BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, VELLORE DISTRICT AT VELLORE. PRESENT: THIRU. A. SAMPATH, B.A., B.L., PRESIDENT Tmt. G. MALARVIZHI, B.E. MEMBER – I THIRU. K. DHAYALAMURTHI,B.SC. MEMBER – II CC. 36 / 1999 MONDAY THE 26th DAY OF JULY 2010. Tmt. Poongodi, W/o. Meganathan, No.110/33 E.B. Quarters, 11 KV Sub Station, Eggunagar Steelplant, Arakkonam, Vellore District. … Complainant. - Vs – Dr.S.Sarala Devi, R.D. Nursing Home, Sholinghur Road, Arakkonam … Opposite party. . . . . This petition coming on for final hearing before us on 22.2.2010, in the presence of Thiru. T.L.Narayanan, Advocate for the complainant and Thiru. Radhakrishnan Advocate for the opposite party, and having stood over for consideration till this day, the Forum made the following: O R D E R Pronounced by Thiru. A. Sampath, President of the District Consumer Disputes Redressal Forum, Vellore District. 1. The brief facts of the case of the complainant is as follows: The complainant was a patient of the opposite party herein for gynecological problems for which she was advised to under go a surgery by the opposite party, who assured the complainant that the Uterus must be removed and if it is removed there will not be any complications. The opposite party assured the complainant that the opposite party is an expert and duly qualified to do the surgery and on that assurance the complainant was advised to get herself admitted in the opposite party’s hospital at Arakkonam on 2.6.98, after several tests which the complainant had ordered to be done. The opposite party performed the surgery on 3.6.98 and discharged the complainant on 11.6.98. The opposite party received a sum of Rs.9,000/- for her service and issued the receipt. Apart from the charges paid to the opposite party before surgery during surgery and after surgery, the complainant spent about Rs.11,000/- for blood, medicines, tests, scan, and to the referral doctors. Thus in all Rs.20,000/- was spent by the complainant for the treatment surgery imparted by the opposite party. Even during her period as an inpatient during post operative period, she was not looked after well and through out she had no control over her urination which was following continuously. Even after her discharge, there were other complications such as profuse sweating, dehydration, loss of appetite, pain and she was suffering from terrible feeling of heat inside and out side the body. The opposite party merely referred to some Madras Doctors, who were also not very helpful. In sheer desperation the complainant and her husband went to Madras for further and better treatment and for rectification of the problem to the Vijaya Hospital, where the complainant was advised immediate surgery, as it was found that the opposite party had performed the surgery very negligently. She was continuously suffering from the intense heat, which was diagnosed by the Vijaya Hospital as due to unwarranted, and unwanted removal of the ovaries, which were fully fit, and functional. M/s. Vijaya Hospital performed the correctional surgery, curing the complainant’s of the problem of constant out flow of urine, and the hormonal replaced therapy for caused by the unwarranted removal of ovaries continues till date. The complainant and her husband spent nearly Rs.75,000/- during the course of treatment at the Vijaya Hospital, necessitated for the gross deficiency of service of the opposite party. 2. Unable to bear with the hormonal difficulties, the complainant was advised to seek treatment and help from the CMC Hospital, Vellore which after a round of tests, found that the complainant has to undergo LIFELONG HARMONE REPLACEMENT THERAPY. The drugs ordered to be taken even during the first course cost about Rs.1000/- apart from the inconvenience, discomfort of traveling to and from the Arakkonam with a delicate health. Only recently the complainant came to know that the opposite party has a long history of such deficient services and had infact been held to be grossly deficient in service by the State Commission for Consumer Disputes Redressal Commission, Chennai. Due to her callous negligence, gross deficiency of service and ignoring the vital needs of the complainant, the opposite party had caused untold misery, hardship and loss to the complainant who is therefore entitled to claim compensation reimbursement refund and costs from the opposite party, who is bound in law and liable to do so. Therefore the opposite party is to be directed to pay a sum of Rs.9000/- collected by her and a sum of RS.11000/- spent by complainant towards the surgery and Rs.75000/- which the complainant spent for her treatment at Vijaya Hospital, and Rs.5,000/- either to spent towards treatment and Drugs at the CMC Hospital, Vellore and Rs.3,50,000/- as compensation for the gross deficiency of service which had caused the complainant extreme pain, suffering and shattering of her good health and Rs.25,000/- towards the costs of the complaint. Hence the complaint. 3. The averments in the counter filed by the opposite party is as follows: The complaint is frivolous and vexations and not maintainable under law and on facts. The various allegations made in the complaint are contrary to facts. The opposite party denies all the allegations in the complaint and puts the complainant to strict proof of the same. She is a holder of an indemnity insurance policy with the National Insurance Company Ltd., Ambatur Branch, C-32, II Avenue Anna Nagar, Chennai 600 040 and that the said company is a necessary party and has to be impleaded in the complaint. Non inclusion of the said company is bad in law and the complaint is liable to be dismissed. The complainant has been a regular patient of the opposite party for several years. For about two years prior to June 1998 she has been complaining of prolonged and excessive bleeding and painful menstrual periods. She was consulting the opposite party for the same and has been taking medicines prescribed to her. However the medications failed to cure her and she continued to suffer. Therefore she was advised to undergo surgery hysterectomy (removal of uterus). The complainant was postponing the operation stating that she has no funds and so on and finally she thought fit to undergo the operation and got herself admitted in the RD Nursing Home of the opposite party on 2.6.98. All the necessary pre operative tests such as ultra sound scan, hematological tests were done. The operation was performed on 3.6.98 by the opposite party with the assistance of well known Urologist Dr.Selvaraj, M.S.Mch., under general anesthesia. Dr. Vasudevan was the anesthetist and they were assisted by Sister Chandralekha who is a theatre trained nurse. Phenestial incision was made and found uterus enlarged 12 weeks size. Both ovaries were found enlarged and showed multiple haemorrhagic cysts. Abdominal hysterectomy with bilateral salpingo oopherectomy was performed. Abdomen closed after complete haemostatis and abdominal was closed in stages. Even though the scan showed ovaries as normal, during the operation both the ovaries were found to be enlarged and had multiple haemorrhagic cysts. After due consideration the opposite party came to the conclusion that it would be in the best interests of the patient to remove both the ovaries as they were found to be not normal but having multiple haemorrhagic cysts. If left alone these cysts were likely to lead complications necessitating major surgery in future and might have also developed further and becoming cancerous. The opposite party also consulted Dr.Selvaraj, urologist who was present and he concurred with the opinion of the opposite party. Only in the above circumstances both the ovaries were removed. The presence of multiple hemorrhagic cysts cannot be detected during scan and were noticed only after opening the abdomen for removal of the uterus. Her condition after operation was stable. She was provided with floes catheter and clear urine was discharged through the same. She was feeling absolutely comfortable. Catheter was removed after three days, that is on the 6th after which she was passing clear urine normally. She was discharged from the nursing home on 11.6.98 since she was absolutely normal. She was advised to come for post operative check up after one week. She was also given instructions to be followed such as not to travel or lift any weight to avoid intercourse for one month etc. 4. But on 11.6.98 evening itself she returned and complained of dribbling of urine. Immediately opposite party examined her and found urine was coming from the vagina. Opposite party suspected Vescico Vaginal Fistula (VVF). Immediately she applied Floyes Catheter and requested Dr.Selvaraj, Urologist to come and examine the patient. He came and performed three swab tests with methylene blue and confirmed VVF. He advised indwelling catheter for 21 days and prescribed antibiotics. The complainant was kept under observation in the nursing home and it was seen that the dribbling of urine through vagina had stopped and clear urine was passing through the catheter. Her general condition was good and she was feeling comfortable. After about a week’s stay the complainant wanted to go home as she was feeling comfortable. The opposite party requested Dr.Selvaraj to come and examine the patient. He advised that the patient may be discharged and that she should come after one week for check up and changing the catheter. He also changed the antibiotics to Tablet NORFLOS (B-d), Tablet GRAMONEG (b-d), with Tablet BECOZYME FORTE and Tablet EVALON. On the 29th June 98 the complainant came for check up. No dribbling of urine per vagina was seen. Catheter was changed and clear urine passed through catheter. The complainant’s general condition was good, and she was not complaining of any other problem. The complainant once again came on 5.7.98 for check up and removal of catheter. The catheter was removed. No dribbling of urine per vagina was seen. The complainant was kept under observation for a day. Slight dribbling of urine per vagina was present. Thereupon Dr.Selvaraj, Urologist was consulted. He examined her and confirmed VVF and advised to refer the patient to Urology Department, Government General Hospital, Madras. The opposite party gave a letter of request to Dr.Sivaraman Professor or Urology, GGH Madras for VVF repair. The opposite parties denies the averment that the complainant has spent Rs.11,000/- for blood, medicine, tests, scan and to referral charges. The opposite party is not aware of her further treatments mentioned in the complaint. The opposite party is an experienced obstetrician and gynecologist of many years standing, practicing in Arakkonam, from 1979. During her career as obstetrician and gynecologist she has performed many major and minor operations successfully. The opposite party performed her duty to the best of her ability with due care and caution in diagnosing and performing the operation and in the post operative care. The complication that occurred were all not due to any negligence on the part of the opposite party in performing the operation but were due to risks inherent in total hysterectomy. The mere fact that there was Vesico Vaginal Fistual cannot lead to the conclusion that there was negligence in performing the operation. The complainant has been pressing the opposite party to give her money and when she failed to extracting any amount she has come up with the complaint before the Hon’ble Forum and this complaint is dismissed with costs. 4. Now the points for consideration are: a) Whether there is any deficiency in service, on the part of the opposite party? b) Whether the complainant is entitled to the reliefs asked for?. 6. Ex.A1 to ExA10 were marked on the side of the complainant and Ex.B1 to Ex.B4 were marked on the side of the opposite party. Proof affidavit of the complainant and Proof affidavit of the opposite party have been filed. No oral evidence let in by either side. 7. POINT NO. (a):- It is admitted case of the parties that the complainant was admitted in the opposite party’s hospital on 2.6.98, after necessary pre operative tests, the opposite party performed the surgery of hysterectomy and the complainant was discharged from the hospital on 11.6.98. 8. The complainant contended that even during her period as an inpatient, during post operative period, she was not looked after well and through out she had no control over her urination which was flowing continuously. Even after discharge, there were other complications such as profuse sweating, dehydration, loss of appetite pain and she was suffering from terrible feeling of heat inside and out side the body. Therefore she was admitted in the Vijaya Hospital, Madras on 30.9.98 and again surgery was done on 1.10.98 and after complete stop of urination from vagina she was discharged from the hospital on 12.10.98. Before admitted in the Vijaya Hospital, Madras. She was continuously suffering from in the intense heat which was diagnosed by the Vijaya Hospital as due to unwarranted, and unwanted removal of the ovaries. Therefore, M/s. Vijaya Hospital, performed the correctional surgery curing the problem of constant out flow of urine, but the hormonal difficulty caused by the unwarranted removal of ovaries continues till date. Due to the negligence and gross deficiency of service and ignoring the vital needs of the complainant, the opposite party has caused untold misery, hardship and loss to the complainant who is therefore entitled to claim compensation reimbursement refund and costs from the opposite party. 9. The opposite party contended that after the necessary preoperative tests, the operation was performed on 3.6.98 by the opposite party with the assistance of will known Urologist Dr. Selvaraj, M.S.M.ch., under general anesthesia. Phenestial incision was made and found uterus enlarged 12 weeks size. Both ovaries were found enlarged and showed multiple hemorrhagic cysts. Abdominal hysterectomy with bilateral salpingo oopherectomy was performed. After due consideration the opposite party came to the conclusion that it would be in the best interests of the patient to remove both the ovaries as they were found to be not normal but having multiple haemorrhagic cysts. The presence of multiple hemorrhagic cysts cannot be detected during scan and were noticed only after opening the abdomen for removal of the uterous. Catheter was removed after three days, that is on the 6th dayafter which she was passing clear urine normally. After discharged from hospital on 11.6.98, evening itself she returned and complained of dribbling of urine, immediately opposite party examined her and found urine was coming from the vagina. Opposite party suspected Vescico Vaginal Fistula (VVF). Immediately she applied Floyes catheter and requested Dr.Selvaraj, Urologist examine the patient. The complainant was kept under observation in the nursing home for a week and it was seen that the dribbling of urine through vagina had stopped and discharged from the hospital on 29.6.98. Dr. Selvaraj, Urologist examined her and confirmed VVF and advised to refer the patient to Urology Department, Government General Hospital, Madras. Therefore the complication that occurred were due to risks inherent in total hysterectomy. The mere fact that there was Vesico Vaginal Fistual cannot lead to the conclusion that there was negligence in performing the operation by the opposite party. 10. From the perusal of Ex.B1, case sheet issued by the opposite party’s hospital it is mentioned that the complainant was admitted in the said hospital on 2.6.98 and after the necessary pre operative tests, the complainant was advised to undergo surgery of hysterectomy (removal of uterus). Accordingly, abdominal hysterectomy with bilateral salpingo oopherectomy was performed by the opposite party on 3.6.98. It is further mentioned that during the operation both the ovaries were found to be enlarged and had multiple hemorrhagic cysts . After due consideration the opposite party came to the conclusion that it would be in the best interests of the patient to remove both the ovaries as they were found to be not normal but having multiple hemorrhagic cysts ovaries removed. Then she was discharged from the hospital on 11.6.98 and on the same day evening she again admitted in the hospital and took treatment till 29.8.98. The opposite party suspected Vescico Vaginal Fistula (VVF) at refer the patient to urology department, Government Hospital, Madras. On the perusal of letter Ex.A3 dt. 15.7.98 issued by Dr. Udesh Ganapathy, Government Hospital, it is stated that the complainant suffering from ordinary tract infection Vitter vescico vaginal fistula, she is advised to allowed urology department, Vijaya Hospital for further treatment.” On perusal of Ex.A4, dt. 23.7.98 test report of Vijaya Hospital, it is seen that they suspected Vescico Vaginal Fistula to further evaluation. On the perusal of Ex.A4, dt. 23.7.98 test report of Vijaya Hospital, it is seen that they suspected VVF to further evaluation. From the perusal of Ex.A7 discharge summary, issued by Vijaya Hospital, it seen that the complainant was admitted in the hospital, on 30.9.98 and on 1.10.98 under general anesthesia the bladder was dissected around the fistulus opening till vagina was reached. Repair: Using 20 catout Vagina was closed in two layers – first continuous and 2nd interrupted : bladder was closed in two layers : bladder incision was closed using 20 catgut in two continuous layer : corrugated drain ket and wound closed in layers: Vaginal Pack kept and 22 Fr was passed through urethra. AT DISCHARGE : discharge on patient comfortable, passing urine freely, no incontinence, general condition good. On perusal of the Ex.A10 dt.23.3.99 medical report issued by C.M.C. Hospital, Vellore it is mentioned that the above hospital advised the complainant Hormone replacement therapy - life long. 11. According to the complainant, after discharged from the opposite party’s hospital on 11.6.98 the complainant was continuously suffering from intense heat, which was diagnosed by the Vijaya Hospital as due to unwarranted and unwanted removal of the ovaries, which were fully fit, and functional, therefore said hospital performed the correctional surgery, curing the complainant’s problem of constant out flow of urine, and the hormone replacement therapy for life long caused by the unwanted removal of the ovaries continues till date. Therefore, due to the opposite party’s negligence, gross deficiency of service, the complainant suffered untold misery hardship, and loss. Hence the complainant is entitled to claim compensation reimbursement refund and costs from the opposite party. In this connection the learned counsel for the complainant relied upon the following Judgment of National Consumer Disputes Redresal Commission, New Delhi, State Consumer Disputes Redressal Commisison, Karala. 1. 2000 (1) CPR 70 (NC) Bhajan Lal Gupta and Anr. ..Vs.. Mool Chand Kharati Ram Hospital Wherein the Hon’ble National Commission, New Delhi is held that “(i) Consumer Protection Act 1986 – Sections 2(1)(c ) read Sections 2(1)(o) and 2(1) (g) complaint against Medical Negligence – Patient admitted in Mool Chand Hospital – Treatment suggested G.B. Pant Hospital – Not available to non-availability of any besides whether complaint against G.B. Pant Hospital or its staff (OP.Nos.6,7 regarding medical negligence sustainable?. (No). “ II. 1998 (1) CPR 39 A.M. Mathew .. Appellant. Versus The Director, Karuna Hospital & Ors. .. Respondents. Wherein the Hon’ble State Consumer Disputes Redressal Commission, Kerala : Thiruvananthapuram is held that “Consumer Protection Act, 1986 – Section 15 – Medical negligence – Complainant took his minor son to first opposite party hospital following fever and cold – Second opposite party prescribed injection – Administered by third opposite party as per direction of second opposite party – Boy developed foot drop on his left leg – Even after for more than two month’s treatment boy could not walk properly – Left leg remained disabled – Complaint – District Forum dismissed complaint on ground that injury to sciatic nerve possible for several reasons – Injury cannot be pinned down to injection – Appeal – Third opposite party had not required qualification to administer injection – Her conduct amounted to actionable negligence – First opposite party hospital vicariously liable – Rs. One lakh awarded as compensation. ” 12. The learned counsel for the opposite party has argued that bare allegations in the complaint would not establish charge of negligence on the part of the 1st opposite party. The burden of proof on the medical negligence lies on the complaint, but in this case, the complainant has not proved the allegation made in the complaint against the opposite party through medical records or expert evidence. In this connection the learned counsel for the opposite party is relying upon the following Judgments of Hon’ble Supreme Court and National Consumer Disputes Redessal Commission, New Delhi. I. (2009) 7 Supreme Court Cases 130 C.P. SREEKUMAR (DR.), MS (ORTHO) ..Vs.. S.RAMANUJAM Wherein the Hon’ble Supreme Court is held that “ As already observed in Jacob Mathew case the onus to prove medical negligence lies largely on the claimant and that this onus can be discharged by leading cogent evidence. A mere averment in a complaint which is denied by the other side can, by no stretch of imagination, be said to be evidence by which the case of the complainant can be said to be proved. It is the obligation of the complainant to provide the facta probanda as well as the facta probantia. In Jacob Mathew case it has been observed as under: (SCC pp.32-33, para-48) “(1) Negligence is the breach of a duty caused by omission to do something which a reasonable man guided by those considerations which ordinarily regulate the conduct of human affairs would do, or doing something which a prudent and reasonable man would not do. The definition of negligence as given in Law of Torts, Ratantal 7 Dhirajlal (edited by Justice G.P.Singh), referred to hereinabove, holds good. Negligence becomes actionable on account of injury resulting from the act or omission amounting to negligence attributable to the person sued. The essential components of negligence are three: ‘duty’ , ‘breach’ and ‘resulting damage’ (2) Negligence in the context of the medical profession necessarily calls for a treatment with a difference. To infer rashness or negligence on the part of a professional, in particular a doctor, additional considerations apply. A case of occupational negligence is different from one of professional negligence. A simple lack of care, an error of judgment or an accident, is not proof of negligence on the par of a medical professional. II. 2007 (2) CPR 260 (NC) N. Krishna Reddy ..Vs.. Christian Medical College and Hospital Rep. by its Medical Superintendent & Anr. Wherein the Hon’ble National Commission, New Delhi is held that, “ Consumer Protection Act, 1986 – Sections 21(a)(i) – and 2 (1) (g) – Complaints about medical negligence – Medical negligence must be established and not presumed. In the absence of expert evidence on behalf of the complainant, no negligence or deficiency in service could be found against the affidavits filed by Hospital and doctors. “ 13. In the present case, on the perusal of letter Ex.A3, dt. 15.11.98, Ultrasound Study for Kub Region Ex.A4 dt. 23.7.98, Discharge Summary Ex.A7 issued by Vijaya Hospital, it is seen that after confirmed the Vescico Vaginal Fistula, and the complainant was admitted in the Vijaya Hospital, Madras on 30.9.98 and on 1.10.98 under general anesthesia, the bladder was dissected around the fistulus opening till vagina was reached. Repair: Using 20 catout Vagina was closed in two layers – first continuous and 2nd interrupted : bladder was closed in two layers : bladder incision was closed using 20 catgut in two continuous layer : corrugated drain ket and wound closed in layers: Vaginal Pack kept and 22 Fr was passed through urethra and at the time of discharge from the hospital patient comfortable passing urine freely, no incontinence, general condition good. According to the complainant the mere fact that there was Vesico Vaginal Fistual cannot lead to the conclusion that there was negligence in performing the operation by the opposite party. The Doctor who gave treatment to the complainant in Vijaya Hospital, Madras have not made any commends or adverse remarks in the Ex.A7 discharge summary, issued by the Vijaya Hospital, Madras about the operation done by the opposite party on 3.6.98. 14. The nature of the medical profession is such that there are many courses of treatment in each disease. The diagnostic procedure may by vary, and the approach by each doctor will be different and the treatment given to a patient differs from man to man. It is for the doctor treating the patient to decide the best course of action and if he has done the job exercising due diligence with such standard of care that is required of him. Unless it is shown that the Doctor has failed to opt a particular precaution or failed to follow the procedure and such failure has called to the ultimate result or complication. In the present case when the complainant admitted in the opposite party’s hospital she has been complaining of prolonged and excessive bleeding and painful menstrual periods, after necessary several pre tests such as ultra sound scan, hematological tests were done. Thereafter she was advised to under go surgery hysterectomy (removal of ultras). Accordingly the operation was performed on 3.6.98 by the opposite party with the assistance of well known Urologist Dr.Selvaraj, M.S.Mch., under general anesthesia. The opposite party stated in her proof affidavit that even though the scan showed ovaries as normal, during the operation both the ovaries were found to be enlarged and had multiple hemorrhagic cysts and after due consideration the opposite party came to the conclusion that it would be in the best interests of the patient to remove both the ovaries as they were found to be not normal but having multiple hemorrhagic cysts. If left alone these cysts were likely to lead complications necessitating major surgery in future and might have also developed further and becoming cancerous. Only in above circumstances both the ovaries were removed. The doctor who gave a treatment to the complainant in Vijaya Hospital, Madras have not made any commends or adverse remarks in the Ex.A7 discharge summary about the operation and removal of ovaries done by the opposite party on 3.6.98. It is clear that the mere facts that there was Vesico Vaginal Fistual cannot lead to the conclusion that there was negligence in performing the operation on 3.6.98 by the opposite party. Further, except the complaint there is no medical record or expert evidence to prove that due to negligence, gross deficiency of service and ignoring the vital needs of the complainant, the opposite party had caused untold misery, hardship and loss to the complainant. Hence, there is no deficiency in service on the part of the opposite party. The authorities cited by the learned counsel for the complainant is not applicable to the facts of this case. But the authorities cited by the learned counsel for the opposite party is squarely applicable to the facts and circumstances of this case. 15. Hence, taking all the above facts into consideration from the contention in the complaint and the counter, as well as proof affidavit of the both the parties, and from the documents Ex.A1 to A7 and Ex.B1 to Ex.B6, we have come to the conclusion that the complainant herein has not clearly proved the deficiency in service on the part of the opposite party herein. Hence we answer this point (a) as against the complainant herein. 16. POINT NO : (b) In view of our findings on point (a), since, we have come to the conclusion that the complainant herein has not clearly proved the deficiency in service on the part of the opposite party herein. We have also come to the conclusion that the complainant is not at all entitled to any relief asked for by him, in this complaint. Hence we answer this point (b) also as against the complainant herein. 17. In the result this complaint is dismissed. No costs. Dictated to the Steno-typist and transcribed by her, corrected and pronounced by the President, in Open Forum, this the 26th day of July 2010. MEMBER-I MEMBER-II PRESIDENT. List of Documents: Complainant’s Exhibits: Ex.A1- 11.6.98 - Doctor’s Prescription Slip. Ex.A2 – 25.2.99 - Receipt issued by opp. party in payment of charges. Ex.A3 – 15.7.98 - X-copy of Certificate issued by Doctor referring Vijaya Hospital, Ex.A4- 23.7.98 - X-copy of Certificate of observation by Vijaya Hospital. Ex.A5- 30.9.98 - Admission slip issued by Vijaya Hospital. Ex.A6- 17.4.98 - X-copy of Scan Report. Ex.A7- -- - X-copy of Discharge Summary. Ex.A8 - -- - X-copy of Bill. Ex.A9- -- - X-copy of Bill. Ex.A10- 23.3.99 - X-copy of Medical Report. Opposite party’s Exhibits: Ex.B1 - -- - Case Sheet. Ex.B2- 15.10.99 - Expert opinion given by Dr.T.V. Shanmugam. Ex.B3- 18.12.96 - X-copy of Cash Sheet relating to Mrs.Kamroon W/o Rasheed Ahmed. Ex.B4- -- - X-copy of Series 1 to 6 references furnished by Dr.T.V.Shanmugam. MEMBER-I MEMBER-II PRESIDENT.
| | [HONORABLE K.Dhayalamurthy] Member[HONABLE MR. JUSTICE Thiru A.Sampath] PRESIDENT[HONORABLE TMT .G.Malarvizhi] Member | | 
