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M.B. Shah, J. (President)

1. Original Petition No. 61 of 1996 I. In a simple hysterectomy operation performed on the Complainant on 21.6.1993, she lost her kidney; her ovaries; she was required to undergo various further curative operations, because there was uncontrollable fecal discharge from vagina from 29.6.1993 onwards; and she suffered pain for months together after the operation. `It is pointed out by the learned Counsel for the Complainant that her large intestines were exposed and small intestines were infected with adhesions at various places. A further surgery was carried out for repair of fistula and closure of fistula on 17.11.1993 and for closure of colostomy operation was performed on 21.2.1994. She remained in pitiable condition in the hospital. She was finally discharged on 14.3.1994.

8. Subsequently, she found that a series of operations were performed on her, i.e. at first Dilation and Curettage (D&C) was carried out; subsequently, hysterectomy - initially through vaginal route, and, thereafter, through abdominal route; her ovaries were removed; and, her left kidney was also removed. No consent was taken for hysterectomy through vaginal route, nor for removal of ovaries nor for removal of kidney.

9. She contends that: (a) no organs or body parts that were removed were ever shown or disclosed to the patient or to her relatives; (b) secondly, the surgery expanded beyond the domain of consent and removal of ovaries and fallopian tubes through vaginal route resulted in rupture of a blood vessel; (c) the rupture of blood vessels which was encountered by the Doctors was not during hysterectomy but during removal of ovaries for which there was no planned surgery and no consent; (d) the left ovarian vein connects the left ovary to the left renal vein and is not connected with the uterus. The length of this vein in an adult woman is approximately 8 to 10 inches. Hence, avulsion could not be to such an extent.

16. As they were not successful in controlling the bleeding, and as the blood pressure was dropping, they decided collectively to remove the left kidney, as a life saving procedure, after checking the right kidney was in position.

17. After the bleeding had been controlled, though unfortunately the left kidney had to be sacrificed to save the patients life, Dr. S.K. Bhandari completed the operation. Patient received 9 units of blood and one unit of plasma during the operation. Another 4 units of blood were given in ICU (Intensive Care Unit). The lost blood had to be replaced promptly. All possible and prompt measures to meet the situation and save the valuable life were employed without any loss of time, which action has actually saved the life of the Complainant.

It is pointed out by the learned Counsel for the Complainant that the left ovarian vein leaves from the end of the ovary (which lies inferior to the pelvic inlet, i.e. inferior to the start of the Sacrum (S1), at about S3) and joins the left renal vein (which lies between LI and LII). Moreover, the ovaries lie very close to the bladder and the length of the ureters (from the bladder to the kidney) is 10 inches. The uterus and the left renal vein join the kidney at almost the same location (between LI and LII). Thus, the length of the left ovarian vein in an adult woman is approximately 8 to 10 inches.