This appeal is directed against order of the Bihar State Consumer Disputes Redressal Commission (in short he State Commission in complaint case no. 32 /2002. By the impugned order, the complaint was partly allowed. The appellants were directed to pay compensation of Rs.4 lakh on account of loss of life of the complainant wife alongwith compensation of Rs.1 lakh towards medical expenditure and Rs.10,000/- as cost of litigation. Feeling aggrieved thereby, the original OP Nos. 1 & 2 have come up in appeal. 2. The appellants admittedly are medical practitioners. They run a clinic styled as ohtas Nursing Home, Station Road, Dalmia Nagar, Rohtas. The appellant no. 1 is Gynaecologist. The appellant no. 2 a general medical practitioner. The clinic is situated in small locality of Dalmia Nagar District Rohtas. There is no dispute about the fact that complaint Kamakhya Singh hails from a remote village called Danwar. No claim was made against OP No. 3 Bose Clinic. In this appeal also Bose Clinic is a formal party. It would be convenient to refer the contesting parties by their nomenclature as was used in the complaint case filed before the State Commission. 3. Briefly stated the case of complainant Kamakhya Singh is that on 10.12.2001, he had taken his wife, namely, Lalti Devi to the clinic of the appellants. She was suffering from abdominal pains. The appellants gave certain medicines to her and advised to take rest in the nursing home. After consumption of the medicines, her pain had increased. At the relevant time, Lalti Devi was pregnant. Appellant No. 1 Dr. (Smt.) Prabha Agrawal advised termination of pregnancy by DNC operation. An amount of Rs.10,000/- was demanded for conducting the operation. However, Kamakhya Singh could manage payment of only Rs.5000/- and sought time to pay the remaining amount. Lalti Devi was operated at about 1:00 AM in the night falling between 10th and 11th Dec. 2001. When she gained consciousness in the next morning, she felt acute pain in the abdomen. On the next date, the appellants asked the complainant whether the remaining amount was arranged and deposited. He could not arrange for the money and, therefore, further treatment was refused. On 12.12.2001, complainant Kamakhya Singh, took his wife to Bose Clinic. He was advised to take her to better medical centre. So, he took her to Patna Medical College Hospital (PMCH) at Patna. She was admitted in the said Hospital on 13.12.2001. At the PMCH, it was noticed that there was history of abortion on 10.12.2001, complaints of vomiting and she had not passed stools for three days. Further investigation revealed that there was prognosis due to perforation over the anterior surface of the uterus as well as in the S.J. The risk of operation was explained to the patient and, thereafter, she was operated. She died on 15.12.2001 at 6:26 AM. The complainant alleged that it was due to negligent surgical procedure done by the appellants that his wife lost her life. He further alleged that appellant no. 1 Dr. Prabha Agarwal had no adequate knowledge of conducting the M.T.P. He, therefore, claimed compensation of Rs.5,75,000/- by filing complaint before the State Commission. 4. The appellants totally denied all the material averments made in the complaint. They denied that deceased Lalti Devi was admitted in their hospital. They denied that she was given treatment by either of them. Their version was full of denial. They submitted that they used to maintain all records showing admission, discharge, etc. and there was nothing in their records to show that deceased Lalti Devi was ever admitted in their nursing home. Needless to say, they denied to have provided any treatment to deceased Lalti Devi. They submitted that appellant no. 1 Dr. (Smt.) Prabha Agarwal is a qualified Gynaecologist and is practicing since 18 years. They contended that false complaint was filed against them in order to malign their high reputation. Consequently, they sought dismissal of the complaint. 5. The complainant filed photocopies of prescription and chithas issued by the clinic of the appellants. He also placed on record discharge card dated 12.12.2001 issued by Bose Clinic and death certificate issued by the PMCH. The appellants produced the indoor patient register and claimed that deceased Lalti Devi was not admitted in their hospital for any medical treatment. The State Commission came to the conclusion that the sequence of events and the record was sufficient to infer gross medical negligence on part of the appellants. Hence the complaint was partly allowed vide the impugned order. 6. We have heard learned counsel for the parties. Mr. Sharma submits that mere production of photocopies of a prescription and chithas cannot be substituted for proof to establish the fact that wife of complainant Kamakhya Singh was subjected to DNC procedure in the clinic of the appellants. He would further submit that complainant Kamakhya Singh is not proved to be consumer qua the appellants. He contended that no sufficient proof of medical negligence was adduced before the State Commission, much less it is not proved that the appellants committed any ross medical negligencewhile treating deceased Lalti Devi. He contended that absence of any receipt regarding payments made by complainant Kamakhya Singh and absence of any medical record would dislodge the story of medical treatment of deceased Lalti Devi in the clinic of appellants. From the grounds of appeal, Mr. Sharma points out the prescription dated 10.12.2001 was the only document produced which also does not indicate that she was treated as an indoor patient. It is argued that complainant Kamakhya Singh fabricated unfounded story that the DNC procedure was done in the nursing home of the appellants. Learned counsel for the appellants submitted that in absence of any tangible material, the State Commission ought not to have held the appellants responsible for alleged medical negligence. He also pointed out that the appellant no. 1 was acquitted from the criminal charge for alleged offence under section 304(A) of the I.P. Code. He pointed out that both the appellants are qualified medical practitioners and there was no substance in the argument that Dr. (Smt.) Prabha Agarwal was incompetent to conduct the DNC procedure. In keeping with the above arguments, learned counsel for the appellants urged to allow the appeal. Per contra, learned counsel appearing for the respondent no. 1 (complainant) supported the impugned order. 7. The material questions involved in the appeal are:- i) Whether it is duly proved by complainant Kamakhya Singh that his wife was subjected to medical termination of pregnancy at the clinic of the appellants on or about 10.12.2001? ii) Whether it is duly proved that the appellants committed gross negligence while conducting the DNC procedure and as a result of such negligence, the wife of complainant Kamakhya Singh lost her life? iii) Whether impugned order of the State Commission is legal, proper and correct? 8. So far as the competency of the appellant no. 1 Dr. (Smt.) Prabha Agarwal is concerned, there is no serious dispute about the fact that she was practicing as a Gynaecologist since about 18 years. It appears from the medical certificates that she is duly qualified medical practitioner. It appears that she had undergone training in Gynaecology. It cannot be inferred that she was not competent to conduct DNC procedure. A vague statement made by the complainant in his complaint about her incompetency is of no avail. 9. Clinching question is whether the deceased wife of complainant Kamakhya Singh was treated by the appellants on 10.12.2001 and whether she was subjected to termination of pregnancy without taking proper care and without exercising due skill expected from a reasonable Gynaecologist. There is no medical record produced by complainant Kamakhya Singh to show that his wife was admitted as indoor patient in the clinic of the appellants. There is no dispute about the fact that his wife ultimately died in PMCH, Patna. No expert opinion was placed on record. Obviously, the question is whether the chain of events, the attending circumstances and conduct of the appellants could be sufficient proof of the alleged medical negligence on their part. This is a peculiar case wherein complainant Kamakhya Singh attributed medical negligence to the complainants though direct evidence was unavailable. In other words, the entire edifice of his case depends on the circumstantial evidence and conduct of the appellants. 10. On careful perusal of the written submissions filed by the appellants it is manifest that at the first blush they denied everything about alleged treatment given to deceased Lalti Devi at their clinic. It was only after the rejoinder filed by complainant Kamakhya Singh that the prescription issued by the appellant no. 1 and the chitthas indicated concern of the clinic of the appellants in the context of treatment of deceased Lalti Devi. After the impugned order, in the appeal memo certain explanation is now given to show that the prescription issued by the appellants was not sufficient to prove that the patient was operated in the appellant nursing home. The averment made in ground (vi) may be reproduced as below:- t is significant to submit that on the basis of the medicine prescribed in these chitthas a conclusion cannot be reached that D&C was performed in the nursing home of the doctor and the fact is that the patient was not operated. The further averment in ground no. vii (e) is as follows:- he prescription relates to 10.12.2001 where after the patient have left and neither the doctor nor the nursing home have any control over the patient who is an outdoor patient once they have left the nursing home. 11. Perusal of the above-mentioned grounds in the Memo of Appeal go to show that the appellants have tried to improve their stand. In their written statement before the State Commission, they completely denied any kind of concern with the treatment of the wife of the complainant. They now attempted to show that she might have been treated as outdoor patient and was not under their control. 12. Case of Kamakhya Singh finds support from his own affidavit as well as from written version of Dr. Sunil Kumar Bose. The written version of the latter reveals that when wife of the complainant was brought to the Bose Clinic, she was in critical condition and was, therefore, advised to go to PMCH, Patna. The medical opinion expressed by Dr. Bose is further supported by the Doctor of PMCH Patna because perforations were found in the layers and anterior surface of the uterus of deceased Lalti Devi. Thus, it is explicit that only on 12.12.2001 Lalti Devi was rushed to Bose Clinic at about 10:15 PM and she was immediately discharged because of her critical condition. The discharge slip issued by Bose Clinic reveals that she was in critical condition following DNC procedure conducted on her three (3) days prior. 13. The stand taken by the appellants that Lalti Devi was never treated in their clinic is falsified by the prescription dated 10.12.2001 issued by appellant no. 1 Dr. (Smt.) Prabha Agarwal. It is pertinent to note that Dr. (Smt.) Prabha Agarwal did not file any affidavit to refute the allegation that the prescription was issued by her. It is also important to note that the State Commission compared hand-writing on the prescription and the chitthas. It was noted by the State Commission that both the chitthas were in the hand writing of the same person. One of the chitthas shows that medicines prescribed were for the treatment of the septicaemia and intra vaginal infection. 14. This takes us to examine conduct of the appellants. They did not adduce any evidence to show that the prescription was issued by somebody else than appellant no. 1, Dr. (Smt.) Prabha Agarwal. The complainant had no previous enmity with appellants. He is rustic, poor and illiterate person. He had no reason to falsely implicate the appellants as the treating Doctors. The indoor register was produced by the appellants before the State Commission. The State Commission noticed that the register was apparently tampered with by re-stitching some of the pages. The State Commission also noticed that there was some re-writing in respect of the entries pertaining to the relevant period. In other words, the appellants attempted to manipulate the indoor register record which was produced before the State Commission. This conduct of the appellants go to speak volumes against them. 15. True, the record could not be produced by the complainant to show that his wife was subjected to DNC procedure by the appellants. Still, however, when he produced the prescription and the chitthas issued by the appellants, the onus shifted on them to show that wife of complainant Kamakhya Singh was not at all treated in their clinic. The conduct of the appellants indicates that they tried to suppress the material facts pertaining to the treatment given to deceased Lalti Devi. They wanted to disengage themselves from any kind of concern with the treatment of deceased Lalti Devi. Their total denial is blown-up on account of production of the prescription and the chitthas by the complainant. Bed head ticket of PMCH shows that deceased Lalti Devi was subjected to operation on 10.12.2001. It was found that she had not passed flatus and stool for three days. It was also found that there were three perforation in the SI and one perforation over the anterior surface of uterus. Though by way of last resort corrective operation was conducted yet she died at about 9:30 PM on 15.12.2001. 16. One cannot totally ignore the fact that deceased Lalti Devi was aged about 34 years. She was well-built and young woman. There is absolutely nothing on record to show that she was suffering from any serious ailment before her pregnancy. On the other hand, what appears from the record is that the appellants performed the operation for medical termination of pregnancy in hush-hush manner. They did not maintain any record about the termination of pregnancy. Obviously, it is difficult to say whether the medical termination of pregnancy was advisable and required. This could be clarified only by the appellants. However, they attempted to put everything under the carpet and adopt a stance of total denial. The cause of death as shown by PMCH, Patna is due to R ante mortem. 17. We are of the opinion that the conduct of the appellants give rise to adverse inference against them. The question of edical negligenceis not only related to negligence in the treatment of a patient but is inclusive of impropriety in dealing with the patient by conducting DNC procedure (abortion) without preparing any record about the same and showing the medical exigency. The medical practitioner may be guilty of negligence for lack of post-operative care too. In our opinion, the appellants did not take proper care while conducting the DNC procedure nor it is shown that such procedure was necessary to save life of the child in the womb or of the mother. We hasten to add that the abortion was carried out in clandestine manner and, therefore, the State Commission was right in holding the appellants guilty of medical negligence. 18. Going by the sequence of events, the fact that the appellants prescribed medicines like Cifran etc. indicated that they were aware about the complications which had occurred as a result of the medical termination of pregnancy. We are of the opinion that they tried to destroy the material evidence pertaining to the treatment given to deceased Lalti Devi and as such have committed unfair medical practice which is no short of medical negligence on their part. This is a case in which principle of es ipsa loquitoris squarely applicable having regard to the attending circumstances, conduct of the appellants and the fact that within a short span after the medical termination of pregnancy the young woman lost her life. In amesh Jain (Dr.) Vs. Jagroop Singh & Ors.[(2008) I CPJ 233 (NC)], this Commission held that when gut loop was cut during DNC / abortion which required second operation, death of patient due to septicaemia could be attributed to deficiency in rendering the medical services. This Commission, therefore, had confirmed order of the State Commission whereby the complaint was allowed. 19. Taking over all view of the matter and in view of the reasons discussed hereinabove, we find ourselves in general agreement with findings of the State Commission. Needless to say, there is no merit in the appeal. The appeal is accordingly dismissed with costs of Rs.10,000/-. The statutory amount deposited by the appellants alongwith accruals, be transferred to the State Commission for payment to be made to the complainant (respondent no. 1).