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12. It was further pleaded that after looking at the medical record of the patient, it was found that the patient was operated for the third degree uterovaginal Prolapse with cystocoel and rectocele and DUB (Menorrhagia) and not only DUB as alleged in the complaint. On merits, it was denied if appellant No.2 had advised the respondent and the patient to undergo family planning operation or if the operation fee was ever demanded for rendering medical services. Appellant No.2 had never advised the patient to undergo family planning operation. Rs.350/- were charged from the respondent for major operation fee as fixed by the Punjab Health Systems Corporation for sterilization operation. No fee was fixed by the Government under the National Family Planning Programme.

Upon inquiry from the patient she disclosed that some mass was coming out of the vagina which was causing her a great deal of discomfort and she wanted relief from the said complaint also. The patient was also advised to seek gynecological opinion.

17. It was further pleaded that thereafter the patient had consulted the Gynecologist on 15.4.2004 at OPD Slip No.3488 in the appellant hospital. She was examined by Dr. Anujit Kaur, Medical Officer (named as Dr. Amarjit Kaur respondent No.3 in the complaint but at its proper name in the appeal). Appellant No.3 had gone through the entire history of the patient. She found that the patient was having 3rd Degree Uterovaginal Proplapse with cystocele with rectocele. The patient wanted relief from the suffering caused by prolapse which was causing great discomfort to her in day to day activity. The patient was told about the surgical measures available at the appellant hospital. Since the patient had completed her family and all her deliveries were conducted at home by a midwife (Dai). Surgery was the definitive and curative treatment for genital prolapse. Uterine prolapse (downward descent of the uterus) per se was not responsible for loss of life but it could be a source of acute discomfort and suffering. No other branch of surgery involves so less risk and gives much relief as the surgery for genital prolapse. The patient was advised to get herself investigated for major surgery. She was put on treatment for vaginal discharge. While taking her history, the patient had disclosed that she was experiencing heavy prolonged bleeding since two months after the birth of her youngest child.

26. It was further denied if the medical report/treatment chart were fabricated by the appellants. It was a surgery for 3rd Degree Uterovaginal Prolapse with cystocele with rectocele and not solely DUB as alleged. The history of the patient clearly revealed that she wanted relief from discomfort caused by the mass coming out of the vagina. Excessive and prolonged bleedings were just coincidental finding. Despite this, the patient was advised to get the ultra-sound done on OPD slip No.3488 dated 15.4.2004 to rule out the various causes of mennorhagia. The patient had refused to get the ultra-sound done. In a case of genital prolapse, a thorough physical examination gives almost all relevant details necessary for diagnosis and for determining the line of management. The sophisticated techniques and investigations have little value in this particular condition.

46. It was further pleaded by appellants No.2 and 3 in the written reply that the patient wanted relief from the suffering caused by prolapse which was causing great discomfort to her in day to day activity. The patient was told by appellant No.3 of the surgical measures available in the appellant hospital to relieve her of her discomfort keeping in mind that the patient had completed her family and all her deliveries were conducted at home by a midwife (Dai). The surgery was the definitive and curative treatment for genital prolapse. It may be as it has been proved by the appellants that the respondent had visited the appellant hospital on 12.4.2004 as OPD patient (Ex.R-3) and she had also visited as OPD patient on 15.4.2004 (Ex.R-4).