State Consumer Disputes Redressal Commission
Mukesh Kumar Nahta vs Partap Parsuti on 5 January, 2021
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vuqiek ukgVk ds lkFk lEIkUu gqvk Fkk fdUrq 'kknh ds 4 o"kZ xqtjus ds i'pkr~
Hkh muds ;gka dksbZ larkuksRifr ugha gqbZA izfri{kh la- 1 }kjk vk, fnu v[kckj
vkfn esa foKkiu nsdj ;g tkfgj fd;k tkrk fd izrki izlwfr x`g chdkusj dk
loksZRre uflZUx gkse gS rFkk mRd`"V ,oa vk/kqfud VsfLVax tk¡p ;a= vkfn }kjk
mipkj fd;k tkrk gS rFkk ;gka cPpksa dh fMyhojh] nwjchu ls tk¡p] ysijksLdksih
vkfn dh fo'ks"k ,oa loksZRre lqfo/kk,a gSa rFkk fuiq.k mPp fMxzh/kkjh fpfdRld gSa
rFkk gksfYMax vkfn Hkh yxk j[kh gSA pwafd ifjoknh o mldh iRuh muds ;gka
lUrku ugha gksus ds dkj.k dkQh ijs'kku Fks blfy, ifjoknh us izfri{kh izrki
izlwfr x`g ds foKkiu ,oa gksfYMax ls izsfjr gksdj fnukad 08-07-2007 dks ifjoknh
o mldh ifRu vuqiek ukgVk izfri{kh izrki izlfw r x`g esa dk;Zjr MkW-iq"ik raoj
,oa MkW- fodze raoj ls feys rc izfri{kh la- 2 o 3 us viuh ;ksX;rk ,oa vuqHko
dk c[kku djrs gq, mudh fpfdRlk lsok mPpLrjh; o vR;k/kqfud fpfdRlk
lsok lqfo/kk,a gksuk crk;k rFkk fulUrku nEifr;ksa ds dbZ dsl gy djuk crk;k
,oa ;g Hkh vk'oklu fn;k fd ifjoknh muds ikl vk;k gS rks ifjoknh o mldh
iRuh dks Hkh cPpk gks tk,xk] nksuksa dh tk¡p djuh gksxhA ifjoknh o mldh iRuh
us viuh cPpk ugha gksus dh ijs'kkuh ds dkj.k izfri{kh i{k fpfdRldksa ds dgs
vuqlkj vko';d Qhl jkf'k 5]000@&:- tek djok fn, ftldh jlhn izfri{kh
la- 3 us ckn esa nsus ds fy, dgk fdUrq ckn esa jlhn ugha nh xbZ ,oa vko';d
tk¡psa djokbZA fnukad 13-07-2007 dks izfri{kh la- 1 dh fpfdRld izfri{kh la- 2
iq"ik raoj }kjk ifjoknh dh ifRu dh tk¡p dh xbZ ,oa fjiksVZl ns[kdj ifjoknh
dh ifRu dh ,d vkSj nwjchu ls tk¡p djuk ,oa bl tk¡p ls cPpk ugha gksus dk
dkj.k Kkr gksuk crk;k rkfd lkjh fiDpj Dyh;j gks tkosA ifjoknh o mldh
ifRu us tc izfri{kh la- 2 ls mDr tk¡p ds lEcU/k esa dksbZ rdyhQ ;k ijs'kkuh
;k [krjk gksus ds lEcU/k esa iwNk rks izfri{kh la- 2 o 3 us ;g fo'okl fnyk;k
fd ;g tk¡p vR;Ur ljy o lk/kkj.k tk¡p gSa ?kcjkus dh dksbZ t:jr ugha gS
,oa mUgksus ,slh dbZ tk¡psa dj nh gSa ,oa ;g muds :Vhu dk dk;Z gSA rc
ifjoknh us vko';d Qhl 5500@&:- izfri{khx.k dks tek djokbZA ftldh
dksbZ jlhn ugha nh xbZA izfri{khx.k ds vk'oklu ij fnukad 14-07-2007 dks
ifjoknh dh ifRu vuqiek lqcg 7 cts [kkyh isV izfri{khx.k ds izrki izlwfr x`g
esa tk¡p gsrq igqaphA izfri{kh la- 2 o 3 us tk¡p ds fy, ifjoknh dh ifRu dks
,fufe;k fn;k o vkWijs'ku fFk;sVj esa ys x,A dkQh le; chr tkus ij ifjoknh
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dks fpUrk gqbZ rks iwNus ij crk;k fd tk¡p ds nkSjku vuqiek ds ekewyh batjh gks
xbZ gSA 4&5 fnu HkrhZ j[kus ij Bhd gks tk,xhA ifjoknh us Qksu djds vius
ifjokjokyksa dks cqyk;k rks mUgsa Hkh izfri{khx.k us vk'oklu fn;k fd ?kcjkus dh
dksbZ t:jr ugha gSA vuqiek dh rfc;r Bhd gSA T;knk tksj nsdj iwNus ij
izfri{khx.k us crk;k fd mudh xyrh ls tk¡p midj.k dh fuMy vuqiek ds
'kjhj ij xyr txg ij xyr rjhds ls yx tkus ds dkj.k mlds 'kjhj esa
fCYkfMax gks jgh gSA fLFkfr dkcw esa gSA mUgksus MkW- ,e-,e-ckxM+h ls vkWijs'ku djok
fn;k gS] nks cts rd ifjoknh dk ifjokj izfri{kh MkWDVjksa ds ihNs ikxyksa dh
rjg ?kwerk jgk vkSj os dgrs jgs fd fLFkfr dkcw esa gS tcfd okLro esa vuqiek
dh rfc;r yxkrkj fcxM+rh jghA vuqiek dh fcxM+rh gkyr dks ns[kdj
izfri{khx.k us vuqiek dks ;g dgdj ih- ch- ,e- vLirky chdkusj jsQj dj
fn;k fd muls dsl fcxM+ x;k gSA rc ifjoknh vuqiek dks ih- ch- ,e- vLirky
chdkusj ysdj x;kA ogka vuqiek dks mlh fnu fnukad 14-07-2007 dks e`r ?kksf"kr
dj fn;k x;kA izfri{khx.k }kjk ?kksj ykijokgh ds dkj.k fuMy xyr rjhds ls
xyr txg Mkyus ls 'kjhj esa fCyfMax ls vuqiek dh e`R;q gqbZA ftlls ifjoknh
dks 'kkjhfjd o ekufld ihM+k gqbZA fnukad 14-07-2007 dks gh izfri{khx.k ds
fo:) izFke lwpuk fjiksVZ ntZ gqbZ ftlesa izfri{kh la- 2 o 3 dk pkyku U;k;ky;
esa fd;k x;kA mfpr fpfdRlh; lqfo/kk ugha gksus ls o bykt dh iwjh tkudkjh
ugha gksus ls izfri{khx.k us viuh xyrh o ?kksj ykijokgh dks fNikus ds fy,
ifjoknh dks fcuk crk;s MkW- ,e- ,e- ckxM+h ls vuqiek dk vkWijs'ku djok fn;kA
izfri{khx.k dks ysizksLdkWih dh tk¡p ds ckjs esa iw.kZ tkudkjh ugha Fkh] uk gh vPNk
lftZdy izcU/ku FkkA izfri{khx.k }kjk iznRr nks"kiw.kZ fpfdRlh; lsok nsuk] lsok
esa deh dh Js.kh esa vkrk gSA ;fn izfri{khx.k lgh rjhds ls lgh txg tk¡p
fuMy Mkyrs rks vuqiek dh e`R;q ugha gksrhA tk¡p fuMy dk fljk vkxs ls CyUV
gksrk gS] tks lkeus ls ncko iM+us ij ihNs gks tkrk gS] uqdhyk fljk vkxs vkdj
ncko ds vUnj ls ikj gks tkrk gS] vojks/k ikj gks tkus ds i'pkr~ fLizax yxh
gksus ls CyUV okyk fljk okfil vkxs vk tkrk gS ftlls ejht dks dksbZ batjh
ugha gksrh fdUrq izfri{khx.k }kjk fLizax dks ykijokghiwoZd ihNs [khapus ls uqdhyk
fljk vk¡r rd pys tkus ls ulsa dV xbZA vr% izfri{khx.k dh ?kksj ykijokgh o
vlko/kkuh o nks"kiw.kZ tk¡p ls vuqiek dh e`R;q gqbZA MkW- ckxM+h ds /kkjk 161 lh-
vkj-ih-lh ds c;ku ,oa vU; lcwrksa ls izfri{khx.k dh ykijokgh Li"V gSA vuqiek
dh NksVh vk¡r ,oa dkWeu bysd vkjVªsjh esa 0-5 ls-eh- dh batjh gksuk izfri{khx.k
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dh ykijokgh dk |ksrd gSA vr% ifjoknh us izfri{khx.k ls ifjokn&i= esa
vafdrkuqlkj {kfriwfrZ jkf'k 15 yk[k :i;s ,oa izfri{khx.k dks nh xbZ Qhl
10]500@&:- ,oa ifjokn O;; 11]000@&:- fnyk, tkus dh izkFk Zuk dh gSA
izfri{khx.k dh vksj ls izLrqr tokc ds lkj&ladyu ds vuqlkj
izfri{khx.k fuiq.k] mPp fMxzh/kkjh fpfdRld gSaA tgka ij buQfVZfyfVh dh tk¡p
djus dh lqfo/kk o vkbZ- oh- ,Q- i)fr ls xHkZ /kkj.k djok;s tkus dh O;oLFkk
djokbZ tkrh gSA fnukad 13-07-2007 dks mUgksus vuqiek dh tk¡p dh Fkh] muds
f[kykQ iqfyl fjiksVZ ntZ gksuk ,oa muds fo:) /kkjk 304, vkbZ-ih-lh- ds rgr
pkyku gksuk Lohdkj djrs gq, ifjoknh }kjk ifjokn&i= esa vafdr 'ks"k rF;ksa dks
vLohdkj djrs gq, vius fo'ks"k dFkuksa esa ;g crk;k gS fd ifjoknh us tku&cw>dj
ifjokn esa lgh o iw.kZ rF; ugha fy[ks gSaA izfri{khx.k ij yxk, x, ykijokgh
ds vkjksi xyr gSaA izfri{khx.k }kjk ysizksLdksfid fof/k ls funku o bykt ds
fy, esMhdy ,.M lkbZUl }kjk fu/kkZfjr o LFkkfir fd, x, lHkh ekin.Mksa dh
v{kjr% ikyuk dh xbZ gSA izfri{kh MkW-iq"ik r¡oj ,e-,l-xk;fudksyksth gSa ,oa
mUgksus ysizksLdksfid i)fr dk Hkh izf'k{k.k izkIr fd;k gqvk gS ,oa gtkjksa jksfx;ksa
dk bykt fd;k gS o muds ;gka o"kZ 2003 ls VsLV V~;wc i)fr ls xHkZ /kkj.k
djok;s tkus dk lsVvi gS o izfri{kh la- 3 MkW- fodze r¡oj Hkh lu~ 2000 lsa
Mh-,u-oh-ltZjh dh mPprj fMxzh izkIr fd, gq, gSaA vuqiek o mlds ifr }kjk
izfri{khx.k ls lEidZ fd, tkus ij izfri{khx.k us crk;k fd lUrku iSnk ugha
gksus ds dkj.kksa dh tk¡p gsrq vko';d tk¡psa djuh iM+asxh ftlesa VªkalostkbZuy
lksuksxzkQh }kjk vaMk cuus dh izfdz;k dh tk¡p] jDr esa gkWjeksUl dh tk¡p] jDr
dh lk/kkj.k tk¡psa rFkk ysizksLdksi }kjk cPpsnkuh o vaMsnkuh o QSyksfiu V~;wc dh
fLFkfr dh tk¡p djuh iM+sxh o mUgksus ysizksLdksfid tk¡p dh izfdz;k dh o blds
laHkkO; [krjksa ds lEcU/k esa foLr`r :i ls le>k fn;k x;k Fkk ,oa ;g Hkh crk
fn;k x;k Fkk fd osfjl fuMy Mkyus ds i'pkr~ Vªksdkj Mkyus dh tks izfdz;k gS
og iw.kZ:i ls CykbZUM gS ,oa ;g Hkh crk fn;k Fkk fd vk¡rfjd vaxksa dh fLFkfr
owesu Vw owesu vUrj gksus ;k ,Mgstu gksus ds dkj.k dbZ ekeyksa esa batjh dh
lEHkkouk jgrh gS o [krjs dh lEHkkouk jgh gSA batjh gksus dh fLFkfr esa vfoyEc
ysizksVkseh dh vko';drk iM+ tkrh gSA lHkh rF;ksa o izfdz;k o budh tfVyrk
o lEHkkO; [krjksa ds ckjs esa vPNh rjg ls le>dj ifjoknh o mldh ifRu us
Lora= lgefr nsrs gq, tk¡p djokus dk fy[kdj fn;kA fnukad 14-07-2007 dks
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lqcg djhc 7-30 cts vuqiek dks tujy ,usfLFkfl;k nsdj ysizksLdksih dh izfdz;k
izkjEHk dh xbZ o bl izfdz;k esa vuqiek dh ukHkh ds Bhd uhps 10 fe-fe- dk phjk
yxkdj fNnz esa ls lko/kkuhiwoZd izfri{kh la- 2 MkW- iq"ik r¡oj }kjk osfjl fuMy
Mkyh xbZ o isjhVksfu;y dsfoVh esa bl osfjl fuMy }kjk <kbZ yhVj dkcZu MkbZ
vkWDlkbZM xSl Hkjdj vuqiek ds isV dks Qqyk;k x;k o osfjl fuMy dks ckgj
fudkydj blh {ks= esa lko/kkuhiwoZd Vªksdkj Mkyk x;k o mlh izdkj mlh Vªksdkj
ds ek/;e ls ysizksLdksih la;a= isV ds vanj Mkyk x;k ftlds vaanj tkrs gh
vkWijs'ku fFk;sVj esa yxs Vh-oh- Ldzhu ij vuqiek ds isV ds vUnj jDrL=ko
fn[kkbZ fn;kA bl fLFkfr dks ns[krs gq, izfri{kh la- 2 MkW- iq"ik r¡oj }kjk ysizksVkseh
djus gsrq vuqiek ds isV esa phjk yxk;k x;k o ekSt wn ,usfLFkfl;k fpfdRld
dks funsZ'k fn;k x;k fd og VsyhQksu ij rqjUr MkW- ,e- ,e- ckxM+h] ,e- ,l-
ltZjh ¼lsokfuo`r izksQslj l- i- esMhdy dkWyst chdkusj½ tks izfri{kh uflZUx
gkse ds fy, vko';drk iM+us ij ltZjh dk;Z ds fy, viuh lsok;sa nsrs gSa ftUgsa
40 o"kksZa ls vf/kd le; dk ltZjh djus dk vuqHko gS] dks vfoyEc izfri{kh la-
1 ds ;gka igqapus dk vkxzg djsa ,oa jksxh dh fLFkfr ds ckjs esa tkudkjh nsAa rc
rd MkW- iq"ik r¡oj jDrL=ko dks jksdus ds fy, ysizksVkseh djrh gSA ,usfLFkfl;k
fpfdRld MkW- vkj- ds- fot; us rqjUr Qksu dj MkW- ,e- ,e- ckxM+h dks lwpuk
nhA blh chp MkW- iq"ik r¡oj us ysizksVkseh izfdz;k ls vuqiek ds isV dks [kksydj
jDrL=ko dh txg dks <wa<k o ik;k fd ehtsaVjh o NksVh vkar ls jDrL=ko gks
jgk gS ml LFkku ij xhys Liat Mkydj ncko nsdj jDrL=ko dks jksdk x;k
rFkk ukWeZy lykbZu Mkydj isV ij Qsys jDr dks lkQ fd;k blh chp 10 feuV
ds vUnj MkWa0 ckxM+h] izrki izlwfr x`g igqWap x, ftUgksusa vkdj vuqiek ds isV
ds vUnj dh fLFkfr dks tkapk o ns[kk fd vuqiek dh NksVh vkar vkil esa rFkk
isV ds vUn:uh nhokj ls fpidh gqbZ gSA NksVh vkWar esa nks txg Nsn gS tks osfjl
fuMy dh batjh ls laHkkO; Fkh lkFk gh mUgksusa ;g ik;k fd ehtsaVjh f>Yyh tks
NksVh vk¡r dks isV ds ihNs dh nhokj ls tksM+dj j[krh gS] esa Hkh mlh rjg dh
batjh gSA lkekU;r;k vk¡rsa vkil esa fpidh gqbZ ugha gksrh uk gh isV dh nhokj
ds vUn:uh lrg esa fpidh gksrh gSA MkW- ckxM+h us rqjUr NksVh vk¡r o ehtsaVjh
f>Yyh esa vkbZ gqbZ batjh dh fjis;j dj nh ftlls ogka ls fCyfMax gksuk can gks
x;kA MkW- ckxM+h o MkW- iq"ik r¡oj us vuqiek ds isV ds vUn:uh fgLlksa dk
lw{erk ls fujh{k.k fd;k] vU;= dksbZ batjh ugha gksuk o vU;= fdlh LFkku ls
dksbZ fCyfMax ugha gksuk ik;k x;kA blh nkSjku izfri{kh la- 3 us 5 ;wfuV CyM
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dh O;oLFkk dj vuqiek dks CyM bUQ~;wtu pkyw fd;k rkfd mlds 'kjhj esa [kwu
dh iwfrZ dh tk lds o ejht dks lnes o vU; dkWEifydslh ls cpk;k tk ldsA
iw.kZ:i ls larq"V gksdj MkW- ckxM+h us vuqiek dh vk¡r o f>Yyh dh fjis;j ds
ckn fdlh vU; LFkku ls jDrL=ko ugha gksuk ikdj vuqiek ds isV es a Mªsu V~;wc
Mkydj isV ij Vk¡ds yxkdj cUn dj fn;k o vkWCtjos'ku ds fy, vkWijs'ku
fFk;sVj esa gh j[kk x;kA ml le; vuqiek dh fLFkfr o iSjkehVj lkekU; FksA
vuqiek ds iSjkehVj lkekU; Fks o mldh fLFkfr esa lq/kkj gksus dh lEHkkouk Fkh]
ijUrq vuqiek ds ifjokjokyksa us izfri{khx.k ij ncko cuk;k fd QnZj bykt ds
fy, vuqiek dks ih-ch-,evLIkrky chdkusj jsQj fd;k tkosA mudh bPNk o
fuosnu ij MkW- iq"ik r¡oj us ,Ecwysal eaxokdj MkW- fodze r¡oj dh fuxjkuh esa
vkWDlhtu flysM
a j o CyM ds lkFk vuqiek dks ih- ch- ,e- vLirky chdkusj
jsQj dj fn;k o mlh fnu yxHkx <kbZ cts vuqiek ih-ch-,e-vLirky ds
vkikrdky okMZ esa HkrhZ gqbZ] ogka ij Hkh MkW- fodze r¡oj mldh ns[kHkky djrs
jgs o vLirky ds MkWDVjksa dks vuqiek ds ckjs esa lHkh tkudkfj;ka nh o gj lEHko
lgk;rk iznku djus dh dksf'k'k dhA blds ckotwn fnukad 14-07-2007 dks gh
ih-ch-,e-vLIkrky chdkusj esa vuqiek dh e`R;q gks xbZ o fnukad 15-07-2007 dks
vuqiek dk 'ko&ijh{k.k fd;k x;kA ml le; izfri{kh la- 2 o 3 ogka mifLFkr
ugha Fks] uk gh mUgsa cqyk;k x;kA ysizkVs kseh ds i'pkr~ MkW- iq"ik r¡oj o MkW- ,e-
,e- ckxM+h us vuqiek ds isV dk vk¡rfjd lw{e fujh{k.k fd, tkus ds ckn mldh
jkbZV dkWeu ,sfy,d vkjVjh esa dksbZ jDrL=ko ugha ik;k FkkA bl lEHkkouk ls
bUdkj ugha fd;k tk ldrk fd ;g batjh 'ko&ijh{k.k djus okys fpfdRld ds
pkdw ls vk ldrh gS] D;ksfa d 'ko&ijh{k.k ds le; phjk yxkrs le; oSlh
lko/kkuh ugha cjrh tkrh tSlh fd thfor O;fDr ds phjk yxkus ds le; j[kh
tkrh gSA ;fn ysizksVkseh fd, tkus ds le; ,sfy,d vkjVjh esa ,slh dksbZ pksV
vkrh rks fuf'pr :i ls Mªsu V~;wc ls CyM ckgj vkrk o isV cUn djus ls iwoZ
isV ds vUnj jDrL=ko utj vkrk] fdUrq ih-ch-,e-vLirky chdkusj jsQj fd,
tkus ds le; rd ,slk dksbZ jDrL=ko ckgj ugha vk;kA izfri{khx.k o MkW- ckxM+h
iw.kZ fpfdRlh; vuqHko ls ;qDr gSaA vuqiek ds vk¡rfjd vaxksa esa gqbZ batjh
ysizksLdksih izfd;k esa fufgr vUn:uh [krjs ¼bugsjsaV Mst
a j½ dh lEHkkouk dk
ifj.kke gS uk fd fpfdRld dh dksbZ Hkwy ;k ykijokghA bl bugsjsVa Msatj dh
tkudkjh vuqiek o ifjoknh dks ns nh xbZ Fkh o mudh lgefr nsus ij gh bykt
'kq: fd;k x;k FkkA ysizksLdksfid izfdz;k esa 3&4 izfr'kr ekeyksa esa efgyk,a bl
7
izdkj dh ?kVuk dh f'kdkj gksrh gS ftls ,DV vkWQ xkWM gh dgk tk ldrk gS
uk fd izfri{khx.k dh lsok esa dksbZ dehA
ifjoknh eqds'k ukgVk us vuqiek dh e`R;q ds i'pkr~ nwljh efgyk ls 'kknh
dj yh gS o vius oSokfgd thou dk Hkjiwj vkuUn izkIr dj jgk gSA izdj.k ds
U;k;laxr fu.kZ;u ds fy, l{ke o foLr`r vUoh{kk dh tkuh vko';d gSA ifjoknh
}kjk fdlh ,DliVZ fpfdRlh; vksfifu;u Hkh ifjokn ds lkFk izLrqr ugha dh gSA
bl dkj.k ,slk ekeyk flfoy U;k;ky; }kjk foLr`r vUoh{kk dj gh fuf.kZr fd;k
tk ldrk gSA ekuuh; ftyk eap dks ifjokn lquus o r; djus dh {ks=kf/kdkfjrk
ugha gSA vr% ifjokn lO;; fujLr fd;k tkosA
cgl tfj;s ohfM;ksdkWQzsaflax lquh ,oa i=koyh dk voyksdu fd;kA
;g izdj.k fpfdRlh; ykijokgh dk gS fpfdRlh; ykijokgh ds laca/k esa
ekuuh; loksZPp U;k;ky; us tks fl)kUr izfrikfnr fd;s gS og eq[; :i ls
fuEu izdkj gS %&
2010 (I) RLW 722 (SC) Kusum sharma & ors. Vs. Batra Hospital & Medical
Research Centre & ors. esa fpfdRlh; ykijokgh ds laca/k esa ekuuh; loksZPp
U;k;ky; us fuEu fn'kk&funsZ'k fn;s gS%&
"On scrutiny of the leading cases of medical negligence both in
our country and other countries specially the United Kingdom, some
basic principles emerge in dealing with the cases of medical
negligence. While deciding whether the medical professional is guilty
of medical negligence following well known principles must be kept in
view:
I. Negligence is the breach of a duty exercised by ommission to
do something which a reasonable man, guided by those
considerations which ordinarily regulate the conduct of human
affairs, would do, or doing something which a prudent and
reasonable man would not do.
II. Negligence is an essential ingredient of the offence. The
negligence to be established by the prosecution must be
culpable or gross and not the negligence merely based upon an
error of judgment.
III. The medical professional is ecpected to bring a reasonable
degree of skill and knowledge and must exercise a reasonable
degree of care. Neither the very highest nor a very low degree
of care and competence judged in the light of the particular
circumstances of each case is what the law requires.
8
IV. A medical practitioner would be liable only where his conduct
fell below that of the standards of a reasonable competent
practitioner in his field.
V. In the realm of diagnosis and treatment there is scope for
genuine difference of opinion and one professional doctor is
clearly not negligent merely because his conclusion differs
from that of other professional doctor.
VI. The medical professional is often called upon to adopt a
procedure which involves higher element of risk, but which he
honestly believes as providing greater chances of success for
the patient rather than a procedure involving lesser risk but
highest chances of failure. Just because a professional looking
to the gravity of illness has taken higher element of risk to
redeem the patient out of his/her suffering which did not yield
the disired result may not amount to negligence.
VII. Negligence cannot be attributed to a doctor so long as he
performs his duties with reasonable skill and competence.
Merely because the doctor chooses one course of action in
preference to the other one available, he would not be liable if
the course of action chosen by him was acceptable to the
medical profession.
VIII. It would not be conducive to the effciency of the medical
profession if no doctor could administer medicine without a
halter round his neck.
IX. It is our bounden duty and obligation of the civil society to
ensure that the medical professionals are not unnecessarily
harassed or humiliated so that they can perform their
professional duties without fear and apprehension.
X. The medical practitioners at times also have to be saved from
such a class of complainants who use criminal process as a tool
for pressurising the medical professionals/hospitals,
particularly private hospitals or clinics for extractine uncalled
for compensation. Such malicious proceedings deserve to be
discarded against the medical practitoners.
XI. The medical professionals are entitled to get protection so long
as they perform their duties with reasonable skill and
competence and in the interest of the patients. The interest and
welfare of the patients have to be paramount for the medical
professionals.
(2005) 6 Supreme Court Cases 1 JACOB MATHEW Vs
STATE OF PUNJAB AND AN OTHER esa ekuuh; loksZPp
U;k;ky; us fuEu fu/kkZfjr fd;k gS %& J. Tort -Negligence -
Medical Negligence -When actionable -Test for Approach to be
taken in dealing with cases of -Rationable for differential treatment
of medical profession, discussed in extenso - Duties undertaken by
doctors enumerated - Held, in a claim of medical negligence, it is
enough for defendant to show that standard of care and skill attained
was that of the ordinary competent medical practitioner exercising an
ordinary degree of professional skill - Test for medical negligence
laid down in Balam case, (1957) 2 All ER 118, 121 D-F [set out in
9
para 19 herein], held, applicable in india -Further explained in detail
when deviation from normal medical practice would amount to
evidence of medical negligence - various issues clarified as to (1)
state of knowledge by which standard of care is to be determined, (2)
Standard of care in case of charge of failure (a) to use some particular
equipment, or (b) to take some precaution, (3) enquiry to be made
when alleged negligence is (a) due to an accident, or (b) due to an
error of judgment in choice of a procedure or its execution--
Considerations to be kept in mind by any forum trying issue of
medical negligence, specified -Medical Practitioners
K. Tort -Negligence - Professional negligence--when
actionable--Test for--Held, a professional may be held liable for
negligence either (1) wnen he was not possessed of the requisite skill
which he professed to have possessed, or (2) when he did not
exercise, with reasonable competence in the given case, the skill
which he did possess--Standard to be applied would be that of an
ordinary competent person exercising ordinary skill in that
profession--Test for professional negligence laid down in Bolam
case, (1957) 2 All ER 118, 121 D-F [set out in para 19 herein], held,
applicable in India - Professional negligence distinguished from
occupational negligence.
N. Tort -Negligence-Definition and meaning
(jurisprudential and forensic), discussed in estenso -Words and
phrases
The jurisprudential concept of negligence defies any precise
definition. In current forensic speech, negligence has three meanings.
They are: (i) a state of mind, in which it is apposed to intention; (ii)
careless conduct; and (iii) the breach of a duty to take care that is
imposed by either common or stature law. All three meanings are
aplicable in different circumstances but any one of them does not
necessarily exclude the other meanings. (paras 10 and 11 )
Negligence is the breach of a duty caused by omission to do
domething which a reasonable man guided by those considerations
which ordinarily regulate the conduct of human affairs would do, or
doing something which a prudent and reasonable man would not do.
Negligence becomes actionable on account of injury resulting from
the act or omission amounting to negligence attributable to the person
sued. The essential components of negligence, as recognised, are
three: "duty", "breach" and "resulting damage", that is to say:
(1) the existence of a duty to take care, which is owed
by the defendant to the complainant;
(2) the failure to attain that standard of care, prescribed
by the law, thereby committing a breach of such
duty; and
(3) damage, which is both causally connected with such
breach and recognised by the law, has been suffered
by the complainant.
If the Claimant satisfies the court on the evidence that these
three ingredients are made out, the defendant should be held liable in
negligence.
10
bl lac/a k es I (2017) CPJ 8 (SC) ALFRED BENDDICT
AND ANOTHER V/S MANIPAL HOSPITAL, BANGALORE
AND OTHERS esa ekuuh; loksZPp U;k;ky; us fu/kkZfjr fd;k
gS fd%& Medical Negligence - Needle - wrongly inserted - Girl
child, aged 2 years, developed gangrene resulting into amputation of
her right arm - Girl will have to suffer throughout her life and has to
live with artificial limb - Not only she would have to face difficulty
in her education but would have also to face problem in getting
herself married - Compensation @ Rs. 20 lakh will be just and
reasonable.
II (2009) CPJ 61 SC NIZAM INSTITUTE OF MEDICAL
SCIENCES Vs. PRASANTH S. DHANANKA esa ekuuh; loksZPp
U;k;ky; us fuEu fu/kkZfjr fd;k gS %& (ii) Medical
Negligence--Burden of Proof -- Initial burden to prove medical
negligence discharged by complainant - Burden shifts on
hospital/attending doctors to satisfy Court that there was no lack of
care or deligence.
III (2017) CPJ 545 (NC) G.V.S. RAO (DR.) VERSUS K.
CHINNA REDDY & ANR. esa ekuuh; jk"Vªh; vk;ksx us fuEu
fu/kkZfjr fd;k gS& Consumer Protection Act, 1986 - Sections
2(1)(g), 21(b) Medical Negligence - Stapedotomy operation on right
ear - Internal injury in skull and haemorrhage occurred - Death of
patient - Deficiency is service - District Forum dismissed complaint
- State Commission allowed appeal - Hence revision - Patient had
died in hospital of opposite party - Cause of death as mentioned in
post-mortem report is pulmonary oedema nad cerebral oedema -
Subdural haemorrhage in the brain found during post-mortem
examination has not been explained either by opposite party or by any
other report available on record - This may be due to internal injury
during operaton or due to delayed effect of anaesthesia administered
by surgeon himself without any informed consent by patient's family
members - Expert has opined that anaesthesia was given by surgeon
himself and not by any anaesthetist - Negligence proved -
Compensation awarded.
11
III (2011 ) CPJ 31 (NC) FAKIR CHAND Vs. PRINCIPAL
MEDICAL SUPERIN TENDENT, SAFDARJANG HOSPITAL,
NEW DELHI esa ekuuh; jk"Vªh; vk;ksx us fuEu fu/kkZfjr
fd;k gS %& Consumer Protection Act, 1986 - Section 2( 1) (g), 14
(1) (d), 21 (b) - Medical Negligence - Hospital - No Proper care -
Deficiency in service - Admitted in casualty - Not admitted in I.C.U.
- Necessary tests done - complainant shifted deceased to another
hospital Died - Alleged deficiency in service - District Forum
allowed complaint - State Commission dismissed appeal - Hence
revision - Complainant contended enhancement of compensation -
Deceased remained for 51/2 hours in hospital ant not admitted in
I.C.U. - No evidence such as sheet/history produced to show medical
support provided Deficiency in service proved -- Compensation
granted by Fora below is adequate.
ekuuh; loksZPp U;k;ky; }kjk izfrikfnr fl)kUrksa dh jks'kuh esa fpfdRlh;
vlko/kkuh ij fopkj djsa rks nks 'kCn vkrs gS %& ¼1½ Skill ¼ 2 ½ Care
Skill dk tks igyk vFkZ gS og ;g fd bZykt ;k vkWijs'ku djus okys
fpfdRld dh Qualification gksuh pkfg,A
f}rh; fcUnq foospu dk gS tks izR;sd izdj.k ds rF;ksa ij fuHkZj djrk gS
fd izksij Skill ls bZykt ;k vkWijs'ku fd;k x;k ;k ughaA blh izdkj Care 'kCn
ns[kHkky ,fifjfl;s'ku dk fo"k; gSA izR;sd izdj.k ij fuHkZj djrk gS fd bZykt
djkus vkWijs'ku djkus ls iwoZ] bZykt ;k vkWijs'ku ds nkSjku ;k bZykt ;k vkWijs'ku
djkus ds ckn Care dh x;h ;k ugha 'kq: esa Skill & Care tujy ekuh tkrh
Fkh fd lkekU;r% Skill & Care mi;ksx fd;k x;k ;k ugha ckn esa /khjs /khjs blesa
ifjorZu vkrk x;k D;ks fd Lis'kfyLV vkSj lqij Lis'kfyLV dk tekuk vk x;k
rFkk dkWjiksjsV gkWfLiVy dk tekuk vk x;k blfy, Skill & Care dh ftEesnkjh
fpfdRldksa ij o vLirkyksa ij T;knk c<+ x;h] blh izdkj Burden of Proof
dk tekuk Fkk igys fpfdRlh; vlko/kkuh fl) djus dk Hkkj iw.kZr% ifjoknh ij
gksrk Fkk ijUrq ckn esa /khjs /khjs blesa ifjorZu gksrk x;k vc Burden of Proof
ifjoknh dks fl) djuk gS] tks lgh :i ls fl) djuk gS mlds ckn fpfdRldksa
o vLirkyksa ij Hkkj vk x;k fd oks mldk iw.kZr [k.Mu djsAa
bl izdj.k ds rF;ksa ij fopkj djsa rks ifjoknh o mldh iRuh Jherh
vuqiek ukgVk dk ?kVuk ds yxHkx 4 o"kZ iwoZ fookg gqvk FkkA fookg ds i'pkr~
12
LokHkkfod :i ls gj tksM+k larkuksRifÙk pkgrk gS ijUrq vuqiek ukgVk xHkZ/kkj.k
ugha dj ik jgh Fkh] rFkk mlds fy, og vPNs vLirky esa x;h ogkWa ds fpfdRldksa
us ns[kk rFkk Mk;XuksfLVd ysizksLdksih djus dk fu.kZ; fy;k rFkk mlds fy,
e`rdk o mlds ifr ls igys fnu lgefr yh x;h] rFkk ckn lgefr vxys fnu
Mk;XuksfLVd ysizksLdksih 'kq: dh x;h lqjk[k fudkyus ds fy, fuMYl Mkyh x;h
isV Qqykus ds fy, xSl Mkyh x;h fQj ml lqjk[k esa Vªksdkj Mkyk x;k rFkk
Vªksdkj fQDl djus ds ckn VsyhLdksi Mkyh x;h VsyhLdksi ls tc dEI;wVj esa
ns[k jgs Fks] rks] CyM fn[kkbZ fn;k rqjUr Mk;XuksfLVd ysizksLdksih cUn dh x;h
rFkk ysizksVkseh 'kq: dh x;h tks ,d izdkj ls open ltZjh gS] ofj"B tujy
ltZu MkWa0 ,e-,e-ckxM+h dks cqyk;k x;k tks gkWfLiVy eas vkdj rS;kj gksdj
ysizksVkseh esa 'kkfey gks x;s] vLirky ds vuqlkj bULVsVkbZu esa esa 2 Nsn Fks ftlls
CyhafMx gks jgh Fkh mldks fjis;j fd;k x;k rFkk bartkj fd;k x;k] vLirky
ds vuqlkj tc dksbZ CyhafMx ugha gks jgh Fkh] rks] izfdz;k ds vuqlkj isV can dj
fn;k x;k rFkk vkCtZo's ku esa j[k fy;k x;kA ;gkWa ;g mYys[k djuk Hkh mfpr
gksxk fd ysizksVkseh tSlh open ltZjh dh x;h rFkk vLirky esa ICU ugha FkkA
bl laca/k esa IV (2017) CPJ 1 (SC) BIJOY SINHA
ROY (D) BY LR. VS. BISWANATH DAS & ORS. esa
ekuuh; loksZPp U;k;ky; us fuEu fu/kkZfjr fd;k gS%&
(iii) Consumer Protection Act, 1986- Sections 2 (1) (g), 14
(1) (d), 23 - Medical Negligence - uterus surgery -Death of
patient -Forcibility of risk in performing surgery at a Nursing
Home which did not have ICU - Decision of perform surgery
may not by itself be held to be medical negligence - Neither
State Commission nor National Commission have examined
plea of appellant that operation should not have been
performed at a nursing home which did not have ICU when
it could be reasonably foresseen that without ICU there was
post-operative risk to life of patient--Compensation @ Rs. 5
Lakh awarded - Directions issued.
2-30 cts ejht dks PBM gkWfLiVy] chdkusj esa jSQj dj fn;k x;k foi{kh
ds vuqlkj ejht ds ifjtuksa dh ftn ds dkj.k jSQj fd;k x;k ijUrq ,slk dksbZ
uksV vLirky ds fjdkMZ esa ugha gS vLirky dh lkjh izfdz;k fuEu izdkj gS%&
Patient was taken for diagnostic laproscopy under GA on
14/7/07, Veris needle was inserted in the peritoneal cavity.
Approximately 10 ML of fluid was administered through the Veris
needle. Abdomen was inflated with CO2 at 12 mm of Hg. 10 mm
retractable trocar was inserted through the umbilical port. On
insertion of telescope in the peritoneal cavity, bleeding was
13
observed through the retro peritoneum. Conversion, Dr MM Bagri
was called immediately and laprotomy done immediately.
Perforation small intestine with Veris needles seen and small rent in
the retroperitoneal space seen. Blood clots removed, hot packing
done, injection mephentine 2 cc given IV, Hemaccael started. BP =
60 MM of HG, pulse = 138 per minute. Blood transfusion started and
intestine repaired. Packing removed after 15 minutes, no fresh
bleeding seen through the rent. Abdominal drain put, abdomen
closed in layers.
BP = 80 MM of Hg, pulse - 140 per minute, feeble .
Continuous blood transfusion given. Second unit of blood started.
Injection GDW5% 500 mL given by Cannula + injection dopamine 4
amp to start
BP = 90 MM of Hg, Pulse - 140/min , feeble brachial pulse,
injection calcium gluconate one ampoule given IV slowly,
injection dobutamine 1 ampoule started in 500 mL,
injection Primacort 200 mg given IV slowly,
Inj. Rantac 1 amp.given IV stat,
Injection Hemaccael one bottle given IV
injection botrapase 2 cc given IV stat,
BP = 70 MM of Hg,Pulse
injection dopamine 4. Amp.given in 500 mL of GDW ,
injection Relidex one bottle given IV ,
third unit of blood transfused ,
BP = 80 MM of HG, pulse = 132 per minute feeble
4th unit of blood transfused
injection dopamine 4 amp given in 500 mL of GDW
fifth unit of blood started
patient referred to PBM at 2:30 PM on 14/7/07 with pulse =
150 per minute , BP = 60 MM of Hg, patient responding to verbal
commands. Patient conscious and shifted to PBM with endotracheal
tube with Ambo bag at 2:30 PM on 14/ 7/ 07
PBM vLirky igqWaps ogkWa fpfdRldksa us bZykt fd;k ijUrq nqHkkZX; ls ejht
dh e`R;q gks x;h] mldh ,Q-vkbZ-vkj- ntZ gqbZ vkjksi&i= Hkh is'k gqvk mldks
nks"keqDr djkj ns fn;k x;k ijUrq vkijkf/kd izdj.k esa nks"keqfDr fpfdRlh;
ykijokgh ds ekeys esa dksbZ ek;us ugha j[krh gSA e`rdk dk iksLVekVZe fd;k x;k
ftldh fjiksVZ fuEu izdkj gS%&
PMR REPORT
14
Injuries present over body at the time of post-mortem
examination
1.Two needle prick including one in each cubital fossa anteriorly present with clotted blood
2. One needle prick mark present on right...... posteriorlateraly
3. Two needle prick marks, one on each inguinal region present Above mentioned injuries number (1 to 3) are due to for IV line Stitched wound of size 16 cm long, present over abdomen anteriorly, midline, vertically placed......... from infra umbilical region.
Supra pubic region on dissection, there is collection of about 2.5 L of blood in the peritoneal cavity. Blood is present in retroperitoneal space and in jejunum, about 1 feet from gastroduedonal Junction , on anterior and posterier wall each one tear of size 0.8 cm * 0 .2 cm present in the mesentry. On further dissection, there is tear of size 0.5 cm present in the anterior wall of right common iliac artery, 2.5 cm away from the bifurcations, adhesions are present in the uterine adnexa and surrounding region.
Opinion - The cause of death is shock and and haemorrhage due to antemortem intra abdominal injury as mentioned in the post- mortem report, sufficient to cause death in .........course of nature iksLVekVZe fjiksVZ dk voyksdu djsa rks e`rdk ds isV ds ckgjh rjQ rhu lqjk[k ds fu'kku Fks tc fd vLirky ds vuqlkj fuMy Mkyh x;h Vªksdkj yxk;k x;k dsejk Mkyk x;k CyM fn[kkbZ nsus yxk rqjUr ysizksVkseh 'kq: dj nh ,slh fLFkfr esa 2 lqjk[k dh D;k vko';drk Fkh] ;g le> ls ijs dk fo"k; gSA vLirky esa foi{kh ds vuqlkj ejht ds flQZ bULVsVkbZu esa vkxs ihNs 2 Nsn Fks ftls ysizksVkseh ds ckn ejEer dj nh x;h vU; dksbZ Nsn ugha Fkk] tc fd 'ko ijh{k.k fjiksVZ ds vuqlkj ,sfy,d vkVZjh dVh gqbZ FkhA ;gkWa ;g mYys[k djuk mfpr gksxk fd ejht dh bruh T;knk CyhafMax gqbZ gS fd 5 ;wfuV [kwu p<k gS bruh T;knk CyhfMax bULVsVkbZu ds Nsn ls ugha gks ldrh ;g ,sfy,d vkVZjh esa jsIpj ds dkj.k gh gks ldrh gS ;gkWa rd fd tc 'ko ijh{k.k fd;k x;k rks mlds isV esa <kbZ yhVj [kwu ik;k x;k tc fd bULVsVkbZu ds lqjk[k dh ejEer dj nh x;h Fkh] rks] <kbZ yhVj [kwu dSls vk x;k \ foi{khx.k dk cpko gS fd 'ko ijh{k.k ds nkSjku /;ku ugha j[kk x;k ml le; ,sfy,d vkVZjh dV x;h rFkk bruh T;knk CyhafMx gks x;h ejht dh e`R;q 14-07-2007 dks 4-40 ih-,e- ij gqbZ gS rFkk 'ko ijh{k.k 15-07-2007 dks 9-40 ,-,e- ij gqvk gS ;kfu djhc 17 ?kaVs ds 15 ckn 'ko ijh{k.k gqvk gS 17 ?kaVs 'ko jgus ds ckn e`rdk ds 'kjhj esa [kwu ugha jg ldrk ;g ;k rks rjy inkFkZ esa ifjofrZr gks ldrk gS ;k DykWV gks ldrs gSA ,slh fLFkfr esa 'ko ijh{k.k ds le; CyM dh fLFkfr gh ugha jgrh gS ;g CyM e`R;q iwoZ dk gh Fkk rFkk bruk T;knk CyM ,sfy,d vkVZjh jsIpj gksus ij gh vk ldrk gS] pkgs ;g ysizksLdksih djrs gq, gqvk gks ;k pkgs ysizksVkseh djrs gq, gqvk gks] pkgs ;g ysizksVkseh ds ckn cUn djrs le; gqvk gks tSlh fLFkfr gks ,sfy,d vkVZjh ysizksLdksih ;k ysizksVkseh ds nkSjku gqvk gS vR;f/kd CyhfMax gqbZ gS CyhfMax ds ifj.kkeLo:i ejht Hypovolemic Shock esa vk;k gS rFkk mlh ds ifj.kkeLo:i mldh e`R;q gqbZ gS Hypovolemic Shock ds ckjs esa fuEu izdkj gS%& What Is Hypovolemic Shock?
Hypovolemic shock is a life-threatening condition that results when you lose more than 20 percent (one-fifth) of your body's blood or fluid supply. This severe fluid loss makes it impossible for the heart to pump a sufficient amount of blood to your body. Hypovolemic shock can lead to organ failure. This condition requires immediate emergency medical attention.
Hypovolemic shock is the most common type of shock, with very young children and older adults being the most susceptible.
What causes hypovolemic shock?
Hypovolemic shock results from significant and sudden blood or fluid losses within your body. Blood loss of this magnitude can occur because of:
bleeding from serious cuts or wounds bleeding from blunt traumatic injuries due to accidents internal bleeding from abdominal organs or ruptured ectopic pregnancy bleeding from the digestive tract significant vaginal bleeding Endometriosis 16 In addition to actual blood loss, the loss of body fluids can cause a decrease in blood volume. This can occur in cases of:
excessive or prolonged diarrhea severe burns protracted and excessive vomiting excessive sweating Blood carries oxygen and other essential substances to your organs and tissues. When heavy bleeding occurs, there is not enough blood in circulation for the heart to be an effective pump. Once your body loses these substances faster than it can replace them, organs in your body begin to shut down and the symptoms of shock occur. Blood pressure plummets, which can be life-threatening.
What are the symptoms of hypovolemic shock?
The symptoms of hypovolemic shock vary with the severity of the fluid or blood loss. However, all symptoms of shock are life-threatening and need emergency medical treatment. Internal bleeding symptoms may be hard to recognize until the symptoms of shock appear, but external bleeding will be visible. Symptoms of hemorrhagic shock may not appear immediately. Older adults may not experience these symptoms until the shock progresses significantly.
Some symptoms are more urgent than others.
Mild symptoms Mild symptoms can include:
headache fatigue nausea profuse sweating dizziness ejht ds Diagnositic Laparoscopy ls 'kq: gqvk ftlds fuEu izdkj gS %& 17 WHAT IS DIAGNOSTIC LAPAROSCOPY?
A laparoscope is a telescope designed for medical use. It is connected to a high intensity light and a high-resolution monitor. In order for the surgeon to see inside your abdomen, a hollow tube (port) is placed through your abdominal wall, and the laparoscope is inserted into the port. The image of the inside of your abdomen is then seen on the monitor. In most cases, this procedure (operation) will be able to diagnose or help discover what the abdominal problem is.
Diagnositic LaparoscopyxHkZorh ugha gksus ds dkj.k dh x;h ftldk laf{kIr fpfdRlh; foKku fuEu izdkj gS%& Laparoscopy may be used to diagnose infertility or to treat a fertility problem.1 Laparoscopy is a surgical procedure that involves making one, two, or three very small cuts in the abdomen, through which the doctor inserts a laparoscope and specialized surgical instruments. A laparoscope is a thin, fiber- optic tube, fitted with a light and camera.
Overview Laparoscopy allows your doctor to see the abdominal organs and sometimes make repairs, without making a larger incision that can require a longer recovery time and hospital stay.
Whether or not diagnostic laparoscopy should be done in women with infertility is controversial.2 If a woman is experiencing pelvic pain, then the consensus is that surgery may be recommended.
However, in cases of unexplained infertility, or situations where pelvic pain is not a factor, whether the benefits of the surgery outweigh the risks is a matter of debate.
When Laparoscopy Is Used Your doctor may suggest laparoscopic surgery to help diagnosis a cause for infertility. Usually, it's performed only after other infertility testing has been completed, or if symptoms warrant testing.
Laparoscopy should not be done routinely, however.
Possible reasons your doctor may recommend diagnostic laparoscopy include:
You experience pain during sexual intercourse 18 You have severe menstrual cramps or pelvic pain at other times in your cycle Moderate to severe endometriosis is suspected Pelvic inflammatory disease or severe pelvic adhesions are suspected Your doctor suspects an ectopic pregnancy (which can be life-threatening if left untreated) Often (but not always), if a diagnostic laparoscopy finds problems, the reproductive surgeon will repair, remove, or otherwise treat the issue right away.
Laparoscopic surgery may be used to surgically treat some causes of female infertility. Your doctor may recommend surgery if:
Hydrosalpinx is suspected. This is a specific kind of blocked fallopian tube. Removing the affected tube can improve IVF success rates.
Endometrial deposits are suspected of reducing your fertility. This is rather controversial, with some doctors saying removal is only warranted if you're in pain, and others saying it can improve pregnancy success rates and is worth doing even if pelvic pain isn't a problem.
Surgery may be able to unblock or repair a fallopian tube. Success rates vary greatly when it comes to tubal repair. If IVF is going to be required even after surgery, then going straight to IVF is a better choice. If the woman is young and all other fertility factors look good, surgical repair may be worth trying first. An ovarian cyst is suspected of causing pain or blocking the fallopian tubes. Sometimes, drainage of the cyst with an ultrasound-guided needle is better. Removal of a large endometrial ovarian cyst may reduce your ovarian reserves. Your doctor should discuss this with you.
A fibroid is causing pain, distorting the uterine cavity, or blocking your fallopian tubes. You have PCOS and your doctor recommends ovarian drilling. Laparoscopic ovarian drilling involves making three to eight tiny punctures into the ovaries. In women with PCOS who have not ovulated on fertility drugs, this procedure may enable them to ovulate on their own. However, the risks may not outweigh the benefits, and its use is controversial.
Why It's Needed 19 Some causes of infertility can only be diagnosed through laparoscopy.2 (Endometriosis, for example.) Laparoscopy allows your doctor to not only see what's inside your abdomen but also biopsy suspicious growths or cysts.
Also, laparoscopic surgery can treat some causes of infertility, allowing you a better chance at getting pregnant either naturally or with fertility treatments.
The most important reason for diagnostic laparoscopy is if you're experiencing pelvic pain.
Laparoscopy can be used to remove scar tissue, a fibroid, or endometrial deposits that are causing pain.
Preparation for the Procedure WHAT TESTS ARE NECESSARY BEFORE LAPAROSCOPY?
Ultrasound may be ordered by your doctor as a non- invasive diagnostic test. In many cases, information is provided which will allow your surgeon to have a better understanding of the problem inside your abdomen. This test is not painful, is very safe, and can improve the effectiveness of the diagnostic laparoscopy.
CT Scan is an X-ray that uses computers to visualize the intra-abdominal contents. In certain circumstances, it is accurate in making the diagnosis of abdominal disease. It will allow your surgeon to have a "road map" of the inside of your abdomen. A radiologist may use a CT scan to place a needle inside your abdomen. This is known as a CT guided needle biopsy. This will often be done before a diagnostic laparoscopy to decide if laparoscopy is appropriate for your condition. A MRI uses magnets and computers to view the inside of the abdominal cavity. It is not required for most abdominal problems, but may be necessary for some.
Routine blood test analysis, urinalysis, and possible chest X-ray or electrocardiogram may be needed before diagnostic laparoscopy. Your physician will decide which tests are necessary and will review the results of those tests, which have already been performed.
How Is It Done?
Laparoscopy is performed in a hospital under general anesthesia. While it is sometimes possible to conduct a diagnostic laparoscopy in a fertility clinic office, this is not recommended. In the office setting, if something is found during the procedure, you will need to have the procedure again in a hospital setting for the repair.20
Your doctor will give you instructions on how to prepare for surgery beforehand. You will probably be told not to eat or drink for 8 or more hours before your scheduled surgery, and you may be instructed to take antibiotics.
When you get to the hospital, you'll receive an IV, through which fluids and medication to help you relax will be delivered. The anesthesiologist will place a mask over your face, and after breathing a sweet-smelling gas for a few minutes, you'll fall asleep.
Once the anesthesia has taken effect, the doctor will make a small cut around your belly button. Through this cut, a needle will be used to fill your abdomen with carbon dioxide gas. This provides room for your doctor to see the organs and move the surgical instruments.
Once your abdomen is filled with gas, the surgeon will then place the laparoscope through the cut to look around at your pelvic organs. The surgeon may also biopsy tissue for testing.
Sometimes, two or three more small cuts are made so that other thin surgical instruments can be used to make repairs or move the organs around for a better view.
The surgeon will visually evaluate the pelvic organs and the surrounding abdominal organs. He or she will look for the presence of cysts, fibroids, scar tissue or adhesions, and endometrial growths. He or she will also look at the shape, color, and size of the reproductive organs.
A dye may be injected through the cervix, so the surgeon can evaluate if the fallopian tubes are open.
Even if no signs of endometriosis or other problems are found, the surgeon may remove a sample of tissue to be tested. Sometimes, very mild endometriosis is microscopic and cannot be seen by the naked eye with the laparoscopic camera.
If an ectopic pregnancy is suspected, the surgeon will evaluate the fallopian tubes for abnormal pregnancy.
Laparoscopy ds tks Risk o Complication gaS og fuEu izdkj gS%& Risks As with any surgical procedure, laparoscopy comes with risks.
According to the American Society of Reproductive Medicine, one or two women out of every 100 may develop a complication, usually a minor one.3 Some common complications include:
bladder infection after surgery 21 skin irritation around the areas of incision Other less common, but potential, risks include:
formation of adhesions
hematomas of the abdominal wall
infection
Serious complications are rare, but include:
damage to the organs or blood vessels found in the abdomen (further surgery may be needed to repair any damage caused.) allergic reaction nerve damage urinary retention blood clots other general anesthesia complications death ejht ds loZizFke Veress needle Mkyh x;h blls blds isV ds vksxZu esa pksVs vk;h mldk fooj.k fuEu izdkj gS %& Veress needle Description Modern needles are 12 to 15 cm long, with an external diameter of 2 mm. The outer cannula consists of a beveled needle point for cutting through tissues of the abdominal wall. A spring-loaded, inner stylet is positioned within the outer cannula. This inner stylet has a dull tip to protect any viscera from injury by the sharp, outer cannula. Direct pressure on the tip--as when penetrating through tissue--pushes the dull stylet into the shaft of the outer cannula. When the tip of the needle enters a space such as the peritoneal cavity, the dull, inner stylet springs forward. Carbon dioxide is then passed through the Veress needle to inflate the space, creating a pneumoperitoneum.[6] Use In a large survey of 155,987 gynecologic procedures and 17,216 general surgery procedures, the Veress needle technique was used in 78% of them. Gynecologists (81%) used the tool more often than general surgeons (48%) who are far more likely to use the open access technique.[7] Iatrogenics 22 In different studies, it has been pointed out that for different laparoscopic surgery applications (such as cholecystectomy, groin hernia repairs and appendectomies) creating pneumoperitoneum by using a Veress needle is not always as safe and effective as other techniques (e.g. direct trocar insertion (DTI)).[8][9][10] However, some other prospective studies point out that there is no significant difference between the technique chosen and incidence of complications by inducing pneumoperitoneum using a Veress needle or the Hasson technique.[11][12] Between the complications associated to this instrument it can be found:
Injury to hollow viscous Bleeding Failure to achieve pneumoperitoneum Prepneumoperitoneum Biloma due to liver puncture.[13] Vascular injury blds i'pkr~ Retractable Trocar Mkyk x;k ftldk fooj.k fuEu izdkj gS%& (EN) RETRACTABLE TROCAR WITH SAFETY SHIELD (FR) TROCART RETRACTIBLE COMPORTANT UNE PROTECTION DE SECURITE Abstract (EN) A retractable safety penetrating instrument (20) with safety shield (26) for introducing a portal sleeve (24) into a cavity in the body includes a portal sleeve, a trocar (22) disposed within the portal sleeve and a safety shield disposed between the portal sleeve and the trocar and having a distal and biased to protrude beyond a sharp distal end (30) of the trocar.
The trocar is supported in a manner to automatically move proximally from an extended position wherein the sharp distal end protrudes from the portal sleeve to a retracted position wherein the sharp end is protected within the retractable safety penetrating instrument in response to distal movement of the safety shield upon penetration into a cavity in the body. A retracting mechanism moves the trocar proximally and is normally locked in a position preventing proximal movement of the trocar and is released by distal movement of an operating member to trigger retraction of the trocar.
(FR) Un instrument rétractible de pénétration de sécurité (20) comportant une protection de sécurité (26) servant à introduire une gaine porte (24) dans une cavité corporelle comprend une gaine porte, un trocart (22) situé à l'intérieur de ladite gaine porte et une protection de sécurité située entre la gaine porte et le trocart et possédant une extrémité distale sollicitée afin de former une saillie au-delà d'une extrémité distale aiguë (30) du trocart. Ledit trocart est supporté de façon à se déplacer automatiquement de façon proximale à partir d'une position étendue dans laquelle l'extrémité distale aiguë forme une saillie depuis la gaine porte vers une position retirée dans laquelle l'extrémité aiguë est protégée à l'intérieur de l'instrument 23 rétractible de pénétration de sécurité, en réaction au déplacement distal de la protection de sécurité, au moment de la pénétration dans une cavité corporelle. Un mécanisme de rétraction déplace le trocart de façon proximale, se verrouille normalement dans une position empêchant le déplacement proximal dudit trocart et se libère par l'intermédiaire du déplacement distal d'un élément fonctionnel, de façon à provoquer la rétraction du trocart.
ejht ds vLirky ds vuqlkj Small intestine esa lqjk[k gqvk bldk fpfdRlh; foospu fuEu izdkj gS %& The small intestine or small bowel is an organ in the gastrointestinal tract where most of the end absorption of nutrients and minerals from food takes place. It lies between the stomach and large intestine, and receives bile and pancreatic juice through the pancreatic duct to aid in digestion.
The small intestine has three distinct regions - the duodenum, jejunum, and ileum. The duodenum, the shortest, is where preparation for absorption through small finger-like protrusions called villi begins.[2] The jejunum is specialized for the absorption through its lining by enterocytes:
small nutrient particles which have been previously digested by enzymes in the duodenum. The main function of the ileum is to absorb vitamin B12, bile salts, and whatever products of digestion were not absorbed by the jejunum.
Structure Size The length of the small intestine can vary greatly, from as short as 3.00 m (9.84 ft) to as long as 10.49 m (34.4 ft), also depending on the measuring technique used.[3] The typical length in a living person is 3m-5m.[4][5] The length depends both on how tall the person is and how the length is measured.[3] Taller people generally have a longer small intestine and measurements are generally longer after death and when the bowel is empty. [3] Small bowel dilation on CT scan in adults[6] <2.5 cm Non-dilated It is 2.5-2.9 cm Mildly dilated 3-4 cm Moderately dilated >4 cm Severely dilated approximately 1.5 cm in diameter in newborns after 35 weeks of gestational age,[7] and 2.5-3 cm (1 inch) in diameter in adults.
On abdominal X-rays, the small intestine is considered to be abnormally dilated when the diameter exceeds 3 cm.[8][9] On CT scans, a diameter of over 2.5 cm is considered abnormally dilated.[8][10] The surface area of the human small intestinal mucosa, due to enlargement caused by folds, villi and microvilli, averages 30 square meters.[11] 24 Parts[edit] The small intestine is divided into three structural parts.
The duodenum is a short structure ranging from 20 cm (7.9 inches) to 25 cm (9.8 inches) in length, and shaped like a "C".[12] It surrounds the head of the pancreas. It receives gastric chyme from the stomach, together with digestive juices from the pancreas (digestive enzymes) and the liver (bile). The digestive enzymes break down proteins and bile emulsifies fats into micelles. The duodenum contains Brunner's glands, which produce a mucus-rich alkaline secretion containing bicarbonate. These secretions, in combination with bicarbonate from the pancreas, neutralize the stomach acids contained in gastric chyme.
The jejunum is the midsection of the small intestine, connecting the duodenum to the ileum. It is about 2.5 m long, and contains the plicae circulares, and villi that increase its surface area. Products of digestion (sugars, amino acids, and fatty acids) are absorbed into the bloodstream here. The suspensory muscle of duodenum marks the division between the duodenum and the jejunum.
The ileum: The final section of the small intestine. It is about 3 m long, and contains villi similar to the jejunum. It absorbs mainly vitamin B12 and bile acids, as well as any other remaining nutrients. The ileum joins to the cecum of the large intestine at the ileocecal junction.
The jejunum and ileum are suspended in the abdominal cavity by mesentery. The mesentery is part of the peritoneum. Arteries, veins, lymph vessels and nerves travel within the mesentery.[13] ejht ds iliac artery dVh bldk fooj.k fuEu izdkj gS %& The common iliac arteries are two large arteries that originate from the aortic bifurcation at the level of the fourth lumbar vertebra. They end in front of the sacroiliac joint, one on either side, and each bifurcates into the external and internal iliac arteries.
They are about 4 cm long in adults and more than a centimeter in diameter. The arteries run inferolaterally, along the medial border of the psoas muscles to their bifurcation at the pelvic brim, in front of the sacroiliac joints.
The common iliac artery, and all of its branches, exist as paired structures (that is to say, there is one on the left side and one on the right).
25The distribution of the common iliac artery is basically the pelvis and lower limb (as the femoral artery) on the corresponding side.
Relations Both common iliac arteries are accompanied along their course by the two common iliac veins which lie posteriorly and to the right. Their terminal bifurcation is crossed anteriorly by the ureters. This is significant as the bifurcation of the common iliac artery is the second point of ureteric constriction.
Dilation Dilatation of the common iliac artery can be graded into the following categories:[1] Normal Diameter ≤12 mm Ectasia Diameter 12 to 18 mm Aneurysm Diameter ≥18 mm tc dSejs esa CyM fn[kkbZ nsus yxk rks ysizksVkseh 'kq: dh x;h tks fuEu izdkj gS%& Laparotomy :
Laparotomy is a surgical procedure that involves a surgeon making one large incision in the abdomen.
Doctors use laparotomy to look inside the abdominal cavity to diagnose or treat abdominal health conditions.
Uses Doctors may use laparotomy for a variety of reasons. It can help them diagnose or treat abdominal conditions, such as:
abdominal pain
abdominal trauma
peritonitis, which is an inflammation of the inner lining of
the abdomen
a perforated organ in the abdomen
infection in the abdomen
internal bleeding
26
the spread of conditions such as cancer or endometriosis Females may have a laparotomy for a hysterectomy, which is the removal of the uterus, or for the removal of the ovaries or fallopian tubes.
Types There are different types of incisions for laparotomy:
Midline: This incision runs down the middle of the abdomen. It is the standard incision for laparotomy. If people only need surgery for their upper abdomen, the incision will not run the whole length of the abdomen. Paramedian: A paramedian incision is a vertical cut that runs to one side of the midline. It allows a surgeon to access the kidneys and adrenal glands.
Transverse: A transverse incision is a horizontal cut. Surgeons may choose to use this approach because it can cause less damage to the nerves supplying the abdominal muscle, and it heals well.
Pfannenstiel: Surgeons may use a Pfannenstiel incision to access the pelvic region, such as in the case of an emergency cesarean delivery.
Subcostal: A subcostal incision is a diagonal cut across one side of the upper abdomen. A surgeon may use a subcostal incision to access the gallbladder or liver on the right side or the spleen on the left side.
Rooftop (chevron): If the surgeon makes a subcostal incision on each side of the body, the incisions may meet in the middle to make a rooftop incision.
Laparotomy procedure A laparotomy is performed under general anaesthesia. The surgeon makes a single cut through the skin and muscle of the abdomen, so that the underlying organs can be clearly viewed. The exposed organs are then carefully examined. Once diagnosed, the problem may be fixed on the spot (for example, a perforated bowel may be repaired). In other cases, a second operation may be needed. Once the laparotomy is complete, the muscle of the abdominal wall and the overlying skin are sutured (sewn)closed.27
Immediately after the operation After the operation, you can expect:
Your temperature, pulse, respiration, blood pressure and wound site are carefully monitored.
You may have a drain inserted at the wound site.
A small tube may have been passed through your nose and into your stomach to help drain stomach secretions for a day or two.
This rests your digestive tract as it heals. A urinary catheter may be inserted to drain off urine.
You are given intravenous fluids (directly into the vein), as you may not be allowed to eat for a few days.
Pain relief should be given regularly, as ordered by your doctor, to keep you comfortable.
As soon as possible, you are encouraged to do your deep breathing and leg exercises.
You are assisted out of bed the day after the operation (all going well). Early walking is important, as it reduces the risks of blood clots and chest infections.
You are given daily wound care and observation, along with advice on caring for your wound at home.
Medication is given to you on discharge.
Possible complications Possible complications of laparotomy include:
Haemorrhage (bleeding)
Infection
Damage to internal organs
Formation of internal scar tissue
(adhesions)
Bowel blockages or abdominal pain,
which may be caused by adhesions.
vc bl fglkc ls ge bl izdj.k dk foospu djsxsAa loZizFke ysizksLdksih djus ls igys ejht dh izkjfEHkd tkWap djok;h tkuh pkfg, Fkh ijUrq ek= H.B. dh tkWap djok;h tks 9 vk;k tc fd lk/kkj.kr;k efgyk dk H.B. 12 ls 15-5 gksuk pkfg,A bl izdkj ejht dk H.B. de Fkk] blds ckotwn ysizksLdksih dj nh 28 x;h] tc fd ejht ds [kwu dh deh Fkh ftldk ifj.kke gS fd vkxs tkdj ejht dh e`R;q gks x;hA vc nwljk fcUnq lgefr dk gS ejht o mlds ifr ls ysizksLdksih ds ,d fnu igys lgefr ys yh x;h FkhA osfyM lgefr ds laca/k esa ekuuh; loksZPp U;k;ky; o ekuuh; jk"Vªh; vk;ksx us tks fl)kUr izfrikfnr fd;s gS og fuEu izdkj gS%& II (2009) CPJ 61 (SC) NIZAM INSTITUTE OF MEDICAL SCIENCES V/s.PRASANTH SA. DHANANKA & ORS. esa ekuuh; loksZPp U;k;ky; us fuEu fu/kkZfjr fd;k gS%& (iii) Medical Negligence - Informed consent - No consent for operation taken - case record produced before Commission with reluctance, after several specific orders - Written consent not part of record - Actual consent taken from complainant not produced on record - Presumption raised against NIMS and attending doctors - Consent given for excision biopsy cannot by inference by taken as implied consent for surgery bl laca/k esa III (2009) CPJ 17 (SC) MALAY KUMAR GANGULY V/S SUKUMAR MUKHERJEE (DR.) ORS. esa ekuuh; loksZPp U;k;ky; us iSjk Xiii esa fuEu fu/kkZfjr fd;k gS %& (xiii) Medical Negligence - Right of patient to be informed - patients by and large are ignorant about disease or side and adverse effect medicine - Ordinarily patients are to be informed about admitted risk if any - If some medicine has some adverse effect or some reaction is anticipated, he should be informed thereabout - It is not done in this case - Law on medical negligence also has to keep up with advances in medical science as to treatment as also diagnostics.
bl laca/k esa 2008 (2) SCC 1 (SC) SAMIRA KOHLI
Vs. Dr. PRABHA MANCHANDA AND ANOTHER esa
ekuuh; loksZPp U;k;ky; us fuEu fu/kkZfjr fd;k gS%& A.
Medical Profession - Medical ethics - consent - consent of 29 patient required for surgical procedure - Nature of such consent and nature and extent of information necessary to be furnished to secure such consent - Principles relating to. stated - Consent, unless it can be clearly or obviously implied, held, should be express consent - Difference in the nature of express consent, known as " real consent" in UK and "informed consent" in America pointed out - An unauthorised further or additional procedure can, in an action for negligence/battery, by justified under the principle of necessity only where the patient is temporarily incompetent ( being unconscious ) to permit the same and delaying of that procedure would be unreasonable because of imminent danger to the life or health of the patient - Consent for diagnostic procedure/surgery would not amount to authorisation to perform therapeutic surgery except in life- threatening or emergent situations--In India, the extent and nature of information required to be given by doctors to the patient in order to obtain a valid consent is governed by the Bolam test laid down in (1957) 1 WLR 582 and not by the "reasonably prudential patient" test evolved in Canterbury, 464 F 2d 72 (1972) - It is for the doctor to decide, with reference to the condition of patient, nature of illness and the prevailing established practices as to how much information regarding the risks 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, held, cannot be said to be negligent merely because a body of opinion takes a contrary view - In the present case, on evidence, held, the patient had given consent for laparoscopy and not for hysterectomy (removal of uterus) and bilateral salpingo-oopherectomy (removal of ovaries and fallopian tubes ) - Further held in the absence of any medical emergency, consent given by the patient's mother when the patient was a competent adult, was not a valid consent - Moreover, the consent given by the mother for hysterectomy did not amount to consent for bilateral salpingo--oopherectomy - Words and phrases - "consent", "real consent", " informed consent" "hysteroscopy"
"laparotomy" - Medical Council Act, 1956 - S. 33 - Code of 30 Medical Ethics--Chapter relating to disciplinary action - Cl. 13
- Consent - General Medical Council of UK (2008) 2 Supreme Court Cases 1 Dr. PRABHA MANCHANDA AND ANOTHER esa ekuuh; loksZPp U;k;ky; us fuEu fu/kkZfjr fd;k gS%& A. Medical Profession
- Medical ethics - Consent - Consent of Patient required for surgical procedure - Nature of such consent and nature and extent of information necessary to be furnished to secure such consent - Pricniples relating to, stated - Consent, unless it can be clearly or obviously implied, held, should be express consent
- Difference in the nature of express consent, known as ''real consent'' in UK and ''informed consent'' in America pointed out
- An unauthorised further or additional procedure can, in action for negligence/battery, be justified under the principle of necessity only where the patient is temporarily incompetent (being unconscious) to permit the smae and delaying of that procedure would be unreasonable because of immient danger to the life or health of the patient - Consent for diagnostic procedure/surgery would not amount to authorisation to perform therapeutic surgery except in life-threatening or emergent situation - In India, the extent and nature of information required to be given by doctores to the patient in order to obtain a valid consent is governed by the Bolam test laid down in (1957) 1 WLR 582 and not by the ''reasonably prudential '' test evolved in Canterbury, 464 F2d 772 (1972) -
It is for the doctor to decide, with reference to the condition of patient, nature of illness and the prevailing established practices as to how much information regarding the risks 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 recognised medical practice, held, cannot be said to be negligent merely because a body of opinion takes a contrary view - In the present case, on evidence, held, the patient had given consent for laparoscopy and not for hysterectomy (removal of uterus) and bilateral salpingo-oopherectomy (removal of ovaries and fallopian tubes) - Further held in the absence of any medical emergency, 31 consent given by the patient's mother when the consent given by the mother for hysterectomy did not amount to consent for bilateral salpingo-oopherectomy - Words and Phrases -
"consent", "real Council Act, 1956 - S. 33 Consent - General Medical Council of UK - Guidelines to doctores issued by III (2010) CPJ 300 (NC) DHANWANTI KAUR Vs. S.K. JHUNJHUNWALA (DR. ) & ANR. esa ekuuh; jk"Vªh; vk;ksx us fuEu fu/kkZfjr fd;k gS& Consumer Protection Act, 1986 - Sections 2(1)(g), 14(1)(d), 19 - Medical Negligence -- Surgery - Post procedure and treatment - Valid consent not obtained - Deficiency in service and negligence alleged - State Commission dismissed complaint - Hence appeal - Negligence of Respondent 1 Surgeon in giving treatment and failure to obtain valid consent from complainant or her husband - Not given requisite care and attention to complaints which developed post procedure - No negligence of nursing home in giving treatment - Surgeon alone must compensate -- Complainant's body defaced, suffered mental and physical pain and could not attend to her house and family for nine months - Surgeon directed to pay lump sum compensation of Rs. 2 Lakh with interest and cost.
I (2010) CPJ 222 (NC) PUSHPA NAMDEO & ORS.
Vs. VIMAL GOLCHA (DR.) (ii) Medical Negligence - Surgery - Valid consent not taken - Removal of ureter calculus by surgical procedure advised - Kidney Found badly affected during surgery - Removal of Kidney decided by doctor - Advance consent of patient not taken for performing nephrectomy - Brother's consent obtained during course of procedure - Consent given by brother of no consequence, cannot be deemed to be valid consent.
II (2008) CPJ 31 (NC) BABURAO VITHAL LOHAKPURE & ORS. Vs. SUNITI DEVI SINGHANIA HOSPITAL AND MEDICAL RESEARCH CENTRE & ORS. esa ekuuh; jk"Vªh; vk;ksx us fuEu fu/kkZfjr fd;k gS& 32
(ii) Medical Negligence - Informed consent - Anaesthetist's name missing in consent form - Risk involved in surgery and administration of anaesthesia not explained to patient -
Signatures on printed consent form obtained mechancially - No informed consent obtained from patient/guuardian proved.
ekuuh; loksZPp U;k;ky; o ekuuh; jk"Vªh; vk;ksx }kjk izfrikfnr fl)kUrksa dks ns[ks rks] ;g lgefr vius vki esa osfyM Cosent gh ugha gSA blesa ek= Mk;XuksfLVd ysizksLdksih djus rFkk ;g MkWa0 iq"ik rWaoj }kjk djus dk vafdr fd;k gS] blessa ,fufLFk;k dh dksbZ lgefr ugha gS ,fufLFk;k dkSu djsxk \ bldk Hkh dgha gokyk ugha gS u gh Mk;XuksfLVd ysizksLdksih dSls o fdl m)s'; ls dh tk jgh gS blds ckjs esa dksbZ fooj.k ugha gSA tc VsyhLdksi esa CyM fn[kkbZ nsus yxk rks rqjUr ckn esa ysizksVkseh 'kq: dj nh x;h tks ,d izdkj dh vksiu ltZjh gS vLirky esa ICU Hkh ugha Fkk] fLFkfr esa MkWa0 ,e0,e0 ckxM+h dks cqyk;k x;k] ijUrq MkWa0 ckxM+h ds igqWp a us ls igys isV [kksy fn;k x;k Fkk ckxM+h us flQZ bULVsVkbZu dh pksVks dh ejEer dh gS iliac arteries ds ckjs esa dqN ugha fd;k gS vLirky esa iwjs lk/ku u gksus dh ckotwn ysizksVkseh 'kq: dj nh x;h] ;gkWa rd fd MkWa0 ckxM+h ds igWapus dk bartkj Hkh ugha fd;k x;k tc fd MkWa0 iq"ik rWaoj dk ;g drZO; Fkk fd T;ksgha VsyksLdksi esa CyM fn[kkbZ fn;k mls ,MokUl lsUVj esa jSQj dj nsuk pkfg, ijUrq viuh xyrh fNikus ds fy, ysizksVkseh dj nh x;h ejht ds iliac arteries esa pksVs Fkh] ftl ij /;ku ugha fn;k x;k rFkk iliac arteries dh ejEer vkikr fLFkfr esa tujy ltZu dj ldrk gS ijUrq fo'ks"kK ds :i esa Vascular Surgeon }kjk djuh pkfg, bl izdj.k esa Vascular Surgeon u rks cqyk;k x;k u gh mls jSQj fd;k x;kA vc iz'u mRiUu gksrk gS fd izh VSLV o MkWDVj dh PokbZl dk bl laca/k esa ekuuh; loksZPp U;k;ky; o ekuuh; jk"Vªh; vk;ksx }kjk fuEu fu/kkZfjr fd;k gS %& bl laca/k esa (2019) 7 Supreme Court Cases 401 ARUN KUMAR MANGLIK V/S CHIRAYU HEALTH AND MEDICARE PRIVATE LIMITED AND ANOTHER esa ekuuh; loksZPp U;k;ky; us izfrikfnr fd;k gS fd %& A. Consumer Protection -Services -Medical Practitioner/services--Medical negligence -failure of the Hospital to regularly monitor patient, 33 as in present case, blood parameters, etc. of patient diagnosed with dengue fever -Consideration of, as medical negligence
--"Standard of care" as enunciated in Bolam, (1957) 1 WLR 582 and as evolved by its subsequent interpretation, extensively surveyed and summarised - Emphasised, that courts not to defer too readily to expert opinion and must duly apply their mind to the reasonableness of the treatment/care given to the patient and/or approach adopted in the circumstances of each case, otherwise medical standards would obviously decline
-- Director of Hospital when is not the treating doctor or the referring doctor - Not personally liable, even when neglignece is confirmed against Hospital
--Held, standard of care which is expected of a medical professional is the treatment which is expected of one with a reasonable degree of skill and knowledge and a medical practitioner would be liable only where the conduct falls below the standards of a reasonably competent practitioner in the field.
-- The spouse of the appellant wad diagnosed with dengue fever and way placed on aregime of administering inravenous fluids - The patient had a prior medical history which included catheter abliation and paroxysmal supra vaentricular tachycardia suggestive of cardiac complications and thus fell in the group of patients that require in hospital management (Group B) under WHO Guidelines and was also suffering from abdominal discomfort--In the present case, held, the hospital authorities were required to closely monitor her condition and in failing to do so in a timely manner, the respondents were unable to meet the standard of reasonable care expected of medical sevices--However, considering that there was no basis for recording a finding of medical neglignece against the Director of the Hospital and the Director of the Hospital was not the treating doctor or the referring doctor, whilst confirming the finding of medical negligence against the Hospital, the second respondent held not personally liable -
"Medical and Health Law - Medical Negligence - Words and phrases "Medical neglignece" - Evidence Act, 1872. S. 45 34 bl laca/k esa (2019) 6 Supreme Court Cases 512 NAND KISHORE PRASAD V/S MOHIB HAMIDI AND OTHERS esa ekuuh; loksZPp U;k;ky; us izfrikfnr fd;k gS fd %& Consumer Protection - Services - Medical practitioners/services - Varying approaches to treatment available - Choice amongst - Medical negligence - Test for - Unreasonableness of decision as to course of treatment adopted, as the criterion - In present case, since decision to operating patient concerned was unreasonable, finding of negligence against Operating Surgeon affirmed
- Held, while adopting a course of treatment, the medical professional must ensure that it is not unreasonable - The threshold to prove unreasonableness is set with due regard to the risks associated with medical treatment and the conditions under which medical professionals function - This is to avoid a situation where doctors resort to "defensive medicine" to avoid claims of negligence, often to the detriment of the patient - Hence, in a specific case where unreasonableness in professional conduct has been proven with regard to the circumstances of that case, a professional cannot escape liability for medical evidence merely by relying on a body of professional opinion B. Consumer Protection - Services - Medical practitioners/services - Medical negligence - Decision to perform surgery - If unreasonable, thus amounting to medical negligence - Determination of - Surgery if was of immediate necessity to save life of patient who had critical platelet count
- Held, at admission, recorded history of patient was to complain about pain in abdomen, fever and hemorrhage in both eyes for five days - No evidence of critical condition of patient to be operated upon even with low platelet count - Surgery to remove roundworms not proved to be of immediate necessity to save life of patient who had critical platelet count - In absence of any evidence that surgery was only option even with low blood platelets, finding of negligence of Operating Surgeon cannot be ignored - Thus, it is a case if unreasonable decision of Operating Surgeon to operate and not a case of "bit negligent" so as to absolve surgeon from allegation of medical negligence - Consequently, finding of NCDRC to that extent set aside.
II (2009) CPJ 61 SC NIZAM INSTITUTE OF MEDICAL SCIENCES Vs. PRASANTH S. DHANANKA esa ekuuh; loksZPp 35 U;k;ky; us fuEu fu/kkZfjr fd;k gS %& (i) Medical Negligence - Incomplete investigation prior to operation -- Complainant operated for tumour--Developed acute paraplegia immediately after surgery - Discharged from hospital completely paralyzed - Medical negligence and deficiency in service alleged - Complaint allowed by State Commission - Compensation granted - Civil appeal filed - Had MRI/Myclography been performed, intraspinal extension could well have been revealed at pre--operative stage which could have led to intervention of Neuro Surgeon at time of removal of tumour, paraplegia perhaps avoided - Complete investigation prior to operation not carried out proved - paraplegia resulted due to cutting of blood supply to spinal cord as a result of operation to remove tumour proved - Attending doctors seriously remiss in not associating neur - Surgeon at pre- operative and at stage or operation - paraplegia set in due to negligence proved - order of Commission upheld - Compensation enhanced.
I (2018) CPJ 507 (NC) KUSUM SABHARWAL (DR.) V/S SANGEETA AGGARWAL & ORS. esa ekuuh; jk"Vªh; vk;ksx us fuEu fu/kkZfjr fd;k gS %& Consumer Protection Act, 1986- Sections 2(1)(g), 14(1)(d), 21(b) - Medical Negligence - Wrong diagnosis - Breach in duty of care - Deficiency in service - District Forum allowed complaint - State Commission dismissed appeal - Hence revision - It is bounden duty of doctors or surgical specialists that any surgical specimen should be studied for histopathological examination for confirmation of diagnosis and further management - Doctors failed to diagnose or to consider possibility of Ectopic Pregnancy but blindly advised patient for antibiotics - USG revealed right Chronic Ruptured Ectopic Pregnancy. - OP and Sonologist were deficient in their duty of care - They have not properly assessed the post MTP status of patient despite patient had complaints of pain in abdomen - OP2, who is a qualified Gynecologist failed to send D&C material to confirm whether it was the products of conception (Pregnancy) - Treatment 36 given by OP2/doctor was not as per standard of practice Negligence proved.
I (2010) CPJ 222 (NC) PUSHPA NAMDEO & ORS.
Vs. VIMAL GOLCHA (DR.) esa ekuuh; jk"Vªh; vk;ksx us izfrikfnr fd;k gS fd %& (i) Consumer Protection Act, 1986
- Section 2 (1) (g), 14 (1) (d) - Medical Neglignece - Failure to make correct diagnosis before surgery - Ultrasonography report about kidney being totally affected, decased required nephrectomy, overlooked - Biopsy not taken from site of operation to rule out squamous cell carcinoma at the earliest, delayed for two months - Doctor negligent for significant ommission - Negligence not directly responsibly for death of patient - However correct and timely diasnosis would have prolonged the life of decased - Doctor held liable to pay compensation tgkWa rd izh VSLV dk loky gS ysizksLdksih djus igys izh VSLV fd;s tkus pkfg, Fks ijUrq dsoy fgeksXyksfcu dh tkWap dh x;h ckdh dksbZ VsLV ugha djok;s x;s tc fd Åij of.kZr fpfdRlh; 'kkL= ds vuqlkj izh VSLV t:jh FksA foi{kh dk Hkh cpko gS fd isV esa vksxZu vkil esa fpids gq, Fks] ftlds ifj.kkeLo:i fuMy nwljs vksxZu esa yx x;h ;fn izh VsLV djok;s gksrs ,Dljs] lksuksxzkQh] lh- Vh- LdSu] ,e-vkj-vkbZ- tSlh tkWaps djok;h gksrh rks isV ds vanj ds vksxZu dh fLFkfr igys gh irk py tkrh] ijUrq ,slk ugha fd;k x;k rFkk va/ksjs esa gh ysizksLdksfid 'kq: dj nh x;hA iwoZ eas ;g fl)kUr Fkk fd fpfdRld fdl i)fr ls bZykt djrk gS mlh ij fuHkZj gS ijUrq orZeku esa fLFkfr esa ifjorZu vk x;k gS vc fpfdRld ftl
i)fr ls bZykt djrk gS og fjtuscy rFkk ejht ds fgr okyh gksuh pkfg, u fd fpfdRld dh euethZ okyhA foi{kh dh vksj ls tksj 'kksj ls fo'ks"kK dh lk{; ds ckjs esa eqn~nk mBk;k gS rFkk dgk gS fd ifjoknh us fo'ks"kK lk{; is'k ugha dh tc fd mUgksusa fo'ks"kK ds 'kiFk&i= is'k djds ;g lkfcr djrk gS fd dksbZ fpfdRlh; vlko/kkuh ugha 37 gqbZ fo'ks"kK lk{; ds lac/a k esa ekuuh; loksZPp U;k;ky; o ekuuh; jk"Vªh; vk;ksx us fuEu fl)kUr izfrikfnr fd;s gS %& (2020) 6 Supreme Court Cases 501 MAHARAJA AGRASEN HOSPITAL V/s MASTER RISHABH SHARMA WITH POOJA SHARMA AND OTHERS V/s. MAHARAJA AGRASEN HOSPITAL AND OTHERS esa ekuuh; loksZPp U;k;ky; us fuEu fu/kkZfjr fd;k gS%& B. Consumer Protection
- Services - Medical practitioners/services - Medical negligence - Determination of - Burden of proof is on complainant to establish medical negligence - Cause of action arises after damage has been caused - Injury caused to victim should be sufficiently proximate to breach of duty by medical practitioner - He would be liable only when his conduct falls below the standards of a reasonably competent practitioner in his field - Applicable principles explained in detail.
- Principle of law laid down in Bolam, (1957) I WLR 582 - Re - examination of - In the context of the changed jurisprudential thinking on the efficacy of the Bolam test, reiterated, the time has come for Supreme Court to reconsider the parameters set down in the Bolam test as a guide to decide cases on medical negligence - This is true especially in view of Art. 21 of the Constitution which encompasses within its guarantee, a right to medical treatment and medical care - The standard of care as enunciated in Bolam must evolve in consonance with its subsequent interpretation adopted by English and Indian court - Thus, held, where expert opinion is not capable of withstanding logical analysis, the court is not bound to accept it and such opinion can be rejected as not reasonable or responsible - In present case, the National Commission was justified in rejecting the expert report as it was unreliable bl laca/k esa ekuuh; loksZPp U;k;ky; us III (2010) CPJ 1 (SC) V. Kishan Rao Vs. Nikhil Super Speciality Hospital and Another esa fuEu fu/kkZfjr fd;k gS %& (iv) Evidence Act, 1872 38
- Sections 61, 64, 74, 75 - Medical Negligence - Wrong treatment - Negligence on part of respondent opposite party No. 1 in giving wrong treatment to complainant appellant's wife, suffering from Malaria--District Forum rightly held that patient diet due to 'cardio respiratory arrest and Malaria as case records show wrong treatment for Typhoid was given to complainant's wife - That there is clear admission on part of respondent No. 1 that patient was not treated for Malaria-- District Forum rightly did not ask appellant to adduce expert evidence as complaints before Consumer forum are tried summarily and Evidence Act does not apply - Both State Commission and National Commission fell into error by opining to the countrary - Expert opinion is required only in complicated cases as held in Dr. J.J. Merchant III (2002) CPJ 8 (SC) and whre in its discreation, Consumer Fora fells it is required - Direction is D' Souza case I (2009) CPJ 32 (SC), for referring all cases of medical negligence to competent doctor specialised in field is contrary to principles laid down by Large Bench of this Court on this point - Those directions are also contrary to avowed purpose o Act - If parties want to adduce expert evidence before Consumer Fora, members fo Fora by applying their mind to facts and circumstances of case and materials on record can allow parties to adduce such evidence
- This Court is constrained to set aside orders passed by State Commission and National Commission and restore order passed by District Fora - Respondent No. 1 is dircted by pay appellant amount granted in his favour by District Fora i.e. sum of Rs. 2 lacs as compensation and Rs. 10,000/-Costs.
bl lac/a k esa III (2009) CPJ 17 (SC) MALAY KUMAR GANGULY V/S SUKUMAR MUKHERJEE (DR.) ORS. esa ekuuh; loksZPp U;k;ky; us iSjk I, III esa fuEu fu/kkZfjr fd;k gS %& (i) Evidence Act, 1872, -- Section 45 - Expert Evidcence - Evidentiary value - Court is not bound by evidence of experts which to a large extent is advisory in nature - Medical science is difficult one - Court for purpose of arriving at decision on basis of experts must take into consideration difference between 'expert witness' and an 'ordinary witness' 39
(iii) Consumer Protection Act, 1986 - Sections 12, 13, 13 (3), 13 (4), 14, 22 - Evidence Act, 1872 - Section 45 - Medical Opinion - Admissible before consumer Court - Provisions of Evidence Act not applicable - Commission is merely to comply with principles of natural justice, save and except ones laid down under Section 13 (4) of 1986 Act.
bl laca/k esa I (2011) CPJ 319 (NC) DEEPAK GUPTA (DR.) V/S BALKISHAN & ORS. esa ekuuh; jk"Vªh; vk;ksx us fuEu fu/kkZfjr fd;k gS %& Consumer protection Act, 1986
- Sections 2 (1) (g), 14 )1) (d), 21 (b) - Medical Negligence - Wrong operation - Deceased died due to burst of stomach, opening of stitches--Forum allowed complaint - Appeal dismissed by state Commission - Hence, revision - Contention, expert evidnce not produced by complainant - Not accepted - No expert medical evidence is required in this case as facts speack for themselves - No interference required.
bu fl)kUrksa dks ns[ks rks vc fo'ks"kK lk{; vfuok;Z ugha gSA i{kdkjku dks viuk viuk dsl lkfcr djuk gSA Burden of Proof Hkh cnyrk jgrk gSA **tSdc eSF;w** ds fu.kZ; esa ekuuh; loksZPp U;k;ky; dh iw.kZ ihB us bls vfuok;Z ugha ekuk gS ckn esa Hkh **ekfVZu fMlwtk** dk fu.kZ; vk;k tks nks ekuuh; U;k;kf/kifr dk fu.kZ; Fkk ftlesa fo'ks"kK lk{; fpfdRlh; vlko/kkuh ds ekeys esa vfuok;Z crk;h rFkk ekuuh; loksZPp U;k;ky; us ;gkWa rd dg fn;k fd tc rd fo'ks"kK lk{; ugha gks u rks nhokuh U;k;ky; fpfdfRld ds fo:) eqdnek ntZ djsxh u gh vkijkf/kd ekeyk ntZ fd;k tk;sxk] ijUrq ;g fu.kZ; tSdc eSF;w ds fu.kZ; ds fojks/kkHkklh Fkk mlds ckn **ds0,l0jko** dk fu.kZ; vk;k ftlesa ekfVZu fMlwtk ds fu.kZ; dks izh ,Dohfj;e crkrs gq, fo'ks"kK lk{; dh vfuok;Zrk% ugha ekuhA vc i{kdkjksa dks viuh viuh lk{; ls fpfdRlh; ykijokgh gqbZ ;k ugha ;g lkfcr djuh gS] dksbZ fo'ks"kK lk{; dh vko';drk ugha gSA ejht vuqiek ukgVk dh 14-07-2007 dks ysizksLdksih gqbZ fQj ysizksVkseh gqbZ fQj PBM gkWfLiVy] chdkusj jSQj gqbZ rFkk ogkWa 4-30 ih-,e- ij mldh e`R;q gks x;h ;kfu ;g lkjk ?kVukdze 14-07-2007 dks gks x;k Fkk ifjokn 15-07-2009 dks is'k fd;k x;k] ;kfu 15-07-2007 dks okn vk/kkj 'kq: gqvk Fkk bl izdkj /kkjk 40 24 ¼ A ½ ds izko/kkuksa ds vuqlkj 13-07-2009 dks fe;kn vof/k lekIr gks x;h mlds 2 fnu ckn ;g ifjokn is'k gqvk gSA bl laca/k esa (2019 ) 6 Supreme Court Cases 489 VIBHA BAKSHI GOKHALE AND ANOTHER Vs. M/S GRUHASHILP CONSTRUCTIONS AND OTHERS esa ekuuh; loksZPp U;k;ky; us fuEu fu/kkZfjr fd;k gS%& Consumer Protection - Consumer Forums - Maintainability - Delay/Laches/Limitation - Dismissal of complaint for marginal delay in filing rejoinder and evidence - Sustainability
--On facts, NCDRC by conditional order dt. 16.11.2018 requiring appellants to file a rejoinder and evidence within four weeks, failing which complaint was t stand dismissed automatically
- On 15.02.2019, NCDRC declined to grant any further time to appellants for delay in filing a rejoinder and evidence and dismissed complaint itself
--Held, observation and inference of NCDRC that case might lack merit, for which there was delay, unwarranted--Orders of this nature detract from true purpose for which NCDRC has been established - NCDRC should have borne this in mind instead of rejecting complaint on a technicality - Such dismissals only add to burden of litigation and defeat purpose of ensuring justice in Consumer Fora--Though Consumer Protection Act, 1986 stipulates a period for disposing of a consumer complaint, it is also a sobering reflection that complaints cannot be disposed of due to non- availability of resources and infrastructure--In this background, it is harsh to penalize a bona fide litigant for marginal delays that may occur in judicial process - Consumer Fora should bear this in mind so that ends of justice are not defeated - Since complaint was dismissed on a mere technicality, issued no notice to respondent - Impugned order dt. 15.02.2019 set aside and Consumer Complaint No. 1432 of 2016 to file of NCDRC restored - Rejoinder and affidavit of evidence being ready, to be taken on record by NCDRC - Consumer Protection Act, 1986, Ss. 12, 13 (3-A) and 21 ekuuh; loksZPp U;k;ky; }kjk fu/kkZfjr fl)kUrksa dh jks'kuh esa ek= 2 fnu ckn ifjokn is'k gksuk og Hkh esMhdy usxyhtsUlh tSls xaHkhj ekeyksa esa is'k gksuk rFkk 30 lky dh efgyk dh e`R;q gks tkuk e`rdk ds ifjokj dks vlkekU; >Vdk FkkA 41 fLFkfr esa ;g 2 fnu nsjh ekQh ;ksX; gS ekQ dh tkrh gSA bl izdkj Åij of.kZr iw.kZ foospu dks ns[ks rks ifjoknh o ifjoknh dh iRuh ftudh ?kVuk ls 4 lky iwoZ 'kknh gqbZ Fkh] ifjoknh dh iRuh vuqiek ukgVk xHkZorh ugha gks jgh Fkh foi{kh fpfdfRld dks fn[kk;k rks ysizksLdksih dh lykg nh x;h ijUrq blls igys tks tkWap gksuh pkfg, Fkh og tkWapas ugha djok;h x;h tks osfyM Cosent ysuh pkfg, Fkh og ugha yh x;h fuMy Mky nh x;h Vªksdkj Mky fn;k x;k bULVsVkbZu o bfy;d vkVZjh jsIpj gks x;h bULVsVkbZu dks 2 txg fjis;j dj fn;k x;k bfy;d vkVZjh ij /;ku gh ugha fn;k x;k CyhfMax gks x;h 5 ;wfuV [kwu p<+k ijUrq dksbZ QdZ ugha iM+k ysizksVkseh dh x;h ysizksVkseh dh dksbZ lgefr ugha yh x;h ysizksVkseh vksiu ltZjh gS blds iwjs lk/ku vLirky esa ugha Fks] ;gkWa rd dh vkbZlh;w Hkh ugha Fkk ejht dks ,MokUl lsUVj esa jsQj fd;k tkuk pkfg, tks ugha fd;k x;k] ckn esa jSQj fd;k x;k ijUrq ejht bruh T;knk CyhfMax ls mHkj ugha ldh rFkk vUrr% mldh nq[kn% e`R;q gks x;hA blls ;g rF; iw.kZr lkfcr gS fd Jherh vuqiek ukgVk dh e`R;q ?kksj fpfdRlh; ykijokgh ds ifj.kkeLo:i gqbZA fo)ku ftyk eap us tks fu.kZ; ikfjr fd;k gS og iw.kZr% fpfdRlk foKku rFkk dkuwu ds foijhr gS tks vikLr ;ksX; gS] vikLr fd;k tkrk gSA vc iz'u mRiUu gksrk gS DokaVe dk ifjoknh us vius ifjokn esa 15]21]500@&: ¼iUnzg yk[k bDdhl gtkj ikWp lkS :i;s ½ dqy {kfr pkgh gS] foi{kh dk ;g dguk gS fd ifjoknh us nwljh 'kknh Hkh dj yh gS rFkk og ldq'ky jg jgk gS foi{kh dk ;g cpko vR;f/kd 'keZukd gS] e`rdk 30 o"kZ dh Fkh ;|fi ?kjsyq efgyk Fkh dEiuls'ku ds laca/k esa ekuuh; loksZPp U;k;ky; us fuEu fu/kkZfjr fd;k gS %& (2019) 7 Supreme Court Cases 401 'C' ARUN KUMAR MANGLIK V/S CHIRAYU HEALTH AND MEDICARE PRIVATE LIMITED AND ANOTHER esa ekuuh; loksZPp U;k;ky; us izfrikfnr fd;k gS fd %& C. Consumer Protection
- Consumer Forums - Exercise of power - Relief - Compensation - Compensation to spouse on death of his non - working wife/house wife/homemaker due to medical negligence - Determination of
--Held, contribution made by a non-working spouse to welfare of family has an economic equivalent and in computing compensation payable on death of homemaker spouse who is not employed, Consumer Forum/court must bear in mind that the contribution in significant and capable of being measured in monetary terms--In the present case, appellant husband held entitled 42 to receive an amount of Rs. 15 Lakhs by way of compensation for the death of his wife due attributable to medical negligence - Tort Law - Compensation /Damages - Words and phrases "Homemaker", "housewife"
55. In Malay Kumar Ganguly v. Sukumar Mukherjee 17, S.B. Sinha, J. held thus: (SCC PP. 282- 83, para 172) "172. Loss of wife to a husband may always be truly compensated by way of mandatory compensation. How one would do it has been baffling the court for a long time. For compensating a husband for loss of his wife, therefore, the courts consider the loss of income to the family. It may not be difficult to do when she had been earning. Even otherwise a wife's contribution to the family in terms of money can always be worked out. Every housewife makes a contribution to her family. It is capable of being measured on monetary terms although emotional aspect of it cannot be. It depends upon her educational qualification, her own upbringing, status, husband's income. etc."
bl laca/k esa I (2017) CPJ 1 (SC) SHEELA HIRBA NAIK GAUNEKAR Vs. APOLLO HOSPITALS LTD. esa ekuuh; loksZPp U;k;ky; us fuEu fu/kkZfjr fd;k gS%& 6."We have heard learned counsel appearing on behalf of the parties of length. Our attention was drawn to the impugned judgment and order as well as the evidence on record, including the cross examination of Dr. Mathews. After a perusal of the evidence on recorded by the commission that there was medical negligence on the part of the hospital in not taking proper post operative care of the deceased, in based on legal and substantive evidence on record. The same has been properly appreciated by the Commission in exercise of its orginal jurisdiction, Therefore, we do not find any error, much less any perversity, in the findings recorded by the Commission so as to interfere with the impugne order in exercise of appellate jurisdiction of this court under Article 136 of the Constitution of India. Therefore, Civil Appeal No. 4408 of 2005, filed by the Apollo Hospitals Enterprise Ltd. is liable to be dismissed and is accordingly, dismissed.
7. Having ffirmed the findings recorded by the Commission on the question of medical negligence and deficiency in services rendered by the respondent-Hospital, We are required to examine as to whether the amount of compensation awarded by the commission was just and reasonable. The Commission awarded compensation of Rs. 2 Lakh along with interest at the rate of 6% per annum. The income tax declaration filed by the deceased to the Income Tax department during the financial year in the which death had occurred is on record as evidence on behalf of the complainant in justification of her claim. According to the Income Tax return, the annual income of the deceased was Rs. 5 Lakhs per annum. Deducting one-third amount of the towards the personal 43 expenditure of the deceased comes to Rs. 3,33000/- (approximately). As on the date of the death, the deceased was aged 60 Years. In terms of the Motor Vehicles Act, 1988 and the decision of this court in the case of Sarla Verma (Smt.) and others V. Delhi Transport Corporation and Another, 162 (2009) DLT 278 (SC)=VI (2009) SLT 663=III (2009) ACC 708 (SC)=(2009) 6 SCC 121, the appropriate multiplier in the instant case is 9. Thus, the annual loss of dependency comes to Rs. 29,70000/- Having regard to the fact that the incident in the instant case occurred in the year 1996 and the litigation has been going on for nearly twenty years, it would serve the ends of justice to award Rs. 40 lakh as compensation. Having further regard to suffering of the complainant on account of mental agony, loss of head of the family, loss of consortium and loss of love and affection, we deem if fit to award a further consolidated sum of Rs. 10 lakh under the abovementioned heads, in accordance with the principles laid down by this Court in the case of Balram Prasad V. Kunal Saha and others, IV (2013) ACC 378 (SC)=VIII (2013) SLT 513=IV (2013) CPJ 1 (SC)=(2014)1 SCC 384 Thus, in the interest of justice, We deem it fit to award a total amount of Rs. 50 lakh as compensation in toto.
8. Accordingly, the compensation awarded by the Commission is modified as aforementioned. Further, interst has to be awarded as 9% per annum, in stead of 6% per annum, from the date of the institution of the complaint till the date of payment, applying the principle laid down by the Court in the case of Municipal Corporation of Delhi, Delhi V. Uphaar Tragedy Victims Association and Others, VII (2011) SLT 757=IV(2011) ACC 382 (SC)=IV (2011) CPJ 74 (SC)= IV (2011) CLT 204 (SC)=(2011) 14 SCC 481.
9. We also modify the order of the commission to the extent that RW.1-Mr. Mathews, who performed the surgery which ultimately resulted indeath of Mr. Gaunekar, is also held liable to pay compensation along with the Apollo Hospital. Applying the principle laid down in the case of Balram Prasad (Supra), it would be just and proper if we direct RW.1-Dr. Mathews to pay Rs. 10 lakhs with proportionate interest to the complainant, out of total of Rs. 50 lakh which has been awarded by way of this Order.
10. Accordingly, Civil Appeal No. 3625 of 2005 filed by the complainant-wife is allowed and civil Appeal No. 4408 of 2005 filed by the Apollo Hospitals Enterprise Ltd. is dismissed. We modify the order passed by the Commission, awarding the compensation at Rs. 2 lakh along with interest at the rate 6% per annum, to payment of compensation of Rs. 50 lakh along with interest at the rate of 9% perannum as full and final settlement of all claims, to be paid within four weeks froom the date of receipt of the copy of this Order. It is once again clarified that the liability of the Apollo Hospital and Dr. Mathews towards compensation will be Rs. 40 lakh and Rs. 10 44 lakh respectively with proportionate interest at the rate of 9% per annum. We further make it clear that in case the Doctor, Dr. Mathews does not deposit the amount as ordered against him, the same shall be paid to the appellant complainant by the respondent Hospital and recovered from him. We further direct the respondent-Hospital to comply with this order and submit compliance report to the Registry of this Court within eight weeks from the date of receipt of the copy of this Order."
II (2009) CPJ 61 (SC) NIZAM INSTITUTE OF MEDICAL SCIENCES V/s.PRASANTH SA. DHANANKA & ORS. esa ekuuh; loksZPp U;k;ky; us fuEu fu/kkZfjr fd;k gS%& (iv) Medical Negligence - Compensation - Quantum - Complainant aged 40 years - Highly qualified individual, employed as IT Engineer -- Earning Rs. 28 Lakh p.a. - Compensation awarded by State Commission under various heads, enhanced in appeal.
ekuuh; loksZPp U;k;ky; }kjk izfrikfnr fl)kUrksa rFkk efgyk ds egRo dks ns[krs gq, rFkk ifjoknh us tks {kfriwfrZ dh ekax dh gS og iw.kZr% okftc gSA blfy, 15]21]500@&: ¼iUnzg yk[k bDdhl gtkj ikWp lkS :i;s ½ {kfriwfrZ fnyok;h tkuh mfpr gSA vr% vihy Lohdkj djds foi{khx.k dks] la;qDr ,oa i`Fkd i`Fkd :i ls vkns'k fn;k tkrk gS fd oks ifjoknh dks 15]21]500@&: ¼iUnzg yk[k bDdhl gtkj ikWp lkS :i;s ½ o ifjokn nk;j djus dh fnukad 15-07-2009 ls 9 izfr'kr okf"kZd dh nj ls C;kt vnk djs]a C;kt dh jkf'k bl fu.kZ; dh fnukad 05 tuojh 2021 rd ewy esa tksM+ nh tk;sxh rFkk mlds ckn tks dqy jkf'k curh gS ml ij Hkqxrku rd 9 izfr'kr okf"kZd dh nj ls C;kt vnk djuk gksxkA vkns'k dh ikyuk ,d ekg esa dh tkosaA ¼ 'kksHkk flag ½ ¼ dey dqekj ckxMh ½ lnL;
@ikBd@ 45 46 ¼ 'kksHkk flag ½ ¼ dey dqekj ckxMh ½ lnL; @ikBd@