State Consumer Disputes Redressal Commission
Sarthi Hospital, Superintendent vs Subhashchand Singh on 24 August, 2023
Reportable
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1.Sarthi Hospital, 1685-A, BSNL, Circle, R.K. Puram, Kota through Hospital Superintendent.
2. Dr. Ritika Mathur, M.B.B.S., (DGO), Gynaecologist, Sarthi Hospital, R.k. Puram, Kota (Raj.)
3. Dr. Ritu Panwar, Gynacologist, Sarthi Hospital, R.k. Puram, Kota (Raj.) Appellants/Non-Applicants VERSUS
1. Subhashchand, Son of Shri Mahaveer Sing, by cast Jat, aged 30 years, resident of hariom Nagar, Kachchi Basti, Mahaveer Nagar, Kota, at present resident at C/o Shri Shivcharan, Nayapura, Near Bus stand, Nayapura, Kota (Raj.) Respondent-Complainant
2. Divisional Manager, United India Insurance Company Ltd, Divisional Office, Aerodrome Circle, Jhalawar Road, Kota, (Raj.) Respondent le{k%& ekuuh; Jh ,l-ds-tSu] ihBklhu lnL; ¼U;kf;d½ ekuuh; Jh 'kSysUnz HkV~V] lnL;
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fu.kZ; fnukad%& 24-08-2023 rk&vnk;xh 9 izfr'kr lk/kkj.k okf"kZd dh nj ls C;kt dh jkf'k izkIr djus dk vf/kdkjh gksxk] ftlds vnk;xh dk leLr o lEiw.kZ nkf;Ro vizkFkhZ&1 ls 3 dk gh gksxkA 3- izkFkhZ dh 'ks"k izkFkZuk vLohdkj dh tkrh gS o vizkFkhZ&4 chek dEiuh ds fo:) izkFkhZ dk ifjokn [kkfjt fd;k tkrk gSA 02- laf{kIr rF;ksa ds vuqlkj ifjoknh&izR;FkhZ lqHkk"kpan us miHkksDrk laj{k.k vf/kfu;e] 1986 ds rgr vihykFkhZx.k ,oa foi{kh la[;k 4 chek dEiuh ds fo:) fo}ku ftyk miHkksDrk vk;ksx] dksVk esa ,d ifjokni= bu vfHkopuksa ds lkFk izLrqr fd;k fd mlus viuh iRuh Jherh deys'k pkS/kjh dks fnukad 01-07-2014 dks izlo ihM+k gksus ij foi{kh la[;k 1 vLirky esa HkrhZ djok;k rc 10]000@&:i;s vfxze tek djok;s] foi{kh la[;k 1 esa dk;Zjr fpfdRld foi{kh la[;k 2 MkW- fjfrdk ekFkqj ,oa foi{kh la[;k 3 MkW- fjrq iaokj us ejht dk fujh{k.k djus ds i'pkr lkekU; izlo gksuk crk;k fdUrq fnukad 02-07-2014 dks vkWijs'ku djus dh ckr dgh] fnukad 02-07-2014 dks ifjoknh dh iRuh dk vkWijs'ku (LSCS) fd;k x;k rc ,d dU;k dk tUe gqvk fdUrq foi{khx.k ds }kjk vlko/kkuhiwoZd vkWijs'ku djus ls ifjoknh dh iRuh ds xHkkZ'k; ,oa isV esa pksV dkfjr gks xbZ] ftldh otg ls vf/kd jDrL=ko gks x;k rc fnukad 03]07-2014 ,oa fnukad 04-07-2014 dks dqN tkaps djk;h xbZA foi{khx.k&vihykFkhZx.k us vlkekU; Bleeding ds nkSjku gh ifjoknh dh iRuh dks fMLpktZ dj fn;kA fnukad 07-07-2014 dks jDrL=ko tkjh jgus ds dkj.k iqu% foi{kh la[;k 1 ds vLirky esa HkrhZ fd;k x;k Fkk] nokb;k¡ nsdj mlh fnu fMLpktZ dj fn;k x;kA ejht dh gkyr esa lq/kkj ugha gksus ij fnukad 09-07-2014 dks iqu% foi{kh&vihykFkhZ vLirky esa HkrhZ djok;k x;k ,oa 15 fnuksa rd bykt djrs jgs fdUrq ifjoknh dh iRuh dh gkyr esa lq/kkj ugha gqvk rc fnukad 21-07-3014 dks foi{khx.k&vihykFkhZx.k us MkW- fnus'k ftUny ds fy, jsQj dj fn;kA MkW- ftUny us USS All Abdominal Sonography and cystoscopy MRI djokbZ rc ;g ik;k x;k fd vkWijs'ku ds nkSjku ejht ds isV esa 0.5cm 4 jkT; miHkksDrk vk;ksx lfdZV cSap] dksVk vihy la[;k 47@2021 lkFkhZ gkWfLiVy ,oa vU;
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fu.kZ; fnukad%& 24-08-2023 x 0.05cm x .04cm dk dV yx x;kA MkW- ftUny ds mipkj ls Hkh ejht dh gkyr esa lq/kkj ugha gqvk rc Hkkjr fodkl ifj"kn fpfdRlky; esa fnukad 20-08-2014 dks HkrhZ fd;k rFkk 26]08-2014 rd bykt fd;k tkrk jgk ,oa 26-08-2014 dks fMLpktZ dj fn;k x;k fdUrq ejht dh gkyr esa lq/kkj ugha gqvk rc ifjoknh us MkW- fuys'k dqekj dks ,e-ch-,l vLirky] dksVk esa fn[kk;k rc mUgksus ejht dh cystoscopy tk¡p djokbZA muds ijke'kZ ds vuqlkj fnukad 10-11-2014 dks ,e-ch-,l vLirky esa HkrhZ djk;k ,oa fnukad 29-12-2014 dks ejht dk iqu% vkWijs'ku dj bykt o mipkj fd;k x;kA mlds ckn fnukad 09-12-2014 dks fMLpktZ fd;k x;kA ifjoknh ds vuqlkj foi{khx.k ds }kjk fnukad 02-07-2014 dks fd;s x;s izlo vkWijs'ku ds nkSjku xQyr ,oa ykijokgh ls pksV dkfjr dj nh] ftlls tku dk [krjk gks x;kA bl izdkj foi{khx.k dk ;g d`R; xQyr ,oa ykijokgh dk gSA ifjoknh us bykt [kpZ isVs 80]000@&:i;s] ekufld larki isVs 2]00]000@&:i;s] 'kkjhfjd larki isVs 2]00]000@&:i;s] uotkr f'k'kq ds ekr`Ro lq[k ls oafpr jgus ds isVs 1]50]000@&:i;s ,oa vU; [kpksZ ds isVs 70]000@&:i;s bl izdkj dqy 7]00]000@&:i;s fnyokus dk fuosnu fd;k A 03- foi{kh la[;k 1 yxk;r 3 vihykFkhZx.k us tokc ifjokni= izLrqr dj ;g fy[kk fd tc ifjoknh dh iRuh fnukad 01-07-2014 dks lka; 8 cts muds vLirky vk;h rc rhu eghuksa ls cPpsnkuh ds jkLrs ls jDrL=ko gks jgk Fkk rFkk ;g crk;k Fkk fd xHkkZoLFkk ds nkSjku fdlh Hkh MkWDVj dks ugha fn[kk;k x;k gSA ejht us ;g Hkh crk;k Fkk fd 10 o"kZ igys ,d cPpk muds xHkZ esa gh [kRe gks x;k Fkk rFkk ?kj ij gh ukseZy fMyhojh gqbZ FkhA nwljh ckj izsXkusUlh gksus ij vkWijs'ku ls yM+dh iSnk gqbZ Fkh] tks ej xbZ FkhA rhljh ckj vkWijs'ku ls yM+dk gqvk Fkk rFkk ml le; ;g lykg nh xbZ Fkh fd vc xHkZorh ugha gksuk gSA mUgksus ;g Hkh fy[kk fd ejht dh xaHkhj gkyr dks ns[kdj 'kh?kz vkWijs'ku djkus dh lykg nh FkhA lksuksxzkQh fjiksVZ ds vuqlkj cPpk vkM+k FkkA ejht dk xqnkZ vlkekU; Fkk] fiÙk rFkk is'kkc dh FkSyh esa iFkjh FkhA bl izdkj ;g 5 jkT; miHkksDrk vk;ksx lfdZV cSap] dksVk vihy la[;k 47@2021 lkFkhZ gkWfLiVy ,oa vU;
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fu.kZ; fnukad%& 24-08-2023 ekeyk gkbZ fjLd izsxusUlh dk Fkk] rc vkWijs'ku fd;k x;k] ftlls yM+dh iSnk gqbZA ;g Hkh fy[kk x;k gS fd ejht rFkk mlds ifjtuksa ds }kjk fMLpktZ fd;s tkus dk ncko fd;s tkus ij fnukad 04-07-2014 dks fMLpktZ fVdV Hkh cuk;k Fkk fdUrq ckn esa fMLpktZ ugha djds bykt fd;k x;k ,oa fnukad 07-07-2014 dks fMLpktZ fd;k x;k Fkk rFkk dsFksVj ugha gVkus dh lykg nh xbZ FkhA bl izdkj foi{khx.k ds vuqlkj fnukad 01-07-2014 ls fnukad 07-07-2014 rd ifjoknh dh iRuh yxkrkj HkrhZ jgh FkhA fnukad 11-07-2014 dks ejht us MkW- fuys'k tSu dks fn[kk;k FkkA fnukad 14-07-2014 ls 18-07-2014 rd ifjoknh dh iRuh muds vLirky esa HkrhZ jgh FkhA fnukad 21-07-2014 dks jsQj fd;k x;k FkkA ;g Hkh fy[kk x;k gS fd okLrfod fLFkfr ds vuqlkj ejht dk 3 ekg ckn gh iqu% vkWijs'ku fd;k tk ldrk Fkk] tks MkW- fuys'k tSu ds }kjk fd;k x;kA foi{khx.k ds vuqlkj LVs.MMZ izksVksdkWy ds vuqlkj vkWijs'ku fd;k x;k FkkA ;g Hkh fy[kk x;k gS fd foi{kh la[;k 2 us foi{kh la[;k 4 ls chek ikWfylh ys j[kh gSA 04- bl ekeys esa foi{kh la[;k 2 ds vkosnu&i= ij foi{kh la[;k 4 chek dEiuh dks i{kdkj cuk;k x;k rFkk mUgksus i`Fkd tokc ifjokni= izLrqr fd;kA ftUgksus tokc ifjokni= izLrqr dj ;g fy[kk fd chek/kkjh ds }kjk mUgs lwfpr ugha fd;k x;k FkkA 05- fo}ku ftyk miHkksDrk vk;ksx us mHk;i{k dh cgl lqudj foi{kh la[;k 1 yxk;r 3 ds fo:) mijksDr of.kZr vkns'k ikfjr djrs gq, ifjokni= Lohdkj fd;k fdUrq foi{kh la[;k 4 chek dEiuh ds fo:) ifjokni= [kkfjt dj fn;k] bl vkns'k ls O;fFkr gksdj foi{kh la[;k 1 yxk;r 3 ds }kjk ;g vihy izLrqr dh xbZ gSA 06- mHk;i{k ds fo}ku vf/koDrkx.k dh cgl lquh xbZ ,oa i=koyh dk voyksdu fd;k x;kA 07- vkWijs'ku ls fMyhojh djkus ds ckjs esa fpfdRlk 'kkL= dks ns[kk tkos rks fuEufyf[kr egRoiw.kZ gS%& 6 jkT; miHkksDrk vk;ksx lfdZV cSap] dksVk vihy la[;k 47@2021 lkFkhZ gkWfLiVy ,oa vU;
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fu.kZ; fnukad%& 24-08-2023 ¼1) What is a C-Section?
A C-section, also called a cesarean section or cesarian delivery, is a surgical procedure in which a baby is delivered through incisions in your abdomen and uterus. They're performed when a vaginal delivery is not possible or safe, or when the health of you or your baby is at risk.
(2) What are the risks involved in a C-Section?
(i) Haemorrhage and Shock.
(ii) Infection.
(iii) Extension of incision and haematoma Formation.
(iv) Injury to bladder opening of the parietal peritoneum whilst extending the incision downwards, or during mobilization of the bladder from the lower uterine segment at the time of opening the utero- vessical flod, and blunt dissection to separate the bladder.
(v) Injury to the ureter particularly when the incision in the lower uterine segment extends laterally and attempts are made to suture it without proper identification of tissues.
(vi) Injury to bowel.
(vii) Paralytic ileus and peritonitis, and distention.
(viii) Formation of pelvic abscess.
(ix) Pelvic thrombophlebitis and later septic emboli.
(x) Thromboembolism and disseminated intravascular coagulation.
(xi) Pulmonary embolism and lung infection.
(xii) Anaesthetic complications - aspiration, hypotension, cardiac arrest.
(xiii) Burst abdomen.
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fu.kZ; fnukad%& 24-08-2023
(xiv) Fistulas.
(xv) Death.
C-section esa mijksDr complications gks ldrs gSaA gLrxr izdj.k esa bl rF; ij dksbZ fookn ugha gS fd foi{kh la[;k 2 MkW fjfrdk ekFkqj i;kZIr 'kS{kf.kd ;ksX;rk ,oa vuqHko j[krh gSA 08- gLrxr izdj.k esa MkW- fnus'k ftUny ds }kjk fnukad 21-07-2014 dks cystoscopy djk;h xbZ gS] ftldh fjiksVZ ds vuqlkj ifjoknh dh iRuh ds Small Vesicouterine Fistula ik;k x;k gSA Vesicouterine Fistula ds ckjs esa fpfdRlk lkfgR; dk voyksdu fd;k x;k] ftls fuEu izdkj le>k tk ldrk gS& ^^Vesicouterine Fistulas (VUF) are the least common type of urogenital fistulas, which is defined as an uncommon communication between the bladder and the uterus or the cervix. It may have an early or delayed presentation. Patients usually experience urinary incontinence (Intermittent or continuous) which may be associated with hematuria. The diagnosis is usually made with cystoscopy, cystography and/or computed to mography (CT) scan. It is usually recommended to delay surgical repair. However, recent cases demonstrate successful fistula closure with conservative management. We report 3 cases of successful surgical repair of VUFs. Two of these patients had an early repair.
Vesicouterine Fistula ds VªhVesUV ds ckjs esa fpfdRlk lkfgR; fuEu izdkj gS& "The options of treatment include watchful waiting for spontaneous resolution of the fistula, use of medications that can stop menstrual periods such as oral contraceptive pills, progesterone and gonadotropin releasing hormone analogs.
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fu.kZ; fnukad%& 24-08-2023 surgery can be carried out through the vagina, bladder or peritoneum and can be done via laparoscopic or robotic surgery.
Watchful waiting is the treatment of choice in case of small fistulas. The bladder is catheterised for a period of 4 to 8 weeks in order to allow spontaneous closure of the vesicouterine fistula. Fulguration of the fistula can also be done vis cystoscopy in cases of small fistulas."
bl izdkj ;g Li"V gS fd Vesicouterine Fistula ds ekeys esa mipkj ds nks rjhds gS] ftlesa izFke rjhdk nokb;ksa ds ek/;e ls rFkk nwljk rjhdk vkWijs'ku ds ek/;e ls gSA fpfdRlk lkfgR; ds vuqlkj ;fn fdlh efgyk ds igys C-section ds ek/;e ls nks cPps gks pqds gksrs gSa rc rhljs cPps ds C-section ds le; Hkh ;g gks ldrk gSA 09- i=koyh esa foi{khx.k ds }kjk fnukad 11-07-2021 dks MkW- fuys'k tSu] ;wjksykWftLV dks jsQj fd;s tkus dk i= lyaXu gS] ftlesa ;g fy[kk gqvk gS fd ejht us vkWijs'ku ds 10 osa fnu xank is'kkc ,oa [kwu vkus dh f'kdk;r nqckjk dh gSA i=koyh esa foi{khx.k ds }kjk MkW- fnus'k ftUny dks jsQj fd;s tkus dk i= fnukad 21-07-2014 lyaXu gS] ftlesa ;g fy[kk x;k gS fd ejht us vkWijs'ku ds 20 osa fnu xank is'kkc ,oa [kwu vkus dh f'kdk;r dh gSA ;g Hkh fy[kk x;k gS fd ejht dk Bladder rhu ckj lkQ fd;k x;k gSA fo}ku ftyk miHkksDrk vk;ksx us vius vk{ksfir fu.kZ; esa ;g ekuk gS fd foi{khx.k ds ;gka ifjoknh dh iRuh fnukad 07-07-2014 rd yxkrkj HkrhZ jgh Fkh rFkk fnukad 07-07-2014 dks mls fMLpktZ fd;k x;k FkkA foi{khx.k ds }kjk i=koyh esa tks fpfdRlk nLrkost izLrqr fd;s x;s gSa] muls Hkh ;g Li"V gksrk gS fd ifjoknh dh iRuh foi{khx.k ds ;gka fnukad 07-07-2014 rd HkrhZ jgh FkhA foi{khx.k us tc fnukad 11-07-2014 dks MkW- fuys'k tSu ;wjksykWftLV dks fn[kkus ds fy, ifjoknh dh iRuh dks jsQj fd;k Fkk rc MkW- fuys'k tSu dks fn[kk;k x;k vFkok ugha fn[kk;k x;k ,oa ;fn fn[kk;k x;k rks MkW - fuys'k tSu ds }kjk D;k Mk;Xuksfll fd;k x;k] bl ckjs esa ifjoknh dh vksj ls dksbZ 9 jkT; miHkksDrk vk;ksx lfdZV cSap] dksVk vihy la[;k 47@2021 lkFkhZ gkWfLiVy ,oa vU;
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fu.kZ; fnukad%& 24-08-2023 nLrkost izLrqr ugha fd;k x;k gSA mHk;i{k us ;g ekuk gS fd fnukad 07-07-2014 dks fMLpktZ gks tkus ds ckn iqu% ifjoknh dh iRuh foi{khx.k ds vLirky esa bykt gsrq vk;h gS rFkk foi{khx.k ds }kjk ,aVhck;ksfVd nh xbZ gS rFkk MkW- fuys'k tSu o fnus'k ftUny dks jsQj fd;s x;s gaSA Bladder Hkh rhu ckj lkQ fd;k x;k gSA fpfdRlk lkfgR; ds vuqlkj Small Vesicouterine Fistula ds ekeys esa C-section ds i'pkr Urine Leakage gksrk gSA Urine ds lkFk Blood vkrk gS rFkk ejht Stress esa jgrk gSA fpfdRlk lkfgR; ds vuqlkj Vesicouterine Fistula gks tkuk ,d Complication gS rFkk bldk bykt nokb;ksa ls vFkok vkWijs'ku ls gksrk gSA ifjoknh Lo;a viuh iRuh dks ysdj foi{khx.k ds vLirky esa nqckjk Hkh x;k gS ,oa foi{khx.k us nokb;k¡ vkfn nsdj bykt fd;k gS rFkk vkWijs'ku ds 10 osa fnu ,oa 20 osa fnu Urine esa Blood vkus ds dkj.k jsQj Hkh fd;k x;k gSA 10- fo}ku ftyk miHkksDRkk vk;ksx us vius vk{ksfir fu.kZ; esa ;g ekuk gS fd foi{khx.k us tYnckth esa vkWijs'ku dj fn;k vFkkZr~ muds vuqlkj lksuksxzkQh ugha djk;h xbZ fdUrq bl ckjs esa i=koyh esa foi{khx.k dk tks Indoor Patient Record izLrqr fd;k x;k gS mlds voyksdu ls ;g Li"V gksrk gS fd blesa fuEu rF; vafdr gS& "USG Shows SLIU Pregnancy ̿C Transeverse Lie and Central Placenta Previa"
'Placenta Previa' dks fpfdRlk lkfgR; esa fuEu izdkj of.kZr fd;k x;k gS& "Placenta Previa means the placenta has implanted at the bottom of the uterus, over the cervix or close by, which means the baby can't be born vaginally. Treatment aims to ease the symptoms and prolong the pregnancy until at least 36 weeks."
mijksDr ls ;g Li"V gS fd Placenta Previa ds ekeys esa cPps dk tUe lkekU; :i ls ugha gks ldrk gS cfYd C-section ls gh gks ldrk 10 jkT; miHkksDrk vk;ksx lfdZV cSap] dksVk vihy la[;k 47@2021 lkFkhZ gkWfLiVy ,oa vU;
cuke lqHkk"kpan ,oa vU;
fu.kZ; fnukad%& 24-08-2023 gSA foi{khx.k ds fpfdRlk nLrkostkr ls ;g Li"V gS fd tc ifjoknh dh iRuh izFke ckj foi{kh vLirky esa vk;h Fkh rc fiNys rhu eghus ls Bleeding dh f'kdk;r dh xbZ Fkh rFkk cPps dk flj vkM+k FkkA blds vykok ;g rF; Hkh egRoiw.kZ gS fd blds igys Hkh nks ckj C-section gks pqds Fks] bl izdkj ;g ekeyk High Risk Pregnancy dk FkkA ,slh fLFkfr esa ifjoknh dk ;g dguk lgh ugha gS fd foi{khx.k us lkekU; izlo djkus dh ckr dgh gks cfYd i=koyh esa ekStwn Indoor Patient Record nLrkost ds vuqlkj 'kq: ls gh C-section dh ckr fy[kh tk jgh gS rFkk 2 Unit Blood dk bartke djus dh ckr fy[kh tk jgh gSA bl izdkj fo}ku ftyk miHkksDrk vk;ksx ds }kjk vius vk{ksfir fu.kZ; esa tks lksuksxzkQh ugha djkus dh ckr fy[kh xbZ gS] og mijksDr foospu ls lgh ugha gS D;ksfa d ifjoknh Lo;a lksuksxzkQh djkds fjiksVZ lkFk esa ys x;k Fkk] ftls ns[kdj HkrhZ fVdV tkjh fd;k x;k gS rFkk mlesa USG dh fjiksVZ dk mYys[k fd;k x;k gSA 11- fo}ku vf/koDrk ifjoknh dh vksj ls tks fpfdRlk lkfgR; izLrqr fd;k x;k gS og Vasicovaginal Fistula ds ckjs esa gSA Vasicovterine Fistula ds ekeys esa nokb;ksa ls Hkh bykt laHko gS] tks fd gLrxr izdj.k esa foi{khx.k ds }kjk fd;k x;k gSA Vasicovaginal Fistula ds ekeys esa vkWijs'ku ls bykt fd;k tkuk vko';d gksrk gS] tcfd ifjoknh dh iRuh dks Small Vasicouterine Fistula FkkA Vasicovaginal Fistula Abdominal vFkok Vaginal vkWijs'ku ds rqjar ckn Develop gks tkrk gS] tcfd Vasicouterine Fistula C-section ds ckn /khjs&/khjs Develop gksrk gSA bl izdkj ifjoknh dk ;g rdZ ekU; ugha gS fd foi{khx.k ds }kjk Fistula ds ckjs esa tkudkjh gksrs gq, Hkh jsQj ugha fd;k x;kA 12- ifjoknh dh vksj ls ekuuh; jk"Vªh; miHkksDrk vk;ksx dk U;kf;d n`"Vkar Revision Petition no. 1385/2018 Lalan Pandey V/s Dr. Chandeshwar Prasad. Decided on 02-05-2019. izLrqr fd;k x;k gSA bl U;kf;d n`"Vkar okys ekeys esa ifjoknh dk ,DlhMsaV gqvk Fkk] ftlls 11 jkT; miHkksDrk vk;ksx lfdZV cSap] dksVk vihy la[;k 47@2021 lkFkhZ gkWfLiVy ,oa vU;
cuke lqHkk"kpan ,oa vU;
fu.kZ; fnukad%& 24-08-2023 mlds iSj esa ÝsDpj gqvk Fkk rFkk bl U;kf;d n`"Vkar okys ekeys esa vkWijs'ku ds i'pkr fpfdRld ds }kjk vko';d dne ugha mBk;s x;s Fks] rc fpfdRld dh ykijokgh ekuh xbZ Fkh] tcfd gLrxr izdj.k ds rF; fHkUu gSA vr% ;g U;kf;d n`"Vkar gLrxr izdj.k ij ykxw ugha gksrk gSA 13- ifjoknh dh vkjs ls ekuuh; jk"Vªh; miHkksDrk vk;ksx dk U;kf;d n`"Vkar Parikshit Dalal &Ors V/s Santosh Hospital & Ors. ifjokn izdj.k la[;k 89@2012 fu.kZ; fnukad 23-05-2023 izLrqr fd;k x;k gSA bl U;kf;d n`"Vkar okys ekeys esa General Anesthesia fn;k x;k Fkk] ftldk Reaction gks x;k FkkA foi{khx.k ds }kjk vkWijs'ku fFk;sVj ds eksfuVj] vkbZ-lh-;w- ds eksfuVj dh jhfMax dks feVk fn;k x;k Fkk rFkk USG dh Digital Copy dks Hkh feVk fn;k x;k Fkk rFkk ;g crkus dk iz;kl fd;k x;k Fkk fd General Anesthesia ds dkj.k e`R;q gqbZ gSA ejht dh e`R;q Hemorrhagic Shock ds dkj.k gqbZ FkhA bl ekeys esa foi{khx.k dh ykijokgh ekuh xbZ Fkh fdUrq gLrxr izdj.k ds rF; ,sls ugha gSA vr% ;g U;kf;d n`"Vkar ifjoknh dh dksbZ lgk;rk ugha djrk gSA 14- ifjoknh dh vksj ls ekuuh; jk"Vªh; miHkksDrk vk;ksx dk U;kf;d n`"Vkar Priyanka Tandon & Anr. V/s Bhatia Global Hospital & Endosurgery Institute & Ors. Decided on 16.06.2023 izLrqr fd;k x;k gSA bl U;kf;d n`"Vkar okys ekeys esa ICSI Procedure ls xHkkZ/kku fd;k tkuk Fkk] tks foi{khx.k ds }kjk fd;k x;kA fnukad 15-06-2019 dks nks cfPp;ksa dk tUe gqvk] ftudk Blood Group Ab+ Fkk] tcfd nksuksa cfPp;ksa ds Parents dk Blood Group B+ ,oa O- FkkA esfMdy lkabl ds vuqlkj ;fn Parents dk Blood Group B+ ,oa O- gksxk] rc mudh larkuksa dk Blood Group Ab+ dHkh ugha gks ldrk gS] rc ;g ekuk x;k fd foi{khx.k ds }kjk bl xHkkZ/kku dh izfØ;k esa ykijokgh dh xbZ gS vFkkZr fdlh vU; O;fDr dk Sperm dke esa ys fy;k x;k gSA blfy, foi{khx.k dh ykijokgh ekuh xbZ gS] tcfd gLrxr izdj.k ds rF; bl 12 jkT; miHkksDrk vk;ksx lfdZV cSap] dksVk vihy la[;k 47@2021 lkFkhZ gkWfLiVy ,oa vU;
cuke lqHkk"kpan ,oa vU;
fu.kZ; fnukad%& 24-08-2023 izdkj ds ugha gSA vr% ;g U;kf;d n`"Vkar ifjoknh dh dksbZ lgk;rk ugha djrk gSA 15- gLrxr izdj.k esa foi{kh la[;k 1 o 2 dh fpfdRlk ykijokgh jgh vFkok ugha] bl ckjs esa gLrxr izdj.k dh rF;kRed fLFkfr dks ns[krs gq;s ekuuh; loksZPp U;k;ky; ,oa ekuuh; jk"Vªh; miHkksDrk vk;ksx] ubZ fnYyh ds fofHkUu U;kf;d n`"Vkarksa dk voyksdu fd;k x;k] ftuesa ls dqN fuEu izdkj gSa%& 15(1) ekuuh; loksZPp U;k;ky; ds U;kf;d n`"Vkar Martin F. D'Suza versus Mohd. Ishfaq, (2009) 3 lqizhe dksVZ dslt s page 1 ds ekeys esa iSjk uacj 40 ,oa 42 esa fuEu izdkj fof/k fl)kar izfrikfnr fd;s x;s gaS%&
40. "Simply because a patient has not favourably responded to a treatment given by a doctor or a surgery has failed, the doctor cannot be held straighaway liable for a medical negligence by applying the doctrine of res ipsa loquitur. No sensible professional would intentionally commit an act or omission which would result in harm or injury to the patient since the professional reputation of the professional would be at stake. A single failure may cost him dear in his lapse."
42. "When a patient dies or suffer some mishap, there is a tendency to blame the doctor for this. Things have gone wrong and therefore, somebody must be punished for it. However, it is well known that even the best professionals, what to say of the average professional, sometimes have failures. A lawyer cannot win every case in his professional career but surely he cannot be penalised for losing a case provided he appeared in it and made his submissions."
13jkT; miHkksDrk vk;ksx lfdZV cSap] dksVk vihy la[;k 47@2021 lkFkhZ gkWfLiVy ,oa vU;
cuke lqHkk"kpan ,oa vU;
fu.kZ; fnukad%& 24-08-2023 mijksDr iSjk la[;k 40 o 42 esa ekuuh; loksZPp U;k;ky; us ;g ekuk gS fd ;fn dksbZ vkWijs'ku vlQy gks tkrk gS] rc blh vk/kkj ij vkWijs'ku dju okys fpfdRld dks fpfdRlk ykijokgh dk nks"kh res ipsa loquitur fl)kar ds vk/kkj ij ugha ekuk tkosxkA ;g Hkh ekuk x;k gS fd ;fn dksbZ ejht ej tkrk gS vFkok fLFkfr fcxM+ tkrh gS] rc fpfdRld ij vkjksi yxkus dh VsUMsUlh gksrh gS] tcfd vPNs ls vPNk izksQs'kuy Hkh failure gks tkrk gS] tSls fd ,d vf/koDrk ges'kk gh viuk izdj.k ugha thr ikrk gSA 15(2) ekuuh; loksZPp U;k;ky; ds U;kf;d n`"Vkar C.P. Sreekumar(Dr.), MS (Ortho) v S.Ramanujam, (2009) 7 SCC 130 ds iSjk la[;k 37 esa fuEu fof/k fl)kar izfrikfnr fd;k x;k gS%& "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."
mijksDr fof/k fl)kar esa ;g crk;k x;k gS fd fpfdRlk lsoknks"k dk vkjksi ifjokni= esa yxk;k tkuk gh i;kZIr ugha gS] cfYd lqn`<+ lk{; ls bl vkjksi dks lkfcr djuk vko';d gSA 15¼3½ ekuuh; loksZPp U;k;ky; ds U;kf;d n`"Vkar ÞKusum Sharma and Others v.Batra Hospital and Medical Research Centre 14 jkT; miHkksDrk vk;ksx lfdZV cSap] dksVk vihy la[;k 47@2021 lkFkhZ gkWfLiVy ,oa vU;
cuke lqHkk"kpan ,oa vU;
fu.kZ; fnukad%& 24-08-2023 and Others, (2010) 3 SCC 480 ds iSjk la[;k 47] 72] 78 esa fuEufyf[kr fof/k fl)kar izfrikfnr fd;s x;s gaS%& "47. Medical science has conferred great benefits on mankind, but these benefits are attended by considerable risks. Every surgical operation is attended by risks. We cannot take the benefits without taking risks. Every advancement in technique is also attended by risks."
"72. The ratio of Bolam case [(1957) 1 WLR 582 : (1957) 2 All ER 118] is that it is enough for the defendant to show that the standard of care and the skill attained was that ordinary degree of professional skill. The fact that the respondent charged with negligence acted in accordance with the general and approved practice is enough to clear him of the charge. Two things are pertinent to be noted. Firstly, the standard of care, when assessing the practice as adopted, is judged in the light of knowledge available at the time (of the incident), and not at the date of trial. Secondly, when the charge of negligence arises out of failure to use some particular equipment, the charge would fail if the equipment was not generally available at that point of time on which it is suggested as should have been used."
"78. It is a matter of common knowledge that after happening of some unfortunate event, there is a marked tendency to look for a human factor to blame for an untoward event, a tendency which is closely linked with the desire to punish. Things have gone wrong and, therefore, somebody must be found to answer for it. A professional deserves total protection. The Penal Code, 1860 has taken care to ensure that people who act in good faith should not be punished. Sections 88, 92 and 370 of the Penal Code give adequate protection to the professionals and particularly medical professionals."15
jkT; miHkksDrk vk;ksx lfdZV cSap] dksVk vihy la[;k 47@2021 lkFkhZ gkWfLiVy ,oa vU;
cuke lqHkk"kpan ,oa vU;
fu.kZ; fnukad%& 24-08-2023 mijksDr iSjkt esa Hkh ekuuh; loksZPp U;k;ky; us Hkh ;gh ekuk gS fd ;fn dksbZ unfortunate ?kVuk ?kfVr gks tkrh gS] rc ;g VsUMsUlh jgrh gS fd bl ?kVuk ds ?kfVr gksus dk dkj.k Li"V gksuk pkfg;s rFkk vkjksi yxkus dh VsUMsUlh gksrh gS] fdarq vizR;kf'kr ?kVuk ?kfVr gksus ds dkj.k gh nks"kh ugha ekuk tkuk pkfg;s] cfYd izksQs'kuy dks izksVsD'ku feyuk pkfg;sA 15¼4½ ekuuh; loksZPp U;k;ky; ds U;kf;d n`"Vkar Dr. Harish Kumar Khurana v Joginder Singh and ors., (2021) SCC Online SC 673 ds iSjk la[;k 11 ,oa iSjk la[;k 14 esa fuEufyf[kr fof/k fl)kar izfrikfnr fd;s x;s gaS%& "11. ........ Ordinarily an accident means an unintended and unforeseen injurious occurrence, something that does not occur in the usual course of events or that could not be reasonably anticipated. The learned counsel has also referred to the decision in Martin F. D'Suza versus Mohd. Ishfaq, ( 2009) 3SCC 1 wherein it is stated that simply because the patient has not favourably responded to a treatment given by doctor or a surgery has failed, the doctor cannot be held straight away liable for medical negligence by applying the doctrine of Res Ipsa Loquitor. It is further observed therein that sometimes despite best efforts the treatment of a doctor fails and the same does not mean that the doctor or the surgeon must be held guilty of medical negligence unless there is some strong evidence to suggest that the doctor is negligent."
"14. Having noted the decisions relied upon by the learned counsel for the parties, it is clear that in every case where the treatment is not successful or the patient dies during surgery, it cannot be automatically assumed that the medical 16 jkT; miHkksDrk vk;ksx lfdZV cSap] dksVk vihy la[;k 47@2021 lkFkhZ gkWfLiVy ,oa vU;
cuke lqHkk"kpan ,oa vU;
fu.kZ; fnukad%& 24-08-2023 professional was negligent. To indicate negligence there should be material available on record or else appropriate medical evidence should be tendered. The negligence alleged should be so glaring, in which event the principle of res ipsa loquitur could be made applicable and not based on perception. In the instant case, apart from the allegations made by the claimants before the NCDRC both in the complaint and in the affidavit filed in the proceedings, there is no other medical evidence tendered by the complainant to indicate negligence on the part of the doctors who, on their own behalf had explained their position relating to the medical process in their affidavit to explain there was no negligence. .................."
mijksDr iSjkt esa ekuuh; loksZPp U;k;ky; us ;g ekuk gS fd fdlh Hkh vkWijs'ku ds vlQy gksus ds vk/kkj ij gh Res Ipsa Loquitor fl)kar ds vk/kkj ij fpfdRld dh ykijokgh ugha ekuh tkosxh] cfYd fpfdRld dh ykijokgh ds fy;s dqN lkexzh gksuh pkfg;sA 15¼5½ ekuuh; loksZPp U;k;ky; ds U;kf;d n`"Vkar II(2022)CPJ 51(SC) CHANDA RANI AKHOURI[DR.(MRS.)] AND ORS. VERSUS M.A. METHUSETHUPATHI [DR.] AND ORS. esa fuEufyf[kr fof/k fl)kar izfrikfnr fd;k x;k gS%& Þ¼1½ Medical Negligence- Duty of care and caution- No doctor would assure full recovery in every case- At relevant time, only assurance given by implication is that he possessed requisite skills in branch of profession and while undertaking performance of his task, he would exercise his skills to best of his ability and with reasonable competence- Liability would only come if either doctor did not possess requisite skills which he professed to have possessed or he did not exercise with reasonable competence in given case skill which 17 jkT; miHkksDrk vk;ksx lfdZV cSap] dksVk vihy la[;k 47@2021 lkFkhZ gkWfLiVy ,oa vU;
cuke lqHkk"kpan ,oa vU;
fu.kZ; fnukad%& 24-08-2023 he did possess- Simple lack of care, error of judgment or accident, is not proof of negligence on part of medical professional- Hospital and doctors are required to exercise sufficient care in treating patients in all circumstances- Sufficient material on medical evidence should be available before adjudicating authority to arrive at conclusion that death is due to medical negligence- Death of patient cannot, on face of it, be considered to be medical negligence- medical practitioner is not to be held liable simply because things went wrong from mischance or misadventure or through error of judgment in choosing one reasonable course of treatment in preference to another- Term 'negligence' has no defined boundaries and if any medical negligence is there, whether it is pre or post-operative medical care or in follow-up care, at any point of time by treating doctors or anyone else, it is always open to be considered by Courts/Commission taking note of exposition of law laid down by this Court of which detailed reference has been made and each case has to be examined on its own merits in accordance with law."
15¼6½ ekuuh; loksZPp U;k;ky; us vius U;kf;d n`"Vkar flfoy vihy uacj 1658/2010 "Bombay Hospital and Medical Research Center Versus Asha Jaiswal", fu.kZ; fnukad 30-11- 2021 esa ;g ekuk gS fd vLirky dk vkWijs'ku fFk;sVj laiw.kZ lqfo/kk ;qDr gks] fpfdRld ;ksX; ,oa vuqHkoh gks] rc Hkh ;fn ejht dh e`R;q gks tkrh gS] rc blh dkj.k ls fpfdRld dks ykijokgh dk nks"kh ugha ekuk tkosxkA 15¼7½ ekuuh; loksZPp U;k;ky; us vius U;kf;d n`"Vkar Bolam versus Frien Hospital Management Committtee (1957) I WLR 582 ds ekeys esa fuEufyf[kr fof/k fl)kar izfrikfnr fd;s gSa %& 18 jkT; miHkksDrk vk;ksx lfdZV cSap] dksVk vihy la[;k 47@2021 lkFkhZ gkWfLiVy ,oa vU;
cuke lqHkk"kpan ,oa vU;
fu.kZ; fnukad%& 24-08-2023
1. Whether the doctor in question possessed the medical skills expected of an ordinary skilled practitioner in the field at that point of time;
2. Whether the doctor adopted the practice(of clinical observation diagnosis - including diagonstic tests and treatment) in the case that would be adopted by such a doctor of ordinary skill in accord with(at least) one of the responsible bodies of opinion of professional practitioners in the field.
3. Whether the standards of skills, knowledge expected of the doctor, according to the said body of medical opinion, were of the time when the events leading to the allegations of medical negligence occurred and not of the time when the dispute was being adjudicated.
In the present case our answer to all points is "yes", because both the OP doctors are qualified ophthalmologists, practicing since two decades. The OP- 2 is a super specialist in IOL and myopia corrective surgery.The OP-3 is a consultant retina surgeon attached to OP-1, the navajyoti eye center. They have adopted the standards of practice, in proper diagnosis, referral and further management. Therefore, in the instant case OPs-2 and 3 are qualified and skilled in their specialty, hence, no negligence can be attributed to their attempts.
15¼8½ ekuuh; jk"Vªh; miHkksDrk vk;ksx us vius U;kf;d n`"Vkar 2016¼2½ CPR 77 ifjokn izdj.k la[;k 1499@2015 "Suman Taneja Versus Metro Hospital and Heart Institute and ors.", 19 jkT; miHkksDrk vk;ksx lfdZV cSap] dksVk vihy la[;k 47@2021 lkFkhZ gkWfLiVy ,oa vU;
cuke lqHkk"kpan ,oa vU;
fu.kZ; fnukad%& 24-08-2023 fu.kZ; fnukad& 02-02-2016 esa fuEufyf[kr fof/k fl)kar izfrikfnr fd;k gS%& "Consumer Protection Act, 1986 Section 2(1)g Allegation of Medical negligence- Referring patient to higher centre- Due to non availability of cardiologist- Patient suffered IWMI, it was a cardiac emergency and he was in a critical stage, After diagnosis, OP-2 rightly treated patient by thrombolysing agents- Due to non- availability of cardiologist, he has referred patient to higher centre- Referring the patient to higher centre is not a Medical negligence - Every cardiologist is not capable or experienced to the extent to perform PCI- Not find the OPs breached in their duty of care or there was deficiency on the part of OP-2 who referred the patient to higher centre due to non availability of cardiologist- Decision taken by OP2 to refer patient to higher centre was proper- Held, that doctors should not be dragged to court unnecessarily on frivolous ground which prevents them from discharging their duty to a suffering person who needs their assistance utmost- Complaint dismissed."
15¼9½ ekuuh; loksZPp U;k;ky; us vius U;kf;d n`"Vkar Jacob Mathew versus State of Punjab and anr.(2005) 6 SSC I esa fuEufyf[kr fof/k fl)kar izfrikfnr fd;k gS%& " a professional may be held liable on one of two findings:
either he was not possessed of requisite skill which he professed to have possessed, or he did not exercise reasonable competence in given case, the skill which he did possess"
16. gLrxr izdj.k dh rF;kRed fLFkfr ds vuqlkj ifjoknh dh iRuh dk High Risk Pregnancy dk ekeyk FkkA foi{kh la[;k 2 MkW- fjfrdk 20 jkT; miHkksDrk vk;ksx lfdZV cSap] dksVk vihy la[;k 47@2021 lkFkhZ gkWfLiVy ,oa vU;
cuke lqHkk"kpan ,oa vU;
fu.kZ; fnukad%& 24-08-2023 ekFkqj ,d ;ksX; ,oa vuqHkoh fpfdRld gS] ftuds }kjk C-section fd;k x;k gSA Vesicouterine Fistula gksuk C-section dk ,d Complication gS] tks fd ifjoknh dh iRuh ds rhljh ckj C-section gksus ds dkj.k laHko gSA fnukad 07-07-2014 dks foi{kh vLirky ls fMLpktZ djrs le; fdlh izdkj dk Urine ls Blood ugha vk jgk Fkk rFkk lHkh Vital Part lkekU; Fks] tks fd i=koyh esa lyaXu tkap fjiksVZ ls Li"V gSA vkWijs'ku ds 10 osa fnu Urine esa Blood vkus dh f'kdk;r dh xbZ] rc MkW- fuys'k tSu dks jsQj fd;k x;k gS rFkk foi{khx.k ds }kjk Hkh ,aVhck;ksfVd vkfn nh xbZ gSA mlds i'pkr vkWijs'ku ds 20 osa fnu iqu% Urine esa Blood vkus ds dkj.k MkW- fnus'k ftUny dks jsQj fd;k x;k gSA mlls igys rhu ckj Bladder lkQ fd;k x;k gSA ;g Hkh Li"V gS fd MkW- fnus'k ftUny ds }kjk dbZ fnuksa rd ifjoknh dh iRuh dk bykt fd;k x;k] mlds i'pkr ifjoknh dh iRuh Hkkjr fodkl ifj"kn~ esa Hkh HkrhZ jgh gSA mlds i'pkr uoEcj] 2014 esa ifjoknh dh iRuh MkW- fuys'k tSu] ;wjksyksftLV ds ikl bykt ds fy, xbZ gS] rc mUgksus vkWijs'ku dj Fistula dk mipkj fd;k gSA bl izdkj ;g Li"V gS fd ifjoknh dh iRuh dk foi{kh vLirky ds vykok vU; vLirkyksa esa Hkh bykt pyk gS rFkk vko';drk gksus ij gh Fistula dk vkWijs'ku fd;k x;k gSA vr% ge ;g ikrs gSa fd foi{kh la[;k 1 yxk;r 3 dh fdlh izdkj dh dksbZ ykijokgh ugha jgh gS cfYd mUgksus Standard Protocol ds vuqlkj bykt fd;k gSA ifjoknh Lo;a viuh iRuh dks nqckjk bykt ds fy, Hkh foi{khx.k ds ikl ysdj x;k gSA fo}ku ftyk miHkksDrk vk;ksx us vius vk{ksfir fu.kZ; esa lgh foospu ugha fd;k gS rFkk xyr rkSj ij foi{khx.k dk lsoknks"k eku fy;k gS] tks fd mfpr ugha gSA bl izdkj ;g fu"d"kZ fudyrk gS fd foi{kh la[;k 1 yxk;r 3 ds }kjk izLrqr vihy Lohdkj fd;s tkus ;ksX; gS rFkk fo}ku ftyk miHkksDrk vk;ksx] dksVk ds }kjk ikfjr vk{ksfir fu.kZ; vikLr fd;s tkus ;ksX; gSA 21 jkT; miHkksDrk vk;ksx lfdZV cSap] dksVk vihy la[;k 47@2021 lkFkhZ gkWfLiVy ,oa vU;
cuke lqHkk"kpan ,oa vU;
fu.kZ; fnukad%& 24-08-2023 vkns'k foi{kh la[;k 1 yxk;r 3 ds }kjk ifjoknh&izR;FkhZ ,oa vU; ds fo:) izLrqr ;g vihy Lohdkj dh tkrh gSA fo}ku ftyk miHkksDrk vk;ksx] dksVk ds }kjk ifjokn izdj.k la[;k 173@2015 lqHkk"kpan cuke lkFkhZ gkWfLiVy ,oa vU; esa ikfjr fu.kZ; fnukad 08-01-2020 vikLr fd;k tkrk gSA mHk;i{k viuk&viuk [kpkZ eqdnek ogu djsaxsA ¼'kSysUnz HkV~V½ ¼,l-ds-tSu½ lnL; ihBklhu lnL; ¼U;kf;d½ ljkst@&