By Sri. K. Gheevarghese, President:

The complaint filed is for compensation alleging medical negligence in the treatment of the Complainant by the Opposite Parties.

2. The complaint in brief is as follows:- The Complainant had undergone hysterectomy surgery from the hospital of the 1^st Opposite Party and treated by the 3^rd and 4^th Opposite Parties. The surgery was conducted for the relief from the complications that the complaint was enduring. The hysterectomy was done on 01.09.2005. The negligent and caution less surgery done by the Opposite Party No.3 and 4 lead to the complications of the surgery. Subsequently the Complainant had discomfort of leaking of urine and felt uneasiness and nervousness. The stomach of the Complainant was bulged, on enquiry it was explained that the switches were broken. Later the Complainant had to undergo an another operation from the same hospital for the rectification of the disorder. The Complainant had no substantial recovery from the ailments and later on reference she was admitted in Medical College Hospital Calicut to repair the leakage of bladder. The Complainant availed the treatment as inpatient from 01.12.2005 to 23.12.2005, on advice of the treated Doctor, Complainant had to take bead rest and the avocation of the Complainant as a sweeper was also lost due to the discontinuity of the service. The Complainant had to undergo an another operation anticipating the recovery from the complications of surgery from Sri Sathya Sai Institute of Higher Medical Science. All the earnings of the Complainant along with the 7 cents of landed property were disposed for the treatment expenses how ever the Complainant was not recovered from the ailment due to the negligence of treatments of 3^rd and 4^th Opposite Parties. The 5^th Opposite Party is the insurer who undertook to compensate if any uneventful or any causality took place in treatment. There may be an order directing the Opposite party give the Complainant Rs.10,00,000/- as a compensation towards negligence of medical treatment by the Opposite Parties along with cost.

3. The Opposite Parties No.2 to 4 filed version. The 1^st Opposite Party was declared exparte. The Opposite Parties were issued notice condoning the delay of 365 days as order in I.A. No. 304/08 dated 20.11.2008.

4. The 5^th Opposite Party was supplemented and also version filed by them. The sum up of the version filed by the Opposite Parties No.2 and 3 is as follows. The Complainant found to be have multiple fibroid uterus on ultra sound scanning for which the hysterectomy was advised and it was done on 01.09.2005 the formalities required prior to the surgery was applied by this Opposite Parties. The surgery was done by the Opposite Parties No.2 to 4. There was no carelessness or any negligence on the part of the Opposite Parties. In the hysterectomy surgery there were lot of adhesions between bladder and uterus and surrounding peritoniums which was the reasons for the recurrent pelvic infection of the Complainant. The immediate post operative period was uneventful whereas on the 3^rd post operative day it was complained of dripping of urine from vagina. The complainant suspected to be having vesico vaginal fistula which warrants immediate repair and subsequently the repair was done in an another surgery and on 10^th post operative day. The Complainant was discharged of within dwelling catheetre and antibiotic. The Complainant was also advised for regular follow up but was not turned up. There is no carelessness or negligence on the part of this Opposite Parties. The allegation of the Complainant that the adhesions were removed rashly and negligently are absolutely baseless. The entire treatments were effectively done with due care and caution. The injury occurred accidentally while the bladder has been supported from interial uterine valve. The vesico vaginal fistula was in turn of the negligence and rashness of treatment are denied. The subsequent treatments and surgery of the Complainant after the discharge from the 1^st Opposite Party's Hospital was not in aware of the Opposite Parties. The leakage of the bladder was ruled out and the patient was discharged from the hospital. The negligence in the treatment of the Opposite Parties to the complainant made the Complainant to forsake her job was also denied by the Opposite Parties. The allegation of the Complainant that she had to undergo rests months after months had no connections with the treatments. The claim of the Complainant is not supported by any reasons and it is also an exaggerated one. The complaint is to be dismissed with cost.

5. The 4^th Opposite Party filed version in short it is as follows:- The service of the 4^th Opposite Party was to assess the 3^rd Opposite Party in surgery. The hysterectomy with bilateral salpingo oophrectony was done under spinal anesthesia keeping up all the formalities required prior to surgery. The Complainant had recurrent pelvic infection which lead to hysterectomy. There were lot of adhesions between bladder and uterine surrounding as usual with the patient who are having pelvic infection. The post operative period was uneventful but only on 3^rd post operative day. It was complained of dripping of urine through vagina. The vesico vaginal fistula was traced out was again. After the repair of bladder the patient was discharged on the 10^th post operative day. The patient did not turn up for the follow up treatments. The allegation of the Complainant that the adhesions were supported rashly and negligently is absolutely wrong the fistula are complication of the hysterectomy surgery. The Complainant had no discomfort as such alleging the bulging of stomach. The switches were not broken as alleged by the Complainant. The vesico vaginal fistula was the known complication following the surgery. The 4^th Opposite Party even attempted to correct fistula formation on the day itself but it was not successful and hence the patient was advised for another 6 months before making 2^nd attempt. The allegation of the Complainant that she had to undergo for major operations are denied by the 4^th Opposite Party. The financial conditions and other circumstances of the Complainant are not known to the 4^th Opposite Party. The treatment rendered by the 4^th Opposite Party was done in due care and caution. The complaint filed is frivolous vexatious and it is to be dismissed with cost.

6. The sum up of the version filed by the 5^th Opposite Party is as follows:- The 5^th Opposite Party had issued a policy in favour of the Aroma Medical Center covering the provisional negligence. The policy indemnify the claims arising out of bodily injury and /or death of any patient caused by or alleged to have caused by error or omission or negligence in provisional service rendered by the insured or qualified assistance in 9^th schedule any intentional disregard of the insurance technical or administrative and the management of the insured does not cover the liability. There is no deficiency on the part of the Opposite Parties No.1 to 4 and 5^th Opposite Party has no knowledge and no claim was forwarded to the 5^th Opposite Party. Hence the complaint is to be dismissed with cost.

7. The Opposite Parties No.2, 3 and 4 filed I.A No. 169/09 and submitted that in pursuance of the ruling of the Hon'ble Supreme Court in Civil Appeal No. 3541/02 in Martin F. D Souza case. It is held that in the matters connected to medical negligence it is to be referred to an expert and committee of expert doctors specialized in that field and the report of them is to be received to know whether primaficea negligence exists in the treatments. The Respondent/Complainant did not filed counter and also submitted for the Complainant that the petition can be allowed, the I.A No.169/09 was allowed. In pursuance of the order in I.A No.169/09 report was called from the board of medical experts at District Hospital Mananthavady and report was filed. According to the opinion of medical board District Hospital Mananthavady it is as follows “V.V.F is a known complication of total abdominal hysterectomy-Incidence is around 0.5-2% following TAH.Board has the opinion that there is no primai facie medical negligence. However an expert opinion from a urologist may be obtained”. The Medical Board however suggested an opinion from the expert of Urologist. Subsequently for an expert opinion from medical board of Urologist is sought from Medical College Hosiptal, Calicut. The records produced by the complainant was also sent for detail opinion of the Medical Board. In the opinion of medical board consists Dr. Shunmugha Das, Asst. Professor, Urology, Dr. Lakshmy. S, Asst. Professor, Obstretics and Gynaecology of Medical College, Calicut going through the complaint and according to them, There is no medical negligence on the part of doctors who involved in the case of the Complainant. On verification of available records and the report was filed. The report of the medical board of the District Hospital, Mananthavady and in the opinion of the medical board of the Medical College Hospital Calicut, there is no primai facie negligence on the part of the doctors who treated the complaint from the 1^st Opposite Party's hospital. In pursuance of the report filed by the medical board. We are in the opinion that the allegation of medical negligence against the Opposite Parties cannot be considered for adjudication in the light of the ruling of the Hon'ble Supreme held in Martin F.D Souza V/s Mohd. Ishfaq case.

In the result, the complaint is dismissed no order as to cost.

Pronounced in open Forum on this the the day of 30^th June 2010.