KERALA STATE CONSUMER DISPUTES REDRESSAL COMMISSION

VAZHUTHACAUD, THIRUVANANTHAPURAM

APPEAL No.586/2014

JUDGEMENT DATED: 16.01.2024

(Against the Order in O.P.No.72/2009 of CDRF, Pathanamthitta)

PRESENT:

APPELLANT:

(by Adv. Narayan R.)

Vs.

RESPONDENTS:

(by Advs. G.M. Idiculla & S. Reghukumar)

(by Adv. M.C. Suresh & C.S. Rajmohan)

JUDGEMENT

SRI. AJITH KUMAR D. : JUDICIAL MEMBER

          This is an appeal filed by the complainant in C.C.No.72/2009 on the file of Consumer Disputes Redressal Forum, Pathanamthitta (the District Forum for short) against the order passed on 24.10.2014.  The complainant had filed a complaint seeking for compensation for medical negligence against the opposite parties which was dismissed by the District Commission.  Being aggrieved with the above order, this appeal has been filed.

The allegations in the complaint in short are as follows:

          2.       The complainant was admitted in the Government Hospital Kozhenchery on 01.11.2007 in connection with her pregnancy.  Since the operation theatre in the Government Hospital was closed, the complainant was referred to Poyyanil Hospital Kozhenchery on 02.11.2007 and got admitted there on at 2 p.m. on that day itself.  A caesarean section was conducted at 8 p.m. after administering Spinal Anaesthesia and delivery was effected.  A male child was born.  During surgery the complainant became unresponsive and went into a deep coma.  She was taken to Pushpagiri Hospital, Pathanamthitta for better management.  She availed treatment as inpatient in the said hospital till 16.11.2007 and later continued treatment at the Medical College Hospital, Kottayam till 29.11.2007.  The doctors attached to the Medical College Hospital Kottayam had diagnosed the case of the complainant as “Post LSCS-Hypoxic ISHEMIL Encephalopathy” which condition occurred due to the improper administration of Anaesthesia.  After prolonged treatment, the complainant got recovered from the coma stage, but still she is in a vegetative condition and unable to do anything for herself.  She has become permanently disabled and unfit to perform any job.  There was gross negligence on the part of the opposite parties in treating the complainant.  The complainant had sought for compensation of Rs.20,00,000/-(Rupees Twenty Lakhs Only) along with interest from the opposite parties.  She had also sought for realisation of an amount of Rs.4,25,835/-(Rupees Four Lakhs Twenty Five Thousand Eight Hundred and Thirty Five Only) being the amount spent for her treatment. 

3.       Initially, the complaint was filed against the hospital alone.  But later, additional opposite parties 2 to 4 were impleaded.  An additional contention was incorporated to the effect that before administration of anaesthesia, the complainant and her relatives had informed the 3^rd and 4^th opposite parties that the complainant was an Asthma patient.  But the doctors, without paying due attention to the said information proceeded ahead with caesarean section by administering anaesthesia without resorting to necessary safeguards. 

4.       The 1^st opposite party had filed a version with the following contentions:

The complaint is not maintainable either in law or on facts.  There is purposeful suppression of facts in the complaint regarding the treatment availed by the complainant immediately before she was admitted in the opposite party hospital.  The complainant was expecting an early delivery and got admitted in the District Hospital, Kozhenchery, though her due date for delivery was around 10.11.2007.  She was attended by Dr. Saraswathy at the Government Hospital.  As per the reference letter issued by the Government Hospital, it is seen that the complainant was referred at 6.30 p.m. on 02.11.2007.  The reference records would further show that on 01.11.2007, the complainant came to the hospital with labour pain and on 02.11.2007 morning per vaginal examination was done and labour was induced.  At 4 p.m. artificial rupture of the membrane was also done.  The complainant was referred to the 1^st opposite party hospital after undergoing various tests and treatments at the District Hospital, Kozhenchery.  At 6 p.m. she was admitted due to labour pain and on per vaginal examination, two finger dilation was present. On further examination, the fluid was found moderately thick with meconium and the baby continued in distress.  Amino infusion was given at the District Hospital for the purpose of washing off the meconium. After the lapse of more than thirty six hours of waiting caesarean section was planned.  When drip was given for speeding up the delivery, a caesarean section also would been planned as an alternative or as a stand-by procedure. But nothing was done and the condition of the foetus and the mother was out of control and ultimately by 7 p.m. on 02.11.2007 the patient was referred to the 1^st opposite party hospital.  On examination her BP was 140/90 and pulse rate 120 per minute.  Mother was fully dehydrated.  But the dilation was only two finger and the condition of the baby was critical as the head of the baby was blocked or jammed in the pelvis. The baby having obstructed for labour the only alternative available was caesarean section.  The life of the mother and baby was in danger and the situation was explained to the relatives of the patient and after obtaining their consent, caesarean section was done.  Blood was required but there was no donor available with the patient.  Hence, cross matched blood available with the opposite party’s blood bank was arranged and the patient was moved to the operation theatre for further follow-up.  Through caesarean the baby was taken out.  But the baby was asphyxiated.  The Paediatrician was entrusted with the baby who did all the requisite steps for revival of the baby. Spinal Anaesthesia was administered which is the best anaesthetic treatment.  After the delivery the complainant had difficulty in breathing.  She had Bronchospasm and oxygen saturation of blood dropped.  Oxygen and other medication was administered but her condition did not improve and she became unconscious.  An endotracheal tube was inserted to her trachea to establish artificial ventilation.  But her lungs could not be ventilated due to severe bronchospasm.   Medicines were again administered.  Cardiac resuscitation was done as heart arrest occurred and continued till bronchospasm got relieved and heart started functioning.

 5.      These complications triggered by amniotic fluid embolism, a condition caused by the discharge of amniotic fluid, foetal debris of meconium into mother’s blood which is neither predictable nor preventive.  Spinal anaesthesia was beneficial in patients with bronchospasm.  The patient was transferred to Pushpagiri Medical College after her cardio respiratory status stabilised and her neurotic status improved.  The Anaesthetist had accompanied the patient.  The complainant had suppressed the treatment availed from the District Hospital, Kozhenchery from 01.11.2007 till 7 p.m. on 02.11.2007.  In fact, the opposite parties were at fault in admitting the patient when the child and mother were on the verge of collapse after a treatment failure from morning of 01.11.2007 till 7 p.m. on 02.11.2007.

6.       The 1^st opposite party had filed an additional version stating that the stand taken by the complainant in disclosing her allergic complication was only an after thought.

7.       The 2^nd opposite party had also filed separate version identical to the contentions raised by the 1^st opposite party.  So those contentions are not reiterated.  There was no deficiency in service on the part of the 2^nd opposite party.  The 2^nd opposite party would admit that a medi-claim policy was availed by the 1^st opposite party for the period from 24.07.2006 to 25.04.2008.  But they denied the liability to indemnify the insured on the ground of violation of policy conditions.  The insured was duty bound to give written notice to the company at the earliest to any claim made against the insured for specific reasons or circumstances that may give rise to a claim being made against the insured.  The 2^nd opposite party also sought for dismissal of the complaint.

8.       The additional 3^rd and 4^th opposite parties had filed a joint version with the following contentions. 

The complaint is not maintainable either in law or on facts.  There was no negligence or deficiency in service.  The claim against the 3^rd and 4^th opposite parties is barred by limitation as they were impleaded as parties to the proceedings after expiring the period of limitation.  The complainant was admitted to the 1^st opposite party hospital at 7.30p.m. on 02.11.2007.  She was referred with “obstructed labour meconium with foetal distress” for further management on the reason that the operation theatre in the Government Hospital was closed for maintenance.  The complainant was admitted to the Government Hospital on 01.11.2007 with a complaint of labour pain and labour induction followed by artificial rupture of membrane.  On noticing thick meconium stained liquor, amino infusion was done and the complainant was referred on 02.11.2007.  She was diagnosed with obstructed foetal distress and had a history of pregnancy induced hypertension.  Per vaginal examination revealed cervix 25% effaced, caput present and Vx at 1 station.  In view of obstructed labour, foetal distress and symptoms of suggestive prolonged labour, it was decided to admit the complainant and to proceed with emergency caesarean.  After taking all precautions, the 4^th opposite party had conducted emergency caesarean under spinal anaesthesia.  Spinal anaesthesia is most commonly employed and accepted modality of anaesthesia in a caesarean section.  After caesarean section, a totally asphyxiated baby was extracted at 8.31 p.m. and handed over to the Paediatrician.  After the delivery, the complainant developed difficulty in breathing.  She had respiratory arrest and was treated with Endotracheal intubation.  Adrenaline was given but was still unable to ventilate the patient.  Deriphyllin and steroids were started but pulse rate got down and BP not recordable.  Bronchospasm remained refractory and the patient suffered cardiac arrest. Immediate cardiac resuscitation was started and oxygen was provided through Endotracheal tube.  By 8.46p.m. the complications started to slow down and the patient was ventilated. Physician and Neuro-Physician were consulted and the line of management was as per accepted protocol.  At about 9.15p.m. marked clinical progress was shown and it was decided to shift the patient to Pushpagiri Hospital for further management.  The 3^rd opposite party had accompanied the complainant when she was taken to the Pushpagiri Medical College.  The sudden occurrence of Bradycardia, hypertension and cardiac arrest was provisionally diagnosed as triggered due to Amniotic Fluid Embolism.  The 3^rd and 4^th opposite parties had exercised due care and assistance in providing emergency treatment by conducting caesarean section for obstructive labour and foetal distress.  The complication arose due to the unexpected spontaneous emergence of Amniotic Fluid Embolism and it was on account of the timely treatment, the complainant got recovered and started breathing as normal.  Neurological impairment is common in such patients but this condition was managed in time.  The complainant had not stated the true and correct facts with respect to the treatment in Government Hospital, Kozhenchery.  The Gynaecologist attached to the Government Hospital did not undertake emergency caesarean in such a case of obstructed labour with meconium stained foetal distress and referred for a reason that the operation theatre was not repaired.  The complainant was attended and expeditious caesarean operation was done with due care and caution.  Hypoxic damage can be caused due to lack of oxygen supply to the brain on account of Amniotic Fluid Embolism.  This is purely an obstetric complication due to obstetric anaesthesia.

9.       The entire allegations contained in the complaint were denied by the opposite parties.  The complainant has no cause of action against the opposite parties.  The 3^rd opposite party has been working as an Anaesthetist for the last fifteen years.  He has got a good service record.  The 4^th opposite party has been working as a Gynaecologist with twenty two years of experience.  The opposite parties would seek for dismissal of the complaint.

10.     An additional version has been filed by the 3^rd opposite party that the complainant or her relatives never informed any of the opposite parties that the complainant was an asthma patient.  Such an allegation is raised with an ulterior motive which is against her treatment records.  Since the 3^rd and 4^th opposite parties were the employees of the 1^st opposite party, the 1^st opposite party is vicariously liable for all such liabilities if anything occurs during the course of their service.

11.     In the appeal memorandum the complainant has reiterated the entire pleadings in the complaint and added the following contentions:

The District Commission ought to have awarded compensation.  The District Commission ought to have found that no one can find fault with the complainant in not specifically mentioning the negligent act committed by the doctors in the treatment and administering of anaesthesia since the case sheet was not furnished to the complainant even after four years after filing the complaint.  The District Commission ought to have found that administration of anaesthesia and treatment can be ascertained only by perusing the treatment records.  The District Commission ought to have found that PW5, the sister of the complainant had adduced evidence to the effect that the complainant was an asthmatic patient which fact was disclosed to the doctors.  The District Commission failed to take note of the evidence let in by DW1, the Anaesthetist that if the fact that the complainant was an asthmatic patient was disclosed the complainant could have been provided with steroids, bronchodilators and nebulisation and even in minor surgeries the history of asthma will be elicited.  The District Commission ought to have found that it was the primary duty of the doctors to rule out asthma and other allergic conditions before conducting the surgery.  The District Commission ought to have found that in Exhibit B1(a) it is recorded that the complainant had a history of bronchial asthma which was not divulged to them.  The District Commission ought to have found that in the version of the doctors there is no case that they have ruled out asthma by collecting necessary information from the complainant as there was no pleadings in the versions filed by them.  The District Commission ought to have found that CW1 had given evidence that improper administration of anaesthesia may cause hypoxic encephalopathy.  The appellant would seek for setting aside the order of the District Commission.

12.     Heard the counsel of the appellant and all the respondents. Written notes of argument filed by the counsel for the appellant.  The records from the District Commission were called for and perused.

13.     The evidence consists of the testimonies of PWs 1 to 5 on the side of the complainant.  Exhibits A1 to A17 and A18 series were marked.  DWs 1 and 2 were examined on the side of the opposite party.  Exhibits B1 series were also marked on their side.  An expert witness was examined as CW1.  Exhibits C1 and C2 were also marked.

14.      The husband of the complainant had given evidence as PW1.  Exhibit A1 is the Power of Attorney executed by the complainant in favour of PW1.  On 23.07.2008 a lawyer notice was issued on behalf of the complainant to the 1^st opposite party.  The copy of the notice is exhibited as A1.  Copy of the reply notice sent by the 1^st opposite party is marked as Exhibit A2.  Counsel for the appellant would attribute deficiency in service on the side of the opposite party for the reason that the opposite party had declined to provide the medical records though a request was made to them.  In Exhibit A1 the complainant had requested the 1^st opposite party to furnish the case sheet and the name and address of the doctors.  But the opposite party neither furnished the address of the doctors nor sent a copy of the case sheet. 

15.     Counsel for the appellant had cited a ruling of the Apex Court reported in Maharaja Agrasen Hospital & Ors. Vs. Master Rishabh Sharma & Ors. 2020 (6) SCC 501.  It was a case where negligence on the part of doctors was established in not providing medical care as per the protocol to a premature baby which resulted in complete blindness of the child.  After reaching such a conclusion the Apex Court was inclined to uphold the finding of the National Commission regarding the medical negligence attributed against the doctors.  The learned counsel for the appellant did not cause production of the entire text of the ruling.  It was a case of a pre-term baby who was referred to the hospital for management.  The baby stayed in the hospital for almost four weeks.  During the treatment there was no advice or recommendation for Retinopathy of Prematurity (ROP) check-up and ultimately the child became totally blind.  The original medical records were not produced but later copies of the medical records alone were produced wherein wrong entries were made to the effect that there was advice for ROP check-up.  The false entries in the copy of the medical records produced was considered by the National Commission and ultimately entered into a finding that the doctors were negligent in providing treatment to the new born baby. 

16.     The learned counsel would also place reliance upon a ruling of the National Commission reported in Apollo Hospitals & Anr. Vs. M. Satyanarayana & Anr. 2011(2) CPR 271 (NC) 271 to substantiate this contention.  It was a case where the Apollo Hospital had declined to cause production of the medical records for the reason that the treatment records were misplaced in the process of transfer of the patient to another hospital.  The National Commission made observations that computerised records could have been retrieved and produced.  The National Commission had affirmed the stand taken by the State Commission in drawing an adverse inference against the hospital in not causing production of the medical records.  In the above ruling, the stipulations imposed by the Medical Council of India in retaining the medical records are seen reiterated.  The stipulations of the Medical Council is that if any request is made for any medical records, the document shall be issued within a period of seventy two days.  It is also obligatory on the part of the hospitals to retain the medical records for a period of three years.  The rulings cited by counsel for the appellant are not applicable to this case since the opposite parties had caused production of the medical records before the District Commission.

17.     In view of the evidence discussed above, the Apex Court had made observations regarding the responsibility of the doctors to cause production of the medical records at the earlier point of time.  Here, the opposite parties had caused production of the medical records and adjudication was done by the District Commission by taking into account of the medical records produced.  There was no prejudice caused to the complainant as discussed in the citations relied upon by the complainant.  We are not inclined to accept those authorities since the facts and circumstances of this case are entirely different. 

18.     The learned counsel for the appellant, before starting his argument had cited these authorities and requested us to reach a conclusion that the opposite parties were negligent in providing treatment to the complainant.  precedents could be accepted if found suitable to the facts and circumstances of the case.  In the original complaint, there was no version that the complainant was an asthma patient and the said fact was disclosed to the doctors before the surgery.  Such a contention was brought into the pleadings at a belated stage by way of amendment.  The learned counsel for the complainant would submit that the District Commission had rejected the prayer for amendment against which a revision was filed before the State Commission.  The revision filed by the appellant was allowed and the complainant was allowed to incorporate additional pleadings as sought for in the amendment.  While allowing the amendment, no rider was fixed by the State Commission that the amendment does not relate back to the original date of filing of the complaint.  If no such rider is fixed while allowing the amendment, it is presumed the amendment relates back to the date of filing of the complaint. 

19.     Counsel for the complainant placed reliance upon the ruling of the Hon’ble Supreme Court in Prithi Pal Singh & Ors. Vs. Amrik Singh & Ors 2013 (9) SCC 576.  It is true that there was no rider fixed by the State Commission restricting the effect of amendment retrospectively.  If no such rider is there, it has to be construed that the amendment had come into effect from the date of filing of the complaint.  But the evidence adduced by the complainant in this regard has to be appreciated.  The husband of the complainant was examined as PW1.  He had no case that his wife was suffering from bronchial asthma and the said fact was disclosed to the opposite parties.  The medical records produced by the opposite party as Exhibit B1 bears an entry that the complainant had a history of bronchial asthma which was not divulged to them prior to the surgery.  This entry has been marked as Exhibit B1(b). 

20.     The complainant had subsequently examined PW5, the sister of the complainant who spoke before the Commission that the complainant was suffering from bronchial asthma which fact was divulged to the doctors prior to the surgery.  But in the cross examination, PW5 had given evidence that prior to the delivery of her sister, the complainant had never undergone any treatment for asthma.  This version is seen in the last sentence of the cross examination of page 6 and the first sentence in page 7 of the deposition of PW5.  If PW5 had stated that the complainant was suffering from bronchial disorders, before the surgery one would expect the doctors making entry in the medical records in that regard.  The doctors had made entry that the complainant was undergoing treatment for hypertension during the period of pregnancy.

21.     In the complaint there was deliberate suppression of material facts regarding the treatment availed by the complainant from the Government Hospital, Kozhenchery.  Several treatments were given by one doctor Saraswathy when the complainant was admitted in the Government Hospital, Kozhenchery.  The medical records produced and marked as Exhibit B1 bears entries regarding the treatment provided for the complainant from the Government Hospital, Kozhenchery.  PW5 had given evidence in this regard.  According to PW5 the complainant had reported before the Government Hospital at 11 a.m on 01.11.2007 and Dr. Saraswathy had examined her.  From morning 11a.m. on 01.11.2007 till 6p.m. on 02.11.2007 the complainant was in the Government Hospital.  Ultimately Dr. Saraswathy had referred the complainant to the 1^st opposite party hospital for the reason that the operation theatre in the Government Hospital was closed.  In Exhibit B1 the history of the complainant is seen written in the first page that the patient was admitted at 7.30p.m. as referred from Government Hospital as “obstructed labour with stained liquor”.  She was induced for labour on 02.11.2007and when the labour was obstructed with foetal distress and was resuscitated the complainant was referred to the 1^st opposite party’s hospital.  So it was an emergency case and there was no time for the opposite party to conduct a thorough check-up.   Hence, caesarean was conducted. 

22.     The case of the opposite party is that during the surgery, complication arose as the complainant had difficulty in breathing.  Ultimately, the complainant was referred to Pushpagiri Medical College.  The medical records pertaining to the Pushpagiri Institute of Medical Science and Research Centre have been produced and marked as Exhibit A14 series.  The number assigned to the document as A series does not appear to be correct as it was a document produced by a third party which ought not have been marked as A series.  The complainant had examined PW4, the Neurologist attached to the Pushpagiri Medical College.  He tendered evidence regarding the entries contained in Exhibit A14 and the treatment given to the complainant.  In Exhibit A14 it is noted that the complainant had a case of bronchial asthma.  PW4 had diagnosed the case of the complainant as hypoxic encephalopathy.  PW4 had given evidence that the above situation arose when the oxygen supply to the brain got blocked.  Four reasons are noted by PW4 as his diagnosis.

(1)  Hypoxic injury secondary to spinal anaesthesia

(2)  Amniotic fluid embolism

(3)  Acute bronchospasm

(4) Septicaemia with hypertension.

23.     While the complainant was undergoing treatment in the Government Hospital, Kozhenchery artificial rupture of the membrane was done and in such cases there is a possibility of septicaemia which fact was spoken to by PW4 in the cross examination.  When septicaemia occurs, the entire complications noted in Exhibit A14 may arise.  Several precedents were cited by the counsel for the appellant to the effect that the principles of “Res Ipsa Loquitur” applies in a case of medical negligence and hence the burden is upon the doctors to tender evidence that they had taken all proper care while providing treatment to the patients.  The learned counsel has cited a decision of the Tamil Nadu State Consumer Disputes Redressal Commission reported in Kanyakumari District Co-operative Hospital Vs. Ramesh Babu & Anr. CPJ 106 TN (2019).  It was a case where the victim lady came to the hospital in walking condition with mild labour pain.  While administering anaesthesia, the patient developed fits.  No arrangements were made by the hospital to provide proper medication and the lady had to remain in a vegetative condition.  The facts of the ruling are not applicable to this case for the reason that the complainant did not reach this hospital directly.  She was brought to the hospital in a critical stage after the initial treatments given by Dr. Saraswathy from the Government Hospital.  If the operation theatre in the Government Hospital was not functioning, the complainant ought not have been admitted there and effected artificial rupture of membrane.  The entire complications arose from the Government Hospital which is evident from the medical records brought by the 1^st opposite party as Exhibit B1.  The patient was brought with obstructed labour and meconium stained liquor.  She was induced labour from the Government Hospital on 02.11.2007 and only when the delivery was obstructed, she was referred.  It is also brought out in evidence that her uterus was washed from the Government Hospital by applying drip through vagina. 

24.     The case of the opposite parties was that at the time of delivery the complications arose and the complainant was referred to the Pushpagiri Medical College.  Disability certificate issued by the Medical Board is marked as Exhibit C1.  Final diagnosis is also seen in Exhibit C1 as “cognitive impairment generalised choreoathetosis and pseudobulbar palsy secondary to hypoxic brain damage”.  The cause of hypoxic brain injury is stated as amniotic fluid embolism or aspiration pneumonia leading to respiratory failure.  Amniotic fluid embolism is a rare complication which may occur during surgery.  Here the possibility of amniotic fluid embolism cannot be ruled out since meconium stained liquor was noticed and the labour was obstructed while the complainant was in the Government Hospital.  Washing of the uterus was also done at the Government Hospital and thereafter the patient had reached 1^st opposite party’s hospital.  It was a critical condition. 

25.     The learned counsel for the complainant would submit that if the doctors attached to the 1^st opposite party had conducted a test to ascertain the ESR it was possible for them to understand as to whether the patient had bronchial disorders.  The reports regarding the examinations conducted at the hospital attached to the 1^st opposite party are seen marked as Exhibit A15 series wherein no tests to ascertain ESR was done.  Such a thorough examination may not be possible for a patient brought in a critical condition as delay in conducting surgery may be fatal to the mother as well as her child.  If the complainant or her bystanders had disclosed the prior history of bronchial disorders, the doctors would have been more alert at the time of conducting the surgery.  There was failure on the part of the complainant and her bystanders in disclosing the prior history of bronchial asthma to the opposite party.  It was not a case of direct visit in the hospital.  It was a referred case and the patient had reached the 1^st opposite party hospital in a critical condition.  When medical negligence is attributed, the primary duty is upon the complainant to establish her case.

26.     On evaluating the entire evidence tendered by the complainant, it could be seen that all precautionary measures were taken by the opposite parties when treatment was given to the complainant though she was brought in the hospital in a critical condition with a complaint of obstructed labour.

27.     The learned counsel for the opposite parties had placed reliance on Oxford Handbook of Anaesthesia wherein amniotic fluid embolism has been elaborately discussed.  Amniotic fluid embolism is the fourth most common direct cause of maternal death in United Kingdom.  The effect of amniotic embolism may be due to anaphylactic response to foetal distress within the first thirty minutes. After amniotic fluid embolism pulmonary vasco constrictions occurs which may associate with right heart failure, Hypoxia, hyper cardiac and acidosis.  This is followed by left heart failure and pulmonary oedema.  Obstructed labour is one of the causes for sudden collapse with hyper tension and foetal distress.   When amniotic fluid embolism occurs, the only treatment which can be given is airway, breathing and circulation.   Intensive care is required for those who survive initial insult. 

28.     The learned counsel had also placed reliance upon the Oxford Handbook of Anaesthesia on the administration of anaesthesia in respiratory disease.  Spinal anaesthesia is desirable to patients with a history of bronchial asthma.  According to the learned counsel spinal anaesthesia was given to such patients.  If general anaesthesia was given probably some complication may arise on account of bronchial disorders of the complainant.

29.     On a cumulative analysis of the entire evidence on record it can be seen that the complainant had suppressed the initial treatments availed by her from the Government Hospital, Kozhenchery.  The opposite parties had raised a specific contention that since the complainant was brought to the hospital in a critical condition with obstructed labour along with meconium stained liquor, the condition was emergent and hence caesarean was immediately done. The complainant did not examine the doctor who treated the complainant from the Government Hospital.  The evidence on record would show that all precautionary measures were taken by the opposite party's as per the medical protocol.  When a complication arises and an unpleasant event occurs, that circumstance alone cannot be taken into account to reach a conclusion that the doctors were negligent in providing treatment to the complainant.  On evaluating the entire evidence, it could be seen that the complainant had miserably failed in proving the medical negligence attributed against the opposite parties and it can be safely concluded that the opposite parties had given the treatment as per the medical protocol.  The District Commission had appreciated the evidence in the proper manner and rightly reached a conclusion that the complainant had failed in proving the case of medical negligence.  We find no merit in the appeal filed by the appellant.  So the appeal is only to be dismissed.

In the result, the appeal is dismissed. On consideration of the peculiar circumstances of the case, it is found that the parties shall bear their respective costs. 

SL