Informed Consent - The concept of 'informed consent' is essential for medical procedures, especially for high-risk surgeries, and failure to obtain express written consent can lead to allegations of negligence.

P.D. Shenoy, Member

Case of the complainant.

1. Smt. Mohinder Kaur was admitted for surgery at Post-Graduate Institute of Medical Education & Research, Chandigarh (hereinafter referred to as PGIMER) at 1 p.m. on 7.3.2001 in the emergency ward under the supervision of Dr. V.K. Khosla, Head of Neuro-Surgery Department. Tests recommended by Dr. Khosla were conducted on 8.3.2001. It is the say of the complainant that angiography of the brain and other tests confirmed leaking aneurysm in the brain and immediate surgery was advised which was not done. Surgery was not performed on 9.3.2001 due to 'Holi' holiday and non-availability of staff. Dr. Khosla assured the complainant that the surgery would be conducted on 10.3.2001 and the complainant should make necessary arrangements like purchase of medicines etc. At about 1.30 p.m. on 10.3.2001 the complainant was told by the opposite parties that operation theatre (hereinafter referred to as OT) was not available. The condition of the patient continued to deteriorate and, therefore, on 11.3.2001 she was admitted to intensive care unit after it was declared that her brain was dead. Patient was declared dead eventually on 14.3.2001. Alleging negligence and carelessness, the complainant claimed a total compensation of Rs. 17,50,000.

Case of the Opposite Parties:

2. The OP Nos. 1, 2 and 4 PGIMER, Dr. V.K. Khosla and Dr. Kajal Jain in their written statements denied the allegations of negligence, deficiency and unfair trade practices on their part. They have submitted that despite repeated verbal requests the relatives of the patient Smt. Mohinder Kaur did not give any written consent for surgery of the brain. On 8.3.2001 Dr. Khosla explained to the relatives about the high risk involved due to the patient's old age, hypertension, drowsy state, multiple brain haemorrhages and double aneurysm. They were also told that they were free to explore other treatment options available elsewhere. Endovascular procedure was suggested to the patient's daughter and son-in-law Dr. Navdeep Khaira who thought that this procedure was a better option than open brain surgery. At the request of the relatives Dr. Khosla gave a letter of reference in the name of Dr. Karapurkar, a Neurosurgeon working in Apollo Hospital, New Delhi for eliciting his expert opinion. Xray films were made available to the relatives of the deceased at 5 p.m. on 8.3.2001 after the deposit of Rs. 1,000 as security. Neurosurgeons were willing and prepared to do the main surgical procedure but there was no written consent. It was not disputed that the condition of the patient deteriorated around 10.00 a.m. on 11.3.2001 when she was shifted from private ward to ICU. At about 12.45 p.m. she became unfit for surgery. Later in the night she was declared brain dead and ultimately declared dead on 14.3.2001. OPs 1,2 and 4 denied the allegations made by the complainant that brain surgery was postponed due to holiday and non-availability of the OT. All preparations were made in anticipation of prior consent.

3. OP No. 3 Dr. Promila Chari, Head of the Department of Anaesthesia, PGIMER filed her separate written statement wherein, she had alleged that she had no contact whatsoever at any point of time with the patient or her relatives nor she was responsible for the non-performance of any surgery that might have been required. There was no negligence on her part as she was on sanctioned leave on 10.3.2001 and was not on duty on 9.3.2001, which was the holiday, and 11.3.2001, which was the Sunday, therefore, she was absent from 9.3.2001 to 11.3.2001.

Evidence:

4. The complainant led evidence in the shape of his own affidavit. Affidavit of Dr. Navdeep Singh Khaira, son-in-law of the patient, Prof, and Head of Nephrology Unit, DMC & Hospital, Ludhiana was also filed. The OP Nos. 1,2 and 4 led evidence in the shape of affidavits of Dr.V.K. Khosla, Professor and Head, Department of Neurosurgery, PGIMER; Dr. Kajal Jain, Assistant Professor, Department of An