors were not able to find the source of the infection, the infectious diseases specialists, Dr. Ramasubramaniam, from Apollo Hospital, endorsed the treatment as correct and further advised to follow the same treatment. Dr. Manoj Kumar further opined that if the patient had undergone another (3rd) surgery on the day of transfer at Apollo on 25.04.2006, it was quite likely that the patient would have been saved. The gastric fistula with hypokalemic metabolic alkalosis, was diagnosed by OP-2, therefore an emergency surgery gastrectomy was eminent at that stage.
23. Opinion of Dr. Jaylal [President of State IMA and Secretary, TNMC] He opined that the abdominal collection was seen on the day before discharge, therefore the team of OP-2 offered a re-laparotomy, which was unfortunately refused by the patient's relatives. Shifting such a huge patient for a CT scan could be detrimental to the patient, thus USG was proper method for investigation. All 13 Doctors tried their best for the 20 days of hospitalisation. Appropriate drugs like Xigris, an antibiotic and Caspofungin an anti-fungal were used. It was affirmed by Dr. Ramasubramaniam, Head of the infectious disease unit in Apollo. Those two drugs were expensive and led to huge expenditure. According to him Dr. Surendran at Apollo should have operated and saved the patient. His failure to do so, the blame has been shifted on OP-2.
24. On collective reading of the expert opinions (supra), in our view, the procedures and treatment followed by OP-2 cannot be faulted. The OP-2 acted with the accepted reasonable standard of practice. Any post-operative complication/ mishap or happening straightway cannot constitute negligence.
25. We would like to rely upon the ratio laid down by the Hon'ble Supreme Court in the case of Sameera Kohli Vs. Dr. Prabha Manchanda & Anr[5] . It states that:
"it is for the doctor to decide, with reference to the condition of the patient, nature of the illness and the prevailing established practices as to how much information regarding the risk and consequences should be given and how they should be couched in the best interest of the patient. A doctor acting accordingly with normal care and in accordance with a recognized medical practice cannot be said to be negligent merely because body of opinion taken a contrary view. In modern medicine and surgery dissection of the various thing a doctor has to do in the exercise of his whole duty of care owned to his patient is neither legally meaningful nor medically practicable."
26. To sum up, in our considered view admittedly the patient was super obese category. The pre-operative routine investigations, TMT and ECHO were found within normal limit. As per standard protocol, on 05.04.4006 the OP-2 performed Sleeve Gastrectomy, the 1st stage of bariatric surgery. It was uneventful. After 4 days patient had symptoms of abdominal pain and on USG examination fluid collection seen, therefore on 08.04.20062nd surgery for closure of gastric leak was performed with interrupted 2.0 vicryl stitches and omental onlay patch. The medical record revealed us the patient was continuously monitored with relevant investigations like culture and sensitivity, electrolytes, ABG etc. The patient was under intensive care of specialists throughout for the treatment of sepsis. On 25.04.2006 patient developed features of gastric fistula, therefore emergency surgery was suggested, but it was refused by the patient's relatives. The 3rd emergency surgery was necessary which might have saved the patient. Moreover, we ignore the vague and unrelated submissions made by the AR for Complainant about the treatment of VIPs/ministers like Mr. Nitin Gadkari, late Mr. Arun Jaitley and Vice President Mr. Venkaih Naidu, who successfully took such treatment without any complications. It is also evident that Dr. Shrihari Dhorepatil at Pune who is considered as the father of Bariatric surgery; opined that there was no negligence from the OP-2. We further note the OPs took informed consent at every stage of treatment like laparotomy for gastric peroration closure, tracheostomy and other procedures. Also high risk handwritten informed consent is on record. We further note that on 26.04.2006 at the time of DAMA discharge the patient's relative in his handwriting clearly stated that on their own risk transporting the patient and for any untoward incident OPs or their staff are not liable. It was signed by the father of the Patient.
27. Considering the entirety and the expert opinions, the medical record and the literature on the subject, the Complainant failed to prove his case. The allegations need to be proved with cogent evidence.
28. In the recent judgment of Hon'ble Supreme Court in Bombay Hospital & Medical Research Centre vs. Asha Jaiswal & Ors.[6], whereby it was held in paragraphs 32 and 34 of judgment as below:-
32. In C.P. Sreekumar (Dr.), MS (Ortho) v. S. Ramanujam [7], this Court held that the Commission ought not to presume that the allegations in the complaint are inviolable truth even though they remained unsupported by any evidence. This Court held as under:
"37. We find from a reading of the order of the Commission that it proceeded on the basis that whatever had been alleged in the complaint by the respondent was in fact the inviolable truth even though it remained unsupported by any evidence. As already observed in Jacob Mathew case [(2005) 6 SCC 1 : 2005 SCC (Cri) 1369] the onus to prove medical negligence lies largely on the claimant and that this onus can be discharged by leading cogent evidence. A mere averment in a complaint which is denied by the other side can, by no stretch of imagination, be said to be evidence by which the case of the complainant can be said to be proved. It is the obligation of the complainant to provide the facta probanda as well as the facta probantia."
34. Recently, this Court in a judgment reported as Dr. Harish Kumar Khurana v. Joginder Singh & Others[8] held that hospital and the doctors are required to exercise sufficient care in treating the patient in all circumstances. However, in an unfortunate case, death may occur. It is necessary that sufficient material or medical evidence should be available before the adjudicating authority to arrive at the conclusion that death is due to medical negligence.
29. Similarly in the recent decision on April 20, 2022, the Hon'ble Supreme Court in the case of Dr. (Mrs.) Chanda Rani Akhouri & Ors. Vs Dr. MA Methusethupathi & Ors.[9] has laid down in no uncertain terms that merely because doctors could not save the patient, he/she cannot be held liable for medical negligence. In the case of S. K. Jhunjhunwala vs. Dhanwanti Kaur and Another[10] Hon'ble Supreme Court held that that there has to be direct nexus with these two factors to sue a doctor for negligence. It was further held that in every case where the treatment is not successful or the patient dies during surgery, it cannot be automatically assumed that the medical professional was negligent.
30. Based on the discussion above, the complainant conclusively failed to prove medical negligence of the opposite parties. The instant complaint is dismissed.
There shall be no order as to costs.
[1] (2009) 7SCC 130 [2] (2010) 5 SCC 513 [3] (2010) 3 SCC 480 [4] Rational for the surgical treatment of morbid obesity - http://www.asbs.org [5] AIR(2008) SC 138 [6] 2021 SCC OnLine SC 1149 [7] (2009) 7 SCC 130 [8] (2021) SCC Online SC 673 [9] 2022 LiveLaw (SC) 391 [10] (2019) 2 SCC 282 ...................... DR. S.M. KANTIKAR PRESIDING MEMBER ...................... BINOY KUMAR MEMBER