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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. 

9.       We shall, therefore, examine the allegations of medical negligence on the touchstone of the aforenoted broad principles.

10.     In the present case, as noted above, the allegations of medical negligence against the treating doctor are culled out in paragraph 2.3 supra.  As per the operation sheets, signed by the treating doctor, the following procedures/operations were conducted on the patient:-

"Operation:-

Lap. Chole, conversion to Open Cholecystectomy and repair of L inguinal hernia under GA           Findings:-     

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."

19.    It appears from the medical literature that complications during Laparoscopy could also be on account of Intra-abdominal hematoma, abscess and free fluid; tears of colon, stomach and small bowel; anastigmatic leak; adhesions small bowel and stomach necrosis, identified during mesh detachment from the abdominal wall; and small bowel obstruction, but the major life risk factor is attributed to injury to bile duct which in turn is relatable to the experience of the Surgeon. In the instant case, nothing had been brought on record by the Complainant to controvert the stand of the treating Doctor that the bleeding was around the pancreatic duodenal area, which was controlled with a stich. The expert opinions of the three Doctors, extracted above, do not even suggest the probable cause of septicaemia, the ultimate cause of death of the patient, let alone an indication of injury to the bile duct. On the contrary, Dr. Vinay G. Mehendale, has given a clean chit to the treating Doctor, opining that  there  was  no  negligence  in  the  performance  of  all the three surgeries/procedures, viz. laparoscopic Cholecystectomy, Laparotomy and open surgery for repair of left inguinal hernia. This expert opinion also remains unrebutted.  As a matter of fact, noticing the bleeding, the treating Doctor rightly switched over to an open laparotomy technique, a recommended protocol in the medical science. Similarly, no material was brought on record in support of the plea that simultaneous open surgery for repair of left inguinal hernia aggravated the complications, leading to the death of the patient.