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Patient, therefore, applied for medical leave for 4 weeks from 12.05.2000 and was examined by Dr. Samuel Parra on that date, who after diagnosis stated that he would remove the cyst by Laparoscopy method and, if required, thereafter a surgery would also be done. Since the Appellant did not have the Laparoscopy instrument required by Dr. Parra, it was arranged from a hospital in Tuticorin and the surgery was fixed for 24.05.2000. Patient got admitted on 23.05.2000 and was thereafter allotted a room which was very unhygienic as sewage water was stagnating nearby. At 8.30 a.m. on 24.05.2000 Patient was taken to the operation theater for surgery and on its completion, she was brought back to the room at 12.45 p.m. Same night, she developed high fever and also later complained of discomfort and severe pain in the abdomen. She was assured by Dr. Parra that this was a routine pain after surgery. However, when her condition worsened, she was again examined on 26.05.2000 by Dr. Parra who asked the Respondent-Complainant to arrange for 2 Pints of blood. Patients condition continued to deteriorate and breathing became belabored and, therefore, she was put on oxygen. When Respondent-Complainant returned with the blood required for transfusion, he found that the Patient had been taken to the operation theater for the second surgery.

3. Appellant on being served filed a written rejoinder denying that there was any medical negligence on their part. It was stated that the Appellant is a charitable hospital which was rendering service to deserving and poor patients.

Respondent-Complainants wife had been admitted in the Appellant hospital where after examination she was diagnosed with Endometrial Cyst and fibromas of the uterus. Patient had agreed to the Laparoscopy after she was clearly informed about the pros and cons of the same, including the possible complications, which could require converting it into an open procedure. On 24.05.2000 after conducting all the pre-operative tests, the Laparoscopy was conducted, which confirmed that Patient had extensive Endometriosis, inflammatory changes and also pelvic inflammatory disease. There was extensive adhesions and some fibrinous fluid. All these were attended to through a time consuming procedure. At 8.00 p.m. on the same day, Patients haemoglobin dropped to 9.3 and she complained of shoulder pain which was common after Laparoscopy. However, there were no other problems. She was given IV fluids and antibiotics. The next day when she was not responding to conservative management and was showing systemic sepsis and peritonitis, Respondent-Complainant was advised about the need for exploratory surgery. It was denied that Dr. Parra had informed the Patient or the Respondent that her colon had ruptured during the first surgery and faecal matter and other body fluids had leaked into the system which needed to be immediately rectified. The second surgery was conducted by Dr. Parra assisted by other qualified Doctors and it was found that she had severe sepsis with peritonitis endometriosis associated with pelvic inflammatory disease, from which she had been suffering prior to the surgery. Because Patient required prolonged ventilator support and other intensive care facilities, which were not available in the Appellant hospital, she was in her own interest advised admission in an advanced medical centre for which necessary arrangements were made by the Appellant and she was transferred to Sri Ramchandra Medical College Hospital at about 9.00 p.m. accompanied by Dr. Parra, an Anaesthetist and a nurse. It was reiterated that there was no medical negligence or deficiency in the treatment of the Patient and the entire medical expenses came to only Rs.25,330/- which was borne by the Appellant.

5. Aggrieved by the order of the State Commission, the present first appeal has been filed.

6. Learned Counsel for the Appellant made oral submissions. Learned Counsel for the Respondent-Complainant was not present but written submissions were taken on record.

7. Counsel for the Appellant stated that the medical records filed in evidence clearly indicated that there was no deficiency or negligence on the part of the Appellant in the treatment of the Patient, including the Laparoscopy as also the surgery. It was stated that the Patient had been brought to the Appellant with Endometrial Cysts and fibromas of the uterus, for which a diagnostic Laparoscopy was necessary, and the procedure was conducted after all the pre-operative tests. It was found during the Laparoscopy that the Patient also had pelvic inflammatory disease which caused complications leading to sepsis and peritonitis. This was not the result of any negligence as alleged, including accidental perforation of the colon, and despite the best medical care and treatment, including a second surgery, these complications persisted. No payment was taken from the Patient by Appellant which was a charitable institution and which also paid for her entire treatment at Sri Ramachandra Medical College Hospital, where she expired. All the Doctors, including Dr. Parra, were well qualified and professional Doctors and, therefore, the findings of the State Commission were not based on correct appreciation of the facts as also the evidence on record.

10. We have considered the oral and written submissions made by learned Counsels for the Appellant and the Respondent-Complainant respectively. Patients admission in the Appellant hospital with a diagnosis of ovarian cyst and her examination by a Doctor from USA, Dr. Samuel Parra, who confirmed the diagnosis and offered to remove the cyst by Laparoscopic method, is not in dispute. It is further a fact that following this procedure, complications developed, because of which a second surgery became necessary, during which it was found that body fluids and faecal matters had leaked into the system and also that both ovaries had to be removed and sent to a laboratory for tissue culture. It is further a fact that on the Appellants own advice Patient was shifted to a higher health facility i.e. Sri Ramachandra Medical College Hospital, where despite her being in the ICCU, she could not be saved. Dr. Parra while denying that there was any medical negligence and deficiency in service on Appellants part in conducting the Laparoscopy as also the subsequent surgery had also admitted on oath before the State Commission that the Laparoscopy equipment was not available in the Appellant hospital and had to be obtained from another hospital just two days prior to the surgery. It was further admitted by Dr. Parra that right from the beginning there were technical difficulties while conducting the procedure since the insulator needle was not working properly so the umbilical trochar was placed by open technique. Further, there were problems with the suction irrigation system as the rubber tubing of the suction were collapsing when applying the suction which was time consuming. Dr. Parra has also admitted that on 26.05.2000 there were intra-abdominal infections and there was also possibility of Peritonitis, which was not responding to conservative management. Therefore, a second exploratory surgery was conducted, wherein Dr. Parra stated that the Patient was explored with the finding of a small tear of the sigmoid colon and there was also a residual fluid from the irrigation during the Laparoscopy. However, despite stating all these facts, Dr. Parra concluded that Patients death was not because of any complications that can arose in such surgeries and was because of pelvic inflammatory disease. We are not able to accept this contention of Dr. Parra in view of the fact that he has clearly stated that there were serious technical difficulties while conducting the Laparoscopy which confirmed the Respondent-Complainants contention that the Patient was used as a guinea pig. Further, the Appellant and Dr. Parra were not able to satisfactory explain the tear in the colon which led to the sepsis and peritonitis, except to say that a non-fault irreparable damage had occurred.