ORDER Dr. P.D. Shenoy, Member—Heard the learned Counsel for the petitioner. This is a case of alleged medical negligence, wherein consent was given to perform the surgery for Laparoscopic Cholecystectomy by the wife of the patient/complainant-Shri Maniram. There is no consent given by the patient though he was conscious and he was in a proper frame of mind and was eligible to give the consent. Secondly, consent given was for Laparoscopic Surgery, which results in small incisions compared to the conventional surgery which causes large incisions which results in longer time for healing. These facts are not disputed. Both the Fora below have a given concurrent decisions holding that hospital was negligent in performing the surgery which resulted in the infection/puss formation and longer stay in the hospital. 2. The patient was admitted to the hospital on 05.08.1997 and was operated on 06.08.1997. He was discharged from the hospital on 14.08.1997, but the complainant suffered severe pain, infection and puss formation, therefore, he was again admitted to the hospital on 17.08.1997, where he was treated for post-operative wound infection. As the infection had extended to the rib, he was discharged on 18.09.1997 after one month of treatment. Even after a month long treatment, the patient was not cured fully. Accordingly, he was treated at District Hospital, Ambikapur and remained under the treatment of Dr Pandey who told the complainant that the rib was damaged during operation and infection has developed and referred the complainant to Dr Pandey, who again treated the complainant on 14.10.1997 to 19.12.1997. The complainant was treated at Dhanwantari Hospital, Bhillai. 3. The District Forum held that the petitioner was negligent in its service and awarded a meager compensation of Rs. 52,538/- to the complainant towards damages together with cost. Instead of paying this small amount Holi Cross Hospital decided to file an appeal and prolonged the agony of the complainant—patient before the State Commission. The State Commission observed in its judgment an extract of which reads as follows: “On perusal of record it is noticed that at page 72 of the appellants paper—book is the copy of the Discharge Ticket dated 18.09.1997 and Final Diagnosis is “Post Operative (Cholecystectomy) wound infection, rib infection”. Moreover, the Medical Certificate issued by the Holy Cross Hospital on 18.09.1997 also shows that the patient was treated for post operative cholecystectomy wonld infection, rib infection. Moreover, the Medical Certificate issued by the Holy Cross Hospital on 18.09.1997 also shows that the patient was treated for post operative cholecystectomy wonld infection, rib infection. So there is no doubt that there rib infection and the treating doctor was well aware of the same. May be that the patient did not know about it till he was told by Dr Firdoushi that his rib was damaged during operation. The learned Counsel for the appellant also submitted that the complainant has not submitted any expert’s report. However, it is noticed that the complainant had got Dr Firdoushi examined before the District Forum and he has in his deposition stated that pus was flowing from the near the right side of the rib and it was a wound caused due to the earlier operation. The patient was suffering from post-operative infection. In cross examination he said in para 6 of the deposition that in our country large number of cases of post-operative infection are reported. He further stated that during stay at the hospital the bandage is tied on the wound so there is lesser chance of infection. Infection may be caused even after discharge. He further stated that infection may also develop if antibiotics are not properly taken”. 4. Accordingly, it is clear that the patient had to suffer for a long time after the surgery for which he could not be compensated by any amount. However, the complainant has not filed an appeal against the State Commission. The State Commission has affirmed the order of the District Forum and directed the appellant hospital to pay Rs.2000/- as cost. Hence, this revision petition. 5. Learned Counsel for the petitioner has vehemently argued that there is no evidence or proof that surgery was performed negligently and as result of which the rib was damaged and infection had taken place. Hence, the orders of the lower Fora suffer from infirmity and deserves to be set aside. He also relied upon the report of Sunita Sonography and X Ray Clinic Ambikapur, Surguja, (MP) to support his contention that there was no infection of the bones. This Sonography report pertains to only Liver, Spleen, Pancreas, Right Kidney, Left Kidney etc. This report was given two months subsequent to the discharge from the Holi Cross Hospital. He also relied upon the report of Sunita Sonography and X Ray Clinic Ambikapur, Surguja, (MP) to support his contention that there was no infection of the bones. This Sonography report pertains to only Liver, Spleen, Pancreas, Right Kidney, Left Kidney etc. This report was given two months subsequent to the discharge from the Holi Cross Hospital. The medical certificate issued by the petitioner hospital on 18.09.1997 shows that the patient was treated for post-operative Cholecystectomy rib infection etc. 6. Learned Counsel for the petitioner has not filed the discharge certificate as well as the certificate issued by the Holi Cross Hospital before us. We draw adverse inference of this. 7. In Samira Kohli v. Dr Prabha Manchanda and Anr.1 the Hon’ble Apex Court has held that: We may now summarize principles relating to consent as follows: (i) A doctor has to seek and secure the consent of the patient before commencing a ‘treatment’ (the term ‘treatment’ includes surgery also). The consent so obtained should be real and valid, which means that the patient should have the capacity and competence to consent; his consent should be voluntary; and his consent should be on the basis of adequate, information concerning the nature of the treatment procedure, so that he knows what is consenting to. (ii) The ‘adequate information’ to be furnished by the doctor (or a member of his team) who treats the patient, should enable the patient to make a balanced judgment as to whether he should submit himself to the particular treatment as to whether he should submit himself to the particular treatment or not. This means that the doctor should disclose (a) nature and procedure of the treatment and its purpose, benefits and effect; (b) alternatives if any available; (c) an outline of the substantial risks; and (d) adverse consequences of refusing treatment. But there is no need to explain remote or theoretical risks involved, which may frighten or confuse a patient and result in refusal of consent for the necessary treatment. Similarly, there is no need to explain the remote or theoretical risks of refusal to take treatment which may persuade a patient to undergo a fanciful or unnecessary treatment. But there is no need to explain remote or theoretical risks involved, which may frighten or confuse a patient and result in refusal of consent for the necessary treatment. Similarly, there is no need to explain the remote or theoretical risks of refusal to take treatment which may persuade a patient to undergo a fanciful or unnecessary treatment. A balance should be achieved between the need for disclosing necessary and adequate information and at the same time avoid the possibility of the patient being deterred from agreeing to a necessary treatment or offering to undergo an unnecessary treatment. (iii) Consent given only for a diagnostic procedure, cannot be considered as consent for therapeutic treatment. Consent given for a specific treatment procedure will not be valid for conducting some other treatment procedure. The fact that the unauthorized additional surgery is beneficial to the patient, or that it would save considerable time and expense to the patient, or would relieve the patient from pain and suffering in future, are not grounds of defence in an action in tort for negligence or assault and battery. The only exception to this rule is where the additional procedure though unauthorized, is necessary in order to save the life or preserve the health of the patient and it would be unreasonable to delay such unauthorized procedure until patient regains consciousness and takes a decision. (iv) There can be, common consent for diagnostic and operative procedures where they are contemplated. There can also be a common consent for a particular surgical procedure and an additional or further procedure that may become necessary during the course of surgery. (v) The nature and extent of information to be furnished by the doctor to the patient to secure the consent need not be of the stringent and high degree mentioned in Canterbury but should be of the extent which is accepted as normal and proper by a body of medical men skilled and experienced in the particular field. It will depend upon the physical and mental condition of the patient, the nature of treatment and the risk and consequences attached to the treatment. 8. The ratio of this case is applicable to, the case on hand. In this case the petitioner—hospital has not taken the consent from the respondent/complainant, but has taken the consent from his wife. Hence, it is a clear-cut deficiency in service. 8. The ratio of this case is applicable to, the case on hand. In this case the petitioner—hospital has not taken the consent from the respondent/complainant, but has taken the consent from his wife. Hence, it is a clear-cut deficiency in service. Further, the so-called consent was given for the Laproscopic surgery and the surgery performed was the traditional one which takes more time to heal. Therefore, in view of the fact that there was infection at the time of discharge which was mentioned in the discharge slip and further this was certified through a medical certificate issued by the Holi Cross Hospital on 08.09.1997, that there was rib wound infection for which prolonged treatment was given to the patient. Therefore, he should have been compensated much more what has been awarded by the District Forum. This is an open and shut case of resp ipse loquitor (facts speaks for themselves). Accordingly, this revision petition is dismissed. The complainant has not filed any appeal seeking for enhancement of compensation before the State Commission. Instead of paying this meager amount i.e. Rs.52,538/- along with cost awarded by the Fora below, as petitioner hospital has dragged the litigant to the State and the National level, therefore, we are constrained to impose a cost of Rs.10,000/- on the petitioner. This amount along with the amount ordered by the Fora below shall be paid to the complainant by the petitioner within a period of four weeks from the date of this order. Revision Petition dismissed. *******