State Consumer Disputes Redressal Commission
Surajbhan S/O Shri Late Naryan Singh vs Shekhawati Hospital & Research Centre on 20 September, 2022
1 jktLFkku jkT; miHkksDrk fookn izfrrks"k vk;ksx] t;iqj ifjokn la[;k 09@2020 lwjtHkku iq= LoxhZ; Jh ukjk;.k flag] tkfr cykbZ] mez yxHkx 60 o"kZ] fuoklh& Type 3/82, CPWD Colony, Sector 2, Nirman Vihar 1st, Vidhyadhar Nagar, Jaipur (Rajasthan).
ifjoknh cuke 01-'ks[kkokVh gkWfLiVy ,.M fjlpZ lsUVj (A Venture of Ganadhipati Purushottam Shekhawati Hospital Pvt. Ltd.), irk& ,@2] VkbZe LDok;j ds lkeus] lsUVªy LikbZu] fo|k/kj uxj] t;iqj] jktLFkku A 02-MkWDVj egs'k dqekj tkafxM+] MBBS, FMAS, DIPMAS Consultant Laparoscopic & General Surgeon, KMC No. 28808/12650, irk& 'ks[kkokVh gkWfLiVy ,.M fjlpZ lsUVj] (A Venture of Ganadhipati Purushottam Shekhawati Hospital Pvt. Ltd.), irk& ,@2] VkbZe LDok;j ds lkeus] lsUVªy LikbZu] fo|k/kj uxj] t;iqj] jktLFkku A foi{khx.k le{k%& ekuuh; Jh ,l-ds-tSu] ihBklhu lnL; ¼U;kf;d½ ekuuh; Jherh 'kksHkk flag] lnL;
mifLFkr%& ifjoknh dh vksj ls lkSjHk tSu] vf/koDrk foi{khx.k dh vksj ls Jh vuh'k dqekj 'kekZ] vf/koDrk fu.kZ; fnukad%&20-09-2022 jktLFkku jkT; miHkksDrk vk;ksx] t;iqj [}kjk Jh ,l-ds-tSu] ihBklhu lnL; ¼U;kf;d½] 2 jkT; miHkksDrk vk;ksx] t;iqj ifjokn la[;k 09@2020 lwjtHkku Vs 'ks[kkokVh gkWfLiVy ,.M fjlpZ lsUVj o vU;
fu.kZ; fnukad 20-09-2022 ifjoknh uss foi{kh la[;k 1 vLirky rFkk foi{kh la[;k 2 fpfdRld ds fo:) miHkksDrk laj{k.k vf/kfu;e]1986 dh /kkjk 17 ds rgr ;g ifjokn i= bl vk;ksx esa fnukad 13-01-2020 dks bu rF;ksa dk izLrqr fd;k fd ifjoknh us fnukad 08-08-2019 dks caly fDyfud Mk;XuksfLVd lsUVj ds ;gka viuh tkap djokbZ] rc mUgksaus vYVªklkm.M djokus dh lykg nh] bl ij ifjoknh us [k.Msyoky Mk;XuksfLVd lsUVj ds ;gka lksuksxzkQh djokbZ] rc irk pyk fd Gall Bladder esa iFkjh gS A ifjoknh us dsUnz ljdkj ls gSYFk Ldhe ds rgr vuqefr ysdj foi{kh la[;k 1 vLirky esa fnukad 09-08-2019 dks fn[kk;k rc foi{kh la[;k 2 fpfdRld us Laparoscopic Cholecystetomy dh lykg nh] ftldk lEiw.kZ [kpkZ 19]639@&:i;s crk;k] ftlds vuqlkj 90 izfr'kr jkf'k 17]670@&:i;s dsUnz ljdkj ls Lohd`r gq,] tks foi{kh la[;k 1 vLirky esa VªkalQj dj nh xbZ A foi{khx.k us vkWijs'ku ls igys leLr tk¡psa djokbZ rFkk fnukad 21-08-2019 dks ifjoknh dk vkWijs'ku fd;k x;k] fdUrq vkWijs'ku ds nkSjku ifjoknh ds iq= dks cqykdj ;g dgk x;k fd ifjoknh ds 'kjhj esa Gall Bladder gh ugha gS rFkk fnukad 23-08-2019 dks ifjoknh dks fMLpktZ dj fn;kA ifjoknh dh rdyhQ lgh ugha gqbZ] rc fnukad 26-08-2019 dks ifjoknh us iqu% lksuksxzkQh djokbZ] ftlesa iFkjh ekStwn feyh A bl izdkj foi{khx.k us ifjoknh ds 'kjhj esa phM+QkM+ djus ds ckn Hkh iFkjh dk vkWijs'ku ugha fd;k RkFkk >wBk vk'oklu nsd s j iSls ys fy;s A foi{khx.k us fnukad 28-08-2019 dks fQVusl izek.k i= Hkh ns fn;k A bl izdkj ifjoknh us foi{khx.k ls bykt esa [kpZ gqbZ jkf'k 6]000@&:i;s] 'kkjhfjd ihM+k dh {kfriwfrZ ds isVs 20]00]000@&:i;s] ekufld ihM+k dh {kfriwfrZ ds isVs 25]00]000@&:i;s rFkk ifjokn [kpZ o odhy Qhl dh ,ot esa 51]000@&:i;s fnyk;s tkus dk vuqrks"k pkgk gS A 02- foi{khx.k us tokc ifjokn i= izLrqr dj ;g fy[kk fd Laparoscopy ds nkSjku ;g ik;k x;k fd Gall Bladder vius lkekU; LFkku ij ekStwn ugha Fkk] blfy, Laparoscopic Cholecystetomy ugha dh xbZ cfYd dsoy 3 jkT; miHkksDrk vk;ksx] t;iqj ifjokn la[;k 09@2020 lwjtHkku Vs 'ks[kkokVh gkWfLiVy ,.M fjlpZ lsUVj o vU;
fu.kZ; fnukad 20-09-2022 Diagnostic Laparoscopic dh xbZ rFkk ;gh vkWijs'ku uksV esa fy[kk x;k A ifjoknh ds bykt ds isVs Diagnostic Laparoscopic ds fy, CGHS njksa ds vuqlkj 4]761@&:i;s pktZ fd;s x;s A foi{khx.k us vius tokc ifjokn i= esa ;g Hkh fy[kk fd foi{khx.k dh dksbZ ykijokgh ugha gS rFkk mUgksua s chek ikWfylh Hkh ys j[kh gS A bl izdkj mUgksua s ifjokn i= [kkfjt fd;s tkus dk fuosnu fd;k A 03- ifjoknh dh vksj ls Lo;a ifjoknh Jh lwjtHkku dk 'kiFk i= izLrqr fd;k x;k ,oa fofHkUu nLrkostkr izLrqr fd;s x;s A foi{khx.k dh vksj ls foi{kh la[;k 1 vLirky ds funs'kd Jh losZ'k 'kj.k tks'kh dk 'kiFk i= ,oa fofHkUu nLrkostkr izLrqr fd;s x;s] ftudk vko';drkuqlkj foospu fd;k tkosxk A 04- mHk;i{k ds fo}ku vf/koDrkx.k dh cgl lquh xbZ ,oa i=koyh dk voyksdu fd;k x;k A 05- fo}ku vf/koDrk ifjoknh dh vksj ls ;g cgl dh xbZ gS fd vk;ksx dh cSap us fnukad 11-11-2021 dks ,d vkns'k ikfjr fd;k fd Gall Bladder ifjoknh ds 'kjhj esa vius fuf'pr LFkku ij gS vFkok ugha] bl ckjs esa fo'ks"kK dh fjiksVZ is'k djokbZ tkos rFkk ;g Hkh funsZ'k fn;k x;k fd Laparoscopic Surgeon lkekU; vkWijs'ku djus ds fy, l{ke gS vFkok ugha A blds i'pkr~ ifjoknh us fnukad 25-11-2021] 26-11-2021 ,oa 27-11-2021 dks rhu LFkkuksa ls lksuksxzkQh djokdj fjiksVZ izLrqr dh gS A muds vuqlkj Whitle Point Diagonstic ds }kjk nh xbZ lksuksxzkQh fjiksVZ esa Gall Bladder vius LFkku ij ekStwn crk;k x;k gS] tcfd foi{khx.k ds vuqlkj Gall Bladder ifjoknh ds 'kjhj esa vius fuf'pr LFkku ij ugha Fkk A bl ckjs esa fo}ku vf/koDrk foi{khx.k dh vksj ls ;g cgl dh xbZ gS fd lksuksxzkQh vFkok ,Dl&js ls ;g irk ugha pyrk gS fd Gall Bladder vius fuf'pr LFkku ij gS vFkok ugha] tcfd Diagnostic Laparoscopic ls gh bl ckjs esa irk py ldrk gS rFkk foi{khx.k fpfdRld us tc Laparoscopic ls ns[kk rc Gall Bladder fuf'pr LFkku ij ugha fn[kk] blfy, Laparoscopic Cholecystetomy ugha 4 jkT; miHkksDrk vk;ksx] t;iqj ifjokn la[;k 09@2020 lwjtHkku Vs 'ks[kkokVh gkWfLiVy ,.M fjlpZ lsUVj o vU;
fu.kZ; fnukad 20-09-2022 dh xbZ A mudk ;g Hkh rdZ gS fd mlh le; ifjoknh ds iq= dks crk fn;k x;k Fkk rFkk vkWijs'ku uksV esa Hkh ;gh ckr fy[kh xbZ gS A foi{khx.k us ifjoknh ls Diagnostic Laparoscopic izfØ;k dh jkf'k gh olwy dh gS A bl izdkj foi{khx.k dh vksj ls dksbZ ykijokgh ugha dh xbZ gS A 06- i=koyh esa CGHS dh njsa vusDlpj&2 ds :Ik esa layXu gS A bl lwph ds Øekad 452 ij Laparoscopy dk pktZ 4]761@&:i;s crk;k gqvk gS rFkk Øekad 502 ij Laparoscopic Cholecystetomy dk pktZ 21]821@&:i;s crk;k gqvk gS A i=koyh esa vusDlpj&5 'ks[kkokVh gkWfLiVy ,.M fjlpZ lsUVj dk Qkbuy fcy layXu gS] tks dqy 17]670@&:i;s dk gS] ftlesa Laparoscopy dk pktZ 4]761@&:i;s tksM+k x;k gS A blds vykok vU; tkapksa ds pktZ tksM+s x;s gSa A bl izdkj bl Qkbuy fcy ls ;g Li"V gS fd foi{khx.k us Laparoscopy dk pktZ gh CGHS njksa ds vuqlkj 4]761@&:i;s fy;k gS vFkkZr~ Laparoscopic Cholecystetomy dk pktZ 21]821@&:i;s ugha tksM+s gSa A i=koyh esa vkWijs'ku uksV vusDlpj&1 layXu gS] ftlds voyksdu ls Hkh ;g Li"V gksrk gS fd fpfdRld us Laparoscopy djus ds ckn ;g fy[kk gS fd Gall Bladder vius fuf'pr LFkku ij ugha ik;k x;k gS] blfy, Laparoscopic Cholecystetomy laHko ugha gksus ls ugha dh xbZ gS A ifjoknh i{k Lo;a ekurk gS fd vkWijs'ku ds nkSjku gh foi{khx.k us ;g ckr crk nh Fkh A ;|fi ifjoknh us vius ifjokn i= ds iSjk la[;k 13 esa fy[k fn;k gS fd fpfdRld us Gall Bladder gh ugha gksuk crk;k Fkk fdUrq ifjoknh us ifjokn i= ds iSjk la[;k 15 esa ;g vkjksi Hkh yxk;k gS fd foi{khx.k us vkWijs'ku djuk rFkk Gall Bladder ls iFkjh fudyk nsuk crk;k Fkk A mDr nksuksa rF; fojks/kkHkklh gS] ftldk ;gh vFkZ fudyrk gS fd ifjoknh ds iq= dks foi{khx.k ds }kjk Laparoscopic Cholecystetomy ugha djuk crk fn;k x;k Fkk A 07- fo}ku vf/koDrk ifjoknh dk ;g rdZ Hkh jgk gS fd foi{khx.k us fnukad 28-08-2019 dks fQVusl izek.k i= izn'kZ&19 tkjh djrs gq, fnukad 30-08-2019 dks M~;wVh T;ksbu djus ds fy, fQV crk fn;k Fkk] blfy, 5 jkT; miHkksDrk vk;ksx] t;iqj ifjokn la[;k 09@2020 lwjtHkku Vs 'ks[kkokVh gkWfLiVy ,.M fjlpZ lsUVj o vU;
fu.kZ; fnukad 20-09-2022 bldk ;gh vFkZ fudysxk fd foi{khx.k us ifjoknh dh iFkjh fudky nsuk gh crk;k Fkk] fdUrq bl izek.k i= ls ge ;g ugha ikrs gSa fd bldk eryc vkWijs'ku dj fn;k tkuk gksxk D;ksfa d ftlds Gall Bladder esa iFkjh gksrh gS og O;fDr viuh M~;wVh T;ksbu djus ds fy, fQV gks ldrk gS A bl izek.k i= ds vk/kkj ij ;g fy[kk x;k gS fd ejht muds ;gka fnukad 20-08-2019 ls 23-08-2019 rd HkrhZ jgk gS rFkk 10 fnu vkjke djus dh lykg nh xbZ Fkh rFkk og fnukad 30-08-2019 dks viuh M~;wVh T;ksbu dj ldrk gS A 08- foi{khx.k dh vksj ls Medical Literature vusDlpj&6 izLrqr fd;k x;k gS] ftlesa fuEufyf[kr rF; egRoiw.kZ gS%& What are these bailout techniques/strategies ? There are five bailout strategies for a difficult gall bladder :
1. Abort the procedure altogether.
2. Covnert to an upon procedure.
3. Tube Cholecystostomy
4. Subtotal Cholecystectomy (STC, open/laparoscopic) ; and
5. Fundus first Cholecystectomy The Surgeon will need to use clinical judgement while performing the cholecystectomy in choosing a specific bailout technique. The best choice will depend on the clinical situation and the experience/expertise of the surgeon.
mijksDr Literature ds vuqlkj difficult gall bladder ds ekeys esa fpfdRld mijksDr of.kZr iakp rjhdksa essa ls dksbZ Hkh rjhdk viuk ldrk gS A uEcj ,d rjhds dks viukrs gq, foi{kh la[;k 2 fpfdRld us ifjoknh dh Cholecystetomy ugha dh gS] cfYd Diagnostic Laparoscopic djds ifjoknh ds ifjtu dks crk fn;k gS A foi{khx.k dh vksj ls fo'ks"kKh; fjiksVZ ds :Ik esa MkWDVj lqjs'k dqekj lSuh] ,e-,l-] Mh-,u-ch-&,l,l-] tujy ,.M 6 jkT; miHkksDrk vk;ksx] t;iqj ifjokn la[;k 09@2020 lwjtHkku Vs 'ks[kkokVh gkWfLiVy ,.M fjlpZ lsUVj o vU;
fu.kZ; fnukad 20-09-2022 xsLVªks,uVªksyksth ltZu dh fjiksVZ izLrqr dh xbZ gS] ftUgksaus foi{kh la[;k 2 fpfdRld ds }kjk viukbZ xbZ izfØ;k dks lgh crk;k gS A 08- ifjoknh dh vksj ls fnukad 25-11-2021] 26-11-2021 ,oa 27-11-2021 dh rhu lksuksxzkQh fjiksVZ~l izLrqr dh xbZ gS] ftuesa fnukad 25-11-2021 ,oa 26-11-2021 dh tks lksuksxzkQh fjiksVZ gS] mlessa Gall Bladder ds ckjs esa ;g ugha crk;k x;k gS fd Gall Bladder vius fuf'pr LFkku ij gS vFkok ugha A blh izdkj ifjoknh Lo;a us bl fookfnr Diagnostic Laparoscopic ds ckn fnukad 26-08-2019 dks lksuksxzkQh djokdj fjiksVZ izn'kZ&18 izLrqr dh gS] ftlesa Hkh Gall Bladder ds 'kjhj esa fuf'pr LFkku ij fLFkr gksus ds ckjs esa dqN ugha fy[kk gqvk gS A foi{khx.k ds }kjk ifjoknh dh tks lksuksxzkQh djokbZ xbZ gS rFkk ifjoknh dh Diagnostic Laparoscopic djus ls igys Lo;a ifjoknh ds }kjk tks lksuksxzkQh djokbZ xbZ Fkh mlesa Hkh Gall Bladder vius fuf'pr LFkku ij gksus vFkok ugha gksus ds ckjs esa dksbZ vadu ugha gS A bl izdkj foi{khx.k dk ;g dguk lgh ekuk tkosxk fd lksuksxzkQh vFkok ,Dl&js vkfn ls ;g irk ugha pyrk gS fd Gall Bladder vius fuf'pr LFkku ij gS vFkok ugha A ,slk yxrk gS fd ifjoknh us fnukad 27-11-2021 dks djokbZ xbZ lksuksxzkQh dh tks fjiksVZ izLrqr dh gS] mlesa Vital Point Diagnostics ls feydj Gall Bladder dks fuf'pr LFkku ij fLFkr gksuk fy[kk fy;k gS A ifjoknh dh vksj ls ,slh dksbZ fo'ks"kKh; fjiksVZ izLrqr ugha dh xbZ gS ftlds vk/kkj ij ;g fu"d"kZ fudkyk tk lds fd ifjoknh ds 'kjhj esa Gall Bladder fuf'pr LFkku ij Fkk vFkok ugha] tcfd foi{khx.k us ifjoknh dh Diagnostic Laparoscopic djds ;g ik;k gS fd ifjoknh ds 'kjhj esa Gall Bladder fuf'pr LFkku ij ugha Fkk] blhfy, muds }kjk Laparoscopic Cholecystetomy ugha dh xbZ A foi{khx.k dk ;g dk;Z Medical Literature ds vuqlkj Hkh lgh gS rFkk foi{khx.k us CGHS dh njkas ds vuqlkj Diagnostic Laparoscopic dk pktZ 4]761@&:i;s gh Qkbuy fcy esa tksM+k gS vFkkZr~ mUgksaus Laparoscopic Cholecystetomy dk pktZ 21]821@&:i;s vius Qkbuy fcy esa ugha tksM+k gSA bl izdkj ge ;g ikrs 7 jkT; miHkksDrk vk;ksx] t;iqj ifjokn la[;k 09@2020 lwjtHkku Vs 'ks[kkokVh gkWfLiVy ,.M fjlpZ lsUVj o vU;
fu.kZ; fnukad 20-09-2022 gSa fd foi{khx.k ds }kjk dksbZ fpfdRldh; ykijokgh ugha dh xbZ A Qyr% ifjoknh ds }kjk izLrqr ;g ifjokn i= [kkfjt fd;s tkus ;ksX; gS A vkns'k ifjoknh ds }kjk izLrqr ;g ifjokn i= foi{kh la[;k 1 o 2 ds fo:) [kkfjt fd;k tkrk gS A [kpkZ mHk;i{k viuk&viuk Lo;a ogu djsxsa A ¼'kksHkk flag½ ¼,l-ds-tSu½ lnL; ihBklhu lnL; ¼U;kf;d½ fVdaj