BEFORE THE A.P.STATE CONSUMER DISPUTES REDRESSAL COMMISSION : HYDERABAD

 F.A.No.413/2013 against C.C.No.116/2009, Dist. Forum, Karimnagar. 

Between:

1.V.Kanaka Raju,                                             

   S/o.Venkataiah, Aged about 40 years,

   Occ:Director, Venkat Sai Nursing Home,

   R/o.Venkata Sai Nursing Home, 

   Manoherlal  X Road,  Karimnagar. 

2.  Dr.Y.Narendra, S/o.Yallayya,

     Aged about 64 years, Occ:Retd. Civil Surgeon,

     R/o.Sri Laxmi Vani Nilayam, Ashok Nagar,

     Karimnagar. 

3.  Dr.Pabba Sri Chaitanya, S/o.Lingaiah,

     Aged about 59 years,  Occ:Gynecologist,

     R/o. Civil Hospital,  Sultanabad,

     Karimnagar  District.                                … Appellants/

                                                                   Opp.parties 1,2 & 4

           And

Damarapalli  Rama Devi, D/o.Laxma Reddy,

Aged about 20 years , Occ: Student,

R/o.Mogdumpur Village, 

Karimnagar Mandal & Dist.

Rep. by father D.Laxma Reddy                    … Respondent/

                                                                  Complainant

Dr.Sanjeeva Rao,S/o.Not known,

Aged about , : Anesthetist,

 X Road,
.                                               

Dr.T.Vamshi Mohan, S/o.not known,

Aged about 44 years, ,

Besides K.K. Maternity  Home,

Civil Hospital Road, .                          … Respondents/

( Respondents 2 & 3 are not necessary parties) 

Counsel for the Appellants          :   M/s. V.Gowrisankara Rao

Counsel for the respondents       :    M/s.P.Elamadhar-R1         

QUORUM: HON’BLE SRI JUSTICE GOPALAKRISHNA TAMADA, PRESIDENT,

SRI T.ASHOK KUMAR, HON’BLE MEMBER,

AND

           SRI S.BHUJANGA  RAO, HON’BLE MEMBER.

TUESDAY,THE  FIFTEENTH DAY OF  APRIL,

TWO THOUSAND  FOURTEEN.

Oral Order: (Per  Sri S.Bhujanga Rao, Hon’ble Member).          

                                                                                    ***

                This appeal is directed against the order dt.16.4.2013 of the District Forum, Karimnagar  made in C.C.No.116/2009  filed by the  respondent no.1/complainant claiming compensation of Rs.20 lakhs  for deficiency in service on the part of the opp.parties 1 to 4.

         The appellants are  the opposite parties 1, 2 & 4 and the respondent  no.2  and 3 herein are the  opposite parties 3 and 5 respectively   and the respondent no.1 herein is the complainant in C.C.No.116/2009.   For the sake of convenience, the parties are described  as arrayed in the complaint. 

        The brief case of the complainant as set out in the complaint is that on   05.06.2009 the complainant   aged 16 years  suffered  mild pain in her stomach, as such, the complainant along with her father approached  opp.party no.1’s   hospital  Venkata Sai Nursing Home, Karimnagar.   After physical examination ofthe  complainant, the opposite party no.1 referred the complainant  to opposite party no.5  for  Ultrasound Abdomen Test. After conducting the  test, the opposite party no.5  reported interalia that the  right and left ovary of the complainant were normal in size and  echotexture, he further reported an impression that “ Non obstructive bilateral renal calculi” and  “Mild amount of free fluid in pelvis”.  On seeing the report, the opposite party no.1 had informed thecomplainant  that appendicitis  was detected and that immediate surgery was required.  The complainant  went to  her  house  at Moqdampur Village.  On 06.06.2009  the opposite party no.1, who is  also  a  native of Moqdampur Village  again checked the complainant  and cautioned the complainant   and her parents   that there was imminent danger to the life of the complainant  and that the complainant had to undergo surgery as early as possible and asked the complainant  to  come to Venkatasai Nursing Home for undergoing the surgery  with empty stomach, early in the morning.

        On 07.06.2009   in the morning hours, the complainant  along with her parents, approached the opposite party no.1 and paid deposit of Rs.3000/-. The complainant was taken to the hospital theatre at about 1 p.m. and commenced surgery on the complainant at about 2 p.m. The surgery team consisted of opposite parties  1 to 4. The opposite parties 1 to 4 made  Mc.Burney Incision  in the lower right quadrant   for appendectomy.    As they did not see any appendicitis, they closed incision in layers with five stitches.  The opposite parties 1 to 4   made Laparotomy  and removed the right ovary of the complainant and closed it in layers with 7 stitches,   apart from making a  drain hole in the lower left guardant of the complainant.   The complainant’s father who was called to the operation theatre was shocked at the situation, wherein  the opposite party no.2  moved the intestines  of the complainant  and there was   heavy bleeding.  The complainant was hospitalised  from 07.06.2009 to 14.06.2009  in Venkatasai  Nursing Home and later moved  to Govt.Civil Hospital, Karimnagar, upon  the directions of Dist. Medical and Health Officer, Karimnagar.

        It is alleged against the opposite parties 1 to 4 that they were negligent  in diagnosing   a mild pain in the stomach of the complainant, even after the report given by opposite party no.5 and that they  were negligent while doing operation  on the right quadrant and further in  a negligent manner they madeLaparotomy  and removed  right ovary of the complainant. On the complaint given by the  complainant’s father, the Dist. Medical & Health Officer, Karimnagarconducted enquiry and found that the hospital was  running  without registration before proper authorities.  On a complaint given by the Dist. Medical and Health Officer, Karimnagar,  S.H.O., II Town  P.S.  registered  the case against opposite party no.1 under Sec.420   I.P.C. on 21.06.2009.  Thus there is deficiency in service on the part of the opposite parties 1 to 4. The acts of the opposite parties 1 to 4  caused mental agony, mental distress apart from losing vital organ i.e. ovary, for which the complainant filed the complaint claiming compensation of Rs.20 lakhs.

        Resisting the complaint, the opposite parties 1, 2 & 4  filed written version/counter denying the material allegations made in the complaint. Theycontended  that at the request of the father of the complainant and after obtaining written consent  of the father of the complainant and  after investigations, the surgery was  contemplated on 07.06.2009  at 1 p.m.  The complainant  was taken to operation theatre and the surgery   was commenced  at 2 p.m. It iscontended  that the surgery team  consisted of only  opposite parties 2 to 4 and opposite party no.1 was not at all present at the operation theatre.  The opposite party no.2 had observed  that there was  minimal free fluid in pelvis. They opined that  though   appendicitis is not visualised  in the routine scan, still   fluid  in the pelvis could  be a result of acutely inflamed appendix and that the presence of free fluid in peritoneal cavity and clinical symptoms and  signs  were in favour  of acute appendicitis. Then  Dr.Sanjeeva Rao (Opp.party no.3) administered the spinal anaesthesia. The abdomen was opened by McBurny’s incision, which is a routine procedure.  On  opening the  peritoneum,  black blood was found,  coming  out from the  medial side.   The black blood was cleaned and appendix was found  containing faecolith  and acutely inflamed,   appendicectomy was done.   To know the source of bleeding,  through that same opening, it was searched and found a big cyst in the mid-lower abdomen which was bleeding.      Immediately  Dr.Chaitanya (Opp.party no.4)  was called and later  the father of the  complainant was called  and he was explained  of the situation.  As per the condition  of the patient and basing    on the  consent given by the  father of the complainant,  as it was necessary to open the abdomen  and explore to  save the patient,  as she was bleeding  actively and   the bleeding should be controlled, the opposite party no.4 opened the abdomen,  by lower  mid line incision, after the opposite party no.3 repeated the spinal anaesthesia. Then the opposite party no.4 found  big right sided  ovarian  cyst   of about  8 cms. x   5 cms.    which was bleeding.  So, right sidedOophorectomy  was done  and cleaned the blood clots and closed the abdomen by keeping the  corrugated  rubber drain in left iliac fossa as the right side was already having incision.   The patient recovered well. Daily she was examined and necessary treatment was given.  She recovered totally and was discharged on 14.06.2009,  after removal of sutures  and necessary prescription was given.  Therefore, enough care and caution was taken while  handling the patient and  only required treatment with sufficient caution was   given to the complainant.   Opposite parties 1 to 4   never breached the legal duty  to take care of the complainant and that there was no  deficiency in service on the part of the opposite parties 1 to 4,  as they discharged  their duty with utmost  caution and care. As such,   they are not liable  for any compensation to be paid to the complainant. 

        Subsequently opposite parties 3 and 5 were  called absent and were  set exparte .

        During the course of enquiry, both parties have filed  affidavit evidence. The complainant got marked Exs.A1 to A3.    The complainant and her father (PW.1 & PW.2)  were cross examined by the contesting opp.parties.  The complainant got examined opp.party no.5  Dr.Vamsi Mohan  as   PW.3  who filed Ex.C1 and C2.  During the course of his evidence, the complainant has also got examined PW.4 through whom Exs.C3 and C4 were marked.  Opposite partyno.4  filed Ex.C5 a photo copy of Hystopathology report dt. 18.06.2009. 

        Having heard the counsel  for  both the parties and  having considered the material on record, the District Forum  came to the conclusion that there was negligence  in conducting the   surgery,  resulting in  heavy bleeding, which  further resulted in  removal of  right ovary  of    the complainant, causing deprivation of reproductive system and consequently  allowed the complaint, in part, directing the opposite parties 1,2 & 4 to  pay to  the complainant,  jointly and severally,   a sum of Rs.3 lakhs  with interest at 9%  p.a. from the date of filing of the complaint and Rs.1000/- towards costs.

        Aggrieved by the said order, the  opposite parties 1,2 & 4  preferred the above appeal  urging  that the opposite party no.2  is an  experienced surgeon having vast experience of about 33 years  and conducted hundreds of appendectomy operations. That the ultra sound scan report revealed  free fluid. That after explaining the condition of the patient to the father of the complainant and after taking his oral consent   as the patient was bleeding heavily, the opposite party nos. 2 & 4  proceeded further and found big right sided ovarian cyst about 8 x 5 cms. which was bleeding.  So  right side Oopherectomy  was done, cleaned the blood clots and closed the abdomen. The District Forum failed to  consider  the  above material  on record,  and erroneously came to the conclusion that there was  negligence  and deficiency in service on the part of the opposite parties 1 , 2 & 4.  Therefore, the  appellants finally  prayed to  allow the appeal and  set aside the impugned order of the District Forum  and dismiss the complaint.

        We heard the counsel for both the parties and perused the entire material placed on record.

        Now the point for consideration is whether the impugned order of the District Forum is vitiated for misappreciation of fact or law?  

        The contention of the complainant is that  as she was suffering  from mild  stomach  pain,  her father took her to opposite party no.1’s hospital  Venkatasai Nursing Home   on 05.06.2009  for treatment. On physical examination of the complainant, the opposite party no.1 referred the  complainant to opposite party no.5  Dr.T.Vamshi Mohan  for an Ultra Sound Abdomen Test.   After conducting the test, the said doctor opined  that right and left ovaries of the complainant  were normal in size and echotexture. He further  reported  an impression   “Non obstructive bilateral renal calculi” and  “Mild amount of free fluid in pelvis”.  After collecting the  report from the said doctor, she again approached the opposite party  no.1,  who informed the  complainant and her father  that appendicitis  was detected  and that immediate surgery was required.   On 06.06.2009, the opposite party no.1  again checked   the complainant  and  informed that surgery    was required,  as soon as possible,  as there is imminent threat to the  life of the  complainant  and asked the complainant to  go to VenkatasaiNursing Home  for undergoing  surgery. 

        On 07.06.2009  with her parents the complainant went to the said nursing home and met opposite party no.1.    The complainant was  taken to   the operation theatre at about 1 p.m. and   surgery was started  on the complainant at about 2 p.m.   The surgery conducted by the team  consisting of opposite parties 1 to 4.   The team of  doctors made Mc.Burney Incision in the lower right quadrant for appendectomy.   The team of doctors did not see any appendicitis, as such, closed the incision in layers with 5 stitches and later, the team of doctors  made Laparotomy and removed the right  ovary of the complainant, apart from making a drain hole in the lower left quadrant of the  complainant.   The complainant was in   the Venkatasai Nursing home belonging to the  oppositeparty  no.1 as an inpatient  from 07.06.2009 to 14.06.2009,   on which date, she was discharged  from the hospital. 

        The  opposite parties 1, 2 & 4 admitted  that the complainant was brought  to  the opposite party no.1 hospital on 05.06.2009,  by her  father,  with a complaint of  severe  pain in her stomach. But according to the  opposite party no.1, the complainant  came with severe stomach pain  besides vomiting cooliky  pains in right iliac  Fossa  for three days.  The opposite party no.1  had admitted that  they examined the condition of the complainant and referred her to the   laboratory  of opposite party no.5 for an ultra sound abdomen test. After  conducting  ultra sound abdomen test on complainant, opp.party no.5 gave a report  which is marked as Ex.A2/1.

         The opposite party no.5 Dr.T.Vamsi Mohan, who has been running  diagnostic   centre in the name of Vinayaka Diagnostic  Centre at Karimnagar  was examined as PW.3.  He has stated that he has examined  Rama Devi i.e. the complainant no.1 and did ultra sound examination on her abdomen on 05.06.2009 and issued Ex.A2/1  Ultra Sound  Abdomen Report.

 The learned counsel for the  appellants submitted that  Ex.A2  report is a wrong report.  Except the submission, the appellants /opposite parties  havenot adduced any evidence to show that Ex.A2/1 Radiology Report is a wrong report.  It is true that P.W.3 who is opposite party no.5  in the complaint  remainedexparte  before the District Forum.   It is significant to note that the complaint is  dismissed by the District Forum against  opp.parties 3  and 5. Under these circumstances, we do not find any reasons to disbelieve  the evidence of PW.3.  Ex.A2/1 report  is therefore proved  by P.W.3 (opp. party no.5).

 Opp.party no.5  has   stated in Ex.A2/1  report that right Ovary and left Ovary  were normal in size and echotexture. He also stated that there is  mildamount  of  free fluid in pelvis.   He  explained   in his evidence  as PW.3 that this fluid is some  liquid which could either puss/ watery fluid/blood/ any other secretion  from any  of the organs  that are   located  within   the abdomen.

         During his cross examination by the counsel for the opposite parties 1,2 and 4, PW3   has   admitted that Ex.A2/1 is having printed matter on the back side  which contains reporting conditions and that Ex.C1  is the same showing the  reporting conditions  on the back side. He accepted all the conditions shown in Ex.C1 as true and correct  and stated  that the report he has given is subject to the conditions in Ex.C1.     Last conditions  mentioned in   Ex.C1 is “Sensitivity  and speciality of any investigation is never more than 90-95% and is limited by various above mentioned  technical  reasons & pit falls”. PW.3 has also admitted the same in his evidence and further added that there might  be chances of 5 to 10%  error in the ultra sound reports. He has also stated that cyst  consists of watery  fluid and that C.T. scan is a     further development for better investigation and that   there might be  variations in findings  in  images and physical appearances.   

        From the last condition  mentioned  in Ex.C1  and the above evidence of PW.3, it  is clear that  Ex.A2/1 report is not 100% accurate. It may be about 90%  accurate.

        It is the case of the opposite parties 1, 2 & 4  that as per medical jurisprudence  it is difficult  to trace out the presence of  cyst with the help of ultra sound examination, because  it may   be in fluid condition. Therefore, on the basis of ultra sound examination  report and with his clinical  judgement and skill, opposite party no.2 diagnosed the  case as acute Appendicitis and he removed the Appendix.  As blood is gushing out, he removed the black blood and searched for the cause for the bleeding and found big cyst. Then he called opposite party no.4 who is  a Gynecologist and opposite party no.4   ascertained the bleeding of ovarian cyst which was a life threatening, as such, he called the father of the patient and explained the consequences and after  taking his consent, he conducted the operation and removed  the right ovarian cyst.    Therefore, there was no negligence on the part of the opposite parties 1,2 & 4.  

        The evidence of PW.3  Dr.Vamshi Mohan (opp. party no.5) and Ex.A2/1  report proved that right and left side ovaries of the complainant  are normal in size  and Echotexture and also found the impression  “NON OBSTRUCTIVE  BILATERIAL  RENAL CALCULI” and  “MILD AMOUNT OF FREE FLUID IN PELVIS”. The contention of the opposite parties 1,2 & 4  is that   visually, acute appendicitis  is not visualised in the  routine  scan,  still fluid in the  pelvis could be a result of  acutely inflamed appendix. RW.1  Dr.Y.Narendra  (Opp.party no.2) who conducted  appendectomy operation on the complainant  stated in his evidence  that presence of free fluid in peritoneal cavity and clinical symptoms  and  signs  were    in favour  of acute appendicitis.   Then he opened the  abdomen of the complainant by Mc Burny’s incision, which is a routine procedure  and on opening peritoneum,  black blood was found  coming out from the medial side. The  black blood  was cleaned and appendix was found  containing faecolith  and acutely  inflamed.   He further stated  about their case as mentioned n their written version.  During his cross examination he has categorically stated that after going through  Ultra Sound  Report vide Ex.A2/1, he preferred to conduct Appendectomy  operation.  He says that most of the times  the USG  reports  may not be correct and depends  upon the surgeon’s experience, clinical knowledge  and his skill. Accordingly  with his clinical knowledge and skill  he has diagnosed  the case  as acute appendicitis.  He denied the suggestion  thatthere was no  necessity to conduct   Appendectomy operation  to the patient.   

Having regard to the  above  evidence, we are of the  view that   simply because  acute appendicitis is not seen in Ex.A2/1, it cannot be held that there was no appendicitis in stomach of the complainant, especially in view of the presence of liquid in pelvis.   The complainant has not placed any evidence, to show that the contention of the opposite parties 1,2 & 4  that fluid in the pelvis may be  the  result of acutely inflamed pelvis is not correct.  The complainant has also not placed any evidence, to prove that the opposite parties were negligent   while doing operation on the right  quadrant and due to that  blood gushed out, from the abdomen. Ex.A2  the copy of the case sheet maintained by Vankata Sai  Nursing   Home for the treatment given to the complainant supports the contention of the opposite parties.  Absolutely there is no evidence on record, for the  conclusion of the District Forum that after  appendectomy was done,  as blood  gushed from the operated portion,  to know the source of bleeding,   through that same opening,  he found one big cyst in the mid lower abdomen which was bleeding.

        Admittedly opposite party no.3 has done Oopherectomy  on the complainant and found  ovarian cyst of  about  8 x 5 cms.   Except the bald allegations, the complainant has not adduced any evidence  to establish that Ooptherectomy  was done on the complainant, on account of  wrong appendectomy done by the opposite party no.2. Since the existence of  cyst on the ovary was not in dispute, the opposite party no.2 cannot be found fault with for not suggesting to have either C.T.Scan or MRI Test,  especially in view of the explanation given by him in his evidence for  not suggesting  to have C.T.  Scan and M.R.I. test. 

        RW.2  Dr.Pabba  Sri Chaithanya, Gynaecologist has stated in his evidence that there is no negligence    while examination and operation in rendering service and biopsy was done by Dr.Raman Kumar M.D.(Path)    and that  the report of the pathologist shows  actively inflamed appendix  and  hemorrhagic ovarian cyst.             

          The copy of the biopsy  report is filed and marked as Ex.C5.   Dr. Ch.Raman Kumar, M.D., (Path) of Manasa Diagnostics,  Karimnagar was examined to prove Ex.C5.  He had stated  in his evidence  that he had issued Histro Pathology Report  of Ramadevi Dt.18.06.2009 . He handed over  the original report to the patient’s father.  As per his report, the patient was suffering from large ovarian cyst of 8 x 7 x 6  cms.,  which is abnormal in size with areas of haemorrhages, along with appendix.    According  to him the  says appendix findings are  that  patient suffering from acute appendicitis.   He opined  “SEROUS CYST  WITH AREAS OF  HAEMORRHAGES AND ACUTE APPENDICITS”.

PW.1, the complainant and PW.2 her father  D.Laxma Reddy  have categorically admitted in their cross examination  that  PW.2  took the removed ovarian cyst for biopsy   test to  RW.3 Dr.Raman Kumar.  PW.2 in his  cross examination admitted that the entire operation for  appendicitis  and removal of cyst was done   at one time and that he  himself took the removed cyst from ovary to the laboratory for  test (biopsy).

It  is true  that Ex.C5  does not  bear  any endorsement of true copy or duplicate  and it does not  contain attestation.  The doctor, who issued the original of Ex.C5 report, himself gave evidence as RW.3 stating that he    issued the original of Ex.C5.   The complainant’s father i.e. PW.2   did not sayanything  in his evidence that the  original of  Ex.C5 was not given to him by RW.3. Therefore, Ex.C5 cannot be ignored, simply  because  it does not bear his endorsement  as true copy or duplicate or attestation.  He denied the suggestion put to him by the counsel for the complainant that Ex.C5 is not the report of the complainant  and that it is fabricated and that the contents of Ex.C5 are false.  The complainant and her  father as PWs.1 and 2 themselves admitted  during their cross  examination  that   ovarian cyst  was taken for biopsy  by  PW.2  to  RW.3.  

        It is true that RW.2  Dr.P.Chaithanya admitted that they have not mentioned in their counter that biopsy was done by Dr.Raman Kumar, M.D., Pathology. Basing on this  evidence of R.W.2, it cannot be held that biopsy was not done  by Dr.Raman Kumar M.D.,Pothologist, especially  in view of the fact that P.W.1 and P.W.2   during their cross examination have categorically admitted that P.W.2 himself taken   ovarian cyst to Dr.Raman Kumar for biopsy test.

The District Forum  basing  on the  discrepancy  regarding the measurement  of the  removed  cyst in the counter and  in the cross examination of R.W.1 and R.W.2   doubted     the genuineness  of Ex.C5.  The size of the  removed ovarian cyst cannot be measured on the table by the doctor who removed the same.  Depending upon the visibility, the approximate size  will be mentioned, if there  is  delay, there is every  possibility for this  cyst to reduce in size.  As such,  different doctors may give different  sizes of the cyst approximately.  Therefore, the District Forum  is wrong in coming  to the conclusion that Ex.C5 is not genuine  and that  R.W.3  did not conduct  biopsy  test of the removed  ovarian  cyst.   Under these circumstances,  we do not find any reasons, much less valid  reasons to   disbelieve the evidence of R.W.3, Dr.Raman  Kumar   and  Ex.C5  report.    The evidence of R.W.3 and Ex.C5 proved that the   complainant was  suffering  from large ovarian cyst measuring  8x7x6 cms. with areas of haemorrhages  along with appendix and that the patient was suffering from acute appendicitis.

        Neither in the complaint nor in their evidence, PWs.1 and 2  have stated anything  about the  negligent act of the doctors while  conducting the operation as  per Exs. C4 and C5.  The  evidence discussed above established  that the diagnosis  made by the opposite parties 1,2 & 4    is right and  there is no material on record to show  that  their diagnosis is wrong.   Before  removal of the right ovarian cyst, opposite party no.2 consulted opposite party no.4, Gynaecologist regarding  bleeding   and in the given circumstances,  if the  cyst is not  removed  it leads to death, as such,    non removal of the cyst amounts to gross negligence. That apart, the complainant has not  filed  expert opinion, to  show  that  there is medical negligence  on the part of the opposite parties 1,2 & 4 in conducting the operation  and  removal of  ovarian cyst. 

PW.4  Dr.N.Sharada  the then Dist.  Medical & Health Officer, Karimnagar has categorically  stated in her evidence that Dr.Narendra ( O.P.No.2) andDr.Chaianya (O.P.No.4)  are qualified doctors to conduct the operation like appendicitis etc. She had stated in her cross examination,  supporting the case of the opposite parties 1,2 & 4.  It is true that she has stated that she was deposing on the basis of the medical record and that she did not examine the patient, but her opinion  basing on the medical record  cannot be ignored. She has categorically stated that as per her opinion, the procedure adopted by the doctors in this case is correct procedure. In view of  the above discussed facts and   circumstances,  we are of the view that the  complainant failed to  prove that there was medical negligence  on the part of the  opposite parties 1,2 and 4 .   

        Now the question for   determination is whether the opposite parties 1, 2 and 4    obtained  proper consent of the   complainant and her father  before proceeding with the operation for appendicitis  and for removal of right ovarian  cyst? Admittedly, they have not obtained the consent of the  complainant or her father before proceeding with the operations.  As seen from the Consent Form,  except the signatures of the patient  and witnesses,  the Consent Form was not filled by the hospital  staff, in which the complainant has undergone  surgery. The important aspect to be mentioned  in the   Consent Form  is diagnosis  and the nature of the treatment  in the  relevant  columns.   The components of    informed consent  i.e. information, voluntariness  and capacity, name of the surgeon or doctor who performed the operation and explained  the purpose of the operation or procedure are not indicated in the consent form.  As stated above, the name of the ailment and the surgery required are also not mentioned.  It is true that PW.1 and 2  have admitted in their  cross examination  that their consent was obtained by the  doctors. In our considered view the oral consent, if any, obtained by the doctors is not a  proper consent require under the prescribed  medical rules and regulations.   Under these circumstances,  we have no hesitation to  hold  that there is deficiency in service on the  part of the opposite parties 1,2 & 4  in not obtaining the proper consent of the complainant  or  her father, before proceeding with the operations.

        For the afore said facts and circumstances, we are of the considered view that there was no negligence  in conducting the surgery on the complainant and removal of  right ovarian cyst  of the complainant. However there is deficiency in service on the part of  opp.parties 1, 2 and 4  in not obtaining proper consent of the complainant  and her  father before proceeding with the operation, for which, they  are to be penalised.  Therefore, we  direct the opposite parties 1, 2 & 4 to pay Rs.1 lakh  (instead of Rs.3 lakhs awarded  by the District Forum) towards the compensation for deficiency  in service with interest at 9%  p.a.

        In the result, the appeal is allowed  in part. The  appellants/ opp.parties 1,2 & 4  are directed to  pay the complainant jointly  and   severally  a sum of Rs.1 lakh towards  compensation. The order of the District Forum is accordingly modified retaining the remaining  portion of the order as it is. The appellants/opp.parties are directed to comply with the order within four weeks from the date of this order.

                                                                        PRESIDENT

                                                                        MEMBER

                                                                        MEMBER

Pm*                                                                  Dt.15.4.2014