Mr. Vinay Kumar, Member:- The appellant Dr Mangala Paradkar, was Respondent No. 1 in the consumer complaint number 48 of 2001 before the MP State Consumer Disputes Redressal Commission. The other two respondents were Dr L.N. Paradkar, husband of Re­spondent No. 1 and the Paradkar Nursing Home, run by this doctor couple. The State Commission has allowed the com­plaint filed by Mr Shailendra Singh in which medical negligence was alleged in the case of treatment of his wife Mrs. Vineeta Singh who, a few days later, had died. The State Commission had held the respondents jointly and severally liable to pay a com­pensation of Rs. 5 Lacs to the complain­ant, along with Rs. 3000/- towards costs. 2. In brief, the case of the complain­ant before the state commission was that his young wife had become pregnant in Sep­tember/October 1999 and had been peri­odically checked up by the appellant/OP from time to time. She was informed that the foetus was developing normally. The delivery was due sometime in August 2000. On 31.7.2000, she developed fever and was seen by the appellant who gave medi­cines to deal with fever and advised return to the nursing home after the labour pains had started. 3. According to the complainant, the medicines had no effect and her condition deteriorated. She was therefore, admitted to the nursing home by the appellant on 3.8.2000. The same day, Mrs. Vineeta Singh delivered a stillborn child. Thereaf­ter, her condition deteriorated and by the next morning she was almost unconscious. According to the complainant, at 11:30 AM on 4.8.2000, he was told by the ap­pellant that the condition of his wife was serious and therefore she was advised to be shifted to Jabalpur, which is about 100 kilometres away. They left for Jabalpur as advised, travelled for about 25 km but had to return as the patient was discharging blood from her mouth and had no pulse. She was readmitted at about 1.45 PM and was declared dead at 3.30 PM. 4. Per contra, the case of the present appellant before the State Commission was that the deceased had already under­gone an abortion before the present preg­nancy. Between October 1999 and August 2000 she did not come regularly for check­ups. Onl.8.2000 she was advised admis­sion but had returned home by choice, in spite of the risk to the baby in the womb been explained to her. Between October 1999 and August 2000 she did not come regularly for check­ups. Onl.8.2000 she was advised admis­sion but had returned home by choice, in spite of the risk to the baby in the womb been explained to her. When she came on 3.8.2000, her pornographic test revealed that the foetus was dead. She delivered a dead child in the night but her general con­dition, the next morning, was good. Dur­ing the course of the day, she was treated for fever and vomiting but everything else was normal. On 5.8.2000 her condition was stable but the relatives wanted to shift her to Jabalpur and therefore a reference was issued. Around 5.30 p.m. she was brought back in the ambulance and found to be dead. According to the appellant, she was not readmitted but the death cer­tificate was issued "on humanitarian grounds". 5. On the basis of the records, plead­ings of the parties and the documents pro­duced, the State Commission has come to the following conclusions- 1. On 1.8.2000, when the patient came with the complaint of fever no complaint symptoms were noted, no investigation was ad­vised and without any examina­tion of the foetus, the patient was put on anti malarial treatment. No tests were either prescribed or con­ducted to confirm whether she was actually suffering from ma­laria or not. 2. Medically malaria and pregnancy make a dangerous combination. Therefore, even assuming that she had malaria, she should have been admitted and administered the drug under medical supervision. 3. The medical record has no men­tion of the patient being advised admission on 1.8.2000. There­fore, this claim of the appellant/OP is an afterthought, unsup­ported by evidence. 4. For prescribing anti-malarial medi­cine to a pregnant woman, with­out any confirmatory tests and without medical supervision amounted to medical negligence on the part of the OP/appellants. 5. The contradictions in the reference it given on 5.8.2000, while refer­ring the deceased to Jabalpur and the case sheet filed by the respondents, make it apparent that the case sheet had been manipulated and prepared later. 6. The claim of the present appellant/OP that the death of Mrs. Vinita Singh was caused due to her negligence and that of her rela­tives in not following the instruc­tions, has been rejected. 6. The claim of the present appellant/OP that the death of Mrs. Vinita Singh was caused due to her negligence and that of her rela­tives in not following the instruc­tions, has been rejected. The State Commission has held that the doctor has not specified what in­structions were given to the de­ceased and which were not fol­lowed by the deceased, which caused her death. 7. According to the death certificate issued by Paradkar Nursing Home, her death was caused by "en­cephalitis due to peripheral circu­latory failure". From the record of treatment and the evidence ad­duced, the State Commission did not find when exactly this diag­nosis of encephalitis was made. And, if such a diagnosis was made, what treatment was given for it. 6. The Appellant/OP- I has challenged the above order primarily on the ground that the State Commission has failed to establish the nexus of treatment for ma­laria with the death of the patient. This is strange logic. It overlooks the fact that it was not for the State Commission but for the treating doctor, i.e. the appellant, to show what diagnostic tests were done to confirm that the deceased was actually suffering from the disease she was treated for i.e. malaria. Equally, it was for the doctor, who certified encephalitis as the cause of death, to explain its relationship with the death of the patient. But, what we find is an admission in the appeal petition that the treatment was started because the patient came from malaria-affected area, mentioned as Bamhori Village. 7. Similarly, explaining the certifica­tion of encephalitis as the cause of death, all that the appellant has to say is that "Learned State Commission was unable to understand at the time of reaching the finding about the cause of death that en­cephalitis is not a new disease but it is a form of malaria, examination in this re­gard has been done by the appellants and on the basis of symptoms of fever of the deceased and accordingly the medicines were prescribed." This statement fails to mask the fact that the appellant could not produce any evidence before the State Commission to establish that it was a di­agnosed case, not assumed case, of ma­laria. The question of certifying it as the cause of death can arise only thereafter. The question of certifying it as the cause of death can arise only thereafter. In the arguments before us, learned coun­sel for the Respondent/Complainant has repeatedly referred to the record of treat­ment to show that no tests were done be­fore starting the treatment. Nor were any tests done to reassess the line of treatment when the condition of the patient failed to improve. Therefore, what we have is in fact a case of two assumptions, one (relating to the cause of death) based on the other (relating to the disease). 8. Learned counsel for the appellant also referred to the affidavit of the driver of the ambulance to show that the patient had died not in the appellant nursing home but on the way to Jabalpur. But, he could not explain why the death certificate was given by the appellant nursing home when death had occurred outside. Nor could he explain the absence of any entry relating to discharge of the patient on 5.8.2000 in the medical records. 9. We therefore conclude that the ap­pellant has failed to substantiate the grounds of challenge to the impugned or­der. In the facts and circumstances of this case we also do not find any justification to interfere with the quantum of compen­sation awarded in the impugned order. Consequently, the appeal is dismissed and the order of the State Commission con­firmed. Parties shall bear their own costs.