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2. The plaintiff was a brilliant youngster aged 17 years in 1966 when he passed the P.U.C. (Pre-University Course) examination securing 100% in Mathematics and 93.5% in Physical Sciences. He was a State Government merit scholar getting a monthly scholarship of Rs. 100/-. He was offered a seat in B.E. Degree course in four Engineering Colleges both within and outside the State of Andhra Pradesh. He had a minor ailment --chronic nasal discharge -- for which his mother took him to the second defendant Dr. Narasimha Rao for consultation. The plaintiffs father at that time was working as Senior Officer at Nagpur in the service of the Central Government. The second defendant diagonosed the disease as Nasal Allergy and suggested operation for removal of tonsils On 6-7'66 the plaintiff was admitted in the Government General Hospital, Guntur and the operation was performed on the morning of 7-7-66. His father came down to Guntur to be present at the time of the operation. None of the relations of the plaintiff including the father were allowed to be present inside the operation theatre and so what happened in the operation theatre at the time of the operation was within the exclusive knowledge of defendants 2 and 3. About one and half hours after the plaintiff was taken inside the operation theatre, he was brought out in an unconscious state and the doctors informed the plaintiffs father that he would regain consciousness within three or four hours. The plaintiff was kept in the E.N.T. Ward of the Hospital. For the next three days he did not regain consciousness and thereafter for another fifteen days he was not able to speak coherently. The treatment was entrusted to two other doctors of the same hospital Dr. Mallikarjuna Rao, Physician and Dr. Surya-narayana, Psychiatrist. He was discharged from the hospital on 28-8-66 and his condition at the time of the discharge was that he was just able to recognise the persons around and utter a few words. He could not even read or write numericals. He lost all the knowledge and learning acquired by him. Greatly upset by the condition of the plaintiff his father took him to Vellore where he was examined by P.W. 1 Dr. K. V. Mathai, Professor of Neuro Surgery, Christian Medical College Hospital, Vellore. After conducting neurological examination and after studying the case history, on 21-11-66 Dr. Mathai gave a written opinion Ex. A-1 stating that the plaintiff had cerebral damage and his intellectual ability was that of a boy of five years age in relation to calculations, reading and understanding. The plaintiff was then taken to Bangalore where he was examined by Dr. S. A. Ansari, Assistant Professor of Psychiatry at the Indian Institute of Medical Health on 28-11-66. After conducting certain tests and studying the case papers the doctor found the plaintiff to be mentally defective. His I.Q. as against the normal 100 was only 60. There was organic brain damage which was due to cerebral anoxia -- the damage to nerve cells was total and irreversible. The prolonged unconsciousness of the plaintiff was due to cerebral anoxia suffered during the operation. Claiming compensation in a sum of Rs. 50.000/- after serving notice under S. 80 of the C.P.C., it was averred by the plaintiff in the plaint that but for the unfortunate operation which marred permanently his future prospects and rendered him unfit for higher studies, he would have joined the B.E., degree course in any of the four Engineering colleges which offered him admission, successfully completed the same and also gone abroad for higher studies. Being a Government merit scholar in the Pre Unviersity Course he would have easily obtained merit scholarship of Rs. 150/-per month until he completed postgraduate studies and secured easily a Government job fetching a minimum initial salary ofRs. l,000/-. Because of the recklessness and negligence on the pan of the defendants 2 and 3 his bright future was marred permanently and he had to depend upon his parents through out his life. Due to the recklessness and negligence of the defendants 2 and 3 the plaintiff suffered respiratory and cardiac arrest for about three or four minutes during general anaesthesia which led to cerebral anoxia causing irreparable damage to the brain. Knowing fully well that he was not in a fit state to be operated upon, the second defendant negligently proceeded to perform the operation and in fact completed the operation, thereby further aggravating the damage to the brain. The necessary precautions that ought to have been taken before and during the operation were not taken. Tonsillectomy being a minor operation involving no risk at all, the damage done to him speaks itself of the gross negligence and carelessness on the part of the defendants 2 and 3, The Anaesthetist did not even maintain any record of the pre-anaesthetic assessment of the plaintiff. The plaintiff, therefore, sought a decree in a sum of Rs. 50,000/- as damages under all the heads including mental pain, suffering, loss of earning capacity, expenses incurred for medical treatment etc.

5. The learned Judge after considering the evidence on record both oral and documentary rejected the version put forth by the defendants that the mental depression and brain damage suffered by the plaintif was functional psychosis. He greatly relied upon the expert medical witness D.W. 5 who stated that the mental disorder of the plaintiff was due to cerebral anoxia, the result of improper induction of anaesthetics and the failure to take immediate steps to reduce anaesthesis and anoxia. That the plaintiff suffered anoxia, the learned Judge concluded, was established beyond reasonable doubt by the notings in the case sheet Ex.A.25.

(1) Whether the brain damage sustained by the plaintiff was due to the negligence of defendants 2 and 3?

(2) If the answer to the above is in the affirmative whether the damages awarded by the court below are inadequate in the circumstances?

10. The brain damage sustained by the plaintiff was cerebral anoxia and the medical evidence established this beyond any doubt. The damage suffered by the plaintiff was irreversible is also proved by medical evidence. The damage sustained was not localised to any part but it was over ail damage was also brought out in the medical evidence. Dr. S.A. Kabir (D.W. 5), Professor of Anaesthe-siology and Dean of Madurai Medical College said in his evidence that respiratory arrest and cardiac arrest resulted in cerebral anoxia. The case sheet Ex. A-25 contains the record of the condition of the plaintiff when he was at the Hospital. It does not contain any record that there was any abnormality in the mental health of the plaintiff prior to the operation. Ex. A-25 clearly shows that the brain damage suffered by the plaintiff was due to cerebral anoxia. On this aspect there is no scope for controversy the doctors examined as witnesses in this case, going through the contents of Ex.A-25, were clear in their opinion on this. Respiratory arrest if prolonged would lead to cardiac arrest and in the case of cardiac arrest even a delay of about three minutes would result in permanent brain damage, according to Dr. Variava, Neuro Surgeon of Poone (P. W. 7) who examined the plaintiff and gave his opinion Ex.C-I. The two leading doctors D.W. 5 D'r. Kabir and P.W. 7 Dr. Variava both agreed that if cardiac arrest has occurred, it is better to postpone the operation and that tonsillec-tomy is an "elective operation". When a patient is under general anaesthesia, all medical authorities agree the views expressed in this regard by Dr. Artusio have been admitted to be correct by Dr. Kabir D.W. 5 it is the mutual responsibility of the surgeon and the anaesthetist, Dr. Kabir said, and this has not been disputed, that prudence on the part of the surgeon requires him to ascertain from the anesthetist about the state of the patient and that a surgeon should know whether cardiac arrest has followed the respiratory arrest. The preparation of the patient for the operation, according to Dr. Kabir, includes "administration of anaesthetics and anaesthesia forms part of surgical procedure. The second defendant who performed the operation giving evidence as D.W.4 and Dr. Kabir D.W. 5 both said in their evidence that surgery, anaesthesia and resuscitation are team work of both the surgeon and anaesthetist.

24. Under the head "special damages' the most important claim relates to future pecuniary loss of the plaintiff. By the date of the operation the plaintiff was a normal healthy youth of 17 years age; except the minor inconvenience of nasal discharge his health was perfectly alright. Ex. A-24 dated 14-6-1966, certificate of physical fitness issued by the Assistant Surgeon, Government Hospital, Vijayawada bears ample testimony to his physical health. Ex. A-11 is the S.S.L.C. register of the plaintiff and it says he was one of the best three students of the school. His rating was that he was a most promising child with a bright future. The marks obtained by him in the P.U.C. examination held in March, 1966 as evidenced by Ex. A-12 further testify his scholastic record he obtained 100% in Mathematics and 93.5% in Physical Sciences. He was a holder of Government scholarship because of his extraordinary brilliant academic career. The monthly scholarship amount paid to him was Rs. 100/- (vide Exs. A-13 and A-14). When he applied for admission to B. E. course, 4 Engineering Colleges including the Regional College of Engineering, Tiruchunapally, Tamil Nadu selected him for admission as can be seen from Exs. A-18 and A-23. As a matter of course he would have got government merit scholarship of Rs. 150/- per month for the entire duration of his Engineering course up to post graduate level with his brilliance and industry he would have effortlessly secured admission into Post Graduate or P.H.D. course in Engineering in any of the reputed colleges in United States if he wanted to pursue higher education, or he would have secured a decent job either in public sector or private sector on a minimum initial salary of Rs. 1,000/- per month in 1971 after completing the B.E. degree course. For about 35 years the plaintiff would have continued in gainful employment and reached higher positions. The permanent brain damage suffered by the plaintiff as a result of the operation disabled him completely from pursuing any lucrative avocation. The plaintiffs father hoping fondly that his mental condition would be improved, put him in Ravi Tutorial College of which P.W-3 is the Principal so that the coaching given by the tutorial college would enable him to secure admission to any of the Engineering Colleges. Even after one year he could not pick up even 20% of the prescribed average. The brain damage because of cerebral anoxia as per the medical evidence was irreversible. P. W-7 Dr. Variava in his opinion Ex. C-l stated that there would be no. appreciable improvement in the mental capacity of the plaintiff and, therefore, the doctor suggested that the plaintiff should not be made to pursue academic studies. He took eight chances for completing his B.Sc., degree obtaining a third class. The small job he got, lower than a clerk in Post and Telegraphs Department, he could not retain because of his brain injury. He was served with memos Exs. A-6 and A-7 for his poor and inefficient work and ultimately his services were terminated by Ex.A-62 dated 5-7-68. With permanent mental deficiency there is no prospect of his getting any gainful employment. For the rest of his life he needs financial support. The permanent mental deficiency of the plaintiff was also established by the evidence of D. W-5 and P.Ws-1 and 2. Taking all these circumstances into consideration, I think, a sum of Rs. 2 lakhs would be reasonable compensation under the head 'future pecuniary loss'.