Samira Kohli vs Dr. Prabha Manchanda

Judicial Analysis Court Copy Headnote Facts Arguments Court observation

2008 Supreme(Raj) 64

(Supreme Court)
Honble B.N. AGARWAL, J. Honble P.P. NAOLEKAR, J. Honble R.V. RAVEENDRAN, J.
Samira Kohli - Appellant
Versus
Dr. Prabha Manchanda & Anr. - Respondents
Appeal (Civil) 1949 of 2004
Decided On : January 16, 2008

Advocates Appeared:
Prashant Bhushan, Rukhsana Choudhary, Sumita Hazarika, for Appellant; Aman Lekhi, Senior Advocate (Meenakshi Lekhi, Rajan Chourasia, Jaspreet S. Rai, Rakesh Kumar, Rohit Nagpal, Harish Pandey, Abhijat Das, Rameshwar Prasad Goyal, Rajesh Kumar, Ajay Majith

Headnote:(a) Medical Council of India Act, 1956, Sec. 33; Code of Medical Ethics, Chapter relating to Disciplinary action, Clause 13 – Guide lines to doctors – Consent of patient required for surgical procedure – Extent and nature of consent – Extent of information necessary to be furnished to secure such consent – Consent for diagnostic procedure or surgery would not amount to authorisation to perform therapeutic surgery except in life threatening or emergent situations – It is for the doctor to decide, with reference to the condition of patient, nature of illness and the prevailing established practices as to how much information regarding the risks and consequences should be given and how they should be couched in the best interest of the patient – Held – Patient given consent for laparoscopy and not for hysterectomy (removal of uterus) and bilateral salpingo-oopherectomy (removal of ovaries and fallopian tubes) – In the absence of any medical emergency, consent given by the mother of the patient when the patient was a competent adult, was not a valid consent – Consent given by mother for hysterectomy did not amount to consent for bilateral salpingo-oopherectomy – A doctor acting accordingly with normal care and in accordance with a recognised medical practice, cannot be said to be negligent merely because a body of opinion takes a contrary view.(Paras 48, 49 & 50)
        ¼v½ Hkkjrh; fpfdRlk ifj"kn~ vf/kfu;e] 1956] /kkjk 33( fpfdRlh; vkpkj lafgrk] vuqkklukRed dk;Zokgh ls lacaf/kr v/;k;] [k.M 13 & fpfdRldksa dks fnkk funsZk & kY; izfØ;k gsrq okafNr jksxh dh lgefr & lgefr dh izd`fr vkSj foLrkj & ,slh lgefr izkIr djus ds fy, iznku dh tkus okyh vko;d lwpuk dh lhek & jksx funku izfØ;k ;k kY; fØ;k gsrq lgefr thou ds fy, ?kkrd ;k vkikrdkyhu fLFkfr;ksa dks NksM+dj jksxgj kY; fØ;k djus gsrq izkf/kdkj nsus dh Js.kh esa ugha vkrk & ;g rks fpfdRld dks gh fofufpr djuk gksrk gS fd jksxh dh nkk] mldh chekjh dh izd`fr vkSj izpfyr lafLFkr izFkkvksa dh n`f"V ls tksf[ke ,oa ifj.kke laca/kh fdruh lwpuk nh tkuh pkfg;s vkSj jksxh ds fgr esa fdruh lwpuk muls fNikuh pkfg;s & vfHkfu/kkZfjr & jksxh us ysijksLdksih gsrq lgefr nh u fd xHkkZk; vkSj v.Mkk; gVkus dh & fpfdRlh; vkikr dh vuqifLFkfr esa jksxh dh ekrk }kjk nh xbZ lgefr] tc jksxh iw.kZ :is.k O;Ld Fkh] oS/k lgefr ugha Fkh & xHkkZk; gVkus gsrq ekrk }kjk nh xbZ lgefr v.Mkk; ,oa Qsyksfi;u V~;wc gVkus dh lgefr dh Js.kh esa ugha vkrh & lkekU; lko/kkuh ds lkFk ,oa ekU; fpfdRlh; izFkk ds vuqlkj dk;Z djus okys fpfdRld dks dsoy blfy, ykijokg ugha dgk tk ldrk fd jk; dk Lo:i izfrdwy n`f"Vdks.k isk djrk gSA ¼in la[;k 48] 49 o 50½
       (b) Consumer Protection Act, 1986, Sec. 23, 21(a), 22(1) and 2(1)(c) – Compensation for deficiency in service – Acting in good faith for the benefit of patient, albeit in excess of patients consent – Without the consent of the patient, while she was still under general anaesthesia and there was no medical emergency but in the doctors opinion that would provide permanent relief to the patient and was likely to be acceptable to the patient while her mother had already consented to such a course – Such surgery amounted to tortious act of assault and battery and, therefore deficiency in service, the doctor having acted in good faith for benefit of the patient directed to pay Rs. 25]000/- to the patient as compensation.(Paras 76, 77) Appeal allowed.
        ¼[k½ miHkksDrk laj{k.k vf/kfu;e] 1986] /kkjk 23] 21¼d½] 22¼1½ ,oa 2¼1½¼x½ & lsok esa deh gsrq izfrdj & jksxh ds fgr esa ln~Hkko esa dk;Z djuk] ;|fi jksxh dh lgefr dh lhek ls c<dj & tc jksxh lkekU; csgkskh dh voLFkk esa Fkh ysfdu fpfdRlk lEcU/kh dksbZ vkikr fLFkfr ugha Fkh ijUrq fpfdRld dh jk; esa blls jksxh dks LFkk;h jkgr feysxh ,oa jksxh dks Hkh ;g ekU; gksus dh lEHkkouk Fkh tcfd mldh ekrk bl dk;Z gsrq iwoZ esa gh lgefr ns pqdh Fkh ijUrq jksxh dh lgefr ds fcuk & ,slh kY; fØ;k geys ,oa ekjihV ds vid`R; dh Js.kh esa vkrk gS vr% jksxh ds fgr esa ln~Hkko esa fpfdRld }kjk fd;k x;k dk;Z lsok esa =qfV gS blfy, mls funsZk fn;k fd og izfrdj ds :i esa jksxh dks 25]000@& :- dk Hkqxrku djsaA ¼in la[;k 76] 77½ vihy Lohdkj dhA

Honble RAVEENDRAN, J.–This appeal is filed against the order dated 19-11-2003 passed by the National Consumer Disputes Redressal Commission (for short Commission) rejecting the appellants complaint (O.P. No.12/1996) under Section 21 of the Consumer Protection Act, 1986 ("the Act", for short).

Undisputed facts

(2). On 9-5-1995, the appellant, an unmarried woman aged 44 years, visited the clinic of the first respondent (for short "the respondent") complaining of prolonged menstrual bleeding for nine days. The respondent examined and advised her to undergo an ultrasound test on the same day. After examining the report, the respondent had a discussion with appellant and advised her to come on the next day (10-5-1995) for a laparoscopy test under general anesthesia, for making an affirmative diagnosis.

(3). Accordingly, on 10-5-1995, the appellant went to the respondents clinic with her mother. On admission, the appellants signatures were taken on (i) admission and discharge card; (ii) consent form for hospital admission and medical treatment; and (iii) consent form for surgery. The Admission Card showed that admission was "for diagnostic and operative laparoscopy on 10-5-1995". The consent form for surgery filled by Dr. Lata Rangan (respondents assistant) described the procedure to be undergone by the appellant as "diagnostic and operative laparoscopy. Laparotomy may be needed". Thereafter, appellant was put under general anesthesia and subjected to a laparoscopic examination. When the appellant was still unconscious, Dr. Lata Rengen, who was assisting the respondent, came out of the Operation Theatre and took the consent of appellants mother, who was waiting outside, for performing hysterectomy under general anesthesia. Thereafter, the Respondent performed a abdominal hystecrectomy (removal of uterus) and bilateral salpingo- oopherectomy (removal of ovaries and fallopian tubes). The appellant left the respondents clinic on 15-5-1995 without settling the bill.

(4). On 23-5-1995, the respondent lodged a complaint with the Police alleging that on 15-5-1995, the Appellants friend (Commander Zutshi) had abused and threatened her (respondent) and that against medical advice, he got the appellant discharged without clearing the bill. The appellant also lodged a complaint against the respondent on 31-5-1995, alleging negligence and unauthorized removal of her reproductive organs. The first respondent issued a legal notice dated 5-6-1995 demanding Rs.39]325/- for professional services. The appellant sent a reply dated 12-7-1995. There was a rejoinder dated 18-7-1995 from the respondent and a further reply dated 11-9-1995 from the appellant.

(5). On 19-1-1996 the appellant filed a complaint before the Commission claiming a compensation of Rs.25 lakhs from the Respondent. The appellant alleged that respondent was negligent in treating her; that the radical surgery by which her uterus, ovaries and fallopian tubes were removed without her consent, when she was under general anesthesia for a Laparascopic test, was unlawful, unauthorized and unwarranted; that on account of the removal of her reproductive organs, she had suffered premature menopause necessitating a prolonged medical treatment and a Harmone Replacement Therapy (HRT) course, apart from making her vulnerable to health problems by way of side effects. The compensation claimed was for the loss of reproductive organs and consequential loss of opportunity to become a mother, for diminished matrimonial prospects, for physical injury resulting in the loss of vital body organs and irreversible permanent damage, for pain, suffering emotional stress and trauma, and for decline in the health and increasing vulnerability to health hazards.

(6). During the pendency of the complaint, at the instance of the respondent, her insurer - New India Assurance Co. Ltd, was impleaded as the second respondent. Parties led evidence - both oral and documentary, Appellant examined an expert witness (Dr. Puneet Bed

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2008 Supreme(Raj) 64

(Supreme Court)Honble B.N. AGARWAL, J. Honble P.P. NAOLEKAR, J. Honble R.V. RAVEENDRAN, J.Samira Kohli - AppellantVersusDr. Prabha Manchanda & Anr. - RespondentsAppeal (Civil) 1949 of 2004Decided On : January 16, 2008

Cases Referred (3)

(Supreme Court)
Honble B.N. AGARWAL, J. Honble P.P. NAOLEKAR, J. Honble R.V. RAVEENDRAN, J.
Samira Kohli - Appellant
Versus
Dr. Prabha Manchanda & Anr. - Respondents
Appeal (Civil) 1949 of 2004
Decided On : January 16, 2008