Tamil Nadu

South Chennai

cc/59/2004

K.S.Karupaiah - Complainant(s)

Versus

Dr.A.Senthil - Opp.Party(s)

H.Jaya Chandhar

21 Feb 2017

ORDER

                                                                        Date of Filing :   04.09.2003

                                                                        Date of Order :   21.02.2017

DISTRICT CONSUMER DISPUTE REDRESSAL FORUM, CHENNAI (SOUTH)

     2^nd Floor, Frazer Bridge Road, V.O.C. Nagar, Park Town, Chennai-3

 

PRESENT: THIRU. S. PANDIAN, B.Sc., L.L.M.                       : PRESIDENT            

                  TMT. K.AMALA, M.A. L.L.B.,                                 : MEMBER I

             DR. T.PAUL RAJASEKARAN, M.A ,D.Min.PGDHRDI, AIII,BCS : MEMBER II

C.C.NO. 59/2004

TUESDAY THIS  21^ST   DAY OF FEBRUARY 2017

K. S. Karuppaiah,

No.68C, Valkmiki Street,

Tiruvanmiyur,

Chennai 600 041.                                  .. Complainant.

                                   ..Vs..

1. Dr. .Senthil M.S. M.Ch.,

No.2, Cholapuram, Street,

Tiruvanmuyur,

Chennai 600 041.

 

2. Dr. C.Prasanna M.B.B.S.,

NO.B-34, Astalakhsmi Apartments,

Besant Nagar,

Chennai 600 090.

 

3. Dr. R.Gopalakrishnan,

Director,

Swarnam Nursing Home,

NO.7, 2^nd East Street,

Kamaraj Nagar,

Tiruvanmiyur,

Chennai 600 041.                                     ..Opposite parties.

 

Counsel for Complainant        :  M/s. A.Jayachandar

Counsel for opposite party-1  :  M/s. Anand & Others.

Counsel for opposite party-2  :  M/s. J.H.Batcha.

Counsel for opposite party-3  :  M/s. Sudha Ramalingam & others.

 

ORDER

THIRU. S. PANDIAN, PRESIDENT

 

          This complaint has been filed by the complainant against the opposite parties under section 12 of the Consumer Protection Act 1986 seeking direction to pay back the entire medical expenses of Rs.79,000/- and also to pay a sum of Rs.1,00,000/- as compensation for mental agony and physical sufferings and also to pay a sum of Rs.3,000/- as cost of the complaint.

1. The averment of the complaint are brief as follows:

         The complainant after acute stomach pain approached the 2^nd opposite party, who is having his clinic at the complainant’s street.  The 2^nd opposite party after examination, asked the complainant to undergo a test for ultra sonogram and the same was done at Genesis Scans, Nungambakkam on 4.3.2003.   As per the said test report, it has been diagnosed as Chronic Appendicitis.   Then the 2^nd opposite party referred the complainant to the 1^st opposite party for further treatment.    The 1^st opposite party immediately suggested for an “appendicitis surgery” and was admitted at the third opposite party’s nursing home according to the advice of the 1^st and 2^nd opposite party on 8.3.2003 and was discharged on 12.3.2003 as per the advice of the 1^st opposite party.

2.     Ever since his discharge from the nursing home, the complainant was not comfortable, because of stomach pain once again and was followed by frequent vomiting.    He again consulted the 2^nd opposite party and the complainant was asked to consult the 1^st opposite party who in turn has done the operation.    After due consultation with the 1^st opposite party the complainant was advised to get admitted with the 3^rd opposite party’s nursing home once again on 19.3.2003 and he was examined by the 1^st opposite party on the same day an on 20.3.2003 the complainant was discharged, stating that the earlier defect has been rectified and that the complainant will not suffer from any further pain or vomiting.   

3.     Even after the second discharge the complainant’s health condition remained the same and neither the stomach pain nor the vomiting stopped and the complainant suffered severe physical strain and mental agony.   That because of frequent vomiting and stomach pain he got suspicion, with regard to the defective treatment of the first and 2^nd opposite parties at the 3^rd opposite party’s nursing home prompted the complainant to go for a second opinion from another surgeon.    He consulted Padmapriya Hospital at Indira Nagar, Adayar on 8.6.2003 and was told that another Surgical intervention may be necessary.

4.     After the said operation only his stomach pain and vomiting stopped and the complainant was discharged after one week of post-operative care.   Due to the lethargic and negligent manner in which the surgery was done, the complainant would not have suffered physical and mental stress and strains.  Hence the complaint.       

5. Written Version of  opposite party-1 is  in brief as follows:

         The 1^st opposite party is an eminent surgeon qualified in the field of surgery with a degree in Master of Surgery.  He has been practicing surgery for the past 10 years after post graduation.   The 1^st opposite party vehemently denies all the averments set out in the complaint except those that are specifically admitted hereunder. 

6.     The 2^nd opposite party had referred the complainant to this opposite party is true.   However, it is incorrect to state that the 1^st opposite party had immediately suggested for an appendectomy to be performed on the complainant.   In fact on 7.3.2003 the complainant had approached the 1^st opposite party at his clinic with a complaint of recurrent pain in his right Iliac Fossa for the past one year and complained that the pain and grown to be more intense for the past three months.   The opposite party understood from the complainant that he had been earlier investigated by another medical practitioner for similar complaints.   An ultra Sonogram had been prescribed which showed a small right renal calculus (Stone) and an intra Venus pyelogram had been done which did not reveal anything significant.

7.     The reports were indicative of acute or chronic or recurrent appendicitis.  Hence he was advised an appendicectony.  The complainant admitted himself in the third opposite party’s nursing home on 8.3.2003 at 11.00 a.m.   On admission, various tests were done preparing him for the surgery and an ECG was taken which appeared to  be normal and blood pressure was also normal infact the complainant was seen and examined by the 2^nd opposite party at 3.30. p.m on 8.3.2003. The opposite party respectfully submits that as the pain recurred it was decided to operate on the complainant on 8.3.2003 at 6.30 p.m.

8.     An Appendisectomy was performed and the inflamed appendix was removed through a small incision made on right iliac fossa.   The appendix was badly inflamed with a friable meso appendix with adhesion of small intestine and omentum forming a mass.  The distal ileum and caecum were edematous (wall of bowel swollen with fluid due to reaction to infection) and the mesoappendix was friable (tears off easily while handling)  appendicitomy was done and the stump was buried within the caecal wall gently with a pursestring suture.   

9.     The postoperative period was uneventful and he was discharged on the 4^th day (12.3.2003).  The Histopathological Examination report (JPE) confirms appendicitis with dense transmural infiltration by acute inflammatory cells extending to periaappendiceal fat.    Further follow-up and suture removal on the 8^th day was done by the 2^nd opposite party and thereafter there was no symptoms of any problems and the complainant recovered smoothly.  

10.    In fact on 19.3.2003 (11 days after surgery) the complainant got himself readmitted in the 3^rd opposite party hospital with history of low grade fever the previous day and nonbilious vomiting this morning.   (There was neither pain in the abdomen nor tenderness and the complainant was passing normal stools).  He had taken food from a petty shop the day earlier.  He was treated conservatively and observed.   The next day the vomiting subsided and he recovered fully.   He was diagnosed to have had food poisoning and discharged with normal diet.  Hence the averment made by the complainant in his complaint pertaining to the earlier defect being rectified is false and baseless. 

11.    On 7.5.2003 the complainant was seen by the opposite party as an outpatient with history of monbilious vomiting and paid in the left side of the abdomen and central abdomen since few hours.  He was suggested admission and further investigation.   His pain and vomiting subsided in a few hours and hence he refused admission but agreed to get an USG done to rule out any renal stone or otherwise for his repeated symptoms.  His USG was done at Surya scans on 8.5.2003 which showed no urinary stones but dilated & thickened bowel loops in the central and lower abdomen.   Possibility of adhesive intestinal obstruction was explained to him during his visit to the opposite party’s clinic on the evening of 8.5.2003 and the necessity of an operation to release any adhesions was also explained.  As he was relieved of all symptoms by then he agreed to come back to the opposite party if symptoms recur for the surgery.  After this episode the complainant did not turn up for further follow up treatment.   In the light of the above it is evidence that the averments in para-8 of the complaint have been made just to substantiate the false case of the complainant.

12.    However the averment of the complainant that the specimen “Ileo-caecal Resection” of the complainant  sent to R & D histo path lab revealed the error committed by the opposite parties is denied as a baseless, frivolous allegation.  Neither any of the operation findings nor the Histopathological findings could be a complication of appendicetomy surgery.  (The findings suggest a chronic inflammatory disease of illencaecal region, possibly Crohns disease as Tuberculosis has been ruled out).

13.    The opposite party replied to the legal notice dated 18.7.2003 and the same at length refuting all the allegations and brining to light the circumstances under which the complainant was operated and the happenings thereafter and that the complainant has been treated as per the established norms and there has been  no  negligence on his part.

14.    That it is a fact that post operative adhesion is the commonest cause of intestinal obstruction which is explained in detail in (Maingot’s Abdominal operation page.1159 and Sabiston Text book of Surgery pg.916) and in cases where infection and inflammation are server the chances are higher which is categorically setout in (Maingo’s page 919).  The most common long term complication of appendicectomy is also adhesive intestinal obstruction (Maingot’s pg 121).  

15.    This opposite party reiterates that the complainant has been treated as per the established medical norms and there has been no negligence or callous attitude on the part of the opposite party as alleged by him.   Hence this complaint is liable to be dismissed.

 

 

16.   Written Version of opposite party-2 is  in brief as follows:

         The 2^nd opposite party denies all the allegations made in the complaint except those that are specifically admitted herein.   The 2^nd opposite party after examination felt that it could be a clinical case of acute appendicitis and suggested an Ultra Sonogram of the Abdomen to be done.  The Ultra Sonogram was done as per the instructions of the opposite party.    The Sonogram report revealed chronic appendicitis.    The 2^nd opposite party felt that a surgeon’s opinion was needed at this juncture and the complainant was referred to the 1stop who is a surgeon of repute for his opinion.

17.    Hence on 8.3.2004 the complainant was admitted in the 3^rd opposite party hospital.   The 2^nd opposite party further states that upon admission various tests were done before surgery and after examination an appendisectomy was performed on the complainant.    The complainant recovered and was normal he was discharged on 12.3.2003 and found that the complainant had fully recovered.

18.    That one week after the surgery on 19.3.2004 the complainant approached the opposite party and complained of continuous vomiting from the morning of 19.3.2004 and fever.   This opposite party advised the complainant to get himself admitted in the third opposite party hospital.    Pursuant to the admission this opposite party saw the patient on the same day at 4.05. p.m. and after examination he was treated for acute gastroenteritis with antibiotic, anti ulserants and anit emetics.  Subsequently yet again at 8.00 pm. On the same day this opposite party visited the complainant at the hospital and checked his vitals and started him on oral liquid feeds and semi solid feeds on the same night.  The complainant was comfortable.  The next day on 20.3.2004 the complainant was reviewed by the opposite party at 10.00 a.m.  since the complainant has recovered completely he was advised soft bland solid diet to be started from that morning and if he tolerated such a soft bland diet he was to be discharged in the afternoon on the same day.  As he recovered completely he was discharged on 20.3.2004 in the afternoon with a diagnosis as acute gastroenteritis.   This opposite party is not concerned with the remaining averments in the said Phara-7.

19.    In fact the opposite party has taken great care and diligence in looking after the complainant wherein within a span of 24 hours from the time of his admission, the opposite party had out of his own volition visited the complainant in the 3^rd opposite party’s Nursing home on three occasions to make sure that everything was in order.  Hence it is neither fair on the part of the complainant nor the reasoning of the complainant alleging negligence / defective treatment on the part of the opposite party is based on facts. 

20.    As there is no negligence on the part of the opposite party and as this opposite party has taken great care while discharging his duties as a medical practitioner towards the complainant there can be no cause of action for this complaint and hence the averments in para-13 the complaint are denied as baseless.   Hence the complaint is liable to be dismissed.

21. Written Version of  opposite party-3 is  in brief as follows:

         Swaram Nursing Home is one of the reputed hospitals established in a predominantly residential area like Tiruvanmiyur, Chennai in 2001.  The hospital was set up with the objective of offering quality medicare facilities at affordable costs to the people residing in the area.   This third opposite party is one of the partners of Swaram Nursing Home.   It is submitted that he is neither a doctor not a director of Swaram Nursing Home.  This Third opposite party at the outset emphatically denies all the allegations of negligence, inefficiency and breach of duty and care that the Swaram Nursing Home owed to the complainant. 

22.    Unless otherwise specifically admitted herein this third opposite party denies all the allegations stated in the compliant as false and baseless.   The 3^rd opposite party submits that Swaram Nursing Home is only a provider of medicare facilities such as admitting privileges and in patient facilities to the visiting consultants, investigative, nursing care and operation theatre supported by qualified technical and nursing staff.  There is no specific allegations in the present complaint with regards to the services provided by the 3^rd opposite party to the complainant.

23.    The specialties and their patients only make use of the facilities of Swaram Nursing Home and the 3^rd opposite party apart from providing medicare facilities are in no way responsible for decision concerning their treatment.    This 3^rd opposite party neither has a role nor does it interfere with the decision of its consultants either in their admission and discharge or in the management of the patients.  

24.    When the complainant was admitted at Swaram Nursing Home by Dr. A.Senthil, it did not deviate from these cherished principles.  This third opposite party submits that the complainant was not produced any evidence to substantiate his allegations that this 3^rd opposite party had a role in his admission or discharge or in the diagnosis and treatment of his ailment.  

25.    The complainant was admitted at Swaram Hospital by Dr.A.Senthil M.S. M.Ch. on 8.3.2003 Dr. A.Senthil is an independent medical specialist  who only has got the privileges of admitting patients at Swaram Nursing Home.  He is not an employee of Swaram Nursing Home.   The complainant underwent appendicectomy on 8.3.2003 and it was performed by Dr.A.Senthil.   The complainant was discharged on 12.3.2003 by Dr.A.Senthil.  The complainant was admitted again on 19.3.2003 and discharged on 20.3.2003 by Dr.A.Senthil.  The complainant has accepted these facts in paras-4,5,6 & 7 of his complaint.   It is submitted that the complainant was provided quality medical services by the staff of Swaram Nursing Home, during his stay at Swaram Nursing Home.  

26.    Third opposite party has been impleaded as an opposite party only to harass him and to get illegal gains.   It is necessary to point out that the complainant has made no allegation about any deficiency or negligence on the part of the 3^rd opposite party warranting legal action under Consumer Protection Act.   Now to accuse Swaram Nursing Home of incompetence, imperfection, shortcoming and inadequacy in quality, nature and manner of performance of the care and service rendered by Swaram Nursing Home to the complainant is incorrect, infelicitous and even crude.   The claims are exorbitant and they are made with ulterior motives.    Swaram Nursing Home is not liable for the same and entire claims made are liable to be dismissed as devoid of truth and merits.

27.      In order to prove the averments of the complaint, the complainant has filed proof affidavit as his evidence and documents Ex.A1 to Ex.A11 marked.  Proof affidavit of opposite parties filed and Ex.B1 to Ex.B10 marked on the side of the opposite parties.  

28.   At this juncture, the point for the consideration before this

        Forum is:  

 

1. Whether there is any deficiency of service on the part of the 

     Opposite parties as alleged in the complaint?

 

2.  Whether the complainant is entitled to any relief as prayed for?

29.  Point No.1

        Regarding this point, on careful perusal of the complaint, it is learnt that through Ex.A1 Ultra Sonogram report dated 4.3.2003 it was confirmed that the complainant suffered Chronic Appendicitis by the examination of opposite party-2 and then the 2^nd opposite party referred the complainant to the 1^st opposite party for further treatment and in turn the opposite party-1 suggested for an  “appendicitis surgery” and then he was admitted at opposite party-3 Nursing Home on 8.3.2003 and operated on 8.3.2003 and discharged on 12.3.2003 in which discharge summary is marked as Ex.A2.   Ex.A3 is the  medical bill given by the 3^rd opposite party towards medical expenses.    It is further seen that ever since discharge from the nursing home the complainant was not comfortable, because of stomach pain and was followed by frequent vomiting.   

30.    He again consulted the 2^nd opposite party and the complainant was asked to consult the 1^st opposite party and advised to get admitted with the 3^rd opposite party’s nursing home once again on 19.3.2003 and discharged on 20.3.2003 stating that the earliest defect has been rectified and the same will  not suffered and the medical bill for which is marked as Ex.A4.  Further perusal even thereafter the complainant’s health condition remained the same and suffered severe physical strain and mental agony  and frequent vomiting  the complainant consulted Padmapriya Hospital at Indira Nagar, Adayar on 8.6.2003 and was told that another surgical intervention may be necessary and the same should be done immediately.    After the said surgery the stomach pain and vomiting stopped and the complainant was discharged after one week of post operative care and the discharge summary given by the Hospital which is marked as Ex.A6.     Therefore the attitude of lethargic and negligent manner in which the surgery was done, the complainant would not have suffered physical and mental stress and strain.  Hence the complainant has issued legal notice Ex.A7 to the opposite parties and reply notice
Ex.A8 given by the opposite parties.  Ex.A9 is the salary proof of the complainant and Ex.A10 is the Surgical Pathology Report. Ex.A11 is the Doctor prescription slip. 

31.    While being so, on going through  the evidence of the opposite party-1 it is learnt that the qualified surgeon as per Ex.B1 to Ex.B3.  It is further stated that on admission various tests were done preparing the complainant for the surgery which appeared to be normal and blood pressure was also normal and it was decided to operate ont eh complainant on 8.3.2003 at 6.30 p.m.  and discharged on 12.3.2003 and on 19.3.2003 the complainant got himself readmitted in the third opposite party hospital with history low grade fever the previous day and nonbilious vomiting and he was treated and discharged to that effect the case sheet is marked as ExB4.  It is further learnt from the evidence that Ex.B5 showed no urinary stones but dilated and thickened bowel loope in the central and lower abdomen.   Possibility of adhesive intestinal obstruction was explained to him to the opposite party’s clinic on the evening of 8.9.2003  and the necessity of an operation to release any adhesions was also explained.   After the episode the complainant did not turn up for further follow up treatment.  It is further stated that the complainant treated as per established medical norms and there has been no negligence or callous attitude on the part of the 1^st opposite party and Ex.B6 to Ex.B10 are the Extract Text book of surgery.

32.    Such being so, it is seen from the evidence of the opposite party-2 the complainant recovered and was normal he was discharged on 12.3.2003 and after one week from the complainant approached the opposite party on 19.3.2003 having complained of continuous vomiting and fever and admitted to the 3^rd opposite party hospital.   He was treated  for acute gastroenteritis with antibiotic and emetics and discharged in good condition and thereby this opposite party-2 has taken great care and while discharging his duties as a medical practitioner.  Hence there is no medical negligence on the part of the opposite party.

33.       On the side of the 3^rd opposite party it is narrated that he is neither a doctor nor a director of Swaram Nursing Home.   There is no specific allegation reveals the opposite party-3 and in fact on admission the complainant was provided quality medical services by the staff of Swaram Nursing Home during stay.   Therefore this opposite party has wrongly impleaded in the complaint.  Therefore this compliant is devoid of merits.  

34.    At this juncture on careful perusal of the rival submission put forth on either side it is admitted fact that the complainant had initiated approached the opposite party-2 for  certain complained stomach pain and thereafter on diagnosed through  Ex.A1 that the complainant had suffered Chronic Appendicitis.   Then the complainant was referred opposite party-1 for surgery for suffering of Appendicitis and in turn he was admitted in opposite party-3 Nursing home on 8.3.2003 and surgery was done and discharged on 12.3.2003.  Similarly on 19.3.2003 the complainant was again admitted for continuous stomach pain followed with continuous vomiting and was treated and discharged on 20.3.2003.   At the outset the point  to be taken as whether any medical negligence has committed by the opposite party  in the complaint.   As per the allegation made by the complainant that even after surgery done by the opposite party-1, in opposite party-3 hospital the complainant got suffered stomach pain and vomiting and not cured he had approached the Padmapriya hospital  undergone another surgery on 8.6.2003 to 21.6.2003 as per Ex.A6.   While so on perusal of the evidence of the opposite party-1 it is crystal clear that there is no dispute that the opposite party-1 is a qualified surgeon by acquiring Master degree in surgery the same has been proved by Ex.B1 to Ex.B3.  Further the opposite party-1 had been practicing past 11 years and holding with experience in medical profession.   It is further seen from the evidence and the document Ex.A2 surgery done by the opposite party-1 as prescribed in Text book.  Further it is seen from Ex.B7 to Ex.B10 that the factors on the application has been read as follows:

35.    It is the fact that post operative adhesion is the most common cause of intestinal obstruction which is explained in detail in Maingot’s Abdominal Operations PG 1159 which has been marked as Ex.B6 and Sabiston Textbook of surgery Pg.916 which has been marked as Ex.B7 and in cases where infection and inflammation are severe the chances are higher which is categorically set out in (Maingot’s page 919 which has been marked as Ex.B8.  The most common long term complication of appendectomy is also adhesive intestinal obstruction (Maingot’s pg 1219 which has been marked as Ex.B9.  Even if adhesive obstruction is suspected, if it is an incomplete obstruction and if there are no signs of ischemic bowel (deceased blood supply to bowel leading to gangrene by way of tendemess, tachycardia, toxic features etc.)  conservative (non operative) treatment can be done with 80% of cases resolving and surgery is indicated only if there is no resolution even after 48 hours. (Maingot’s Pg 1165-1166 and Sabiston 919 which has been marked as Ex.B10) whereas the complainant had his symptoms resolved within 24 hours on both occasions.

36.    Further during whether cross examination of opposite party-1 clearly explained that  “Adhesions are a known complication post appendix surgery in 80% of the cases which has not been rebutted by the complainant by either letting in expert evidence or by the production of any medical literature.   Further it has also made clearly the intestinal adhesions could be also due to crohn’s diseases which yet again has not been rebutted by the complainant.   Furthermore there is no averments on mentioning about any medical negligence committed by the opposite party-1 in Ex.A6.. Not only that as rightly point out by the opposite party-1 there is no expert opinion produced on the side of the complainant to show that the opposite parties have committed medical negligence during surgery.    At this juncture this forum to want to enlighten that it is well settled law of medical negligence that the complainant himself proved by the evidence or through any expert opinion or through any medical literature that the Doctor concerned was not qualified or was not competent to handle the case and it should have been done resulting in any injury to the patient.  In fact there is no expert opinion in support of the allegation made in the complaint produced by the complainant.  Therefore absence of expert opinion leads to come to the conclusion that the negligence has not been proved in order to substantiate the above fact.  The  opposite party-1 has relied upon the following decision:

                                  1)   2007 (2) CPR 260 (NC)

National Consumer Disputes Redressal Commission

                        N.Krishna Reddy

                               ..Vs..

               Christian Medical College & Hospital reported in

 

 

                                  2)   2004 (iii) CPJ 20 (NC)

National Consumer Disputes Redressal Commission

Inderjeet Singh

Vs

Dr.Jagdeep Singh

 

 

37.    In the light of the above facts and circumstances and also observation and decision relied upon by the opposite parties this forum can easily, come to the conclusion that the medical negligence as alleged in the complaint has not been proved.  Thus point No.1 is answered accordingly.

38.  POINT No.2:-

          As per the view concluded in points 1, the complainant is not entitled for any relief as prayed for in the complaint.  Thus the point No.2 is answered accordingly.

In the result, the complaint is dismissed.  No cost.

 

         Dictated by the President to the Assistant, taken down, transcribed and computerized by her, corrected by the President and pronounced by us in the open Forum on this the  16^th   day  of  February 2017.  

 

MBER-I                        MEMBER-II                             PRESIDENT.

Complainant’s side documents:

Ex.A1- 4.3.2003    - Copy of Ultra Sonogram report.

Ex.A2- 12.3.2003  - Copy of Discharge summary.

Ex.A3- 12.3.2003  - Copy of Medical bill of the 3^rd opposite party.

Ex.A4- 20.3.2003  - Copy of medical bill of the 3^rd opposite party.

Ex.A5- 8.6.2003    - Copy of Scan Report from Padmapriya Hospital.

Ex.A6- 8.6.2003     Copy of Discharge summary of Padmapriya Hospital.

           21.6.2003  

Ex.A7- 18.7.2002  - Copy of legal notice.

Ex.A8- 1.8.2003    - Copy of reply notice.

Ex.A9- 31.7.2003  - Copy of Salary proof of the complainant.

Ex.A10-10.6.2003 - Copy of Surgical Pathology Report.

Ex.A11-8.5.2003   - Copy of Doctor Prescription Slip.

 

Opposite party’s side document: -   

Ex.B1-         -       - Copy of Degree in Master of Surgery.

Ex.B2- 17.8.1995  - Copy of Service Certificate.

Ex.B3- 22.12.1993         - Copy of Certificate from Gujarat University.

Ex.B4- 19.3.2003  - Copy of Case sheet.

Ex.B5-8.5.2003     - Copy of USG from Surya Scans.

Ex.B6-         -       - Copy of Extract from Manigot’s Abdominal Operation

Ex.B7-         -       - Copy of Sabiston Textbook of Surgery (Pg 916).

Ex.B8-         -       - Copy of Extract from Maingot’s book (Pg.919).

Ex.B9-         -       - Copy of Extract from Manigot’s book (Pg.1219)

Ex.B10-       -       - Copy of Extract from Manigot’s book (Pg.1165 -1166)

 

Cross examination of opposite party-1

 

 

MEMBER-I                        MEMBER-II                             PRESIDENT.