CHITRA v. DR.MALATHI M.D DGO GOVERNMENT DOCUTOR

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that a sum of Rs. 50,000/- would be required for the same. Accordingly the complainant got admitted at the opposite party hospital on 12-06-2023 and the above said amount was paid to the opposite party and she was informed that the bill would be provided along with the discharge summary. The surgery was performed by the opposite party on 13-06-2023. The opposite party had informed that during the surgery the complainant had suffered cardiac arrest and had gone into coma and advised to get her admitted at Madurai Meenakshi Mission Hospital & Research Centre, Madurai for management of her medical condition and accordingly she was shifted by ambulance to the said hospital. The complainant had spend Rs. 4,00,000/- at Madurai Meenakshi Mission Hospital, Madurai for her admission as inpatient for the period from 13-06-2023 to 16-06-2023 and she remained in coma and they informed that she might require treatment for prolonged period which would need several lakhs of rupees. Accordingly she was shifted to Government Rajaji Hospital on 16-06-2023 and she inpatient up to 28- 08-2023 recovered from coma and discharged but she was not able to walk and able to talk properly. Subsequently the complainant was admitted as inpatient and got treatment from 30-09-2023 to 11-10-2023 at Aristo Hospital, Madurai and had spent around Rs. 1,50,000/- nursing assistants has been engaged round the clock to take care of her as she was bed ridden. The complainant had spent around Rs. 8,00,000/- as medical expenses in all the 3 hospitals. The complainant states that she had suffered acute pain and incurred exorbitant medical expenses to save her life due to the gross medical negligence and deficiency in service on the part of the opposite party. The complainant had sent lawyer notice to the opposite party claiming compensation of Rs. 15,00,000/- to compensate the unnecessary medical expenses incurred by her and for the mental agony, pain, anguish, indignation, helplessness suffered by her but the opposite party had sent a reply with false stand that she had provided free treatment to the complainant. The complainant states that opposite party is a private hospital and the allegation that she provided free of cost is absolutely false and made with intention to avoid any liability that would be saddled on her for her gross negligence and deficiency in service committed by her. The complainant submits that the act of the opposite party amounts to gross negligence coupled with deficiency in service which had resulted in mental agony and financial burden imposed on her. The complainant

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had lodged the complaint seeking to direct the opposite party to pay a sum of Rs. 10,00,000/- as compensation and cost of the complaint.

2. The crux of the opposite party written version is : -

The opposite party had denied all the averments and allegations made in the complaint are denied as false and incorrect except those that are specifically admitted by them. The opposite party had raised preliminary objection contending that Consumer Commission It was contended by the opposite party that it is a mandatory requirement for the Consumer Commission to refer complaint against medical professional to a committee of specialized medical professionals before proceeding with the case and only if the said committee finds a prima facie case can the Consumer Commission then admit the complaint and issue a notice to the opposite party. The complainant is not a consumer and the complaint is bad for non-joinder of necessary party namely Meenakshi Mission Hospital, Aristo Hospital Madurai and therefore deserves to be dismissed in view of these preliminary objections. The opposite party submits that the complainant had gynaecological issues for which ultrasound abdomen was taken and as per the instructions at Government Rajaji Hospital the complainant was advised hysterectomy. Further the opposite party admits that with the above reports she approached her and she was informed that abdominal hysterectomy is necessary and she willingly agreed and surgery was done at Saroja Memorial Clinic on 13-06-2023 by the opposite party. It was further submitted that her health condition was informed to the complainant and her daughter for the surgery and risks involved in the said surgery was explained. The opposite party submits that during the end of the surgery the complainant had sudden cardiac arrest and anaesthetist acted quickly and revived her and after which surgical procedure was over and this development was immediately informed to the complainant's daughter and relatives and was requested to shift her to Madurai Meenakshi Mission Hospital and Research Centre, Madurai for management and that she had not collected single penny from the complainant before or after the surgery on humanitarian basis she performed the surgery. The opposite party submits that there is no negligence or deficiency in service on her part and prayed for dismissal of the complaint.

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3. The complainant to prove her case had filed proof affidavit along with 16 documents and the same has been marked as Exhibit A-1 to A-16. The opposite party had filed proof affidavit along with 2 documents and the same has been marked as Exhibit B-1 to B-2.

4. The points for determination are : -

1. Whether the complainant is a 'consumer' and whether the present consumer complaint is maintainable ?

2. Whether the Consumer Commission is empowered to admit and adjudicate the a consumer complaint without referring and obtaining prior opinion from the Medical Board or Expert Committee ?

3. Whether informed consent was obtained from the complainant or her family members by the opposite party prior to hysterectomy ?

4. Whether there is any deficiency in service on the part of the opposite party ?

5. If so to what relief the complainant is entitled for ?

5. POINT NO. 1

We on perusal of the written version observed that the opposite party had raised preliminary objection contending that she had provided surgery free of cost to the complainant as she is from economically weaker section of the society. Our examination of the records reveals that the opposite party, by their own acknowledgment, runs a medical facility known as "Saroja Memorial M.M. Clinic,"

where they offer treatments to patients on the receipt of payment for the medical services rendered by them. It is crucial to note that the opposite party has not claimed or established that her operations are conducted purely on a charitable basis. This fact is pivotal in understanding the nature of the services rendered and the obligations that arise from such a commercial enterprise. In light of this

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context, the assertion made by the opposite party, that they provided treatment and performed surgery for the complainant without charging any fees, appears to be disingenuous and lacks credibility. This claim not only contradicts the established commercial nature of the hospital, which is predicated on the receipt of payment for the medical services rendered, but also raises significant questions about the veracity of the opposite party's statements. It is implausible that a hospital, which operates as a for-profit entity, would undertake surgical procedures without any expectation of remuneration. The opposite party's contention seems to be a calculated attempt to evade responsibility for the treatment provided to the complainant. By asserting that the surgery was performed pro bono, the opposite party seeks to create a façade of benevolence, thereby attempting to absolve herself of any potential liability that may arise from the quality of care provided. Moreover, the implications of such a claim extend beyond mere semantics, they touch upon the fundamental principles of accountability and transparency in health care. The opposite party's attempt to portray the treatment as a charitable act serves to obscure the contractual nature of the patient-provider relationship, which is inherently based on the exchange of services for fee paid by them.

6. In auxiliary the opposite party has asserted that she provides medical services to the general public and extends free treatment to individuals from economically disadvantaged backgrounds. However, this claim is fundamentally undermined by the circumstances surrounding the complainant's case. The opposite party referred the complainant to an eminent corporate hospital namely Madurai Meenakshi Mission Hospital & Research Centre, Madurai vide Exhibit B-2 to a higher-level medical facility for more effective management of her condition. It is noteworthy from records that the complainant had incurred substantial expenses for her treatment at this facility. This sequence of events directly contradicts the opposite party's assertion that the complainant belongs to the economically weaker section and that she received treatment and surgery entirely free of charge. If the complainant were indeed part of an economically disadvantaged weaker section, it raises significant questions about the rationale behind the complainant's reference to Madurai Meenakshi Mission Hospital & Research Centre, Madurai to a more advanced private medical institution, where the costs of treatment would be

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considerably higher rather than Government Hospital. Had it been true that the complainant belongs to a economically weaker section then she would have definitely referred her to the Government Rajaji Hospital, Madurai for better management of her medical condition. The fact that the complainant had to seek further treatment at the Madurai Meenakshi Mission Hospital and Research Centre, coupled with the financial burden she faced in doing so, casts serious qualm on the credibility of the opposite party's claims. It is implausible to maintain that the complainant was treated without charge while simultaneously requiring her to pay for subsequent medical care at a different facility. This inconsistency not only undermines the opposite party's argument but also highlights a lack of transparency and accountability. It would be appropriate and apposite to refer to the landmark judgement of the Hon'ble Supreme Court in the case titled as

Indian Medical Association Vs V.P. Shanta & Others reported in 1996 AIR 550 wherein the Court elaborated that even if a hospital offers free services to patients unable to pay, the income derived from paying patients supports the overall functioning of the institution. Thus, these services would still be considered within the Act's purview. This dicta of the Hon'ble Apex Court clearly supports and bolster the case of the complainant.

7. Moreover, the opposite party's narrative appears to be an attempt to deflect responsibility and evade liability for the treatment provided. By portraying the complainant as a member of the economically weaker section, they seek to create a misleading image of benevolence, which is starkly contradicted by the financial realities faced by the complainant in securing necessary medical care. The evidence presented clearly undermines the opposite party's claims regarding their charitable practices and the economic status of the complainant. The subsequent treatment at the Madurai Meenakshi Mission Hospital and the significant expenses incurred by the complainant serve to expose the inconsistencies in the opposite party's assertions, thereby calling into question their credibility and the integrity of her contentions.

8. In light of the above deliberations we are persuaded to conclude that the opposite party's assertion that they provided treatment and performed surgery for

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the complainant without charging any fees is not only implausible, lacks merit but appears to be a strategic maneuver designed to evade liability and hence the same deserves to be rejected outright.

9. Sequel to the above discussions we hold that the complainant is a consumer and the present consumer complaint is perfectly maintainable and adjudicatable by this Commission. Accordingly we answer Point No. 1 in favour of the complainant.

10. POINT NO. 2

We on perusal of the written version observed that the opposite party had raised preliminary objection contending that it is a mandatory requirement for the Consumer Commission to refer any complaint to a committee of specialized medical professionals before proceeding with the case. According to their argument, only if this committee finds a prima facie case can the Consumer Commission then admit the complaint and issue a notice to the opposite party and in support of the same the opposite party relied on the judgement of the Hon'ble Supreme Court in the case titled as Martin F. D' Souza vs Mohd. Ishfaq reported in AIR 2009 Supreme Court 2049. The ruling in Jacob Mathew (supra) is explicitly limited to the issue of medical negligence in the context of criminal prosecution, whether initiated through a formal complaint or an FIR. The findings articulated in paragraph 48 of Jacob Mathew (supra) unequivocally indicate that the Supreme Court was addressing a situation involving medical negligence that led to the prosecution of the implicated physician under Section 304A of the Indian Penal Code. However, the judgement of the Hon'ble Supreme Court in the case titled as V. Kishan Rao Vs. Nikhil Super Speciality Hospital & Anr. (2010) 5 SCC 513 has declared judgement in Martin F. D'Souza (supra) as per incuriam.

"Per incuriam" in legal contexts, refers to a decision made by a Court that is considered to have been rendered without proper consideration of relevant law or precedent. When a court's ruling is deemed per incuriam, it may be disregarded in future cases because it is viewed as not having the authoritative weight of a properly reasoned judgment. In practice, if a court finds that a previous decision was made per incuriam, it may choose not to follow that decision, especially if it conflicts with established legal principles or statutes.

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11. In this regard our mind is redolent and reminiscent to the judgement of the

HON'BLE SUPREME COURT in the case titled

DR. A. SRIMANNARAYANA

VS.

DASARI SANTAKUMARI & ANR.

vide its order dated 09-01-2013 in Civil Appeal No. 368 of 2013 arising out of S.L.P

(C) No.26043 of 2010 and Civil Appeal No. 369 of 2013 arising out of S.L.P (C) No.1495 of 2011 wherein the relevant extract from the said judgement is reproduced here below which reads as follows : -

" 5. The complaint was duly registered and notice was issued to the appellant and respondent No.2. Against the issuance of the notice, the appellant filed a revision petition before the State Consumer Disputes Redressal Commission, Hyderabad on the ground that the complaint could not have been registered by the District Forum without seeking an opinion of an expert in terms of the decision of the Supreme Court reported in Martin F. D'Souza Vs. Mohd. Ishfaq (2009) 3 SCC 1. In this revision petition, respondent No.2 filed I.A. No.2240 of 2009 praying for stay of proceedings before the District Consumer Forum. The State Commission rejected the revision petition by granting liberty to the appellant to file the necessary application before the District Forum to refer the matter to an expert. He did not file any application before the District Forum, but challenged the aforesaid order of the State Commission by filing Revision Petition No. 2032 of 2010 before the National Commission. The revision petition has been dismissed by the National Commission by relying upon the subsequent judgment of this Court in V. Kishan Rao Vs. Nikhil Super Speciality Hospital & Anr. (2010) 5 SCC 513, wherein this Court has declared that the judgment rendered in Martin F. D'Souza (supra) is per incuriam. Hence the present special leave petitions challenging the aforesaid order of the National Commission dated 15.07.2010.

9. The aforesaid observations leave no manner of doubt that the observations in Jacob Mathew (supra) were limited only with regard to the

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prosecution of doctors for the offence under Section 304A IPC.

10. The aforesaid observations and conclusions leave no manner of doubt that the judgment rendered by a two-Judge Bench of this Court in the case of Martin F. D'Souza (supra) has been correctly declared per incuriam by the judgment in V. Kishan Rao (supra) as the law laid down in Martin F. D'Souza (supra) was contrary to the law laid down in Jacob Mathew case

11. In view of the above, we are of the opinion that the conclusion recorded by the National Commission in the impugned order does not call for any interference. The civil appeals are dismissed.

12. A mere running of the eye over the above precedent stated supra would connote and denote, exemplify and demonstrate that the same is perfectly and squarely applicable to the facts and circumstances of the present case in hand.

13. Keeping in mind the principles as found enshrined in those precedents, if the case of the complaint is analyzed, it is glaringly and pellucidly clear that the assertion of the complainant the act of admission of the present consumer complaint and issuance of notice to the opposite party without obtained report of expert committee is fundamentally flawed and reflects a significant misunderstanding of the applicable legal framework.

14. To elaborate, the Consumer Protection Act, which governs the proceedings before the Consumer Commission, does not impose an obligatory requirement for such a referral to a committee of doctors as a prerequisite for the admission of a complaint. The Act is designed to facilitate access to justice for consumers, ensuring that their grievances are addressed in a timely and efficient manner. The notion that a preliminary assessment by a committee of medical experts is a necessary step before the Commission can entertain a complaint undermines the very purpose of the Consumer Protection Act, which is to empower consumers and provide them with a straightforward mechanism for redress. Furthermore, the role of the Consumer Commission is to evaluate the merits of the complaint based on

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the evidence presented by the parties involved. While the Commission may, at its discretion, seek expert opinions or consult with medical professionals during the course of the proceedings, it is not mandated to do so prior to the admission of a complaint. The Consumer Commission possesses the authority to assess the sufficiency of the complaint based on the documentation and arguments submitted by the complainant, and it is within its purview to determine whether the matter warrants further investigation or a hearing. In light of the above deliberations we are firmly of the outlook that the opposite party's preliminary objection lacks merit and is based on a misapprehension of the legal requirements governing the Consumer Commission's procedures. The Consumer Commission is fully empowered to admit and adjudicate complaints based on the evidence presented, without the necessity of a prior referral to a committee of medical experts.

15. In wake of the position sketched above we hold that Consumer Commission is empowered to admit and adjudicate a consumer complaint without obtaining prior opinion from the Medical Board or Expert Committee. Accordingly we reject the preliminary objection raised by the opposite party in this regard.

16. POINT NO. 3

Now, let us examine whether informed consent was obtained from the complainant by the opposite party prior to performing hysterectomy.

17. Albeit the opposite party had contended in paragraph 8 of the written version which reads as follows : -

8. The opposite party states that the status of the complainant's health condition was informed and consents were obtained from the patient and the patient's daughter for the surgery and the risks involved in the said surgery was also explained it is therefore clear that the complainant and her family members were duly informed in this regard.

In order to substantiate obtaining of consent as stated above the opposite party had produced and consent form as Exhibit B-1. We on close scrutiny of the Exhibit

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B-1 noticed that the consent has been obtained in a pre-printed form and the nature of surgery and name of the patient has been written by those attached to the opposite party.

18. We are of the outlook that a consent to be effective, a patient's consent must be informed, that is the doctor must explain the material facts related to the treatment so as to enable the patient to make an informed decision concerning the proposed treatment. A well-designed informed consent process would include discussion of the following elements, a description of the proposed surgery, including the anesthesia to be used, the indications for the proposed surgery, material risks and benefits for the patient related to the surgery and anesthesia, including the likelihood of each, based on the available clinical evidence, as informed by the responsible doctor's clinical judgment. Material risks could include risks with a high degree of likelihood but a low degree of severity, as well as those with a very low degree of likelihood but high degree of severity, treatment alternatives, including the attendant material risks and benefits, the probable consequences of declining recommended or alternative therapies, who will conduct the surgical intervention and administer the anesthesia, whether physicians other than the operating practitioner, including but not limited to residents, will be performing important tasks related to the surgery, in accordance with the hospital's policies etc.

19. Usually, hospitals/doctors often ask the patient to sign a general consent form as a mere ritual purportedly authorizing the practitioner to render care, including but not limited to performing labs, receiving diagnostic tests, etc. Such general consents are for sufficient basic care however, if unaccompanied by communication of material risks and benefits, such general consent forms do not constitute effective informed consent and are subject to challenge as can be evidenced from the case in hand. We are of the opinion that effective consent requires that the consent be informed, that the patient or patient representative is given the information, explanations, consequences and options needed to allow them to make an informed decision. The more significant or risky the care, the more important it is to document specific informed consent, in the facts and

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circumstances of the reliance on a general, generic consent form by the opposite party cannot be construed as informed consent.

20. We on close scrutiny of the said Exhibit B-1 noticed that the consent is in pre-printed form with limited space for handwritten entries. Thus, the consent obtained by the opposite party hospital from the complainant and her husband, in our view is not a informed consent as contended by the opposite party hospital. A conjoint reading of the contentions of the opposite party with regard to consent is not supported by Exhibit B-2 which is bereft of all the particulars contended by the opposite party. In the above circumstances the same cannot be construed as informed consent under any stretch of imagination. The use of fixed "pre-printed consent form" by the doctors/surgeons to record consent from the patients amounts to "unfair trade practice" as defined under the Consumer Protection Act.

21. In this connection, our mind is redolent and reminiscent of the judgement of the HON'BLE NATIONAL COMMISSION in the case titled as

VINOD KHANNA

Vs

R.G. STONE UROLOGY AND LEPROSCOPY HOSPITAL

vide its order dated 06-07-2020 in Consumer Case No. 428 of 2018 wherein it was observed and held as follows : -

"We but note that a pre-printed and fixed 'informed consent cum undertaking' form, with blank spaces for limited select handwritten entries and for the signatures has been used. The main body of the form is pre- printed and fixed. It can fit into any procedure, any doctor, and any patient, after filling up the blank spaces for the limited select handwritten entries and getting/affixing the signatures. We note this to be administrative arbitrariness and one-sided high handedness, and to be unfair and deceptive, on the part of the opposite party no. 1 (hospital) ".

22. In this regard it would apposite for us to recollect and refer to the judgement rendered by the HON'BLE SUPREME COURT in the case titled as

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SAMIR KOHLI

VS

DR. PRABHA MANCHANDA & ANR

reported in (2008) 2 SCC 1 while summarizing the principles relating to consent, the interalia, stated as follows :

" (i). a doctor has to seek and secure the consent of the patient before commencing a treatment (the term treatment includes surgery also). The consent so obtained should be real and valid, which means that : the patient should have the capacity and competence to consent ; his consent should be voluntary ; and his consent should be on the basis of adequate information concerning the nature of treatment procedure, so that he knows what is consenting to. " It is clearly evident that in the present case the respondent/opposite party doctor is guilty of medical negligence for not taking the informed consent from the appellant/complainant before the surgery.

23. Reliance is placed by us by recollecting and referring to the dicta of the

HON'BLE NATIONAL COMMISSION in the case titled as

DR VAIDYANATH CHAKRABORTY

VS

CHANDI BHATTACHARJEE

reported in II [(2014) CPJ 601 NC] wherein it was observed and held as follows : -

"Informed consent means that the patient has been explained consequences in layman's language so that he is able to take a decision to whether to go for surgery or not. Merely writing 'informed consent' on the top of the form does not make it an informed consent. The form is one page fully printed form containing ten clauses. The clauses are so widely worded that virtually they do not leave any situation. Obtaining signature on such printed form amounts to obtaining signature on dotted lines. I have no hesitation in concluding that such consent is no consent in the eyes of law."

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24. Apart from that we would like to recollect and refer to the judgement of the

HON'BLE NATIONAL COMMISSION in the case titled as

DR. DHILIP C SHAH

VS

SUBASH CHANDRA

vide order dated 26-11-2014 in R.P. No. 2385/2014 wherein it was observed and held as follows : -

" it is crystal clear that the OP Doctor had not take the consent of the complainant before performing surgery for which he is liable to pay compensation to the complainant …".

25. Further we would like to refer to the judgement of the HON'BLE NATIONAL COMMISSION in the case titled

MS. PRASANNA LAKSHMI

VS

MAXIVISION LASER CENTER PVT. LTD.

vide order dated 05-04-2018 in F.A. No. 170/2013 and 196 /2013 wherein in paragraph 19 has held as follows : -

19. An Informed Consent ought to have been taken from the Complainant with all the common complications which may arise after Lasik even the issue of 'Dry Eyes' which admittedly is a common complication, has not been mentioned in the consent form to have given an opportunity to the Complainant to exercise her choice of going into the Lasik Surgery or not. Therefore viewed from the ratio laid down by the Hon'ble Supreme Court in the aforementioned judgment, we are of the considered opinion that the Lasik Centre is deficient in service in not taking 'Informed Consent' from the Complainant. In today's day and age, Lasik Surgeries are being advertised to be extremely simple and uncomplicated. We are of the considered view that Medical Professionals involved in performing Lasik Surgeries should at least explain the common complications like Dry Eyes, for example, prior to the performance of the Surgery.

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26. Turning to the consent for surgery is concerned it is now well settled preposition of law that medical practitioners/doctors must take consent before performing any procedure/operation, which is a legal requirement as per

REGULATION 7.16 OF INDIAN MEDICAL COUNCIL (PROFESSIONAL, CONDUCT,

ETIQUETTE AND ETHICS) REGULATIONS, 2002, which reads as under:-

"7.16 Before performing an operation the physician should obtain in writing the consent from the husband or wife, parent or guardian in the case of minor, or the patient himself as the case may be. In an operation which may result in sterility the consent of both husband and wife is needed."

The obtaining of consent must be informed consent before performing any surgery doctors must obtain permission from a competent patient in a manner that is informed and voluntary. Patients, their family members must have the right to information about risks, benefits, and alternative treatments when making decisions about medical care and the freedom to choose. The law requires that doctors take reasonable steps to communicate adequately with patients who do not speak English or who have other communication barriers. Informed consent is substantially achieved when patients understand their current medical status, including its likely course if no treatment is pursued, potentially helpful treatments, including a description and explanation of potential risks, benefits, and burdens, uncertainties associated with each of these elements. The consent should be properly documented and preferably witnessed, so that the consent becomes legally acceptable and in the case in hand from the pleadings in the proof affidavit it can evidenced that mere thumb impression has been obtained by a staff nurse. The MCI Regulations, 2002, as amended up to date, clearly stipulates the need to respect the patient's autonomy and doctor's obligation to adequately inform the patient for self- determination and in the present case the opposite party had miserably failed to obtain informed consent. The act of opposite party in not obtaining of peopwe informed consent from the complainant amounts to deficiency in service and medical negligence on the part of opposite party.

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27. In the case in hand the opposite party hospital had obtained consent in pre-printed and fixed forms vide Exhibit B-1. In view of the authoritative finding in the above precedent stated above that the uniform use of the pre-printed and fixed informed consent cum undertaking by the doctors/hospitals will help them gain an undue advantage and it is beyond doubt a practice of "administrative arbitrariness"

as the forms are pre-printed and fixed, with limited space for handwritten entries, they could be misused after the filling up of blank spaces.

28. A mere running of the eye over the above precedents would connote and denote, exemplify and demonstrate that the same are perfectly and squarely applicable to the present case in hand.

29. Sequel to the above deliberations we hold that the opposite party has not obtained informed consent from the complainant and the obtaining of consent in pre-printed form by the opposite party is arbitrary and unfair trade practice as adumbrated in the precedent stated supra.

30. POINT NO. 4

Shorn and bereft of details, the re'sume' of facts absolutely necessary for the disposal of the complaint could be portrayed thus the complainant sought medical attention from the opposite party for gynecological issues. Following an examination and review of the scan report, the opposite party recommended an abdominal hysterectomy. When the complainant inquired about the estimated costs for hospitalization and surgery, she was informed that a sum of Rs. 50,000/- would be required. Consequently, the complainant was admitted to the opposite party's hospital on 12-06-2023, and paid the aforementioned amount, with the understanding that a detailed bill would be provided along with the discharge summary. The surgery was conducted on 13-06-2023. However, during the procedure, the complainant experienced a cardiac arrest and subsequently fell into a coma. The opposite party advised that she be shifted to Madurai Meenakshi Mission Hospital & Research Centre for further management of her condition. Following this referral and recommendation, she was transported by ambulance to the aforementioned facility. During her inpatient stay from 13-06-2023 to 16-06-

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2023, the complainant incurred expenses amounting to Rs. 400,000/-. Unfortunately, she remained in a coma, and the medical team indicated that her treatment might extend over a prolonged period, necessitating additional financial resources. Consequently, she was transferred to Government Rajaji Hospital on 16- 06-2023, where she remained hospitalized until 28-08-2023. Although she eventually regained consciousness, she was left unable to walk or speak properly. Subsequently, the complainant was admitted to Aristo Hospital, Madurai, from 30- 09-2023 to 11-10-2023, incurring further expenses of approximately Rs. 1,50,000. Due to her bedridden condition, nursing assistants were engaged around the clock to provide care. In total, the complainant spent approximately Rs. 8,00,000/- across all three hospitals. The complainant asserts that she endured significant pain and incurred exorbitant medical expenses as a direct result of gross medical negligence and a deficiency in service on the part of the opposite party. Following this distressing experience, she issued a legal notice to the opposite party, seeking compensation of Rs. 15,00,000/- to cover the unnecessary medical expenses and to address the mental anguish, pain, indignation, and helplessness she suffered. In response, the opposite party provided a rebuttal, falsely claiming that the treatment was rendered free of charge. The complainant contends that the opposite party, being a private hospital, is making a baseless assertion regarding the provision of free treatment, which is a deliberate attempt to evade liability for the gross negligence and deficiency in service that she experienced. The complainant maintains that the actions of the opposite party constitute gross negligence, resulting in significant mental distress and an undue financial burden. In light of these circumstances, the complainant seeks a directive for the opposite party to pay a sum of Rs. 15,00,000/- as compensation and cost of the complaint.

31. Remonstrating and refuting the complaint averments, the opposite party in their reply to the complaint, categorically denied the veracity of the allegations and averments made by the complainant. The opposite party had submitted that she provides medical services to the general public and extend free treatment to individuals from economically disadvantaged backgrounds. It was contended by the opposite party that the complaint should be dismissed on the grounds that the complainant does not qualify as a consumer under the relevant legal framework

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and that there has been a failure to join necessary parties, specifically Meenakshi Mission Hospital and Aristo Hospital in Madurai and these preliminary objections, the opposite party prayed for dismissal of the complaint. The opposite party submitted that the complainant had gynecological issues, which necessitated a diagnostic ultrasound of the abdomen and she had undergone evaluation at Government Rajaji Hospital, and was advised to undergo a hysterectomy. The complainant with above reports had the complainant to discuss the necessity of an abdominal hysterectomy. The complainant and her daughter was fully informed of her medical condition and the implications of the surgery, willingly consented to the procedure, which was subsequently performed at Saroja Memorial Clinic on 13- 06-2023. It is emphasized that prior to the surgery, the opposite party took the necessary steps to ensure that both the complainant and her daughter were adequately informed about the surgery, including the associated risks. During the course of the surgical procedure, the complainant suffered a sudden cardiac arrest and the anesthetist acted promptly and successfully revived the complainant. Following this incident, the surgical procedure was completed, and the opposite party promptly communicated the developments to the complainant's daughter and relatives. Recognizing the seriousness of the situation, she referred the complainant be transferred to Meenakshi Mission Hospital and Research Centre in Madurai for further management of her condition. Moreover, the opposite party contends that she did not charge the complainant any fees for the surgery, emphasizing that her actions were motivated by humanitarian considerations rather than financial gain. The opposite party contended that there is no of negligence or deficiency in service and prayed for dismissal of the complaint in entirety.

32. We carefully considered the rival contentions and the documents produced and placed before us by both sides.

33. We before get on to the merits of the present complaint for effective adjudication, it is prudent to familiarize ourselves with several pertinent medical terminologies that are crucial to our understanding. These terms include abdominal hysterectomy, spinal anesthesia, hypotension, and bradycardia.

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ABDOMINAL HYSTERECTOMY is an operation that removes the uterus through a cut in the lower belly, also called the abdomen. This is known as an open procedure. The uterus, also called the womb, is where a baby grows when someone is pregnant. A partial hysterectomy removes the uterus, leaving the neck of the womb in place. The neck of the womb is the cervix. A total hysterectomy removes the uterus and the cervix. This surgery may be performed for various reasons, including the treatment of uterine fibroids, endometriosis, abnormal bleeding etc. The procedure can be classified into different types, such as total hysterectomy, which involves the removal of the entire uterus along with the cervix, and subtotal or partial hysterectomy, where only the upper part of the uterus is removed.

SPINAL ANESTHESIA is a form of regional anaesthesia that involves the injection of anaesthetic agents into the cerebrospinal fluid surrounding the spinal cord. This technique is commonly employed during surgical procedures involving the lower abdomen, pelvis, or lower extremities, as it provides effective pain relief and muscle relaxation while allowing the patient to remain conscious. A spinal anaesthetic is performed by an anaesthetist. In spinal anaesthetic a very fine needle is inserted into the middle of the lower back and local anaesthetic is injected through the needle into the fluid that surrounds the spinal cord. The local anaesthetic numbs the nerves that supply the tummy, hips, bottom and legs. Once the nerves are completely numb you will not feel any pain from an operation and you will also not be able to move your legs. Other medications can also be injected which provide excellent pain relief for several hours after the operation. Familiarity with spinal anaesthesia is vital, as it carries specific risks and benefits that can influence the overall management of the patient during and after surgery.

HYPOTENSION refers to abnormally low blood pressure, which can lead to inadequate blood flow to vital organs. This condition may manifest as dizziness, fainting, or shock, and can be a significant concern in the

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perioperative setting, particularly in patients undergoing major surgical procedures. Understanding the causes and implications of hypotension is crucial for ensuring patient safety and effective management during the course of treatment.

BRADYCARDIA, on the other hand, is characterized by an abnormally slow heart rate, typically defined as fewer than 60 beats per minute. While bradycardia can be a normal physiological response in well-trained athletes, it may also indicate underlying health issues, particularly when accompanied by symptoms such as fatigue, dizziness, or syncope. In the context of surgical procedures, bradycardia can be a side effect of certain anaesthetic agents or a response to surgical stress, necessitating careful monitoring and potential intervention.

By elucidating these medical terminologies, hysterectomy, spinal anaesthesia, hypotension, and bradycardia, we prepare ourselves with the information necessary for a nuanced understanding of the complaint at hand, thereby enhancing our capacity for effective adjudication.

34. We on gleaning through records observed that the opposite party on 13-06- 2023 had performed abdominal hysterectomy on the complainant and it was informed by the opposite party that during the surgery the complainant had suffered cardiac arrest and had gone into coma and advised to get her admitted at Madurai Meenakshi Mission Hospital & Research Centre, Madurai for management of her medical condition and accordingly she was shifted by ambulance and admitted at the said hospital where she was treated for hypotension, bradycardia, cardiac arrest consequent to spinal anaesthesia for performing abdominal hysterectomy by the opposite party.

35. We have referred to medical literature on PHYSIOLOGY OF SPINAL

ANAESTHESIA AND PRACTICAL SUGGESTIONS FOR SUCCESSFUL SPINAL

ANAESTHESIA. by Salinas FV, Sueda LA, Liu and SEVERE BRADYCARDIA DURING SPINAL AND EPIDURAL ANESTHESIA by Lesser JB, Sanborn KV, Valskys R, Kuroda

21

M. wherein we observed that the physiological ramifications of spinal anaesthesia are well-documented, particularly concerning its impact on cardiovascular dynamics. One of the primary consequences of this anaesthetic technique is the induction of hypotension, which is characterized by a significant drop in systemic blood pressure. This phenomenon arises from the blockade of sympathetic spinal efferent, which are responsible for mediating vasoconstriction and maintaining vascular tone. When these sympathetic pathways are inhibited, there is a resultant predominance of parasympathetic activity, leading to a state of unopposed vagal influence. This imbalance not only facilitates vasodilatation, where blood vessels widen, further contributing to decreased vascular resistance—but also can precipitate bradycardia, a condition marked by a slower than normal heart rate. The interplay between these autonomic nervous system components underscores the intricate regulatory mechanisms governing cardiovascular function during spinal anaesthesia. Moreover, the extent of these cardiovascular effects can be influenced by various factors, including the level of the spinal block, the volume and type of local anaesthetic used, and the patient's individual physiological characteristics. Clinicians must remain vigilant in monitoring these potential side effects, as they can significantly impact patient stability and outcomes during surgical procedures. Understanding the underlying mechanisms of these cardiovascular responses is crucial for the effective management of patients undergoing spinal anaesthesia, ensuring both safety and efficacy in anaesthetic practice.

36. We from the medical literatures observed that the precautionary measures like early diagnosis and effective and aggressive treatment are necessary when facing significant bradycardia during spinal anaesthesia. It is essential to monitor the respiration, pulse and blood pressure closely. The blood pressure can fall precipitously following induction of spinal anaesthesia. Bradycardia is quite common during spinal anaesthesia .Patient should be well hydrated before local anaesthesia is injected and should have an intravenous infusion in place so that further fluids or vasoconstrictions can be given if hypotension occurs. Hypotension and bradycardia should be treated with intravenous fluids, atropine and vasopressors. Treatment if not started quickly the combination of hypoxia,

22

bradycardia, hypotension may result in cardiac arrest. Hypotension and bradycardia are common sequelae of spinal anaesthesia. They demand the anaesthesiologist's vigilance because of their propensity to suddenly and unpredictably cause major hemodynamic compromise. When this occurs, treatment is aimed toward reversal of those physiologic perturbations leading to impaired cardiac output reduced SVR, reduced preload, bradycardia, and decreased myocardial contractility.

37. We have referred to medical literature/text book on SPINAL ANESTHESIA

published by NYSORA (organization which promotes the practice of anesthesia, pain management and perioperative medicine through timely free of charge dissemination of new information using far reaching and innovative educational resources) observed that aanaesthetists occupy a distinctive and pivotal role in the realm of patient-cantered care, particularly when integrated into critical teams such as those responding to cardiac arrests and trauma, as well as in the provision of obstetric care and intensive care management. Their expertise is essential not only in the administration of anaesthesia but also in the vigilant monitoring of patients post-procedure. Following the successful placement of an anaesthetic block, continuous monitoring of the patient is imperative to assess block progression and identify potential complications. Initial blood pressure measurements should be taken every three minutes, with increased frequency warranted if any abnormalities arise. It is crucial to evaluate the adequacy of the block in relation to the surgical procedure while ensuring that it does not ascend to an excessive level.

38. In our meticulous review of the medical records, it became evident that the complications arising from spinal anesthesia specifically hypotension, bradycardia, and cardiac arrest underscore the critical role that the anesthetist plays in the perioperative period. The term "perioperative" encompasses the comprehensive timeframe surrounding a surgical intervention, which is divided into three distinct phases pre-operative, intra-operative, and post-operative. Each of these phases is integral to the continuum of patient care, involving thorough assessment, meticulous preparation, the administration of anesthesia, the surgical procedure itself, and the subsequent recovery process. The primary objective of perioperative

23

care is to ensure the utmost safety of the patient, optimize surgical outcomes, and facilitate a smooth recovery. In this context, the anesthetist's responsibilities are paramount, as they are tasked with monitoring the patient's vital signs, managing anesthesia, and responding promptly to any adverse events that may arise during the procedure. Upon meticulous examination of the records, it becomes glaringly evident that the opposite party has conspicuously failed to disclose the identity of the anesthetist involved in the case at hand. The anesthetist, who was engaged by the opposite party, remains unknown to the complainant, who lacks any information regarding the individual responsible for administering anesthesia during her hysterectomy. In this context, it is rather perplexing that the opposite party, while withholding the name of the anesthetist, has simultaneously asserted that the complainant has not included the anesthetist as a party to the complaint. This stance is fundamentally contradictory on one hand, the opposite party refrains from revealing the identity of the anesthetist engaged in the procedure, while on the other, it raises the issue of non-joinder of the anesthetist as a defense.

39. In auxiliary the opposite party has not taken the initiative to examine the anesthetist it employed, nor has it procured any affidavit from this individual to substantiate its claims regarding the standard of care that was purportedly extended to the complainant. This glaring lack of accountability raises substantial concerns regarding the standard of care that was provided during the perioperative period. The absence of the anesthetist's involvement in the documentation not only undermines the credibility of the assertions made by the opposite party but also underscores a potential breach of the duty of care owed to the complainant. The failure to present evidence of the anesthetist's assessment and management during the surgical procedure casts significant doubt on the adequacy of the care rendered and the measures implemented to mitigate the inherent risks associated with anesthesia. In the realm of medical practice, particularly in surgical contexts, the role of the anesthetist is critical, as they are responsible for monitoring the patient's vital signs and ensuring their safety throughout the procedure. The lack of transparency regarding the anesthetist's identity and their subsequent non- examination raises serious questions about the overall quality of care provided and the adherence to established medical protocols. In conclusion, the opposite party's

24

contradictory position, coupled with its failure to provide essential evidence regarding the anesthetist's involvement, not only jeopardizes the integrity of its defense but also highlights a significant lapse in the duty of care that should have been afforded to the complainant. This situation necessitates a thorough investigation into the practices and protocols followed during the surgical procedure to ascertain whether the requisite standard of care was indeed met.

40. In the continuation of our deliberation, we delve into the matter concerning the complainant's assertion that the opposite party has egregiously neglected her duty to deliver adequate medical care. This dereliction of responsibility has culminated in a series of severe health complications, including hypotension, bradycardia, and ultimately, cardiac arrest, all precipitated by the administration of spinal anesthesia. The ramifications of this negligence have not only imposed a substantial financial burden upon the complainant, necessitating extensive medical expenditures, but have also inflicted profound physical pain, emotional distress, and a sense of helplessness. In light of the evidence presented and the arguments articulated, we are compelled to conclude that the opposite party has indeed exhibited a clear breach of the standard of care expected in medical practice. The failure to monitor and manage the complainant's condition adequately during and after the administration of spinal anesthesia constitutes a significant lapse in professional duty. Such negligence not only jeopardizes the well-being of complainant but also undermines the trust that is foundational to the patient-provider relationship. Therefore, after careful consideration of the facts and the implications of the opposite party's actions, we arrive at the judicious determination that the opposite party is guilty of medical negligence and has demonstrated a deficiency in the requisite standard of service. This finding underscores the necessity for accountability in the medical profession, ensuring that patients receive the care and attention they rightfully deserve, free from the specter of preventable harm.

41. In auxiliary in light of the facts and circumstances surrounding the case at hand, we are compelled to conclude that the complainant has satisfactorily discharged the primary burden of proof, as evidenced by the documentation

25

presented in Exhibits A-3 and A-4 medical records of Madurai Meenakshi Mission Hospital & Research Centre and Government Rajaji Hospital. It is incumbent upon the opposite party to adduce compelling evidence to substantiate their assertions and defences. Considering the entirety of the case it can be easily concluded that the necessary foundational facts, to hold that the application of res ipsa loquitur was warranted, were proved in all detail. Herein the initial burden is discharged by the complainant by demonstrating negligence on the part of the opposite party, the onus shifts to the opposite party to prove the absence of negligence. When the complainant or aggrieved party had adduced some evidence that the patient suffered due negligence or lack of care suffered irremediable injury due to want of diligence, the burden lies on the opposite party to justify that there was no negligence on the part of the treating doctor or hospital. Therefore, in any case, the hospital and its doctors are in a better position to disclose what care was taken. The complainant has effectively invoked the doctrine of res ipsa loquitur, which posits that the mere occurrence of certain types of accidents implies negligence on the part of the opposite party in absence of any credible evidence to the contrary. Consequently, the onus now shifts to the opposite party to demonstrate, with a preponderance of evidence, that she exercised the requisite standard of care and were not negligent in the provision of surgical treatment to the complainant. However, the opposite party has egregiously failed to meet this burden. She had not proffered any cogent or tangible evidence that would convincingly establish their lack of negligence. The absence of such evidence not only undermines her position but also reinforces the complainant's claims, thereby warranting a favourable consideration of the complainant's case. In the absence of a robust evidentiary foundation from the opposite party, the presumption of negligence remains intact, compelling us to favour the complainant's assertions.

42. We would like to recollect and refer to the dicta of the HON'BLE SUPREME COURT in the case titled as

SMT. SAVITA GARG

VS.

DIRECTOR, NATIONAL HEART INSTITUTE

reported in (2004) 8 SCC 56, wherein was observed and held as follows : -

26

" ............ once a prima facie case is observed, the onus shifts on the Hospital and the Treating Doctor to explain as to how a particular condition has occurred and explain the treatment that was rendered to her. In the case in hand nothing has been done in this regard by the opposite parties 1 and 2 by divulging the nature of treatment and injections administered between11-45 Am and 3-15 PM to establish as to what has really transpired in the operation theatre "

43. Reliance is placed by us recollecting and referring to the judgement of the

HON'BLE MADRAS HIGH COURT in the case titled as

SONI HOSPITAL

VS

BALAKRISHNAN IYER

reported in AIR 2003 MAD 389 wherein in it was observed and held as follows :

in a case where an act was done by a doctor which he is otherwise not supposed to do and such an act was done in a negligent manner resulting in a substantial injury to the patient, then he cannot escape the liability. When a doctor who performs a surgery is in possession of certain facts and the factum of surgery has not been disputed, coupled with the fact that, the complications have arisen in pursuant to the surgery not correctly done then the onus is on him to prove that the negligence is not on his part. When the accident is such that in the ordinary course of action is not likely to happen if the person in-charge has not taken proper care then, the consequential liability will be on him. In such a case the principle of res ipsa loquitur can be applied.The duties which a doctor owes to his patient are clear. The opposite party doctor who holds herself out ready to give medical advice and treatment impliedly undertakes that she is possessed of skill and knowledge for the purpose. Such a person when consulted by a patient owes him certain duties, viz., a duty of care in deciding whether to undertake the case, a duty of care in deciding whether treatment to give or a duty of care in the administration of that

27

treatment and when she fails by discharging her duties results in shortcoming and imperfection in her services.

44. Applying the principle of res ipsa loquitur in medical negligence case the

HON'BLE SUPREME COURT in the case titled as

NIZAM INSTITUTE OF MEDICAL SCIENCES CASE

VS.

PRASANTH S. DHANANKA

reported in (2009) 6 S.C.C. 1, stating that once the initial burden is discharged by the complainant by demonstrating negligence on the part of the hospital or doctors, the onus shifts to the hospital or attending doctors to prove the absence of negligence. The Court had observed,

"In a case involving medical negligence, once the initial burden has been discharged by the complainant by making out a case of negligence on the part of the hospital or the doctor concerned, the onus then shifts on to the hospital or to the attending doctors and it is for the hospital to satisfy the Court that there was no lack of care or diligence."

45. In the case in hand, it is imperative to acknowledge that the opposite party possesses the requisite qualifications and credentials that ostensibly affirm her competence within the medical field. However, despite this professional standing, it is evident that she has egregiously failed in her duty of care, a fundamental obligation that is incumbent upon all practitioners in the healthcare domain. The doctrine of duty of care mandates that medical professionals adhere to a standard of care that is consistent with that of a reasonably competent practitioner in similar circumstances. This standard is not merely a theoretical construct; it is a practical benchmark that serves to protect patients from the deleterious effects of negligence and substandard medical practices. In this instance, the opposite party's actions or lack thereof demonstrate a significant deviation from this established standard. Specifically, the failure to adequately monitor the complainant's vital signs and overall condition during the administration of spinal anaesthesia constitutes a breach of the duty of care. The absence of vigilant

28

oversight in such a critical medical procedure is not only a lapse in judgment but also a violation of the ethical and professional obligations that govern medical practice. The resultant complications, including hypotension, bradycardia, and cardiac arrest, are not merely unfortunate outcomes; they are direct consequences of the opposite party's negligence in fulfilling her responsibilities. Furthermore, the legal principle of causation must be examined in this context. It is incumbent upon the complainant to establish a direct link between the opposite party's failure to provide adequate care and the adverse health outcomes that ensued. In this case, the evidence suggests a clear causal relationship, wherein the lack of appropriate medical intervention and monitoring directly contributed to the complainant's deteriorating condition. In summation, while the opposite party may possess the necessary qualifications to practice medicine, her failure to uphold the duty of care, as evidenced by her inadequate monitoring and management of the complainant's condition, constitutes a breach of the legal and ethical standards expected of medical professionals.

46. We would like to recollect and refer to the judgement of the HON'BLE NATIONAL COMMISSION in the case titled as

PANKAJ R. TOPRANI & 3 ORS.

VS

BOMBAY HOSPITAL AND RESEARCH & MEDICAL & 2 ORS

vide order dated 04.07.2019 in First Appeal No.101 of 2016 wherein it was observed and held as follows : -

" … it is the duty of medical officer to take care of the patient whenever patient is under the treatment of doctor. If there is any breach in duty, resulting in injury or damage to the life of the patient, the Doctor is liable for the same "

47. We would refer to another judgement of the HON'BLE NATIONAL COMMISSION in another case titled as

D. UMA DEVI

29

VS

YASHODA HOSPITAL & ORS

vide its order dated 11.04.2016 in F.A. No.1169 of 2014 had observed and held as follows : -

"11. In this context, we rely upon the judgment in Laxman Balkrishna Joshi (Dr) vs Dr. Triambak Bapu Godbole reported in AIR 1969 SC 128, it was held that a doctor, when consulted by a patient, owes him certain duties. It was held as under:

"A person, who holds himself out ready to give medical advice and treatment, impliedly undertakes that he is possessed of skill and knowledge for the purpose. Such a person when consulted by a patient, owes certain duties, namely, a duty of care in deciding whether to undertake the case, a duty of care in deciding what treatment to give, and a duty of care in the administration of that treatment."

48. When examined through the lens of the principles established in the precedents, it becomes unequivocally evident that, in the present case, the actions (or lack thereof) of the opposite party constitute a clear and manifest breach of duty, amounting to a flagrant instance of medical negligence. The facts of the case, as presented, leave no room for reasonable doubt regarding the failure of the opposite party to adhere to the requisite standard of care, a failure that directly resulted in the harm and detriment suffered by the complainant. The breach is not only conspicuous but also undeniable, as it is apparent that the negligent conduct in question deviated significantly from accepted medical practices and protocols, thereby rendering the opposite party liable for the resulting damages. The duties which a doctor owes to his patient are clear. The opposite party doctor who holds herself out ready to give medical advice, surgery and treatment impliedly undertakes that she is possessed of skill and knowledge for the purpose. Such a person when consulted by a patient owes him certain duties, a duty of care in deciding whether to undertake the case, a duty of care in deciding whether treatment to give or a duty of care in the administration of that treatment and when she fails by discharging her duties results in shortcoming in her services.

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49. We are of the outlook that the absence of the case sheet, which is a critical component of the medical record, constitutes a significant deficiency in the opposite party's defence. The case sheet is not merely a collection of notes, it is an essential document that encapsulates the entirety of the clinical interaction, including the administration of anaesthesia, the timing of such administration, the onset of the alleged cardiac arrest, and the subsequent medical interventions undertaken. The meticulous documentation of these elements is paramount in establishing the standard of care exercised by the medical practitioner and in elucidating the circumstances surrounding the surgical procedure. The failure of the opposite party to produce this vital document raises substantial concerns regarding the integrity and reliability of her assertions. In legal parlance, the principle of "res ipsa loquitur" shall be invoked, suggesting that the very absence of the case sheet speaks volumes about the likelihood of negligence. The opposite party's inability to provide the case not only undermines her credibility but also creates a presumption of negligence, as it is reasonable to infer that the case sheet would have contained information detrimental to opposite party's defence. Moreover, the doctrine of adverse inference is particularly pertinent in this context. This Commission is entitled to draw negative conclusions from the opposite party's failure to produce evidence that is within her control and that would ordinarily be expected to clarify the facts at issue. The non-production of the case sheet, therefore, not only weakens the opposite party's position but also bolsters the complainant's claims of inadequate care and oversight during the surgical procedure. The implications of this omission are profound. The complainant, having placed her trust in the opposite party's professional expertise, is entitled to a thorough and transparent account of the events that transpired during the surgery. The lack of case sheet raises serious questions about the standard of care provided and whether the opposite party acted with the requisite prudence and diligence expected of a medical professional in such circumstances. In light of these considerations, it is our firm position that the opposite party's failure to produce the case sheet is not merely a procedural oversight, it is a critical failure that undermines her defence and substantiates the complainant's allegations of negligence. The opposite party wants to put "veil of secrecy" as what transpired inside the operation theatre by not producing the case sheet so that the truth

31

never comes out and remains embedded. This Commission should, therefore, draw adverse inferences from this omission, reinforcing the complainant's entitlement to relief and affirming the necessity for accountability in the provision of medical care. Put simply, the evidence on opposite party is nothing but a mishmash of artificial and unbelievable versions. The complainant's claims, supported by the absence of the opposite party's documentation, warrant serious consideration and should be adjudicated in favour of the complainant. En passant, we would like to point out that the contentions put forth on the side of the opposite party are far from satisfactory. We while appreciating the complainant's evidence as a whole appears to have a ring of truth and honesty. Here, the above narration of facts would speak by themselves so to say, res ipsa loquitur principle would be attracted and one could understand the magna neglegentia on the part of the opposite party. Based on the discussion above, it is held that the medical negligence in the present case stands fully established from the material on record. The whole kit and caboodle of facts as found transpired from the records, could succinctly and precisely shows that the opposite party doctor is guilty of deficiency in service.

50. Given the nature of the case at hand, we wish to give a pointed analysis of the case specifics and the question of law involved. It is trite law that "necessary party" is a person who ought to have been joined as a party and in whose absence no effective order could be passed at all by the Commission. It also thus becomes imperative that if the necessary party is not impleaded, the complaint itself is liable to be dismissed. At the same time "proper party" is a party who, though not a necessary party, is a person whose presence would enable the Commission to completely, effectively and adequately adjudicate upon all the matters in dispute in the complaint, though it need not be a person in favour of or against whom the order is to be made. Herein the opposite party had contended that Madurai Meenakshi Mission Hospital & Research Centre, Madurai and others who have provided treatment subsequent to the surgery performed by her has not been impleaded as part to the complaint and therefore the complaint has to be dismissed for non-joinder of the necessary party. It is pertinent to point out that the medical records pertaining to the subsequent treatment has been produced and placed before us which helps in better appreciation and adjudication of the

32

case by this Commission. Moreover it is common law that for being a necessary party, the celebrated "twin test" has to be satisfied. The first one is that there must be a right to some relief against such party in respect of the disputes involved in the proceedings and the second one is that no effective order can be passed in the absence of such party. This fact is underscored by the HON'BLE SUPREME COURT

in the case titled as

MORESHAR YADAORAO MAHAJAN

VS

VYANKATESH SITARAM BHEDI (D)

vide its order dated 27-09-2022 -n Civil Appeal No 5755 -5556 Of 2011

reported in 2022 LIVE LAW (SC) 802 wherein it was observed and held as follows : -

"19. As already discussed hereinabove, the plaintiff himself has admitted in the plaint that the suit property is jointly owned by the defendant, his wife and three sons. A specific objection was also taken by the defendant in his written statement with regard to non-joinder of necessary parties. Since the suit property was jointly owned by the defendant along with his wife and three sons, an effective decree could not have been passed affecting the rights of the defendant's wife and three sons without impleading them. Even in spite of the defendant taking an objection in that regard, the plaintiff has chosen not to implead the defendant's wife and three sons as party defendants. Insofar as the reliance placed by Shri Chitnis on the judgment of this Court in the case of Kasturi (supra) is concerned, the question therein was as to whether a person who claims independent title and possession adversely to the title of a vendor could be a necessary party or not. In this context, this Court held thus :-

7. From the above, it is now clear that two tests are to be satisfied for determining the question who is a necessary party. Tests are — (1) there must be a right to some relief against such party in respect of the controversies involved in the proceedings; (2) no effective decree can be passed in the absence of such party."

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20. It can thus be seen that what has been held by this Court is that for being a necessary party, the twin test has to be satisfied. The first one is that there must be a right to some relief against such party in respect of the controversies involved in the proceedings. The second one is that no effective decree can be passed in the absence of such a party.

Hence, in the case at hand, the result of the twin test goes in favour of the complainant and therefore the contention of non-joinder of necessary party deserves to be rejected and discarded.

51. In auxiliary on thorough examination of relevant medical literature and clinical records, it is our firm position that the opposite party should have anticipated the well-documented complications associated with spinal anesthesia, particularly in the context of a hysterectomy. These complications, which include hypotension, bradycardia, and the potential for cardiac arrest, are not merely theoretical risks they are established medical realities that necessitate a proactive and prepared approach from the opposite party when undertaking such procedures. It is incumbent upon the opposite party to ensure that adequate facilities and resources are readily available to manage these complications should they arise. The failure on the part of the opposite party to do so constitute a significant lapse in the standard of care expected in such medical contexts. The opposite party lacked the requisite facilities to meet these potential complications, it was her professional obligation to either perform the surgery in a setting equipped to handle such emergencies or to refer the complainant to a facility that could provide the necessary care. In this instance, the opposite party's actions or lack thereof, demonstrate a troubling disregard for the principles of promptness, prudence, and diligence that are fundamental to the practice of medicine. When the complications manifested, rather than taking immediate and appropriate action to stabilize the complainant, the opposite party opted to refer her to Madurai Meenakshi Mission Hospital & Research Centre, Madurai for management of the complications. This decision not only reflects a failure to provide timely care but also raises serious questions about the adequacy of the initial medical intervention. The complainant, therefore, finds herself in a position of vulnerability, having been

34

subjected to a surgical procedure without informed consent and without the assurance of comprehensive care for potential complications. The opposite party's negligence represent a breach of the duty of care owed to the complainant, resulting in unnecessary risk and potential harm.

52. We would like to recollect and refer to the latest judgement of the HON'BLE NATIONAL COMMISSION in the case titled as

JAITA MITRA BASU & ORS Vs

DR. ANIRBAN CHATTERJEE & ORS

vide its order dated 28.02.2025 in Consumer Complaint No. 2644/ 2017

wherein its observed and held as follows : -

21. Now, we would like to discuss with regard to the "Bolam Test", which was articulated in 1957. At that point of time emphasis was not on the principle of autonomy rather on the principle of beneficence. The doctor was considered to be the best person and the patient was kept in dark with regard to the risks and alternative treatment relating to the illness. Now there is a seismic shift in medical ethics and societal attitude towards the practice of medicine. Also, the Medical Council framed statutory regulations regarding professional conduct, etiquette and ethics. This warrants legal tests to adjudicate the advice aspect of doctor patient relationship. The MCI Regulations as amended up to date clearly stipulate the need to respect the patient's autonomy and doctor's obligation to adequately inform the patient for self-determination. Nature of the patient doctor relationship has to be examined in the light of education and access to the knowledge of ordinary citizens. In the light of these facts and statutory provisions, the "Bolam Test" can no longer be applied to a doctor's advice to his patient, unless it complies with the statutory provisions. The information given to the patient has to be examined from the patient's perspective. The information disclosed is not limited to risk- related inputs. It should include doctor's diagnosis of the patient's condition, the prognosis of that condition with and without medical

35

treatment, the nature of proposed medical treatment and the risks associated with it, the alternative to the proposed medical treatment, advantages and risks of the said treatment and the proposed treatment. The doctor must ensure that information given is "in terms and at a pace that allows the patient to assimilate it, thereby enabling the patient to make informed decision".

23. As regards the material issue whether before undergoing surgery, the patient or her parents were informed about the possible risks and complications and their informed consent was taken, it is true that every operation, as small as it may be, carries wide range of risks from the most insignificant to the most serious, may lead to fatal complications. Discussing all complications with the patient and attending relatives is a necessity, so that she may make up her mind for surgery. Before commencing a treatment or procedure, an „Informed Consent" is required to be obtained satisfy the following conditions: "The consenting party i.e. the patient or his/her family members must be aware of the nature and extent of complications and risks of the surgery. The consenting party must have understood the nature and extent of the complications and risks and the consenting party or his/her family members must have consented to the harm and assumed risk. Comprehensive explanation of the possible complications and risks and the extent of entire procedure and transaction, inclusive of all its consequences, must be explained to the patient or his/her family members."

The above judgement is squarely and perfectly applicable to the present consumer complaint in hand.

53. A thorough examination of the details presented in this complaint, along with a comprehensive review of the accompanying records, clearly illustrates the situation at hand. This aligns with the legal principle of res ipsa loquitur, which posits that the facts of the case speak for themselves, indicating that negligence is evident without the need for extensive evidence or testimony. In this instance, the

36

circumstances surrounding the complaint reveal a significant degree of negligence, termed magna negligentia, on the part of the opposing party. The evidence suggests that the actions (or lack thereof) of the opposite party were not only careless but also fell far below the standard of care expected in similar situations. This egregious oversight has directly contributed to the grievances expressed by the complainant. Thus, the application of the aforementioned judgment, in conjunction with the principle of res ipsa loquitur, underscores the clear liability of the opposing party. The facts are compelling and unambiguous, leading to the inevitable conclusion that their negligence has resulted in harm, warranting appropriate redress for the complainant.

54. Let us to refer to the definitions of the term DEFICIENCY IN SERVICE

under SECTION 2(11) provided in the CONSUMER PROTECTION ACT - 2019

which reads as follows : -

Section 2 (11) of Consumer Protection Act, 2019 defines DEFICIENCY OF SERVICE as "any fault, imperfection, shortcoming or inadequacy in the quality, nature and manner of performance which is required to be maintained by or under any law for the time being in force or has been undertaken to be performed by a person in pursuance of a contract or otherwise in relation to any service and includes (a) any act of negligence or omission or commission by such person to the consumer and (b) deliberate withholding of relevant information by such person to the consumer."

55. A comprehensive and holistic reading of the aforementioned statutory provision, when coupled with the detailed analysis set forth in the preceding paragraphs, leaves no doubt that the actions (or omissions) of the opposite party unequivocally fall within the ambit of the definition of medical negligence as delineated by law. The conduct of opposite party, as outlined, aligns directly with the criteria for negligence, including the failure to adhere to established medical standards and the consequent harm to the complainant. It is evident that the negligent acts in question are not merely incidental but form a central and

37

inextricable part of the case at hand, thus clearly implicating the opposite party within the scope of the legal definition of medical negligence.

56. Ultimately for the foregoing reasons, a fortiori, we hold that the opposite party is guilty of any negligence or deficiency in service. Accordingly we answer Point No. 1 in favour of the complainant.

57. POINT NO. 5

As Point 1 is answered in favour of the complainant holding that the opposite party is guilty of negligence and deficiency in service, we cannot deny the relief of compensation to the complainant.

58. Moreover the sine qua non for entitlement of compensation is proof of loss or injury suffered by the consumer due to the negligence of the opposite parties. Once the said conditions are satisfied, the Consumer Commission shall decide the quantum of compensation to which the consumer is entitled. There cannot be any dispute that the computation of compensation has to be fair, reasonable and commensurate to the loss or injury. There is a duty cast upon this Commission to take into account all relevant factors for arriving at the compensation to be paid on the basis of accepted legal principles, on moderation. This Commission has to compensation to the extent it finds it reasonable, fair and proper in the facts and circumstances of a given case according to the established judicial standards where the claimant is able to establish his charge.

59. In cases of medical negligence, or negligence is tied to two concepts. At the one end is the duty of care - and establishing its breach, and thereby fault - and resultant injury. At the other end is remedial - usually restitution, in monetary terms, by payment of damages. The ingenuity of common law has been to adapt - and evolve, through refinement, and reinvention, the idea of duty to care. In the case of medical professionals, or other professionals, for instance, their duty to care not only involves the professionals' assessment of the suitability of treatment, or use of technology, but the concomitant duty to inform the patient (or consumer) of the likely results, or even the risk(s) because the service recipient, so to say, has

38

to bear the consequent consequences. Damages, in theory, can have no limit. Yet, the duty of care is woven with the idea of causation or proximity. Thus, only one is liable in law to the extent of one's actions, which cause the injury. The quantum of compensation must not be a pittance but "just compensation" which include all elements that would go to place the complainant in as near a position as she was in, before the occurrence of the negligence. Whilst no amount of money or other material compensation can erase the trauma, pain and suffering monetary compensation is the manner known to law, whereby society assures some measure of restitution to those who had faced the mental agony, pain and trauma.

60. At this juncture we would like to recollect and refer to the judgement of the HON'BLE SUPREME COURT the case titled as

SARLA VERMA AND OTHERS

V

DELHI TRANSPORT CORPORATION AND ANOTHER

vide order dated 15-04-2009 in Civil Appeal No 3483/2008 wherein it has held that

"Compensation awarded does not become 'just compensation' merely because the Tribunal considers it to be just…Just compensation is adequate compensation which is fair and equitable, on the facts and circumstances of the case, to make good the loss suffered as a result of the wrong, as far as money can do so, by applying the well settled principles relating to award of compensation."

61. In auxiliary we would like to recollect and refer to the judgement HON'BLE SUPREME COURT the case titled as

CHARAN SINGH

VS

HEALING TOUCH HOSPITAL AND OTHERS

reported in (2000) 7 SCC 668 wherein it was observed and held as follows : -

" While quantifying damages, consumer forums are required to make an attempt to serve ends of justice so that compensation is awarded, in an

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established case, which not only serves the purpose of recompensing the individual, but which also at the same time, aims to bring about a qualitative change in the attitude of the service provider. Indeed, calculation of damages depends on the facts and circumstances of each case. No hard and fast rule can be laid down for universal application. While awarding compensation, a Consumer Forum has to take into account all relevant factors and assess compensation on the basis of accepted legal principles, on moderation. It is for the Consumer Forum to grant compensation to the extent it finds it reasonable, fair and proper in the facts and circumstances of a given case according to established judicial standards where the claimant is able to establish his charge. It is not merely the alleged harm or mental pain, agony or physical discomfort, loss of salary and emoluments etc. suffered by the appellant which is in issue it is also the quality of conduct committed by the respondents upon which attention is required to be founded in a case of proven negligence. it must be remembered that National Consumer Forum has jurisdiction, without pecuniary limitations, to award proper compensation., even less than the one claimed in a given case, depending upon the established facts and circumstances of that particular case and the evidence led by the parties."

62. Reliance is placed by us by recollecting and referring to the judgement of the HON'BLE SUPREME COURT in the case titled as

SHODA DEVI

VS

DDU/RIPON HOSPITAL, SHIMLA & ORS.,

decided on 07.03.2019 and reported in (2019) 14 SCC 357, wherein it was observed and held that

"15.2. We are constrained to observe that the National Commission, even after appreciating the troubles and trauma as also disablement and disadvantage suffered by the appellant, had been too restrictive in award of compensation. Ordinarily, the general damages towards pain and

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suffering as also loss of amenities of life deserve to be considered uniformly for the human beings and the award of compensation cannot go restrictive when the victim is coming from a poor and rural background; rather, in a given case like that of the appellant, such a background of the victim may guide the adjudicatory process towards reasonably higher amount of compensation (of course, after having regard to all the attending circumstances).

15.3. Such granting of reasonability higher amount of compensation in the present case appears necessary to serve dual purposes: one, to provide some succour and support to the appellant against the hardship and disadvantage due to amputation of right arm; and second, to send the message to the professionals that their responsiveness and diligence has to be equi-balanced for all their consumers and all the human beings deserve to be treated with equal respect and sensitivity. We are impelled to make these observations in the context of an uncomfortable fact indicated on record that when the appellant was writhing in pain, she was not immediately attended at and was snubbed with the retort that "the people from hilly areas make unnecessary noise". Such remarks, obviously, added insult to the injury and were least expected of the professionals on public duties.

15.4. Apart from the above, when the appellant is shown to be a poor lady from rural background, her contribution in ensuring the family meeting both ends also deserves due consideration. With her disablement and reduced contribution, the amount of compensation ought to be of such level as to provide relief in reasonable monetary terms to the appellant and to her family. 16. For what has been discussed and observed hereinabove and in the given set of facts any circumstances, we are of the view that the appellant deserves to be allowed further an amount of Rs 10,00,000 towards compensation, over and above the amount awarded by the State Commission and the National Commission. Having regard to the quantum of enhancement being allowed herein, it is

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also considered proper to grant three months' time to the respondents to make the requisite payment and else, to bear the burden of interest.

17. Accordingly, this appeal is allowed. The appellant is awarded further an amount of Rs 10,00,000 (Rupees ten lakhs) towards compensation, over and above the amount awarded by the State Commission and the National Commission. The respondents shall make the requisite payment within 3 months from today failing which, the enhanced amount of compensation shall carry interest at the rate of 6% per annum from the date of filing of the complaint before the State Commission."

63. We are of the view that the word 'deficiency' defined by the legislature prescribes very high standard of service which means that service provided by the opposite party hospital should be in very prefect and in flawless manner. Such an insensitivity or casual or indifferent attitude of the opposite party had left the complainant/ consumer high and dry and suffer immensely for her no fault. It was for keeping opposite party/service providers on tenterhook and to protect the interests of the consumers those very stern standards of 'service', 'deficiency' were provided. Every act of omission or commission by the opposite party/service provider has to be ascertained on the anvil of definition of 'deficiency' as provided in the Consumer Protection Act and not on any other premise. The main component of remedy for this is an amount of compensation to be paid for the actual loss or injury, which includes mental agony, emotional suffering, disability & physical discomfort due to negligence/deficiency in service of the service provider.

64. According to us the main component of remedy is an amount/quantum of compensation as to the actual loss or injury, which includes mental agony, emotional suffering, harassment and physical discomfort due to negligence or deficiency in service on the part of the service provider. Such a relief is available to the complainant by virtue of Section 38 of the Consumer Protection Act 2019. The word compensation is of a very wide connotation. It may constitute actual loss or expected loss and may extend to compensation for loss. The provisions of the Consumer Protection Act enable a consumer to claim and empower this Commission

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to redress any injustice done. This Commission is entitled to compensate a consumer for injustice suffered by him. Such compensation is for vindicating the strength of law.

65. Turning to the matter of the quantum of compensation, it is imperative to recognize that this assessment is inherently subjective in cases of medical negligence. Each situation is unique, shaped by its own distinct facts and circumstances. The sine qua non for entitlement of compensation is proof of loss or injury suffered by the consumer due to the deficiency in service, unfair trade practice and negligence of the opposite party. Once the said conditions are satisfied, the Consumer Commission shall decide the quantum of compensation to which the consumer is entitled. There cannot be any dispute that the computation of compensation has to be fair, reasonable and commensurate to the loss or injury. There is a duty cast upon this Commission to take into account all relevant factors for arriving at the compensation to be paid on the basis of accepted legal principles and grant compensation to the extent it finds it reasonable, fair and proper in the facts and circumstances.

66. We taking into account the facts and circumstances of the case and the judgments stated supra while quantifying the compensation we had taken note of the medical expenditure to the tune of Rs. 2,21,956/- at Madurai Meenakshi Mission Hospital & Research Centre vide Exhibit A-10 and it has been affirmed by the complainant that she had spent around Rs. 1,50,000/- at Aristo Hospital, Madurai and she would definitely require further medical treatment and nursing care to take day to day care for considerable period of time. Thus, the complainant was forced to incur the above medical expenses due to the gross negligence and deficiency in service on the part of the opposite party. The mammoth medical expenses incurred which was forced to borne by the complainant for recovery from her medical condition which caused due to gross medical negligence and deficiency in service on the party of the opposite party. In light of the discussions above, we believe that the negligent and deficient actions of the opposite party would have caused significant emotional distress to the complainant. This distress is not just a minor setback, rather, it encompasses a profound experience of

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mental pain characterized by a complex mix of emotions, including distress, fright, and anxiety. The complainant has endured a high level of mental suffering, which goes beyond simple disappointment. This pain arises from a combination of grief and indignation, as the complainant has felt wronged and has faced financial constraints as a direct consequence of the opposite party's negligence. The anxiety stemming from cycle of worry would have lead to further emotional strain. In summary, the negligent actions of the opposite party have not only caused financial loss but have also inflicted substantial emotional harm, highlighting the need for accountability and redressal of his genuine and legitimate grievance.

67. In assessing the quantum of compensation, it is imperative to underscore that our evaluation transcends a mere mechanical response to the claims articulated in the complaint or a reaction fueled solely by empathy. Instead, our determination is the product of a comprehensive and scrupulous analysis of a myriad of factors, encompassing both the emotional and physical tribulations endured by the complainant. The emotional upheaval experienced by the complainant in this context is both profound and intricate. The initial revelation of a debilitating condition, particularly one that can be traced back to medical negligence, engenders a deep-seated sense of betrayal and mourning. The complainant is likely to grapple with intense feelings of anger, not only directed towards the medical professionals whose actions or inactions precipitated this unfortunate outcome but also towards a healthcare system that has ostensibly failed in its fundamental duty of care. This grief is further exacerbated by the harrowing realization that the disability could have been averted, engendering a heightened sense of guilt and helplessness that can be psychologically debilitating.

68. In auxiliary, the complainant's current state of being bedridden imposes significant physical demands on caregivers, who often find themselves navigating an exhausting landscape of responsibilities. If the disability entails limited mobility, the caregivers are thrust into a role that requires constant vigilance and intervention, leading to a cascade of physical and emotional challenges. The toll on caregivers is substantial; sleepless nights become the norm, and the physical strain of lifting, supporting, and assisting the complainant in daily activities can lead to

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their own health complications. The burden of caregiving is not merely a logistical challenge but a profound emotional and physical ordeal that can leave caregivers feeling overwhelmed and depleted.

69. In addition to the immediate physical demands, caregivers may be compelled to undertake significant modifications to their living environments to ensure safety and accessibility for the complainant. These adjustments, while necessary, can impose a considerable financial strain, further complicating the already challenging dynamics of care giving. The complainant, once vibrant and healthy, approached the opposite party seeking assistance for what were ostensibly manageable gynecological issues. However, due to gross negligence and a palpable deficiency in the standard of care provided, she has been irrevocably transformed into a frail, weakened individual, now beset by a multitude of medical conditions. The direct ramifications of this negligence are acutely felt by the complainant, who must now contend with the relentless specter of pain, fatigue, and restricted mobility. The emergence of secondary health conditions, stemming from the initial negligence, compounds her suffering and further diminishes her quality of life. The emotional toll associated with frequent medical appointments, invasive surgeries, and ongoing therapies is profound, fostering a potentially lifelong struggle with health anxiety and a pervasive sense of frustration over her inability to meet developmental milestones typically expected of children her age.

70. In light of these multifaceted challenges, it is essential to approach the determination of compensation with a nuanced understanding of the profound impact that medical negligence has wrought on the complainant's life. The interplay of emotional distress, physical limitations, and the burdens borne by caregivers must be meticulously considered, ensuring that the compensation awarded reflects not only the tangible losses incurred but also the intangible suffering that has irrevocably altered the complainant's existence.

71. In the realm of medical negligence, the determination of compensation is inherently complex and multifaceted, necessitating a nuanced understanding of the myriad factors at play. Our assessment, far from being a mere reflection of the

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claims articulated in the complaint or a response motivated solely by empathy, represents a comprehensive and rigorous analysis of the circumstances surrounding the case. The complainant, having endured significant distress and hardship as a result of the alleged negligence, is entitled to a compensation amount that not only addresses the immediate financial repercussions but also acknowledges the prolonged emotional and psychological toll inflicted over the past two years. The passage of time since the incident on 13-06-2023 has undoubtedly exacerbated the complainant's suffering, underscoring the necessity for a compensation that is both equitable and reflective of the enduring impact of the negligence experienced.

72. In light of these considerations, we have meticulously quantified the compensation payable by the opposite party to the complainant at Rs. 10,00,000/- with an interest rate of 9 % per annum, commencing from the date of the incident ie. 13-06-2023. This interest is not merely a financial addendum it serves as a recognition of the time value of money and the ongoing repercussions of the complainant's ordeal. The imposition of interest is a critical component of our decision, as it compensates the complainant for the delay in receiving justice and acknowledges the financial strain that has likely persisted in the interim.

73. In this regard, our mind is redolent and reminiscent as we recollect and place reliance on the dicta of the HON'BLE NATIONAL COMMISSION in the case titled as

VISHNU PRIYA GIRI

VS

G.M. MODI HOSPITAL RESEARCH CENTRE FOR MEDICAL SCIENCES,

decided on 13-05-2022 reported in 2022SCC online NCDRC 58 wherein it was observed and held as follows : -

The impugned Order was modified to the extent that the treating Surgeon was liable for medical negligence; as well, the hospital was vicariously liable. The hospital needed qualitative change and systemic improvement

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also. Therefore, on the basis of the foregoing discussion, OP 1 and 2 shall pay total compensation of Rs 25 lakhs with interest of 6% pa and cost of litigation shall remain at Rs 1 lakh only.

74. We find that the judgment referenced above is directly applicable to the present consumer complaint at hand, as it underscores the principle of awarding interest on the compensation granted to the complainant. This alignment with established legal precedents not only reinforces the legitimacy of our decision but also highlights the importance of ensuring that the complainant is adequately compensated for the prolonged period of distress and financial burden endured since the incident. By imposing interest on the compensation, we acknowledge the time elapsed since the occurrence of the alleged negligence, which has undoubtedly compounded the complainant's suffering. This approach is not merely a procedural formality it is a fundamental aspect of delivering consumer justice that recognizes the ongoing impact of the harm inflicted. The award of interest serves to mitigate the financial disadvantage experienced by the complainant during the intervening period, thereby affirming our commitment to consumer rights and the principles of equity. This holistic approach to compensation is essential in fostering trust in the consumer protection framework and ensuring that consumer justice is served in a manner that is both fair and comprehensive.

75. We wrap up by recollecting the quote of George Bernard Shaw, "We have not lost faith, but we have transferred it from God to the medical profession." This sentiment captures a profound truth, many individuals regard doctors as earthly deities, placing immense trust in their hands. When a patient seeks medical help, they often surrender themselves entirely to the expertise of their physician. This profound conviction elucidates the considerable weight of responsibility that medical practitioners must shoulder. The trust that patients place in their physicians is not merely a professional obligation, it is a sacred covenant that demands unwavering commitment and ethical integrity. It is imperative that medical professionals approach their roles with the utmost care, diligence, and a profound sense of duty, recognizing that their actions can significantly impact the lives of those who seek their counsel and healing. In this intricate and sacred

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relationship between physician and patient, the call to compassion transcends mere empathy, it requires a deep understanding of the human condition, an appreciation for the vulnerabilities that accompany illness, and a steadfast commitment to alleviating suffering. Moreover, the ethical dimensions of this relationship necessitate that medical professionals remain vigilant stewards of the trust conferred upon them. They must navigate the complexities of medical decision-making with transparency and respect, ensuring that patients are informed participants in their own care. This collaborative dynamic fosters a sense of agency and dignity, empowering patients to engage actively in their healing journeys. Ultimately, the interplay of compassion and excellence within the medical profession is not merely an ideal it is a fundamental tenet that underpins the very essence of healthcare. By embodying these principles, medical professionals not only honour the faith bestowed upon them but also contribute to the cultivation of a healthcare environment that prioritizes the sanctity of life, the alleviation of suffering, and the promotion of holistic well-being.

In the result the complaint is allowed in part and (i). the opposite party is directed to pay a sum of Rs. 10,00,000/- (rupees ten lakhs only) to the complainant as compensation for mental agony, pain, anguish, helplessness, acute financial expenses and constraints to her along with interest at the rate of 9 % per annum, commencing from the date of the surgery ie. 13-06-2023 to till date of payment

(ii). the opposite party is directed to pay a sum of Rs. 10,000/- (rupees ten thousand only) to the complainant as cost of this complaint. Time for compliance: 45 days from the date on which the copy of this order is made ready.

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This order is dictated by the President to the Steno-Typist, transcribed, typed by him and corrected, signed and pronounced by us in open Commission, today on th this 05 day of March 2025.

Sd/- Sd/-

(P.SHANMUGAPRIYA) (M.PIRAVIPERUMAL)

MEMBER-I PRESIDENT

Documents filed by the complainant:-

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Documents filed by the opposite party

Sd/- Sd/-

(P.SHANMUGAPRIYA) (M.PIRAVIPERUMAL)

MEMBER-I PRESIDENT