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6.      In reply before the State Commission, OP-1 and 2 vehemently and specifically denied each allegation made by the Complainant and asserted that they provided the highest standard of professional care. The Complainant visited to OP-2 hospital on 27.06.2012 with a history of 'dysmenorrhea and menorrhagia' persisting for past two years, along with intermittent abdominal pain. Notably, she had history of diabetes mellitus, hypertension, hypothyroidism and bronchial asthma, all of which were under treatment for the last three years. Additionally, she had undergone a caesarean section delivery 18 years prior and experienced secondary infertility since then. Upon ultrasound examination, multiple fibroids were detected, prompting the medical team to recommend surgery. Given her age and symptomatic profile, a decision was taken for hysterectomy, with clinical consideration of possible endometriosis despite the ultrasound findings indicating a fibroid uterus. Due to the presence of multiple fibroids, a total hysterectomy was deemed necessary. The OPs informed both the patient and her husband in detail about the potential risks and complications associated with laparoscopic hysterectomy. These included the possibility of bowel and bladder injury, which might become apparent postoperatively and necessitate further surgical intervention. Additionally, the inherent risks of anaesthesia were also discussed and explained, considering her underlying medical conditions such as diabetes mellitus type II, bronchial asthma, and hypothyroidism. Moreover, the likelihood of adhesions due to previous caesarean section and the strong clinical suspicion of endometriosis were also communicated.

26.    On the contrary, the learned counsel for the Respondents/OP-1 & 2 argued that the principle of "Res Ipsa Loquitur" is inapplicable in the present case because the Complainant failed to provide any evidence demonstrating medical negligence on the part of OP-1 & 2. They emphasized that the treatment administered to the Complainant at Mediciti Hospital and the medical advice provided by OP-1&2 were consistent, which is clearly documented in the discharge summary issued by Mediciti Hospital, which attributes the exacerbation of the Complainant's abdominal pain to consumption of solid food, indicating non-compliance with the prescribed liquid diet advised by OP-1 & 2. Further, after conducting an ultrasound examination, multiple fibroids were detected, leading OP-1 & 2 to recommend Total Hysterectomy Surgery due to clinical suspicion of endometriosis. This decision was based on the diagnostic findings and professional judgment of OP-1 & 2, aiming to address her medical condition appropriately. She further argued that the Hon'ble State Commission failed to properly consider that laparoscopic surgeries, by their nature, entail certain known risks and complications. Citing authoritative sources such as the "Telende' textbook, 10th edition, page 333," the counsel highlighted that general statistics indicate a 3.6% risk of bowel injury and a 1 in 300 risk of urinary tract injury during such procedures. These figures underscored the inherent risks involved in laparoscopic surgeries, including those performed on the Complainant. The learned counsel emphasized that the treatment provided to the patient at Mediciti Hospital was conservative and lasted only three days, after which she was discharged in stable condition with no reported complications. This is clearly documented in the discharge summary from Mediciti Hospital. Furthermore, the counsel pointed out that the Complainant did not submit any independent expert opinion to substantiate her allegations of medical negligence and asserted that the absence of such expert testimony undermines the claim that there was any negligence on the part of OP-1 & 2 in the treatment provided. She also asserted that an enquiry and report by the A.P. Medical Council, specifically File No. MCI-211 (2)(538)/2012 - Ethics, issued on 20.02.2023, is still pending. This pending inquiry suggests ongoing scrutiny of the matter by the medical authorities, indicating that the issue is still under official review and assessment.

51.    Per contra, OP-1 & 2 asserted that upon admission on 27.06.2012, the Complainant was diagnosed with uterine fibroids, alongside a medical history of diabetic mellitus and hypertension under treatment for the past three years. She was also known to have hypothyroidism. Multiple fibroids were identified, prompting a decision for total hysterectomy. OPs communicated to the patient and her husband about the potential risks and complications associated with laparoscopic hysterectomy, including anticipated bowel and bladder injuries that might manifest post-surgery, potentially requiring re-laparotomy. They also informed about the risk of anesthetic complications given the underlying medical conditions such as type II diabetes mellitus, bronchial asthma, and hypothyroidism. Additionally, OP-1 & 2 cited strong clinical suspicions of endometriosis and the likelihood of encountering surgical adhesions due to the patient's history of previous caesarean section with a uterus affected by multiple fibroids.