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2023 Supreme(Online)(Ker) 62778


IN THE HIGH COURT OF KERALA AT ERNAKULAM PRESENT THE HONOURABLE MRS. JUSTICE C.S. SUDHA TUESDAY, THE 28TH DAY OF NOVEMBER 2023 / 7TH AGRAHAYANA, 1945 RFA NO. 9 OF 2003-A (AGAINST THE JUDGMENT AND DECREE DATED 8.4.1999 IN O.S.NO.1373/1994 ON THE FILE OF THE SUB COURT, TRISSUR)
APPELLANT/PLAINTIFF:
SINEBHA, AGED 39, W/O HOSSARMVEETIL HANEEFA, PILLAKKAD DESOM, POOKKODE VILLAGE, CHAVAKKAD TALUK, TRISSUR DISTRICT.
BY ADVS.V.R.K.KAIMAL N.M.MADHU RESPONDENTS/DEFENDANTS:
1 THE DISTRICT COLLECTOR, THRISSUR, REP.BY GOVT.OF KERALA.
2 DR.JOSE PARAKKAL RAILWAY STATION ROAD, (CHALAKUDY ROAD),IRINJALAKUDA,THRISSUR DISTRICT.
3 UNITED INDIA INSURANCE COMPANY REPRESENTED BY BRANCH MANAGER,KUNNAMKULAM BY ADVS.SRI.V.MANU-SR.GP SRI.M.RAJEEV, GOVERNMENT PLEADER T.J.LAKSHMANAN IYER FOR R3.
THIS REGULAR FIRST APPEAL HAVING COME UP FOR FINAL HEARING ON
17.11.2023, THE COURT ON 28/11/2023 DELIVERED THE FOLLOWING:
“C.R.”
C.S.SUDHA, J.
------------------------------
R.F.A.No.9 of 2003 -----------------------------------------
Dated this the 28th day of November, 2023

Failure of sterilization surgery alone does not establish medical negligence; the burden is on the claimant to prove carelessness, with mere surgical failure insufficient for liability.

Headnote:(A) Civil Procedure Code, 1908 - Section 96 - Medical Negligence - Sterilization Surgery - Plaintiff underwent sterilization but conceived thereafter; claimed damages, alleging negligence - Trial Court found no negligence; plaintiff appealed - The standard of care expected from medical practitioners established that mere failure of a sterilization procedure does not equate to negligence - Plaintiff did not demonstrate the required standard of care breach by the defendant. (Paras 8-21)

(B) Medical Negligence - In cases of sterilization failure, the onus is on the plaintiff to establish negligence - Evidence may reflect natural causes for pregnancy, thus absolving the doctor from liability - In absence of negligence, the State cannot be vicariously liable. (Paras 10-21)

Facts of the case:
The plaintiff underwent Post Partum Sterilization on the advice of the defendant, who assured no future pregnancies; she later conceived, leading to a claim for damages due to supposed negligence during surgery.

Findings of Court:
The evidence did not support claims of carelessness; the court stressed the burden of proof on those alleging negligence.

Issues: The primary question was whether the surgery's failure resulted from negligence, and if the state could be held accountable vicariously.

Ratio Decidendi: The court emphasized that negligence must be proven; natural failure of the sterilization does not equal negligence unless evidence is provided to the contrary.

Result: Appeal dismissed.

JUDGMENT

This appeal under Section 96 read with Order XLI Rule 1 C.P.C. has been filed by the plaintiff against the judgment and decree dated 08/04/1999 in O.S.No.1373/1994 on the file of the Subordinate Judges' Court, Thrissur. The respondents herein are the defendants in the suit. The parties and the documents in this appeal will be referred to as described in the suit.

2. According to the plaintiff in O.S.No.1373/1994, a suit for damages, she belongs to a very poor family. Her husband is a coolie. As they already had four children, they decided not to have any more children and hence the plaintiff and her husband consulted the 2nd defendant who was then working as a doctor in the Government Hospital, Kunnamkulam. The 2nd defendant advised the plaintiff to undergo Post Partum Sterilization (P.P.S.) surgery, which according to him was the best and safest method of avoiding future pregnancies. The plaintiff and her husband were told that if the said surgery was conducted, there would be no chance of any future pregnancy. Accordingly, the plaintiff underwent P.P.S. surgery. After the surgery, believing the assurance given by the 2nd defendant at the time of the surgery that she would not conceive, the plaintiff and her husband continued their conjugal life. However, the plaintiff thereafter conceived and gave birth to a girl child. The pregnancy was never intended by the plaintiff and her husband. This happened only because the surgery conducted by the 2nd defendant was not successful and had been done in a careless and negligent manner. The 2nd defendant had not taken the precautions that ought to have been taken by a specialist in the matter. If necessary precautions had been taken and the surgery done in a proper manner, there would have been no occasion for the plaintiff to conceive again. The plaintiff claimed compensation to the tune of ₹50,000/- for mental agony, pain and suffering; ₹1,40,000/- towards expenses of delivery; fees paid to the doctors; money spent for purchasing medicines ; laboratory expenses ; expenses for feeding the child and other expenses including the marriage expenses to be met in future for the child. Thus, she claimed an amount of ₹2 lakhs as compensation from the defendants.

3. The 1st defendant filed written statement admitting that the plaintiff on 06/10/1987 had undergone P.P.S. surgery at the Government Hospital, Kunnamkulam, which surgery was conducted by the 2nd defendant herein. The 2nd defendant is a qualified and experienced gynecologist who in the year 1987 achieved 100% target in tubectomy and I.U.D. within a period of five months. He performed around 2,502 sterilization surgeries during the period from 09/06/1986 to 29/05/1990. To date, the case of the plaintiff was the first failure that has been reported. The allegation that the surgery was conducted in a careless and negligent manner is incorrect and false. The 2nd defendant had performed the surgery with utmost care, caution, and devotion. There is a small percentage, that is, 0.5 to 1% failure of such a surgery even in developed countries. The sterilization surgery is not a foolproof method to avoid further pregnancy. Failure in sterilization surgery is quite rare but like in the case of other surgeries, the same is possible. The plaintiff had undergone the 2nd P.P.S. surgery on 27/03/1993 at the District hospital, Thrissur. After the surgery, the senior medical officer, P.P.Unit diagnosed that the plaintiff had P.P.S. failure due to Rt- Tube-Peritoneal Fistula. As there was no negligence or carelessness on the part of the 2nd defendant, the plaintiff is not entitled to the reliefs prayed for.

4. The 2nd defendant filed a separate written statement denying the allegation of carelessness or negligence. The plaintiff had approached the 2nd defendant with a request for P.P.S. surgery. She had given a consent letter also before undergoing the surgery. The promoters of the family planning programme had disclosed all the pa

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