DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION, KOZHIKODE

PRESENT : Sri. P.C. PAULACHEN, M.Com, LLB    : PRESIDENT

                  Smt. PRIYA.S, BAL, LLB, MBA (HRM) :  MEMBER

                  Sri.V. BALAKRISHNAN, M Tech, MBA, LL.B, FIE: MEMBER

      Monday the 31^st  day of January  2022

C.C. 272/2013

Complainant

        Babu.K.V , S/o. K.G. Vakkachan

        Kurupath House, Chundel (P.O),  Wayanad.

Opposite Parties

1. The Managing Director

     Malabar Institute of Medical Science Ltd (MIMS)

Mini Bypass Road, Govindapuram, Kozhikode – 673 016

2. Dr. George Abraham

Malabar Institute of Medical Science Ltd (MIMS)

Mini Bypass Road, Govindapuram,Kozhikode – 673 016

3. Dr. Gopalakrishnan.M.L.

Malabar Institute of Medical Science Ltd (MIMS)

Mini Bypass Road, Govindapuram,Kozhikode – 673 016

          (By Adv.  Sri. Shyam Padman )

ORDER

By Sri. P.C. PAULACHEN  – PRESIDENT.

        This is a complaint filed under  Section 12 of the Consumer Protection Act, 1986.

2. For the same grievance, the complainant  had earlier filed a complaint before the Consumer Disputes Redressal Forum, Wayanad as C.C.31/2013. But the same was returned for want of jurisdiction. Thereafter this complaint was filed  before this Commission.

        3. The case of the complainant, in brief, is as follows:

            The complainant is  a carpenter by profession. On 03/01/2013 while doing work with a wood cutting machine, he met with an accident in which  his right hand  middle, ring and little finger were caught in the machine and cut off. He was rushed to Leo Hospital, Kalpetta  along with the amputated parts. After giving first aid, he was advised to go to any hospital in Kozhikode and accordingly,  he was taken to the first opposite party’s  hospital, Kozhikode. The first opposite party is the Managing Director, the 2^nd opposite party is the Head of Department of Orthopaedics and the 3^rd opposite party is an expert claimed  to have specialisation in the field of micro vascular surgery in the said hospital. The second and third opposite parties after examining  the complainant, told that the amputated parts could be successfully re-implanted through a micro vascular surgery  and  assured 80% success. The cost of the surgery was Rs.70,000/- and he was asked to pay an advance amount of Rs.40,000/- immediately. The brother and wife of the complainant repeatedly asked the opposite parties about the possibility of recovery and they were assured that the said  hospital was having high reputation in conducting such micro vascular surgery and it had never failed so far. The complainant managed to raise Rs.40,000/-  and remitted in the  hospital on the same day and consented to undergo the surgery. He was taken to  the operation theatre at about 7.30 p m  and surgery was conducted. On 04/01/2013 morning he was shifted to  post operative ward. But the second and third opposite parties had never visited him till the  third day of the surgery.  He had suffered acute pain due to the fact that the nerve block done was not in proper position. He was again taken back to the theatre and the nerve block was done in proper position. The surgery was conducted without  conducting any tests to ensure  proper blood circulation. Post operative pus culture and sensitivity test were  not done.

4. On the third day,  after examining the complainant, the third opposite party opined that the  fingers became  gangrenous and the same  had to be amputated. The first reason stated by the third opposite party was that the possibility of recovery is very low as the nature of amputation was a crush amputation. The second reason stated was that the amputated fingers brought were not preserved. Thus the re-implanted fingers were amputated on 07/01/2013  by the opposite parties. By this time  the complainant had already remitted the entire amount of Rs.70,000/- to the 1^st opposite party being the cost of micro vascular surgery. Thereafter he got discharged from that hospital and was hospitalised in the Government Medical College, Kozhikode where the treatment  for flap covering of the raw area continued. The raw area which was infected due to the unwanted surgery was debrided in the Medical College hospital. He had undergone this procedure due to the unwanted surgery conducted by the opposite parties . The opposite parties were well aware of the fact that it was a crush  amputation and the amputated fingers were not properly preserved.  Even then they advised micro vascular surgery and assured 80% success. They knew very well that the chance of success in case  of crush amputation was very rare. Neither the complainant nor his relatives would have agreed for such a surgery had they been told that the possibility of success was below 80%. In spite of that,  with the fraudulent intention of  squeezing money, they induced  the complainant and his relatives to undergo  such a surgery and thereby  committed negligence and unfair trade practice. Besides Rs.70,000/-, the complainant had to spend an amount of Rs.25,000/- towards the price of the medicines and other surgical items. He had to suffer acute physical pain and mental agony. Though the gangrene was noted on the next day of surgery itself, the opposite parties did not take care to see that  it was amputated on that day itself. Thus he was made to suffer pain for some more days. If pus culture and sensitivity test were conducted, it could have avoided further complication  following amputation.

5. Complainant had already spent an amount of Rs.95,000/- and he is entitled to get back the same from the opposite parties. Further he is entitled to get at least Rs.4,00,000/- as compensation for physical pain and mental agony suffered. Hence the complaint.

        6. The  opposite parties resisted the complaint  by filing version jointly. Their contentions, in a nutshell, are as follows:

        There was no negligence or deficiency of service on the part of the opposite parties. The treatment was done by the universally accepted standard medical protocol bestowing all care, caution and attention. The complainant has suppressed material facts.  The complication alleged is a medically accepted complication which can occur in spite  of best care, caution and attention on the part of the treating doctors.  The first opposite party hospital is a fully equipped super speciality tertiary care hospital with qualified and experienced doctors, nursing and other para medical staff. The second and third opposite parties are well qualified  and experienced having  expertise.  7. The complainant was brought to the 1^st opposite party hospital on 03/01/2013 with a history of sustaining injury to the right hand by a wood cutting machine. On examination there was total crush amputation of the middle, ring and little fingers as well as injury to the index finger and thumb. Thumb and index fingers were viable and rest of the fingers were totally amputated and non-viable. X-ray revealed amputation of  middle and ring fingers at the level of  meta carpo phalangeal joint  and little finger at the level of  proximal  inter phalangeal joint and communition at the fractured site indicative of  crushing nature of injury. After conducting clinical as well as x-ray examination, the 3^rd opposite party informed the complainant as well as his relatives about the nature of injury and the planned work up for an attempted  re-implantation of the severed fingers. In view of the fact that 3 fingers of the dominant right hand were amputated, plan for an attempted re-implantation  was made in spite of the  part being crushed and unpreserved. The 3^rd opposite party had explained the pros and cons of the intended re-implantation procedure and the risk and chances of failure involved in the procedure due to crushed nature of injury of the severed fingers. The complainant  and the relatives were informed  of the following facts:

1. the procedure involves re-implantation of middle and ring fingers and shortening closure of the little finger.
2. no guarantee for 100% revival of the fingers to its earlier condition.
3. there is chance for the fingers turn to gangrenous condition and in that case it requires removal.
4. skin over the fingers might necrose requiring flap cover at a later stage.
5. even if fingers survive the movements and sensation cannot be guaranteed.
6. the expected appropriate expenses would be about Rs.1,00,000/-
7. reference to  seek treatment  elsewhere at the option of the complainant was also given.

8. The complaint and his relatives voluntarily agreed and  consented for  the  attempted implantation of severed fingers . Under all aseptic care and precaution, the third opposite party conducted re-implantation of the ring and middle fingers and shortening closure of  little finger on 03/01/2013 around 7 p m  under general anaesthesia and completed by 3.15 a m on  04/01/2013. The procedure involved dissection of the distal and proximal part of middle and ring fingers and arteries, veins, and nerve anastomosis under microscopic magnification and bony stabilisation with two K-wires followed by Flexor Digitorum Profundus  repair. Middle finger vascularity was doubtful and hence arterial re-anastomosis was done  and ring finger appeared viable. Wound was closed and non-adhesive dressing  and dorsal plaster of paris  slab was applied. Post operatively the patient was shifted to ward and advised limb elevation and plenty of oral fluids. Catheter placed pre operatively for pain relief and to avoid vessel spasm was repositioned post operatively since the patient complained  of severe pain . The condition  of the patient was assessed on regular basis and medicines were continued. In view of poor vascularity in the middle finger dressing kept in situ for 3 days and the dressing was changed on 07/01/2013. The routine protocol for patient  care is such traumatised limb was followed. On inspection the fingers were found gangrenous beyond the scope restoring back to life and it was decided to remove the gangrenous fingers and  the raw areas required  flap cover. After taking consent, the gangrenous fingers were removed and he was advised flap cover for the raw area at a later date. But the complainant himself got discharged on request on  10/01/2013 and was not available for further follow up and management.

9. The opposite parties had tried all possible means  with diligence and care to restore the fingers back to position in spite of crushed nature of severed fingers since he sustained injury  to his dominant hand. The allegation that the complainant was assured 80% success is not correct. The allegation that post operatively the 2^nd and 3^rd opposite parties never visited him till the 3^rd day is false and hence denied. As per the accepted protocol they attended the patient, assessed his condition and prescribed medicine. The allegation that the complainant suffered immense pain due to nerve block which was not in proper position is highly ill-motivated and hence denied. The patient sustained severe traumatic injury by a cutting machine and immense pain was attributable to the severity of the injury. Pre operatively catheterisation was done to relieve pain and to avoid vessel spasm and due to severe pain post operatively, it required repositioning. The allegation that the surgery was done without conducting any tests to ensure proper blood circulation is untenable and hence denied. The allegation that the complainant had to undergo flap cover procedure due to unwanted surgery conducted by the opposite party is highly ill motivated and hence denied. The statement that gangrene was noted on the next day of the surgery is not correct and hence denied.

10. The amount shown as expended by the complainant towards cost of surgery and other expenditure is not correct and  hence denied. There was no negligence or unfair trade practise of the part of the opposite parties. The compensation claimed under the head of physical pain and mental agony is without any basis, besides being highly excessive. No loss, injury, hardship or damage was caused or occasioned to the complainant  on account of the opposite parties. The opposite parties have acted in utmost good faith to save a dominant limb of the complainant after taking high risk informed consent  and in the best interest of the patient with all bonafides.  The complaint lacks truth and bonafides and is an experimental one. It is, therefore, prayed to dismiss the complaint with compensatory costs.

        11.  The points that arise for determination  in this case are:

                (1)  Whether there was any deficiency of service or unfair trade practice on the part  of the opposite parties, as alleged ?

                         (2)  Reliefs and costs.

12. Evidence consists of the oral evidence of PWS  1 to 3 and Exts. A1 to A18 on the side of the complainant. RWS 1 and 2 were examined and Ext. B1 and B1 (a) were marked on the side of the opposite parties.

        13. Heard both sides. Brief argument note was filed by the opposite parties.  

        14. Point No.1 : The complainant has approached this Commission seeking compensation of Rs.4,95,000/- alleging negligence  and unfair trade practice on the side of the opposite parties.

15. The complainant alleges that he was subjected to an unwanted surgery  and the opposite parties gave him false promises and assurances even when they knew  that the success rate was very low in the case of crush amputation  and when the amputated fingers were brought unpreserved. In order to substantiate his case, the complainant got himself examined as PW1. PW1 has filed proof affidavit and deposed in terms of the averments in the complaint. PW2 is the Associate Professer in Plastic Surgery Department, Governement Medical College, Kozhikode, who treated PW1  in that  hospital. PW3, the wife of the complainant, also deposed supporting the case of  PW1.  Ext.A1 is the discharge summary, Ext A2 and A3  are the discharge book of Medical College hospital, Exts. A4 to A7 are inpatient statements, Exts A8 to A16 are the cash bills and advance receipts and Exts A17 and A18 are the requisitions for advance payment.

16. The opposite parties, in their version, have denied any negligence or unfair trade practice. Their contention is that  the complainant  and his relatives were well informed of the pros and  cons of the intended re-implantation procedure and the risk and chances of the failure involved in the procedure due to the crushed nature of injury of severed fingers. According to them,  they attempted re-implantation of the severed fingers in view of the fact that  three fingers of the dominant right hand  were amputated  in spite of the part being crushed and brought unpreserved.  Their specific case is that they had tried all possible means  with diligence and care  to restore the fingers back to position  and the procedure followed during and after surgery was according to the universally accepted standard  medical protocol. The third opposite party was examined as RW1. RW1 has filed proof affidavit and deposed supporting the contentions  in the version of the opposite parties. Dr. John Oommen, Head of Department of Plastic Surgery, Baby Memorial Hospital, Kozhikode was examined as RW2. Ext.B1 is the case sheet pertaining to the treatment of the complainant in the 1^st opposite party’s hospital and Ext B1 (a) is  pages 49  and 50 of  Ext.B1 wherein  the consent for surgery was given by the complainant and his wife.

17. The learned counsel for the complainant argued that the complainant was subjected to an unwanted surgery  on the false promises and assurances given by the opposite parties and this is evident from the testimonies of PWs 1  to 3 and the documents produced.  It was pointed out that the opposite parties  very well knew that the success  rate was very low because of the  crush  nature of the injury and  the amputated fingers were brought unpreserved.  It was submitted  that  the consent of the complainant and his relatives was obtained by assuring 80% success with the malafide intention to grab money by  conducting an unwanted surgery. Per contra, the learned counsel for the opposite parties  vehemently argued  that  the treating doctors had tried all possible means with diligence and care to restore the fingers back to position in spite of severe crushed nature of the severed fingers since the patient, who is a carpenter by profession,  sustained injury to his dominant hand. It was submitted that micro vascular surgery was attempted after informing the complainant and his bystanders about the risk of failure and their informed consent was obtained before the surgery. It was submitted that in cases of this nature of severance, no reasonable medical practitioner could assure  success rate  in percentage and  in the management of the patient, the treating doctors had acted as per accepted medical practice. It was also pointed out that no expert evidence is let in by the complainant to prove any deficiency in service, but on the other hand, the evidence of PW2 and RW2 would positively prove that  there was no latches or deficiency on the part of the  treating doctors.

18. It is well settled that the onus of proving the alleged negligence and deficiency of service in the treatment is on the person  who alleges medical negligence. So the burden is upon the complainant to prove that there was negligence on the part of the opposite parties. The main allegation of the  complainant is that he was subjected to  an unwanted surgery on the false promises and  assurances given by the  opposite parties, even though  the success rate is very low in the case of crush amputation and the amputated fingers were brought  unpreserved.  Admittedly, it is a case of  crush amputation. Exts.A1 and B1  show that there was total crush amputation  MP joint level  of mid and ring fingers and PIP Joint level little finger and there was crush injury without skin loss dorsum of right  index finger. It is also an admitted fact that the amputated fingers  were brought unpreserved.

19. At the very outset, it may be noted that on sustaining such injury complainant was first taken to  Leo Hospital, Kalpetta and after initial first aid,  he was taken to the first opposite party’s hospital where specialist doctors in the field of Microvascular surgery was available. PW1 has admitted in the cross examination that he approached the said hospital with the intention to save his fingers. He has added that his wife and brother were also of the same intention and desire.  In the proof affidavit,  PW1 has denied the statements regarding  the prior information and discussion of pros and cons of the surgery, success rate of the surgery, details regarding  the treatment expenses, procedure to be followed and the opposite party’s consent to  shift the patient to any other hospital of complainant’s choice etc.  But during cross examination, it is clearly admitted by PW1 that  before the surgery, all relevant details about the surgery expenses, complications etc were discussed  with him and his relatives. It is also admitted by PW1 that  it was  after  discussion that  consent was given for the  surgery. The  specific allegation of the complainant is that  80% success was assured by the 2^nd and 3^rd opposite parties. But this is stoutly   denied by the opposite parties. There is absolutely nothing to show that  80% success was assured  by the doctors. The evidence of PW1 shows that he was well aware of the risk of failure  due to  severe crushed nature of fingers and as the  severed fingers were brought  unpreserved. Admittedly, PW1 sustained injury to his dominant hand. Microvascular surgery was attempted after informing the complainant and his bystanders about the risk of failure. Ext.B1(a) is the written consent given by the patient and the bystander, who is none other than his wife. It is clearly stated in Ext.B1 that no guarantee for success was assured by the doctors. Ext.B1 (a) is  indicative of the fact that  the doctors did not give any such assurance as  to the outcome of the surgery.

20.  PW2, who treated PW1  in the Medical College hospital,  has  stated that the success rate is very low in the case of crushed amputation and unpreserved  distal part. To a specific question put by the learned counsel for the complainant  as to whether  she would recommend a micro vascular surgery with total crush amputation with unpreserved distal parts,  the answer of PW2 was that in the given situation total crushed amputation with an unpreserved distal part, any micro vascular surgeon would be concerned about replantation surgery, but respect the patient’s wishes also  in an individual case,  and it cannot be generalised. To the  question as to whether any reasonable prudent doctor always strive to preserve the organs by way of replantation  and such other procedure, the answer of PW2 was in the affirmative.  To another suggestion  put to PW2 as to whether in risky and marginal cases, it is always the volition and decision of the patient  which finally matter in determining the course of treatment, the answer of PW2 was that  he cannot agree with ‘always’ , but it is one of the criteria which would be considered while deciding the treatment course.  Further PW2 has  stated that even in cases of clear cut injury with fully preserved parts , there is always the possibility of auto amputated  failure of  re-implantation. PW2 has added that in spite of  best care, caution and attention on the part of the treating doctor/surgeon, there is the possibility of re-implantation failure and  the decision of the re-implantation is an emergent or emergency situation one cannot predict without prejudicing the possibility of success. Further PW2 has deposed that there are numerous causes  for implant failure, which are independent and not connected with  the surgery, surgeon or the treatment given. In spite of best care,  caution and attention on the part of the treating doctor, there is always the possibility of things to go wrong and in medicine  we can only guarantee care  and not cure. PW2 has opined that from Exts.A1 and B1 treatment records of the patient, there is no negligence on the part of the treating doctors. PW2 has deposed that the statement given by him during the chief examination was general answers and that the treatment records were seen by her only at the time of the cross examination. She has  added that whatever treatment was given in the medical college hospital was the continuous treatment and management of the patient in continuation of the treatment  given earlier.

21. It may be noted that no expert evidence  is let in  to corroborate the case  of  the complainant.   On the other hand, the opposite parties have examined RW2. The qualification of RW2 is MS and MCH in Plastic Surgery. He is specialised in Plastic Surgery and has been working since 1985. RW2  has given evidence that in case of clear cut injury and well preserved body parts, there is chance of failure in  replanting the same. To a specific question as to whether  in the case of crush injury and the body parts not preserved is there any chance of success of re- implanting,  the answer of RW2 was in the affirmative  and stated that there is chance. Regarding  the time in which  the re-implantation has to take place, RW2 has  stated that safety time varies in different parts of body where  the injury occurs  and regarding fingers,  it can be implanted up to 12 hours.  RW2 has opined that in this case there is  nothing indicating  any medical negligence on the part of the treating doctors  and he added that if he was conducting the surgery,  he would have followed the same procedure. RW2 has categorically stated that the treatment given to the  patient in this case is according to the universally accepted standard medical protocol. Thus the evidence of RW2, the expert, rules out any negligence on the part of  the treating doctors. There is absolutely no reason to disbelieve RW2. Even though he was subjected to  searching cross examination, nothing has been brought out to discredit his version.

22. It is admitted by the PW1 in the cross examination that prior to the surgery all the required tests were conducted. It is also admitted by him that during the post operative days, the duty doctor attended him and necessary medicines were given. The second opposite party also visited him and treated him.

23. The complainant has an allegation that he had to go to the Medical College hospital for further procedures due to the unwanted surgery conducted. But while in the box, PW1 has admitted that  what was done in the Medical College hospital was the continuous treatment. PW2 has also given evidence that whatever  was done in the Medical College hospital was the  continuous treatment and management of the patient in continuation  of the treatment given earlier.  PW2 has deposed that flap surgery is a sequelae of re- implantation  surgery.

24. In Jacob Mathew Vs. State of Punjab reported in AIR 2005 SC 3180  the Hon’ble Supreme Court   has observed  as follows:

“Negligence by professional in the law of negligence, professional such as lawyers, doctors, architects and others are included in the category of persons professing some special skill or skilled persons generally. Any task which is required to be performed with a  special skill would generally be admitted or undertaken to be performed only if the person possesses the requisite skill for performing that task. Any reasonable man entering into a profession which requires a particular level of learning to be called a professional of that branch, impliedly assures the person dealing with him that the skill which he professes to possess shall be exercised and exercised with reasonable degree of care and caution. He does not assure his client of the result. A lawyer does not tell his client that the client shall win the case  in all circumstances. A physician would not assure the patient of full recovery in every case. A surgeon cannot and does not guarantee that the result of surgery would invariably be beneficial, much less to the extent of 100% for the person operated on. The only assurance which such a professional can give or can be  understood to have given by implication is that he is possessed of the requisite skill in that branch of profession which he is practising and while undertaking the performance of the task  entrusted to him he would be exercising his skill with reasonable competence. This is all what  the person approaching the professional can expect. Judged by this standard, a professional may be held liable for negligence on one of  two findings; either he was not possessed of the requisite skill which he professed to have possessed, or, he did not exercise, with reasonable competence in the given case, the  skill which he did possess. The standard to be applied for judging, whether the person charged has been negligent or not, would be that of an ordinary competent person exercising ordinary skill in that profession”.

It is not disputed that the first opposite party’s hospital is a fully equipped super speciality hospital with all the facilities. The qualification of the second opposite party is D (Ortho) M S (Ortho), F Spine (AUS) with vast experience of 28 years as a consultant Orthopaedic surgeon .   In the instant case,  the 3^rd opposite party is an expert in the field of micro vascular surgery. RW1  has  deposed that he completed his MS (Ortho) from DJMC Medical College, Ahmedbad and later FNB  and  Micro vascular Surgery  from Stanley Hospital and Medical College, Chennai, a premier institute in training hand surgeons. He is the  holder of fellowship in  Hand and Micro vascular Surgery certified by the  National Board of Examinations of Delhi. PW1  has also admitted in the cross examination that RW1 is an experienced microvascular surgeon having expertise. So there can be no doubt that   the doctors who treated PW1  possessed the requisite skill which they professed to have possessed.  There is nothing to  indicate that the doctors did not exercise with reasonable competence, the skill which they possessed. On the other hand, the evidence of PW2 and RW1 would  affirm the fact that  the management of the patient was as per accepted  medical practice and there was no negligence on the part of the treating doctors.

25.  There is nothing to indicate that the opposite parties have done anything  which a reasonable or prudent doctor would not have done  in the given circumstances or omitted to do anything that a reasonable or a prudent doctor would have done in the given circumstances. The complainant was a carpenter by profession and the injury was on the right hand.  The surgery was attempted  after informing the patient and his bystanders  about the risk of failure and obtaining  informed consent.  There is nothing to indicate that  the patient or the bystanders were assured of 80% success. The evidence of the expert (RW2) indicates that there is  chance of success even in the case of crush injury and the  body parts are not preserved. The patient and the relatives were also desirous of saving the fingers. In these circumstances, it cannot be said that it was an unwanted surgery. There is expert evidence to the  effect that the treatment given to the patient was proper and correct and according to the universally accepted  medical procedure. The post operative care  was also  in order. It is well settled that medical science  is not an exact science and in spite of all care, caution and attention on the part of the treating doctor,  something may always go wrong.    So no negligence or deficiency of service or unfair trade practise can be  attributed against the opposite parties. Consequently, the opposite parties in this case cannot be held liable.

  26. Point No.2   : In view of the finding on the above point,  the complainant is not eligible to claim  and get any compensation from the opposite parties and the complaint is only to be dismissed.

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

 Dictated to the Confidential Assistant, transcribed by her and corrected by me and pronounced in the open Commission  on this the 31^st day of January 2022. Date of Filing: 25/06/2013.

Sd/-                             Sd/-                          Sd/-

        PRESIDENT                 MEMBER                    MEMBER

APPENDIX

Exhibits for the Complainant :

Ext. A1 –  Copy of the discharge summary

Ext. A2 –  Discharge book of Medical College hospital, Kozhikode.

Ext. A3 –  Discharge book of Medical College hospital, Kozhikode.

Ext.A4 – Inpatient statement

Ext.A5 – Inpatient statement

Ext.A6 –  Inpatient statement

Ext.A7 – Inpatient statement

Ext.A8 –  Cash bill

Ext.A9 –  Cash bill

Ext. A10 –  Cash bill

Ext.A11 –  Cash bill

Ext.A12 –  Advance receipt

Ext.A13 –  Cash bill

Ext.A14 –  Cash bill

Ext.A15 –  Cash bill

Ext.A16 –  Pharmacy bills 

Ext.A17 –  Requisition for advance payment.

Ext.A18 –  Requisition for advance payment.

Exhibits for the Opposite Parties

Ext. B1 –  Case sheet pertaining to the treatment of the complainant

              from the 1^st Opposite party’s hospital.  

Ext.B1 (a)   - Page No.49 and 50 of Ext.B1.

Witnesses for the Complainant

PW1 – Babu.K.V – Complainant

PW2- Dr. Sheeja Rajan

PW3 – Smt. Beena Babu

Witnesses for the opposite parties

RW1 – Dr. Gopalakrishnan

RW2 – Dr. John Ommen

       Sd/-                                   Sd/-                         Sd /-                      FORWARDED/BY ORDER

     PRESIDENT                     MEMBER                      MEMBER             

                                                                SENIOR SUPERINTENDENT