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2. Appellants-Dr. Harprit Singh & Anr. have filed F.A. No. 295 of 2021 to challenge the impugned order dated 20.04.2021 passed by the District Consumer Disputes Redressal Commission, Jalandhar (in short, "the District Commission"), whereby the Complaint filed by the Complainant had been Allowed.

3. It would be apposite to mention here that hereinafter the parties will be referred, as were arrayed before the District Commission.

4. Briefly, the facts of the case as made out by the Respondent No.1/Complainant-Kulwant Kaur in the Complaint filed before the District Commission are that she was having problem of Knees. In the month of September, 2016, the Complainant had consulted OP No.1, being Ortho Specialist in OP No.2 Hospital for the treatment of the same. OP No.1 after examining had advised her for the replacement of both the knees. OP No.1 had intimated the total expenses of Rs.3 lakh for the treatment of both knees. On the assurance of OP No.1, the Complainant had got herself admitted in the OP No.2 Hospital and her both the knees were replaced on 19.09.2016 & 20.09.2016. She was discharged from the Hospital on 25.09.2016 with the advice to do exercise for knees at home and to come after few days for further check-up. Afterward due to suffering with pain, she had visited OP No.2 Hospital and tried to consult OP No.1. But OP No.1 had not attend her, only the Junior Doctor had attended and advised to follow up exercises and prescribed some medicines. On this, the Complainant had approached Dr. Guriqbal Singh Chhina, M.Ch Ortho at Amritsar, who had informed her that her left knee was not proper in angle, due to which shape of her left leg had been tilted. Thereafter, she had consulted Dr. Sanjeev Kumar Singh Marya at Medanta Hospital, New Delhi. Said Doctor had advised that her left knee will have to be replaced again. Her left total knee replacement was done in Medanta Hospital and bones which were damaged due to wrong replacement of knee were wrongly operated on 08.12.2016 by the said Doctor of Medanta. After said surgery, the Complainant had received relief from pain and had been able to walk. On the treatment in Medanta Hospital, she had incurred an expenses of Rs.5,70,000/- on knee replacement and had also incurred Rs. 2 lakh on travelling to Delhi.

6. Upon issuance of notice in the Complaint, the Appellants/ Opposite Parties No. 1 & 2 had filed the written statement by raising certain preliminary objections to the extent that the Complainant had no cause of action to file the Complaint. It was admitted that the Complainant had been admitted in OP No.2 Hospital where OP No.1-Doctor had treated her on 19.09.2016. The surgery was successful and thereafter, she was discharged on 26.09.2016 from the Hospital. At the time of discharge, she was walking comfortably. On this, she had given the statement that she was quite satisfied with the treatment/services of the OPs. After surgery, X- rays were again taken and the condition of the patient regarding operation part was found good and proper. At the time of discharge, the patient and her attendants were informed regarding the things/precautions to be taken at home and the Complainant had gone out of Hospital in walking condition without any pain. The Complainant was discharged in a fully satisfied condition. She was advised for exercise of knees at home and was asked to come after a few days for follow up. After discharge when she had visited the OPs for check-up, in the X-ray and Fluoroscopy examination, everything was found fine/OK. As the Complainant had not followed the exercise as advised, hence, after 01.11.2016, she had not approached the OPs for further check-up. During the check-up, the Complainant had never complained any problem. At one point of time, the Complainant had alleged that Dr. Harpreet Singh had not checked her but on the other hand pleaded that one Junior Doctor had checked her but she was not satisfied. Both the statements were contradictory to each other. Only Dr. Harpreet Singh had checked the patient. There was no Junior Doctor in the Hospital as all the prescriptions bear the handwriting and signatures of Dr. Harpreet Singh. There was no report of Dr. Guriqbal Singh Chinna that replacement of left leg knee was not in proper angle and tilted. Neither any X-ray in this regard taken by Dr. Chhina had been attached nor any report of Radiologist was annexed. In the report dated 24.11.2016 of Fortis Memorial Research Institute, Gurgaon, no loosening had been reported. Only in the discharge summary dated 06.12.2017 of Medanta Hospital (Pg. 140 of Appeal file), it was reported that there was depression/compression fracture of the lateral TIBIAL Condyle on left side, resulting in mis- alignment of the knee replacement Prosthesas on left side. However, the report of Orthonova was shown as normal. It was possible that the problem occurred to the Complainant could be happened afterwards, which may get due to any injury on account of fall or striking with some hard object. OP No. 1 did not want to comment upon if anything had happened afterwards the discharge from their Hospital. It was specifically pleaded that the acceptance time of knee replacement was from six months to one year, which fact was proved from the medical studies. It was necessary for the patient to be in contact with the Surgeon during that period apart from Physiotherapy to be carried out as advised. Conducting of Revision Surgery itself reflected that the patient had not followed the advice of her Surgeon. It was clear that there was no fault on the part of OP No.1 in conducting surgery. It was pleaded that the patient had not given the adequate time of acceptance to the knee replacement and in hurriedly got operated on a perfect implanted knee, for the reasons best known to her. No nuclear scan of the implant was done to prove that the knee replacement was loose or infected. OP No. 1 had a vast experience in knee replacement and his success rate was 98%. If the patient had approached her for the treatment and if any revised surgery was required in her case, the Hospital had done the same free of cost but the Complainant had not approached the OPs with any such problem. It was pleaded that there was no medical negligence in the treatment of the Complainant and also during post-operative care. The Complainant was discharged from the Hospital in a satisfactory condition and thereafter the Complainant had failed to continue the follow-up. It was prayed that the Complaint being devoid of any merit, be dismissed.

"10. From perusal of entire record, it has revealed that the complainant admitted in the hospital of OPs no. 1 & 2 for treatment of his both knee problem. She admitted in the hospital of OPs on 19.09.2016 and discharged on 26.09.2016, this fact is clear from document Patient Medical Record as Ex.OP1&2 on the record. The complainant spent Rs. 3 lakh on his treatment, this fact is clear from copy of certificate Ex. C-6 on the record. This document issued by OPs/Institute of Orthonova, in this document it has been mentioned that it is to certify that patient named Kulwant Kaur w/o S. Pritam Singh is admitted in our Hospital from 19.09.2016 to 25.09.2016 for (B/L TKR) Total knee replacement. We have received total amount of Rs. 3 lakh. The treatment of knee replacement taken by complainant from OPs is not successful, as such, she consulted with other doctor in this regard. If, OPs no.1 and 2 operated the knee replacement of the complainant in a well manner, then why she consulted with other doctor in this regard. The complainant also produced on record affidavit of Dr. Guriqbal Singh Chhina Ortho M.Ch Ortho at Amritsar as Ex. CW-2/A this doctor stated that "complainant's knee tibial component was malpositioned due to which she was having pain and problems in walking. After examining the complainant, prescribed some medicines and also advised her to get further operated upon her knees for permanent solution of her problem. Further, the complainant has produced on record affidavit of Dr. Mohit Arora MBBS MS (Ortho) Amritsar as Ex. CW-3/A on the record, this doctor also stated that "upon examining complainant's knee, came to know that her knees tibial component was malpositioned due to which she was having pain and problems in walking. After examining the complainant, prescribed some medicines and also advised her to get further operated upon her knees for the permanent solution of her problem." Dr. Mohit Arora MBBS MS (Ortho) Amritsar is senior consultant, Department of Orthopedics & Joint Replacement Surgery, Fortis Escorts Hospital, Amritsar. He is competent in his field and working as Doctor in a renowned hospital. This doctor has also given prescription slip to the complainant regarding medicines, which is Ex. C-13 on the record. The affidavit of Dr. Guriqbal Singh Chhina Ortho M.Ch Ortho at Amritsar as Ex. CW-2/A and affidavit of Dr. Mohit Arora MBBS MS (Ortho) Amritsar are the vital documents on the record. If OPs no. 1 and 2 operated knee replacement of the complainant in a well manner then why Dr. GuIriqbal (Guriqbal) Singh Chinna and Dr. Mohit Arora MMBS (MBBS) gave his different opinion from the opinion of OPs. The complainant consulted Dr. Sanjeev Kumar Singh Marya and upon checking this document advised her that her left knee will have to be replaced again. The said doctor told her that bones were damaged due to wrong replacement of knee. The complainant admitted in the Medanta Hospital New Delhi, this fact is clear from discharge summary Ex. C-34 on the record. In this document, the date of admission of the patient/complainant is mentioned as 06.12.2016 and date of discharge as 12.12.2016. From perusal of this document, it is clear that complainant consulted Dr. Sanjeev Kumar of Medanta Bone & Joint Institute New Delhi after getting treatment from OPs no. 1 and 2 hospital. Firstly, the complainant admitted in the Hospital of OPs no. 1 and 2 on 19.09.2016 and discharged on 26.09.2016 and after that she admitted on 06.12.2016 and discharged on 12.12.2016 further treatment. It proves medical negligence on the part of OPs no.1 and 2 in performing their duties."

26. No allegations were levelled by the Complainant with regard to the professional ability of the OP No.1, who was having MBBS MS (Ortho).

There was no allegations of the Complainant that said Doctor was neither possessing the above said qualification nor using the requisite skills of his medical field during the treatment because out of both knee replacements, problem had occurred only in left knee replacement, therefore, in such circumstances, said action of OP No.1 does not fall in the category of medical negligence. Rather it may be some deficiency (deficit) occurred in the surgery of her left knee replacement or some instructions might not been followed by the Complainant. After both knee replacements, the Complainant had improved satisfactorily and was discharged from the Hospital in a stable condition as per the version of OPs No.1&2, which fact had not been denied by the Complainant herself. However, after sometime, some problem of pain had occurred in her left knee and the prescription slips of other Doctors had reflected that the left knee was not proper in angle. Therefore, certainly there was some problem in her left knee. The Hon'ble Supreme Court in the judgment of case titled as "Kusum Sharma and others versus Batra Hospital & Medical Research Centre & Others", 2010(3) SCC 480 had issued the guidelines to the effect that the following principles must be kept in mind while deciding whether the medical professional is guilty of negligence. It was mentioned under these guidelines that the medical professional is expected to bring a reasonable degree of skill and knowledge and must exercise a reasonable degree of care. It was also held under these guidelines that medical practitioner would be liable only where his conduct fell below that of the standards of a reasonably competent practitioner in his field. As out of two knee replacements, the problem had occurred only in one, therefore, in the present case it had not been proved on record that during the treatment the conduct of the OP No.1-Doctor was not upto the mark.