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Monday, October 1, 2018

Consumer Case - MEDICAL NEGLIGENCE - no medical evidence of any expert was adduced = In our opinion, there has to be a direct nexus with these two factors to sue a doctor for his negligence. Suffering of ailment by the patient after surgery is one thing. It may be due to myriad reasons known in medical jurisprudence. Whereas suffering of any such ailment as a result of improper performance of the surgery and that too with the degree of negligence on the part of Doctor is another thing. To prove the case of negligence of a doctor, the medical evidence of experts in field to prove the latter is required. Simply proving the former is not sufficient. = not able to prove that the ailments which she suffered after she returned home from the Hospital on 08.08.1996 were as a result of faulty surgery performed by the appellant. = It is apt to remember the words of the then Chief Justice of India when he said in Jacob Mathew’s case (supra) which reads as under: “The subject of negligence in the context of medical profession necessarily calls for treatment with a difference. There is a marked tendency to look for a human actor to blame for an untoward event, a tendency that is closely linked with a desire to punish. Things have gone wrong and therefore somebody must be found to answer for it. An empirical study reveals that background to a mishap is frequently far more complex than may generally be assumed. It can be demonstrated that actual blame for the outcome has to be attributed with great caution. For a medical accident or failure, the responsibility may lie with the medical practitioner, and equally it may not. The inadequacies of the system, the specific circumstances of the case, the nature of human psychology itself and sheer chance may have combined to produce a result in which the doctor’s contribution is either relatively or completely blameless. The human body and its working is nothing less than a highly complex machine. Coupled with the complexities of medical science, the scope for misimpressions, misgivings and misplaced allegations against eh operator i.e. the doctor, cannot be ruled out. One may have notions of best or ideal practice which are different from the reality of how medical practice is carried on or how the doctor functions in real life. The factors of pressing need and limited resources cannot be ruled out from consideration. Dealing with a case of medical negligence needs a deeper understanding of the practical side of medicine. The purpose of holding a professional liable for his act or omission, if negligent, is to make life safer and to eliminate the possibility of recurrence of negligence in future. The human body and medical science, both are too complex to be easily understood. To hold in favour of existence of negligence, associated with the action or inaction of a medical professional, requires an in­depth understanding of the working of a professional as also the nature of the job and of errors committed by chance, which do not necessarily involve the element of culpability.”= the appeal succeeds and is accordingly allowed. The impugned order is set aside and that of the order passed by the State Commission is restored.

          REPORTABLE
IN THE SUPREME COURT OF INDIA
CIVIL APPELLATE JURISDICTION
CIVIL APPEAL No.3971 OF 2011
Dr. S.K. Jhunjhunwala          ….Appellant(s)
VERSUS
Mrs. Dhanwanti Kumar & Anr.        …Respondent(s)
J U D G M E N T
Abhay Manohar Sapre, J.
1. This   appeal   is   directed   against   the   final
judgment and order dated 01.09.2009 passed by
the   National   Consumer   Disputes   Redressal
Commission (hereinafter referred to as “the National
Commission”), at New Delhi in First Appeal No. 93
of 2004 whereby the National Commission allowed
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the appeal filed by respondent No.1 and set aside
the   order   dated   19.01.2004   of   the   State
Commission,   West   Bengal,   Kolkata   in   Complaint
Case No.698/O/1997.
2. In order to appreciate the issue involved in the
appeal, it is necessary to set out the relevant facts
hereinbelow.
3. The   appellant   was   the   opposite   party   No.1
whereas   the   respondent   No.1   herein   was   the
complainant and respondent No.2 herein was the
opposite party No.2 in the complaint out of which
this appeal arises.
4. The appellant is a doctor by profession and is
practicing in Calcutta since 1969.  He is a qualified
Surgeon having expertise, especially in gall bladder
surgery.   He   obtained   his   MBBS   degree   from
Banaras Hindu University in 1968 and thereafter
went to England and obtained FRCS degree in 1976.
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He then worked for seven years in various hospitals
in England as a Surgeon and returned to India in
1978 and settled in Calcutta.   He was a visiting
consultant  to several Hospitals out of which one
was­Life Line Diagnostic Center and Nursing Home
(respondent No.2 herein) at Calcutta where he used
to perform operations on his patients.
5. Respondent No.1(complainant)­a lady, who,  at
the relevant time, was residing in Calcutta felt pain
in   her   abdomen   in   June   1996.     She,   therefore,
consulted a local doctor but she did not get any
relief.   Therefore, she consulted Dr. Lakshmi Basu
who,   on   examination,   advised   her   to   get   some
medical   tests   done   such   as   X­ray,   PA   Chest,
Ultrasound   of   upper   abdomen   Endoscopy,   Blood
Tests etc. Respondent No.1, as advised, carried out
these medical tests. On examination of the reports
of respondent No.1, Dr. Basu opined that her Gall
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Bladder had two calculi in its lumen and the same
could   be   cured   only   by   operation.   Dr.   Basu
accordingly   advised   respondent   No.1   to   undergo
laparoscopic surgery from any good Surgeon and
suggested the name of the appellant.
6. Respondent   No.1,   as   advised,   consulted   Dr.
S.K. Jhunjunwala­the appellant herein who, after
her examination  and also her medical test reports,
agreed with the advise of Dr. Basu and accordingly
advised respondent No.1 for undergoing Surgery of
her   Gall   Bladder.   The   appellant   also   advised
respondent   No.1   to   get   herself   admitted   in
respondent No.2’s Hospital for undergoing Surgery.
7. On   07.08.1996,   respondent   No.1   got   herself
admitted in respondent No.2’s Hospital as an indoor
patient. On 08.08.1996 the appellant performed the
laparoscopy   and   after   that   open   surgery   and
removed   the   Gall   Bladder   of   respondent   No.1.
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Respondent No.1 was in the hospital for about a
week   or   ten   days   for   post­operative   care   and
thereafter she was discharged.
8. In   December   1997,   respondent   No.1   filed   a
complaint   under   Section   10   of   the   Consumer
Protection Act, 1986 (for short, “the Act”) against
the appellant (opposite party No.1) and respondent
No.2 (opposite party No.2) claiming compensation
for the loss, mental suffering and pain suffered by
her   throughout   after   the   surgery   on   account   of
negligence   of   the   appellant   in   performing   the
surgery   of   her   Gall   Bladder   on   08.08.1996.
Respondent   No.1,   in   substance,   complained   that
firstly,   she   had   never   given   her   consent   for
performing   general   Surgery   of   her   Gall   Bladder
rather   she   had   given   consent   for   performing
laparoscopy   Surgery   only   but   the   appellant
performed general surgery of her Gall Bladder which
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resulted in putting several stitches and scars on her
body,   Secondly, even the surgery performed was
not   successful   inasmuch   as   respondent   No.1
thereafter   suffered   for   several   days   with   various
ailments,   such   as   dysentery,   loss   of   appetite,
reduction of weight, jaundice etc., Thirdly, in June
1997,   she   was,   therefore,     required   to   undergo
another Surgery in Ganga Ram Hospital, Delhi for
removal of stones which had slipped in CBD.  It was
alleged that all these ailments were incurred due to
the negligence of the appellant, who did not perform
the   surgery   properly   and   rather   performed   the
surgery   carelessly   leaving   behind   for   respondent
No.1   only   mental   agony,   pain,   harassment   and
money loss and hence she filed a complaint to claim
the   reasonable   amount   of   compensation   under
various heads as mentioned above.
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9.   The appellant filed his reply and denied the
allegations   made   by   respondent   No.1   in   her
complaint. In substance, the appellant stated in his
reply   that   he,   after   examining   respondent   No.1,
advised her to go for surgery of Gall Bladder, which
may even include removal of Gall Bladder. It was
stated   that   consent   of   respondent   No.1   for
performing   the   laparoscopic   cholecystectomy   was
duly obtained before performing the surgery. The
appellant   stated   that   after   starting   laparoscopic
surgery,   he   noticed   swelling,   inflammation   and
adhesion   on   her   Gall   Bladder   and,   therefore,   he
came out of the Operation Theater and disclosed
these facts to respondent No.1's husband and told
him that in such a situation it would not be possible
to   perform   laparoscopic   surgery   and   only
conventional procedure of surgery is the option to
remove   the   malady.   The   husband   of   respondent
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No.1   agreed   for   the   option   suggested   by   the
appellant and the appellant accordingly performed
conventional   surgery.     Respondent   No.1   was
discharged after spending few days in the Hospital
for   post­operative   care.   The   appellant,   therefore,
denied any kind of negligence or carelessness or
inefficiency on his part in performing the surgery on
respondent   No.1   and   stated   that   all   kinds   of
precautions to the best of his ability and capacity,
which were necessary to perform the surgery were
taken   by   him   and   by   the   team   of   doctors   that
worked with him in all such operational cases. 
10. Parties adduced affidavit evidence in support
of their respective cases set up in their pleadings.
The State Commission, by order dated 19.01.2004,
dismissed the complaint filed by respondent No.1
finding   no   merit   therein.   Respondent   No.1   felt
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aggrieved   and   filed   appeal   before   the   National
Commission.
11. By impugned order, the National Commission
allowed the appeal filed by respondent No.1 in part
and awarded a total compensation of Rs.2 lakhs to
be   paid   by   the   appellant   to   respondent   No.1   on
account of negligence on his part in performing the
surgery   which   gives   rise   to   filing   of   the   present
appeal by way of special leave in this Court by the
appellant­Dr.   S.K.   Jhunjhnwala(opposite   party
No.1).
12. The   short   question,   which   arises   for
consideration in this case, is whether the National
Commission   was   justified   in   allowing   respondent
No.1’s appeal and was, therefore, justified in holding
the   appellant   (opposite   party   No.1)   negligent   in
performing   the   Surgery   of   Gall   Bladder   of
respondent No.1 and, in consequence thereof, was
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justified   in   awarding   Rs.2   lakhs   by   way   of
compensation to respondent No.1.
13. Heard   Mr.   Ateev   Kumar   Mathur,   learned
counsel for the appellant and Mrs. Rupali Samanta
Ghosh, learned counsel for respondent No.1.
14. Having   heard   the   learned   counsel   for   the
parties and on perusal of the record of the case, we
are inclined to allow the appeal and while setting
aside the impugned order restore the order of the
State Commission for the following reasons.
15.   Before we proceed to examine the facts of this
case, it is apposite to take note of legal principle
that governs the controversy involved in the appeal.
16. The question as to how and by which principle,
the Court should decide the issue of negligence of a
professional   doctor   and   hold   him   liable   for   his
medical acts/advise given by him/her to his patient
which caused him/her some monetary loss, mental
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and physical harassment, injury and suffering on
account of doctor’s medical advise/treatment (oral
or operation) is no longer  res integra  and settled
long back by the series of English decisions as well
as the decisions of this Court.
17. The classic exposition of law on this subject is
first laid down in a decision of Queens Bench in a
leading   case   of  Bolam vs. Friern   Hospital
Management Committee [1957]1WLR 582 = (1957)
2 All ER 118 (QBD).
18. McNair J., in his opinion, explained the law in
the following words:
“Where you get a situation which involves the
use of some special skill or competence, then
the   test   as   to   whether   there   has   been
negligence or not is not the test of the man
on the top of a Clapham omnibus, because he
has not got this special skill.  The test is the
standard   of   the   ordinary   skilled   man
exercising and professing to have that special
skill.     A  man  need  not  possess   the  highest
expert skill ….. It is well­established law that
it   is   sufficient   if   he   exercises   the   ordinary
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skill   of   an   ordinary   competent   man
exercising that particular art”
19. The aforesaid principle of law was reiterated
and explained by Bingham L.J. in his speech in
Eckersley  vs.  Binnie  (1988) 18 Con LR 1 in the
following words: 
“From   these   general   statements   it   follows
that a professional man should command the
corpus of knowledge which forms part of the
professional   equipment   of   the   ordinary
member of his profession. He should not lag
behind   other   ordinary   assiduous   and
intelligent  members  of  his  profession   in  the
knowledge  of  new  advances,  discoveries  and
developments   in   his   field.   He   should   have
such   an   awareness   as   an   ordinarily
competent   practitioner   would   have   of   the
deficiencies   in   his   knowledge   and   the
limitations on his skill. He should be alert to
the hazards and risks in any professional task
he   undertakes   to   the   extent   that   other
ordinarily   competent   members   of   the
profession  would  be  alert.  He  must  bring  to
any  professional  task  he  undertakes  no   less
expertise, skill and care than other ordinarily
competent  members  of  his  profession  would
bring, but need bring no more. The standard
is   that   of   the   reasonable   average.   The   law
does  not  require  of  a  professional  man  that
he   be   a  paragon   combining   the   qualities   of
polymath and prophet.”
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20. All along and till date, the law laid down in
Bolam’s case  (supra) is consistently followed by all
the   Courts   all   over   the   World   including   Indian
Courts as laying down the correct principle of law
on the subject.  It is known as Bolam Test.
21. So   far   as   this   Court   is   concerned,   a   Three
Judge Bench in the case of Jacob Mathew vs. State
of  Punjab  [(2005) 6 SCC 1] examined this issue.
Chief Justice R.C. Lahoti, (as he then was) speaking
for the Bench extensively referred to the law laid
down in  Bolam’s  case  (supra) and in  Eckersley’s
case  (supra)   and   placing   reliance   on   these   two
decisions observed in his distinctive style of writing
that the classical statement of law in Bolam’s case
(supra) has been widely accepted as decisive of the
standard of care required by both of professional
men generally and medical practitioner in particular
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and it is invariably cited with approval before the
Courts in India and applied as a touchstone to test
the pleas of medical negligence. 
22. It was held that a Physician would not assure
the patient of full recovery in every case. A surgeon
cannot and does not guarantee that the result of
surgery would invariably be beneficial, much less to
the extent of 100 % for the person operated on.  The
only assurance which such a professional can give
or can be understood to have given by implication is
that he is possessed of the requisite skill in that
branch   of   profession   which   he   is   practicing   and
while   undertaking   the   performance   of   the   task
entrusted to him he would be exercising his skill
with reasonable competence. This is what the entire
person   approaching   the   professional   can   expect.
Judged by this standard, a professional may be held
liable for negligence on one of two findings: either he
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was not possessed of the requisite skill which he
professed to have possessed, or, he did not exercise,
with reasonable competence in the given case, the
skill which he did not possess.
23. It was further observed that the fact that a
defendant charged with negligence acted in accord
with the general and approved practice is enough to
clear   him   of   the   charge.   It   was   held   that   the
standard of care, when assessing the practice as
adopted,   is   judged   in   the   light   of   knowledge
available at the time of the incident and not at the
date of trial. It was held that the standard to be
applied for judging whether the person charged has
been negligent or not would be that of an ordinary
competent person exercising ordinary skill in that
profession.  It is not possible for every professional
to possess the highest level of expertise or skills in
that   branch   which   he   practices.   His   Lordship
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quoted   with   approval   the   subtle   observations   of
Lord Denning made in  Hucks  vs.  Cole  (1968) 118
New LJ 469, namely,   “a medical practitioner was
not be held liable simply because things went wrong
from mischance or misadventure or through an error
of judgment  in choosing one reasonable  course of
treatment   in   preference   of   another.   A   medical
practitioner   would   be   held   liable   only   where   his
conduct   fell   below   that   of   the   standards   of   a
reasonably competent practitioner in his field.”
24. In our view, the facts of the case at hand has
to be examined in the light of the aforesaid principle
of law with a view to find out as to whether the
appellant­a doctor by profession and who treated
respondent   No.1   and   performed   surgery   on   her
could be held negligent in performing the general
surgery of her Gall Bladder on 08.08.1996.
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25. It   is   not   in   dispute   that   the   appellant   is   a
professionally trained doctor and has acquired the
post­graduate   degree   in   the   subject   (FRCS)   from
London way back in 1976 and worked there (UK) for
seven years and earned enough experience in the
field of surgery. It is also not in dispute that since
1976/1977, he has been in the field of surgery in
India   till   the   date   he   performed   operation   of
respondent No.1 on 08.08.1996.
26. These undisputed facts, in our opinion, clearly
prove that the appellant is a qualified senior doctor
with   an   experience   in   the   field   and   had   also
possessed the requisite knowledge and skill in the
subject to perform the surgery of Gall Bladder.
27. It   is   also   not   in   dispute   that   initially   he
proceeded to perform the laparoscopy surgery of the
Gall   Bladder   of   respondent   No.1   as   advised   but
while so performing he noticed some inflammation,
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adhesion   and   swelling   on   the   Gall   Bladder   and,
therefore,   decided   to   perform   the   conventional
surgery, which he actually did on respondent No.1,
to remove the Gall Bladder.
28.    According to respondent No.1, the appellant
could not have done so because she had not given
her consent to him to perform this surgery on her.
In other words, according to respondent No.1, she
had given her express consent in writing to perform
only “laparoscopy surgery” but the appellant instead
of   performing   “laparoscopy   surgery”   proceeded   to
perform conventional surgery and in that process
removed her Gall Bladder.  It is due to this reason,
according   to   respondent   No.1,   a   clear   case   of
negligence on the part of the appellant is made out
which   entitles   respondent   No.1   to   claim
compensation in terms of money.
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29.   The   State   Commission   did   not   accept   the
aforementioned submission of respondent No.1 but
this   submission   found   favour   to   the   National
Commission   for   holding   the   appellant   guilty   of
negligence in performance of his duty in performing
the surgery.  We do not agree with the reasoning of
the   National   Commission   on   this   issue   for   more
than one reason mentioned below.
30. First,   clause   4   of   the   Consent   Form   dated
07.08.1996   at   page   282   of   the   SLP   paper   book,
which is duly signed by respondent No.1, in clear
terms, empowers the performing doctor to perform
such   additional   operation   or   procedure   including
the administration of a blood transfusion or blood
plasma   as   they   or   he   may   consider   substitute
necessary or proper in the event of any emergency
or if any anticipated condition is discovered during
the course of the operation.
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31. Second, in terms of clause 4 of the Consent
Form,   the   appellant   was   entitled   to   perform   the
conventional surgery as a substitute to the former
one having noticed some abnormalities at the time
of   performing   Laparoscopy   that   it   would   not   be
possible   for   the   team   of   doctors   attending
respondent   No.1   to   continue   further   with
laparoscopy of the Gall Bladder.
32. In other words, we are of the view that there
was no need to have another Consent Form to do
the   conventional   surgery   in   the   light   of
authorization contained in clause 4 itself because
the substitute operation was of a same organ for
which the former one was advised except with a
difference of another well known method known in
medical subject to get rid of the malady.
33. Third, there is an evidence on record and we
are   inclined   to   accept   the   evidence   that   the
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appellant   having   noticed   while   performing
laparoscopy   that   there   was   some   inflammation,
adhesion and swelling on Gall Bladder, he came out
of operation theater and informed respondent No.1's
husband   who   was   sitting   outside   the   operation
theater   about   what   the   condition   of   respondent
No.1's   gall   bladder   and   sought   his   consent   to
perform the substitute operation. It is only after the
consent given by the husband of respondent No.1,
the appellant proceeded to do conventional surgery.
34. In our opinion, there is no reason to disbelieve
this fact stated by the appellant in his evidence. It
is,   in   our   opinion,   a   natural   conduct   and   the
behavior of any prudent doctor, who is performing
the operation to apprise the attending persons of
what he noticed in the patient and then go ahead
accordingly to complete the operation.
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35.  It is not the case of respondent No.1 that her
husband was neither present in the hospital on that
day nor he was not sitting outside the Operation
Theater and nor he ever met the appellant on that
day.
36. In our opinion,  a clear case of grant of consent
to   the   appellant   to   perform   the   substituted
operation of Gall Bladder of respondent No.1 was,
therefore,   made   out   to   enable   the   appellant   to
perform the conventional surgery, which he actually
performed.
37. The National Commission while recording the
finding on the issue of consent against the appellant
relied upon the decision of this Court in the case of
Samira Kohli vs. Dr. Prabha Manchanda & Anr.
(2008) 2 SCC 1.  In our view, the said decision itself
has made an exception to the cases observing in
para 49 of the judgment which reads as under:
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“The only exception to this rule is where the
additional procedure though unauthorised, is
necessary in order to save the life or preserve
the   health   of   the   patient   and   it   would   be
unreasonable   to   delay   such   unauthorised
procedure   until   patient   regains
consciousness and takes a decision.”
38. In our opinion, the case of the appellant also
falls   in   the   excepted   category   mentioned   by   this
Court   because   the   appellant   having   noticed   the
abnormalities in the Gall Bladder while performing
laparoscopy   surgery   proceeded   to   perform   the
conventional surgery and that too after obtaining
fresh   consent   of   respondent   No.1’s   husband.   In
other words, it was not an unauthorized act of the
appellant and he could legally perform on the basis
of original consent (clause 4) of respondent No.1 as
also on the basis of the further consent given by the
respondent No.1’s husband.
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39. That apart, we also find that respondent No.1
never raised the objection of “consent issue” to the
appellant or/and opposite party respondent No.2 ­
Hospital   and   it   was   for   the   first   time   in   the
complaint,   she   raised   this   issue   and   made   a
foundation   to   claim   compensation   from   the
appellant. Nothing prevented her or her husband to
raise   the   issue   of   consent   immediately   after
performance the surgery while she was in hospital
as an indoor patient and even after discharge that
being the natural conduct of any patient.   It was,
however, not done.
40. It is not in dispute that respondent No.1 failed
to   prove   any   specific   kind   of   negligence   of   the
appellant   while   performing   the   operation   or/and
thereafter.   Indeed, even the National Commission
in Para 18 held this issue in favour of the appellant
in following words:
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“18.   Yet   another   grievance   of   the
complainant is that she was not treated with
care during her hospitalization from 07.08.96
to 18.08.96.  No specific instances which can
amount to carelessness or negligence on the
part of the surgeon or the nursing home have
been brought on record and, therefore, we are
unable to hold that there was any lack of care
amounting   to  negligence  during  her   stay   in
the   nursing   home   for   which   either   the
surgeon or nursing home can be made liable.”
41. Likewise the National Commission further held
in favour of the appellant in para 19 that the stones,
which   were   removed   in   the   second   operation   at
Ganga Ram Hospital after 11 months (04.06.1997)
were the same which were noticed by the appellant
while  performing the first surgery on 08.08.1996
and remained inside. In other words, respondent
No.1 failed to prove with the aid of any medical
evidence that the stones, which were noticed in the
second surgery performed after 11 months, were the
same stones which the appellant failed to remove
from the Gall Bladder.   It is apposite to note the
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finding   of   the   National   Commission   in   para   19
hereinbelow. 
“………We  have  already   found  that   from   the
material   placed   on   record   that   it   is   not
possible   to   hold   with   certainty   that   any   of
the calculi which were removed from the bile
duct   of   the   complainant   at   Sir   Ganga   Ram
Hospital   was   the   same   for   which   she   had
undergone  Cholecystectomy  at  the  hands  of
the   surgeon   and,   therefore,   the   only   lapse
which we can find on the part of the surgeon
is that he did not care to bestow the kind of
attention  which  the  problem of  complainant
required   when   she   consulted   him   after   the
procedure   of   Cholecystectomy,   more
particularly during April­May 1997……….”
42. Had it been so, the appellant could be held
liable for failure on his part to remove the stones
and allowed them to remain in the Gall Bladder for
such a long time.   There was no medical evidence
adduced by respondent No.1 to prove this fact.
43. In   our   opinion,   no   medical   evidence   of   any
expert was adduced by respondent No.1 to prove
any specific kind of negligence on the part of the
appellant in performing the surgery (conventional
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surgery) of Gall Bladder except raising the issue of
“non­giving of express consent”.  This issue we have
already   dealt   with   above   and   found   no   merit
therein. In our view, respondent No.1 was under
legal obligation to prove a specific kind of negligence
on   the   part   of   the   appellant   in   performing   the
surgery and also was required to prove that any
subsequent   ailment   which   she   suffered   on   her
return to home such as,   jaundice, dysentery, fever,
loss of weight etc. were suffered by her only due to
improper  performance   of  conventional  surgery  by
the   appellant   and   if   the   surgery   had   been
successful, she would not have suffered any kind of
these ailments. 
44. In our opinion, there has to be a direct nexus
with   these   two   factors   to   sue   a   doctor   for   his
negligence.  Suffering of ailment by the patient after
surgery   is   one   thing.     It   may   be   due   to   myriad
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reasons known in medical jurisprudence.  Whereas
suffering   of   any   such   ailment   as   a   result   of
improper performance of the surgery and that too
with the degree of negligence on the part of Doctor
is another thing.  To prove the case of negligence of
a doctor, the medical evidence of experts in field to
prove the  latter is required.    Simply  proving  the
former is not sufficient.  
45. In our considered opinion, respondent No. 1
was not able to prove that the ailments which she
suffered after she returned home from the Hospital
on 08.08.1996 were as a result of faulty surgery
performed by the appellant.   
46. Learned   counsel   for   respondent   No.1
(complainant)   vehemently  argued  that   respondent
No.1   suffered   immensely   due   to   the   surgery
performed   by   the   appellant   and   that   she   was
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rightly, therefore, awarded the compensation by the
National Commission.
47.     Learned   counsel   for   respondent   No.1   also
placed reliance on the Discharge Certificate which,
according   to   her,   mentions   that   Laparoscopy
surgery was performed on respondent No.1.  On this
basis, learned counsel contended that respondent
No.1   had   not   given   her   consent   for   performing
general surgery.
48. In the light of the detailed discussion made
above on the issues arising in the case including the
issue of grant of consent, we are unable to accept
the   aforesaid   submissions   of   learned   counsel   for
respondent No.1.
49. It is apt to remember the words of the then
Chief   Justice   of   India   when   he   said   in  Jacob
Mathew’s case (supra) which reads as under:
“The subject of negligence in the context of
medical   profession   necessarily   calls   for
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treatment   with   a   difference.   There   is   a
marked tendency  to  look  for a  human  actor
to  blame  for an untoward event, a tendency
that is closely linked with a desire to punish.
Things   have   gone   wrong   and   therefore
somebody must be found to answer for it. An
empirical study reveals that background to a
mishap   is  frequently  far  more  complex  than
may   generally   be   assumed.   It   can   be
demonstrated   that   actual   blame   for   the
outcome   has   to   be   attributed   with   great
caution.    For   a  medical   accident  or   failure,
the   responsibility  may   lie  with   the  medical
practitioner,   and   equally   it   may   not.     The
inadequacies   of   the   system,   the   specific
circumstances   of   the   case,   the   nature   of
human   psychology   itself   and   sheer   chance
may   have   combined   to   produce   a   result   in
which   the   doctor’s   contribution   is   either
relatively   or   completely   blameless.     The
human  body  and  its  working  is  nothing   less
than   a   highly   complex   machine.     Coupled
with the complexities of medical science, the
scope   for   misimpressions,   misgivings   and
misplaced allegations against eh operator i.e.
the  doctor,   cannot   be   ruled   out.     One  may
have  notions  of  best or  ideal practice  which
are different from the reality of how medical
practice   is   carried   on   or   how   the   doctor
functions in real life.  The factors of pressing
need   and   limited   resources   cannot   be   ruled
out from consideration.   Dealing with a case
of   medical   negligence   needs   a   deeper
understanding   of   the   practical   side   of
medicine.     The   purpose   of   holding   a
professional liable for his act or omission, if
negligent,   is   to   make   life   safer   and   to
eliminate   the   possibility   of   recurrence   of
negligence   in   future.     The  human  body  and
30
medical science, both are too complex to be
easily   understood.     To   hold   in   favour   of
existence  of  negligence,  associated  with  the
action  or inaction  of  a  medical professional,
requires   an   in­depth   understanding   of   the
working  of  a  professional  as  also  the  nature
of the job and of errors committed by chance,
which do not necessarily involve the element
of culpability.”
50. In the light of what we have held above, we
cannot   concur   with   the   reasoning   and   the
conclusion arrived at by the National Commission.
As   a   consequence,   the   appeal   succeeds   and   is
accordingly   allowed.   The   impugned   order   is   set
aside and that of the order passed by the State
Commission is restored.    
                       
…...……..................................J.
         [ABHAY MANOHAR SAPRE]
………...................................J.
    [VINEET SARAN]
New Delhi;
October 01, 2018
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