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AND SRI R.LAKSHMINARASIMHA RAO, HONBLE MEMBER   FRIDAY THE FOURTH DAY OF MARCH TWO THOUSAND ELEVEN   Oral Order (As per Sri R.Lakshminarasimha Rao, Honble Member) ***

1. The opposite parties no.1 and 2 are the appellants.

2. The complainants daughter Bamidi Kalyani was admitted to the hospital of the opposite party no.3 with the complaint of pain in her stomach. After conducting tests, the opposite party no.3 diagnosed her suffering from appendicitis and advised her to be shifted to the opposite party no.1 nursing home on 19.2.2002 where tests were conducted and the patient was advised to undergo operation. The second opposite party conducted the operation 20.2.2002. The patient was kept in ICU for seven days. Ischiorectal Abscess was drained under general anaesthesia. The wound was left open to granulate. The patient was advised for gradual mobilization with the assistance of a walker and she was encouraged to use toilet instead of a bed pad. The patient developed with faecal fistula with residual infection. Soft solids and laxatives were administered to the patient for spontaneous closure of the fistula. The patient left the opposite party no.1 hospital and she was admitted to King George Hospital where she was treated for three days and died 29.4.2002.

3. The complainants contended that the opposite parties no.1 to 3 were negligent in rendering the treatment as a result of which the patient died and the report of experts had shown the cause of death as septic shock due to multiple infected perforations of loops of intestine and faecal fistulae and peritonitis with infected laparotomy.

4. The opposite party no.1 has submitted that no negligence was on their part and the second opposite party had conducted the operation successfully and anesthetic recovery was very smooth as also the patient was kept in the ICU until her general condition was improved.

5. The second opposite party has contended that the ultrasound report was suggestive of gas in the anterior abdomen and paracolic space was likely due to colorectal perforation and after going through ultrasound report he had obtained consent of the parents of the patient and conducted surgery. It was submitted that every care was taken during all the stages i.e., preoperative stage, operative stage and post operative stage. There was discharge in the form of serous purulent material with bits of necrotic fat due to narcotiring fascitis during the post operative stage and the wound was regularly dressed and ischeorectal abscess was drained under general anaesthesia. The wound was left open to granulate. The patient was encouraged to take soft solids and laxatives for closure of fistula. The complainants created unpleasant and unhappy atmosphere and attacked the second opposite party and got discharged the patient from the opposite party no.1 hospital by creating nuisance and dharna before the opposite party no.1 hospital. The infection developed after surgery was not due to the negligent treatment but it was due to uncontrollable and unforeseen conditions which are likely to arise in such kind of operation.

15. The expert committee of doctors had submitted report opining that the patient died of septic shock due to multiple infected perforations of loops of intestines and faecal fistulae and peritonitis with infected laparotmy. In the light of the finding of the experts doctors that the patient suffered septic shock due to infected laparotomy the complainants have discharged their initial onus and it is for the opposite parties no1 and 2 to show that the treatment particularly during the post operative stage they had rendered with great concern and there was no negligence on their part. The entire evidence brought on record before this commission during the pendency of the appeal does not support the case of the opposite parties no.1 and 2 that they were not negligent as the patient was kept for about seven days in the opposite party no.1 hospital after the surgery was performed on her and there was no sufficient explanation forthcoming from the opposite parties no.1 and 2 as to the steps taken to prevent the spreading of infection.