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2.2     On 19.09.1997, the Patient consulted the treating Doctor, who, after subjecting the Patient to certain tests, i.e. Biochemical Test for Bilirubin, Sugar and Blood Counts, advised him to get himself admitted in the Hospital on 26.09.1997, for Laparoscopic Cholecystectomy, which was scheduled for 27.09.1997. On Patient's informing the treating Doctor that he also had Hernia, the treating Doctor advised Laparoscopic surgical procedure for removal of the gallbladder and an Open Surgery for repair of left inguinal Hernia, simultaneously. As scheduled, the Patient was operated upon at 7.00 a.m. on 27.09.1997. Around 10.40 a.m., the treating Doctor informed the relatives of the Patient that though the procedures/surgeries were successful but there was some bleeding due to a cut in the blood vessel, which had been attended to.  While in the ward, on 28.09.1997 at about 2.30 a.m., the Patient developed fever and breathlessness. When his condition deteriorated, he was shifted to the Emergency Ward at 3.30 a.m. and after examination, the treating Doctor informed the relatives that he had developed some infection, which would be attended to and in a couple of days he would be shifted to the ward again.  At 6.00 a.m., the Doctors in the Emergency Ward noted in the case papers that the Patient was possibly in 'early septicaemia' and his hemoglobin had come down from 11 grams to 9.8 grams. At about 1.30 p.m., on 30.09.1997, the Patient was shifted to the Intensive Care Unit (ICU). There too, the Patient's condition kept on deteriorating and on 03.10.1997 he was put on a ventilator.  The treating Doctor informed the relatives of the Patient that the Patient was not responding to the antibiotics. Ultimately, on 06.10.1997 at 7.10 p.m., the Patient breathed his last, due to Cardio Respiratory Failure secondary to Gram Negative Septicaemia and Right Basal Consolidation with Cholecystectomy for Gall Stones and Obstructive Jaundice with Cholecystitis as associated causes. 
The gallbladder was shrunken.  Pneumo  created with Veres needle.  There were  adhesions? Infective. The adhesions were separated.  The cystic duct was dissected, clipped and cut.  The cystic artery was dissected, clipped and cut.  The GB was dissected from the bed after doing the LapChole there was a bit of bleeding around the pancreatic duodenal area which required a mini Lap to control the bleeding with a stich.  The hernia was repaired with a Prolene mesh. It was a direct hernia.
The GB fossa was clear.  The clips on the cystic duct were intact.  The stent was felt in the CBD.  The bleeder was in the supraduodenal part of the pancreas probably due to the separation of the adhesions.  The cystic artery was intact.  The wash fluid was sucked out.  There was no bleeding at the time of closure and hence no drain was put for the patient as the patient had a stent as well.
Wound closed with 2.0 Vicryl in layers.  Hernia repair done with Prolene mesh since it was direct hernia (L).  Post operative blood loss calculated at 250cc."
 

11.     Similarly, as per the Nurses' notes, recorded at 7.45 a.m. on 27.09.97, the following procedure was performed in the operation theatre:-

"OT 7.45 AM Lap Cholecystectomy and left inguinal hernia repair meshplasty with mini laprotomy done to control the bleeding from the duodenum with a stitch.  GA done by Dr. Anil Pinto asst by Dr Lawrence and Dr. B Sodder.  Anaesthetist Dr. Salyankar."

15.     Additionally, in support of his stand that there was no negligence in the conduct of surgeries on the patient, the treating doctor filed an affidavit of one Dr. Vinay G. Mehendale, M.S., M.N.A.M.S., Hon. Surgeon Rajawadi Mun. Hospital, Hon. Prof. of Surgery D.Y. Patil Medical College, which reads as under:-

"        I Dr. Vinay G. Mehendale would like to state that I have done over 2500 laparoscopic surgeries all over India.  I have gone through the case papers of Mr. Alfred Pais, age 62 years, who was operated on by Dr. Anil Pinto at the Holy Family Hospital, Bandra, for a laparoscopic cholecystectomy which was converted to open surgery.  He also had a left inguinal hernia at the same time.  I find no negligence on part of Dr. Anil Pinto in the above said procedures. I also find no negligence in the fact that the surgery was done 3 weeks after ERCP.  There was also no negligence in repairing the hernia at the same time."