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2.3 The opposite party no. 4 in preliminary objections of the written statement stated that the deceased was admitted in the opposite party no 4 on 11.06.2012 vide Hospital Unit No.C-7383823 with a diagnosis of post open cholecystectomy CBD injury and complaints of abdominal distension and bile leak from the drain side. The deceased had undergone an open cholecystectomy on 31-5-2012 in the hospital of the opposite party no.l. The deceased was managed with TV. antibiotics and was moderated. MRCP was planned but could not be done in view of massive ascites. The deceased underwent a diagnostic laparoscopy and drain insertion on 14-6-2012. The deceased was recovering post operatively and nasogastric tube was removed on the second post operation day. The deceased was put on liquid diet. The deceased suffered from fever on Sth post operation day and developed Candida sepsis. The deceased showed improvement after medication but developed tachypnoea on 15 post operation day. The deceased on 2-7-2012 i.e. 19th day after operation became drowsy and developed severe metabolic and respiratory acidosis. The deceased was intubated and put on peripheral ventilator with inotropic support. The deceased was planned to be shifted in ICU but discharged as LAMA at insistence of the complainants. There was no negligence or deficiency in service on the part of opposite party no. 4 and prayer for dismissal of the complaint was made..

10.1 We shall now refer other medical documents as detailed herein and are referred and relied on by the complainant and the opposite parties no 1 and 2.

The ultrasound of the deceased was also conducted on 04.06.2012 during her admission in the opposite party no 3. It reflected gall bladder was with history of cholecystectomy and CBD was of normal caliber. Spiral CECT Abdomen of the deceased was also conducted on 09.06.2012 during her admission in the opposite party no 3. The perusal of report reflects that no sign of biliary obstruction was observed. Another important medical document is MRCP (Magnetic Resonance Cholangiopancreatography) dated 12.06.2012 Ex. C-8 prepared at the opposite party no 4 and is stated to be non-invasive, radiation free MRI scan used to create detailed images of the liver, gall bladder, bile ducts and pancreas to diagnose blockages, stones, tumors or inflammation. It indicated CBD injury. It also reflects that gall bladder was absent consistent with history of cholecystectomy and proximal common bile duct was found to be normal in course and caliber of 5.7 mm. The relevant portion of MRCP dated 12.06.2012 is reproduced verbatim as under:-

17.1 The District Forum in order dated 23.04.2013 also referred medical record prepared by the opposite party no 4 Ex. C-14 which contained that the CBD injury was finally diagnosed. The District Forum also referred MRCP Report dated 12.06.2012 which was prepared when the deceased was admitted in the opposite party no 4 and Report dated 12.06.2012 Ex. C-8 and these reports also indicated CBD injury besides collection of small fluid at Revision Petition Nos. 303, 684 and 2982 of 2017 33 ( this site. It was opined in MRCP Report dated 12.06.2012 that "focal non visualized segment of mid CBD with small adjacent collection as described was suggestive of CBD". The District Forum also referred CT scan Report dated 25.06.2012 Ex. C-9 which referred "common bile duct visualized distal CBD measures 6 mm". The District Forum also referred history of the deceased prepared at the opposite party no 4 which also mentioned impression of CBD injury post cholecystectomy. The District Forum also relied on affidavit Ex. C-l tendered by Dr. Shekhar Upadhya, Associate Professor in the Department of Surgery, CMC & Hospital, Ludhiana wherein he did not deny that deceased had a CBD injury with bile leak. The District Forum held that the deceased was a case of CBD injury post Cholecystectomy and the opposite party no 4 treated the deceased only for CBD injury. The District Forum opined that CBD injury was caused to the deceased during operation in the hospital of the opposite party no 1. The District Forum also considered but not accepted contention of the opposite parties no 1 & 2 that as per CT scan report dated 25.06.2012 Ex. C-9, which was prepared when the deceased was admitted in the opposite party no 4, there was no damage or cut of any type in CBD because report dated 25.06.2012 reported that size of common bile duct visualized digital measures as 6mm. The District Forum held that the deceased had died due to negligence of the opposite parties no 1 & 2. The State Commission in the impugned order also held that CBD injury was caused to the deceased during surgical procedure at the hospital of the opposite party no 1 and for this relied on medical documents i.e. ultrasound report Ex. C-8 dated 12.06.2012 which was prepared post-operation, CT scan Report dated 25.06.2012 Ex.C-9 which indicated common bile duct injury.

17.2 We have also considered arguments advanced on behalf of the opposite parties no 1 & 2. The counsels for the opposite party no 1 while primarily argued that there is no concrete evidence to establish medical negligence on Revision Petition Nos. 303, 684 and 2982 of 2017 34 f the part of the opposite party no 1 referred CT scan report dated 25.06.2012 reflecting that CBD was intact and was of normal caliber (6mm), ultrasound report dated 04.06.2012 indicating normal CBD and spiral CECT of the abdomen conducted on 09.06.2012 showing no sign of biliary obstruction and confirming normal bile flow. The counsels for the opposite party no 2 argued that the deceased was given proper medication and care during her admission in the hospital of the opposite party no 1 and the opposite party no 2 performed the cholecystectomy procedure on 31.05.2012 in accordance with standard medical practice. The counsels for the opposite party no 2 during arguments also referred ultrasound report dated 04.06.2012, spiral CECT abdomen report dated 09.06.2012 and MRCP report dated 12.06.2012 to establish that CBD post-surgery was normal and complications to the deceased might have caused due to subsequent admission in the opposite parties no 3 & 4 and PGI, Chandigarh. We are not in agreement with these arguments advanced on behalf of the opposite parties no 1 & 2 after considering medical documents which were referred by the respective counsels in the arguments. MRCP dated 12.06.2012 Ex. C-8 and CT Scan Report dated 25.06.2012 Ex.C-9 themselves were suggestive and indicative of CBD injury and these documents cannot be disbelieved and good enough for reliance. There is no force in arguments advanced on behalf of the opposite parties no 1 & 2 that ultrasound report dated 04.06.2012, spiral CECT abdomen report dated 09.06.2012 and MRCP report dated 12.06.2012 established that CBD post-surgery was normal and complications to the deceased might have caused due to subsequent admission in the opposite parties no 3 & 4 and PGI, Chandigarh. There is factual force in the argument advanced by the counsels for the complainants that MRCP dated 12.06.2012 Ex. C-8 and CT Scan Report dated 25.06.2012 Ex.C-9 clearly indicated CBD injury post-surgery and this argument deserved to be accepted. We after analyzing medical reports/documents as referred herein above are of Revision Petition Nos. 303, 684 and 2982 of 2017 35 J considered opinion that CBD injury was caused to the deceased only during cholecystectomy conducted on 31.05.2012 by the opposite party no 2 in the hospital of the opposite party no 1 and at that time opposite party no 1 being anesthetists was also present. The opposite party no 1 & 2 are guilty of medical negligence while conducting cholecystectomy on the deceased on 31.05.2012 in the hospital of the opposite party nol. The District Forum and the State Commission rightly and logically placed reliance on medical documents as referred herein above to arrive at medical negligence on the part of the opposite parties no 1 & 2. The opposite parties no 1 & 2 are also guilty of negligence in not taking post-operative care of the deceased. There is absolutely no force in the arguments advanced on behalf of the opposite parties no 1 and 2 that CBD might have injured due to surgical intervention done when the deceased was admitted in the opposite parties no 3 and 4 and the opposite party no 4 should have repair CBD where the deceased remained admit for 22 days. There is no evidence that the deceased had undergone any surgical procedure when she was admitted in the opposite parties no 3 and 4. The deceased was also given appropriate treatment at the opposite party no 4. We have also gone through decisions delivered by the Supreme Court in Kalyani Rajan V Inderprastha Apollo Hospital, (2024) 3 SCC37 and M.A. Biviji V Sunita and others, (2024) 4SCC242 which were referred during arguments. The complainants are able to prove medical negligence on the part of the opposite parties 1 & 2 by producing convincing evidence.