The court applied the standard of reasonable care and skill required from a normal doctor/consultant to determine negligence in medical treatment.

1. The plaintiff, Smt. Sudha Garg, alleges medical negligence and seeks recovery of damages of Rs.53,41,723/- from Union of India, Chief of Army Staff, Adjutant General, Directorate General of Medical Services (Army) and Army Hospital (Referral and Research), defendant Nos. 1 to 5, respectively (hereinafter collectively referred to as defendants, for short) and two doctors Lieutenant Colonel A.K. Nagpal and Lieutenant Colonel V.K. Shukul (hereinafter referred to as defendant Nos. 6 and 7 respectively). Admitted facts

2. The plaintiff is wife of Brigadier M.L. Garg (Retd.) and on 14th October, 1999 had visited Gastroenterology Department of the defendant no.5 hospital, at Delhi. She was examined by defendant No. 6, Gastroenterologist and diagnosed as an old case of severe gastritis with history of heart burn. OPD card/ case history Exh.PW1/2 dated 14th Oct.,1999, an admitted document, records that the plaintiff did not complain of pain in abdomen and dysphagia (difficulty in swallowing). She was advised to undergo Upper Gastro Intestinal Endoscopy (UGIE, for short) on 15th October, 1999. UGIE is a procedure for visual examination of lining of food pipe, stomach etc. by using a flexible tube with an endoscope, which is inserted through mouth, swallowed and gently pushed inside the esophagus or food pipe.

.3. The case sheet dated 15th October, 1999, prepared by defendant No. 6, is an admitted document Exh. PW1/1, records that UGIE was attempted but was not successful as the plaintiff could not swallow the endoscope. Exh. PW1/1 also records that the plaintiff had earlier undergone CA Tongue and fleshy vascular structures were seen post to larynx. Plaintiff was advised ENT evaluation.

4. Defendant No. 7 is an ENT specialist working with the defendants and had examined the plaintiff on 16th October, 1999 in the defendant no.5 hospital. Case sheet dated 16th Oct.,1999 was denied by the defendants at the time of admission/denial, but it is clear from the affidavit/evidence of defendant No. 7 that he has accepted the said case sheet. The said case sheet has been marked Exhibit P-1A/DW-1. Case sheet dated 16th October, 1999 records that UGIE had been attempted several times yesterday (i.e. 15th October, 1999) and the plaintiff had developed odynophagia (painful swallowing) to solids and liquids after one day. After physical examination, defendant No. 7 has recorded that the plaintiff had swelling in left pyriform sinus (left aperture space of voice box) most likely due to iatrogenic trauma (injury caused during medical or surgical procedure) during UGIE and pooling of saliva in left PF FOSSA (left aperture space of voice box). The defendant No. 7 prescribed tablet Rentec and liquid antacid for a period of twelve days. He also prescribed Prednisolone 40 mg each for three days to be tapered down by 10 mg every three days for a total period of twelve days. CLAIM OF THE PLAINTIFF

5. The plaintiff claims negligence in performance of UGIE, which had damaged her esophagus, and in follow up diagnoses, treatment and medication, which had the effect of masking or suppressing symptoms and failure to treat damage/perforation of esophagus. During the period 16th to 23rd October, 1999 the plaintiff continued to have pain in her throat and difficulty in swallowing liquid or food. Plaintiffs husband Brigadier M.L. Garg (Retd.) consulted defendant No. 6 on phone twice and was advised that her condition would settle down. The condition of the plaintiff continued to deteriorate. She developed fever. On 24th October, 1999, the plaintiff developed severe backache and a bag like hang on the right side of her neck. On 25th October, 1999, the plaintiff had severe pain in the left shoulder spreading to her arm and chest, accompanied by profuse sweating. She was shifted to M.P. Heart Institute but examination/tests were negative for a cardiac problem. However, the X-Ray revealed that the plaintiffs pleura (cavity along the thin lining that e