BEFORE THE A.P.STATE CONSUMER DISPUTES REDRESSAL COMMISSION
HYDERABAD.
C.D.No.18 OF 2005
Between:
Smt.Madhu Agarwal @ Madhubala
W/o.Sri Naresh Kumar Agarwal,
Aged about 39 yrs., Occupation:Household,
R/o. Domalguda, Hyderabad. ..Complainant
And
1. Apollo Hospital, rep. by the
Chairman/Managing Director
Situated at Jubilee Hills,
Hyderabad.
2. Dr.Pradeep Singh, S/o. not known
Major and R/o.Flat No.601,
Sikh Niwas Apartments, H.No.6-3-783/84/85,
Panjagutta, Hyderabad.
3. Dr.J.Janardhan Rao, S/o. not known
Major and working at the Apollo
Hospital, Jubilee Hills, Hyderabad. ..Opposite parties
4. United India Insurance Company, 2-4-1/4,
M.G.Road, Secunderabad-500 003.
(impleaded as per the order in C.D.I.A.610/2006,
Dt.24-10-2007).
Counsel for the Complainant: M/s N.V.Jagannath
Counsel for the Opposite Party: Mr.V.R.N.Prashanth for O.Ps. 1 to 3.
Mr.E.Venugopal Reddy-O.P.4
QUORUM: THE HON’BLE SRI.JUSTICE D.APPA RAO, PRESIDENT.
SMT.M.SHREESHA, MEMBER.
AND
SRI G.BHOOPATHI REDDY, MEMBER
THURSDAY, THE TWELFTH DAY OF JUNE,
TWO THOUSAND EIGHT
Oral Order:(Per Smt.M.Shreesha, Hon’ble Member).
***
The brief facts as set out in the complaint are that the complainant belongs to a business family and was adept in fashion technology, stock market and associated trades. She won accolades for her work in all the above fields and was also an all-round sports person. The complainant submits that due to her versatile occupation, she was a well known figure not only in social gatherings and functions but also in organizing melas, theme parties and club meetings and that she was the eyesore and her presence worked enormously in the success of various events. The complainant submits that due to an ear ache on the right side in November, 2002, she consulted a ENT Specialist and thereafter visited Apollo Hospital and was examined by opposite party No.2, who advised her to undergo an operation.
On the advise of opposite party No.2, she was admitted in Apollo Hospital on 08-5-2003 at 8.00 a.m. and under the supervision of opposite party No.3, opposite party No.2 performed the operation inside the right ear and this operation is called ‘Tymparaplasty’. The complainant submits that she discovered to her shock that the right side of her face had been deviated and paralyzed. Opposite parties 2 and 3 tried to mitigate the paralytic effect by putting the complainant on high doses of steroids, anti-biotics and fluids during her stay in the hospital. She was discharged on 10-5-2003 with an advise to do physiotherapy and take medicines as prescribed. The complainant submits that she was admitted in the hospital for surgery in the right ear but came out with a paralyzed face which forced her to say indoors and suffered mental agony and trauma with recurrent pain in her ear. Even her eye sight was effected and she was advised to take eye drops and use sun glass throughout her life. She submits that she lost weight due to depression and could not chew and eat the food as before and consequently her entire life style changed with pain and suffering only due to the carelessness and negligence of the surgery performed by opposite parties 2 and 3 in opposite party No.1 hospital. She submits that she is not able to pronounce words properly and could not recite the vedic verses as before, is unable to drive the car, cannot wear ear rings, engage a separate cook because she is not able to cook and that her married life is also effected and she is not able to take care of her children and husband properly. She lost a sizable income and they are still spending on treatment. The complainant further submits that she even got issued a legal notice on 07-3-2005 to the opposite parties for payment of compensation of Rs.25,00,000/- which was served on the opposite parties 1 to 3. Opposite party No.2 evaded service of notice and there was no reply from any one of them. Therefore, she seeks direction to the opposite parties to pay the following amounts:
i) Compensation towards medical expenses Rs. 5,00,000-00
already incurred
ii) Future expenses towards medical treatment Rs. 5,00,000-00
iii) Compensation towards facial deviation, paralysis Rs.15,00,000-00
pain & suffering and lack of social contact and
permanent disability.
iv) Loss of income towards various sources Rs. 5,00,000-00
v) Amount incurred for engaging a cook Rs. 60,000-00
vi) Amount incurred for engaging a car driver Rs. 60,000-00
--------------------------
Total compensation Rs.31,20,000-00
---------------------------
Opposite parties 1 to 3 filed counter submitting that the complainant came to Apollo Amar Hospital on 16-12-2002 with a complaint of intermittent right ear discharge for the past four months. At the time of examining the complainant by the 2nd opposite party, she informed him that she was having right ear discharge, on and off, for the past 29 years. After examining the patient, second opposite party observed that the discharge was due to fungal infection (Otomycosis) and after explaining the complainant the nature of the ailment, started the medical treatment. After the attack (Otomycosis) subsided, second opposite party advised the complainant to undergo surgery viz., tympanaplasty. The complainant was informed the nature of surgery and inherent risks involved in it. The complainant has agreed to undergo the above surgery. Accordingly she got herself admitted into Apollo Amar Hospital on 8-5-2003.
It is submitted that the complainant was shifted to Apollo Hospitals, Jubilee Hills for surgery, which was scheduled to be conducted on 8-5-2003. The complainant was taken into the operation theatre at 12.00 noon and was administered general anesthesia. During the surgery, the second and third opposite parties found that the facial nerve which supplies one side of the face wad dehiscent (abnormally placed) which is rare anomaly. The nerve was covered with thick tympanascierotic plaques, which was the result of long standing ear disease. The second and third opposite parties found that the ossicular chain of the complainant was abnormal and partly necrossed and the nerve band was touching and pushing the head of the stapes (ossicular bone) restricting its movement. Post operatively the complainant showed signs of right facial nerve paresis. The complainant was given appropriate treatment post operatively by administering intravenous antibiotis, intravenous fluids and steroids and was managed conservatively. The complainant was discharged on 10-5-2003 with necessary medical advice and to undergo physiotherapy.
Opposite parties further contend that in view of the continuous ear discharge for about 29 years and in view of the abnormal course of the nerve and the absence of bone covering the nerve, the complication of facial nerve paresis occurred to the complainant. They deny that the complainant suffered with a paralytic face because of the surgery done. They also deny that it is due to the mishandling of operation that the complainant became an unknown person for her family and also at her work place and that she became a nervous wreck and spent sleepless nights. They also deny that it is due to the faulty operation that her eye sight was effected and that she spent lot of money for continuous treatment and that her entire life changed. Opposite parties submit that they conducted the operation with utmost care and special attention and that post operative facial nerve paresis is internationally recognized complication and the treatment given to the complainant is internationally accepted and that the nerve and muscle studies of the face (electromyography and electroneurography) done in June, 2003 showed that the nerve was still responding to stimulation. Opposite parties submit that this is a positive sign of recovery to the extent of 25 to 30% and contend that there is no deficiency of service on their behalf and to that effect they also issued a reply notice and prayed for dismissal of the complaint with costs.
Opposite party No.4, insurance company, filed their counter and submitted that opposite parties did not submit any intimation to them regarding the alleged complications due to the surgery and that they are not in a position to either admit or deny the contents made in the application for want of genuineness. They further submit that there is no information in the complaint to show that they had issued any coverage covering the risk to opposite parties 1 and 2. There is no policy number mentioned and that Apollo Hospital or opposite party No.2 did not intimate any claim on the receipt of this complaint and unless correct policy number is furnished, they cannot be made liable. They deny the issuance of coverage to opposite parties 1 and 2 and reserve their right to submit the material as and when opposite parties 1 and 2 furnish the information.
The complainant filed her affidavit by way of evidence and got marked Exs.A1 to A59 on her behalf. Opposite parties also filed affidavit by way of evidence and Exs.B1 and B2 were marked on their behalf. The complainant was cross examined as P.W.1 and Ravish G.Daway as P.W.2. Opposite party No.2 was cross-examined as R.W.1.
The complainant filed a detailed affidavit reiterating the facts in the complaint. Ex.A1 is the legal notice got issued by the complainant to the opposite parties calling upon them to pay Rs.25,00,000/- towards compensation for medical negligence. Ex.A2 and A3 are postal acknowledgements. Ex.A4 is the medical prescription by Dr.T.V.Krishna Rao. Ex.A5 is the certificate given by PHYSIOTHERAPY CLINIC dated 30-11-2003. Ex.A6 is the report of ‘Sneha Hearing’. Ex.A7 is the prescription of Dr.T.V.Krishna Rao dated 13-12-2002. Ex.A8 is the prescription of Dr. Pradeep Singh dated 29-3-2003. Ex.A9 are the bills of Apollo Hospital. Ex.A10 is the provisional diagnosis of Apollo Hospital. Ex.A11 and A12 are the discharge summary dated 10-5-2003 in which it is sated that post operatively the patient showed signs of facial nerve paresis and the patient was put on high doses of steroids. Ex.A13 is the Histopathology report which diagnosis TYMPANASCLEROSIS. Ex.A14 is Department of Neurology report dated 17-5-2003 in which it is stated as follows:
“IMPRESSION: Rt. facial nerve show low amplitudes (20% of
left side) suggestive of moderate degree function loss. Suggest
follow up study after 2 weeks”.
Ex.A15 is the prescription of Dr. Sajeet Kumar. Exs.A16, A17 and A18 are the prescriptions of Dr. Pradeep Singh, Dr .R.M.Saboo and Dr. Pradeep Singh respectively. Ex.A19 is the report of Srushti Ayurvedic Clinic dated 28-10-2004. Ex.A20 is the prescription of Ayush dated 16.02.2005. Ex A 21 is the prescription of G.S Physiotherathy Clinic dated 15.03.2005. Ex A22 is the prescription of Yo’cures dated 1.03.2005. Ex A23 is the prescription of Hyd Nursing home dated 06.03.2005. Ex A24 is the bill Srikaar Physiotherapy dated 11.05.2003.Ex A25 is the bill of Srikaar Physiotherapy dated 30.11.2003. Ex A 26 is the bill and prescription of Care Hospital dated 21.07.2004. Ex A27 is the bill of Apollo hospital dated 16.12.2002. Ex A28 is the bill of Friends medical hall dated 05.01.2005. Ex A29 is the bill of Ayush therapy centre dated 06.02.2005 and bill of Ayush therapy centre dated 21.02.2005. Ex A 30 is the bill of Ayush & Dr. Pradeep dated 22.02.2005 and bill of Ayush & Dr. Pradeep dated 16.12.2002. Ex A31 is the bill of Ayush therapy centre dated 23.02.2005. Ex A 32 is the bill of Yo’cures dated 17.03.2005. Ex A 33 is the bill and treatment certificate of Dr.Bharat Reddy Homeo dated 01.04.2005. Ex A34 is the certificate of Helpage India. Ex A35 is the Certificate of Kamala Nehru Polytechnic. Ex A36 Certificate of Board of Technical Education. Ex A37 is the Certificate of Agarwal Samaj dated Dec1998. Ex A38 are Demat details of Stock Holding Corporation dated 16.05.2002. Ex A39 is the Certificate of Roots, Montessori school dated 23.03.2005. Ex A40 is Certificate for Designing Jewels of Sri Balaji Jewellers dated 04.04.2005. Ex A41 is Certificate of Balachitrakala. Ex A42 is the Certificate of Jawahar Bal Bhavan in Table Tennis. Ex A43 is Certificate of the Hyderabad Athletic Association dated 1980-81.Ex A 44 is Certificate of the BSA SLR tournament. Ex A45 is Certificate of the MCH dated 30.05.1981. Ex A46 is Certificate of the MCH dated 30.05.1981. Ex A 47 is Certificate of the Hyderabad Athletic Association. Ex A48 is Certificate of the Kamal Nehru Polytechnic dated 1982-83. Ex A49 is Certificate of the Vivekvardhani Kanyashala dated 15.06.1982. Ex A50 to A56 are Certificates of the Kamala Nehru Polytechnic.
Opposite parties also filed a detailed affidavit by way of evidence reiterating the facts in the counter and filed Ex.B1, which is the case sheet detailing the line of treatment given from the date of admission till the date of discharge. Ex.B2 is the policy bearing No.051581/46/02/32/00000272 and the period of coverage is from 25-3-2003 till 24-3-2004.
The point for consideration is whether there is any negligence on behalf of the opposite parties and if the complainant is entitled to the relief sought for in the complaint?
The learned counsel for the complainant submitted that the complainant is from a well to do family and did business in shares, fashion designing, jewel designing and other trades. She was also adept in melas, get togethers and also participated in sports and games. He submitted that the evidence of P.Ws 2 and P.W.5 support her activities in this regard. In November, 2002 when she experienced ear ache in the right side of the ear, she contacted a ENT Specialist. In the month of December, 2002 she visited opposite party No.2 doctor. It is not in dispute that opposite party No.2 performed an operation on 8-5-2003 at about 8.00 a.m. under the supervision of opposite party No.3. It is the case of the complainant that immediately after the operation, she suffered facial paralysis and attributes this to the negligence in performing the surgery. It is the case of the opposite parties that facial nerve in the patient’s face was abnormally placed which is a rare anomaly and the nerve was covered with thick tympanasclerotic plaques, which was a result of long standing ear disease for the past 29 years.
The learned counsel for the complainant filed written arguments and contended that the facial nerve paralysis is not a common complication which is supported by the medical literature filed by opposite parties i.e. Brookwood ENT Associates P.C. by Birmingham, Alabama and in Page-7, para 4 it is stated as follows:
“The facial nerve travels through the ear bone in close association
with the middle ear bones, eardrum and the mastoid. An uncommon
postoperative complication of ear surgery is temporary paralysis of
one side of the face. This may occur as the result of an abnormality or
a swelling of the nerve and usually subsides over time without further
treatment.
He further relied on the book of TEXAS NEUROSCIENCES INSTITUTE in Page 1of 3, which states as follows:
Injuries of the Facial Nerve
The most common cause of facial nerve injury is due to a skull
fracture. This injury may occur immediately or may develop
some days later due to nerve swelling.
Injury to the facial nerve may occur in the course of operations
on the ear. This complication, fortunately, is very uncommon.
It may occur, however, when the nerve is not in its normal anatomical
Position.
As against this the learned counsel for the opposite parties relied on TEXAS NEUROSCIENCES INSTITUTE in Page 2 of 3,
Facial Nerve Neuroma: A nonmalignant fibroid growth may grow in
the facial nerve itself, producing a gradually progressive facial nerve
paralysis.
The learned counsel for the opposite parties vehemently argued that it is a known complication in surgery of ear and that all necessary precautions have been taken by opposite parties and therefore, there is no negligence on their behalf.
We have gone through the deposition of the complainant and the opposite party No.2. R.W.1 in his deposition stated as follows:
‘We found that the ossicular chain of the complainant was abnormal and party necrossed and the nerve band was touching and pushing the head of the stapes (ossicular bone) restricting its movement. Post operatively the complainant showed signs of right facial nerve paresis. The complainant was given appropriate treatment post operatively by administering intravenous antibiotics, intravenous fluids and steroids and was managed conservatively. The complainant was discharged on 10.05.03 with necessary medical advice and to undergo physiotherapy’.
‘It is submitted that the nerve and muscle studies of the face (electromyography and electroneurography) done in june, 2003 showed that the nerve was still responding to stimulation, which is a positive sign of recovery to that extent of 25% to 30%. The patient did not come to me thereafter.
Opposite party No.2 in his cross-examination further deposed that this complication is a rare phenomenon and admitted that when the patient was discharged, she had facial paralysis but denied that it was due to his negligence. It is apparent from the discharge summary, from the case sheet and from the depositions that facial nerve paralysis had set in after the operation which was conducted on 8-5-2003. As per Histopathology report (Ex.A13) it was suggestive of tympanasclerosis and as per Ex. A14, which is a report of Department of Neurology, stated that ‘Right facial nerve show low amplitudes (20% of left side) suggestive of moderate degree function loss’. This also clearly stated that the complainant had suffered from facial paralysis immediately after the operation and it is no where recorded that an informed consent was taken from the complainant explaining the inherent risks and complications involved in the surgery, thereby giving an opportunity to the complainant to make a decision as to whether she would like to go ahead with the surgery or not.
We also rely on the judgement of Dr.Laxman Balkrishna Joshi v. Dr.Trimbak Bapu Godbole and Anr. reported in (1969) I SCR 2006. In this case the death of patient was caused due to shock resulting from reduction of the fracture attempted by doctor without taking the elementary caution of giving anaesthesia to the patient. In this case the court discussed the duty of care a doctor should undertake
a) A duty of care in deciding whether to undertake the case
b) A duty of care in deciding what treatment to be given
c) A duty of care in the administration of that treatment
We also rely on the judgement of the Apex court in I (2008) CPJ 56 (SC) between SAMIRA KOHLI v. PRABHA MANCHANDA (DR.) & ANR. In this landmark judgement, the Apex court while discussing the various aspects of medical negligence discussed about
‘real consent’ and ‘informed consent’. The apex court preferred ‘real consent concept’ evolved in Bolam’s Test to ‘reasonably prudent patient test” in Canterbury, considering ground realities in medical and health care in India. The Principle of necessity laid down in this case is that the patient’s consent taken for diagnostic procedure or surgery cannot be considered as authorization or permission to perform therapeutic surgery either conservative or radical except in life threatening or emergent situation.
An extract from para 32 of the judgement reads as follows:
32. We may now summarize principles relating to consent as follows:
i) A doctor has to seek and secure the consent of the
patient before commencing a ‘treatment’ (the term
treatment includes surgery also). The consent so
obtained should be real and valid, which means that:
the patient should have the capacity and competence
to consent; his consent should be voluntary; and
his consent should be on the basis of adequate
information concerning the nature of the treatment
procedure, so that he knows what is consenting to.
ii) The ‘adequate information’ to be furnished by the
doctor (or a member of his team) who treats the
patient, should enable the patient to make a balanced
judgment as to whether he should submit himself to
the particular treatment as to whether he should
submit himself to the particular or not. This means that the
Doctor should disclose (a) nature and procedure of the
treatment and its purpose, benefits and effect;
b) alternatives if any available; c) an outline of the
substantial risks; and d) adverse consequences of
refusing treatment. But there is no need to explain
remote or theoretical risks involved, which may
frighten or confuse a patient and result in refusal
of consent for the necessary treatment. Similarly
there is no need to explain the remote or theoretical
risks of refusal to take treatment which may persuade
a patient to undergo a fanciful or unnecessary treatment.
A balance should be achieved between the need for
disclosing necessary and adequate information and at the
same time avoid the possibility of the patient being
deterred from agreeing to a necessary treatment or
offering to undergo an unnecessary treatment.
iii) Consent given only for a diagnostic procedure, cannot
be considered as consent for therapeutic treatment.
Consent given for a specific treatment procedure
will not be valid for conducting some other treatment
procedure. The fact that the unauthorized additional
surgery is beneficial to the patient, or that it would
save considerable time and expense to the patient,
or would relieve the patient from pain and suffering
in future, are not grounds of defence in an action
in tort for negligence or assault and battery.
The only exception to this rule is where the additional
procedure though unauthorized, is necessary in order to
save the life or preserve the health of the patient and it
would be unreasonable to delay such unauthorized procedure
until patient regains consciousness and takes a decision.
iv) There can be a common consent for diagnostic and operative
procedures where they are contemplated. There can also be
a common consent for a particular surgical procedure and an
additional or further procedure that may become necessary
during the course of surgery.
v) The nature and extent of information to be furnished by the
doctor to the patient to secure the consent need not be of
the stringent and high degree mentioned in Canterbury but
should be of the extent which is accepted as normal and
proper by a body of medical men skilled and experienced
in the particular field. It will depend upon the physical and
mental condition of the patient, the nature of treatment,
and the risk and consequences attached to the treatment’.
In the instant case there is no documentary evidence to state that the patient has been sufficient information for her to understand the nature of the operation, its likely effects, and any complications which may arise and which the surgeon in exercise of his duty to the patient considers that she should made aware, only then she can reach a proper decision. As the Apex court held in the aforementioned judgement only when there is a recognized risk, the surgeon is under a complication to warn the patient of that risk which in the instant case opposite parties failed to do. The patient ought to have been informed about the risk and complication of facial nerve paralysis thereby giving an opportunity to her to decide whether she wants to go ahead with the operation or not. This itself is a aspect of medical negligence as observed by the Apex court.
Now we address ourselves to the quantum of compensation. In the book of LAW OF DAMAGES AND COMPENSATION, 5TH EDITION BY C.KAMESHWARA RAO at page 2229, it is stated that ‘money cannot renew a shattered human frame. Still, the law has said that this is a head of damage for which monetary compensation can be awarded, and so the Court must do the best it can in the light of such comparable cases as it may consider to be of assistance to it’.
The case which we find comparable is the case of an lady advocate in MOHINDER GUPTA, 1983 ACJ 760: (1) TAC 170 (P&H) in
‘The claimant a lady advocate sustained head injury as also injury on both
the jaws. She had 50 per cent of diminished sensation on the right side of
her face. Even after a treatment of one year and seven months she was
not fully recovered, was awarded Rs.30,000/- for injuries, pain and
suffering and Rs.6,700/- towards medical expenses’.
However taking into consideration that this judgement was delivered in the year 1982 and 25 years have lapsed since then and the lady is a young 38 years old mother of two children and was active socially and organized events, we are of the considered view that an amount of Rs.2,00,000/- towards compensation for medical negligence and mental agony and Rs.1,00, 000/- towards medical expenses would meet the ends of justice.
In the result the complaint is allowed in part directing opposite party to pay an amount of Rs. Rs.1,00,000/- towards medical expenses and compensation of Rs.2,00,000/- towards mental agony and medical negligence together with costs of Rs.5,000/- to the paid to the complainant by opposite party No.4 since it had issued policy bearing No. 051581/46/02/32/00000272 within a period of six weeks from the date of receipt of this order failing which the amount would attract interest at 9% p.a.
PRESIDENT. LADY MEMBER. MALE MEMBER.
JM Dt. 12-6-2008
/APPENDIX OF EVIDENCE//
Witnesses examined for
Complainant: Opposite Party:
P.W.1-Smt.Madhu Agarwal R.W.1-Dr.Pradeep Singh
P.W.2-Ravish G.Daway
Exhibits marked on behalf of the complainant:
Ex.A1-Legal notice got issued by the complainant to the opposite parties.
Exs.A2 & A3 are postal acknowledgements.
Ex.A4-Prescription by Dr.T.V.Krishna Rao.
Ex.A5-Certificate given by PHYSIOTHERAPY CLINIC dated 30-11-2003.
Ex.A6-Report of ‘Sneha Hearing’.
Ex.A7-Prescription of Dr.T.V.Krishna Rao dated 13-12-2002.
Ex.A8-Prescription of Dr. Pradeep Singh dated 29-3-2003.
Ex.A9-Bills of Apollo Hospital.
Ex.A10-Provisional diagnosis of Apollo Hospital.
Ex.A11& A12-Discharge summary dated 10-5-2003.
Ex.A13-Histopathology report which diagnosis TYMPANASCLEROSIS.
Ex.A14-Department of Neurology report dated 17-5-2003.
Ex.A15-Prescription of Dr. Sajeet Kumar.
Exs.A16, A17 & A18-Prescriptions of Dr. Pradeep Singh, Dr .R.M.Saboo
and Dr. Pradeep Singh respectively.
Ex.A19-Report of Srushti Ayurvedic Clinic dated 28-10-2004.
Ex.A20-Prescription of Ayush dated 16.02.2005.
Ex A 21-Prescription of G.S Physiotherathy Clinic dated 15.03.2005.
Ex A22-Prescription of Yo’cures dated 1.03.2005.
Ex A23-Prescription of Hyd Nursing home dated 06.03.2005.
Ex A24-Bill Srikaar Physiotherapy dated 11.05.2003.
Ex A25-Bill of Srikaar Physiotherapy dated 30.11.2003.
Ex A26-Bill and prescription of Care Hospital dated 21.07.2004.
Ex A27-Bill of Apollo hospital dated 16.12.2002.
Ex A28Bill of Friends medical hall dated 05.01.2005.
Ex A29-Bills of Ayush therapy centre dated 06.02.2005 and dated 21.02.2005.
Ex A 30-Bills of Ayush & Dr. Pradeep dated 22.02.2005 and 16.12.2002.
Ex A31-Bill of Ayush therapy centre dated 23.02.2005.
Ex A 32-Bill of Yo’cures dated 17.03.2005.
Ex A 33-Bill and treatment certificate of Dr.Bharat Reddy Homeo dated 01.04.2005.
Ex A34-Certificate of Helpage India.
Ex A35-Certificate of Kamala Nehru Polytechnic.
Ex A36-Certificate of Board of Technical Education.
Ex A37-Certificate of Agarwal Samaj dated Dec1998.
Ex A38-Demat details of Stock Holding Corporation dated 16.05.2002.
Ex A39-Certificate of Roots, Montessori school dated 23.03.2005.
Ex A40-Certificate for Designing Jewels of Sri Balaji Jewellers dated 04.04.2005.
Ex A41-Certificate of Balachitrakala.
Ex A42-Certificate of Jawahar Bal Bhavan in Table Tennis.
Ex A43-Certificate of the Hyderabad Athletic Association dated 1980-81.
Ex A 44-Certificate of the BSA SLR tournament.
Ex A45-Certificate of the MCH dated 30.05.1981.
Ex A46-Certificate of the MCH dated 30.05.1981.
Ex A 47-Certificate of the Hyderabad Athletic Association.
Ex A48-Certificate of the Kamal Nehru Polytechnic dated 1982-83.
Ex A49-Certificate of the Vivekvardhani Kanyashala dated 15.06.1982.
Ex A50 to A56 are Certificates of the Kamala Nehru Polytechnic.
Exhibits marked on behalf of the Opposite Parties:
Ex.B1- Case sheet.
Ex.B2- Policy bearing No.051581/46/02/32/00000272.
PRESIDENT. LADY MEMBER. MALE MEMBER.
JM Dt. 12-6-2008
