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2020 DIGILAW 256 (KER)

District Medical Officer, Malappuram District, Manjeri v. Azhukuthi Parambil Ayappans Son Thami Thirunavaya Amsom

2020-03-02

DEVAN RAMACHANDRAN

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JUDGMENT : This Court can only rue that an appeal, which ought to have never been filed by the State, has nevertheless occupied the file space of this Court for merely 17 years. 2. This Appeal arises out of the judgment and decree in a Suit filed by the respondents herein, who are the husband and children of a hapless woman by name Smt.Valli, who died of post-surgery complications, consequent to a procedure of sterilization done on her. Late Smt.Valli and her husband are concededly from a very disadvantaged background and who had approached the appellants for performance of a sterilization surgery on her -after she had delivered their fifth child-promised by the framed health system of the State of Kerala that she would be taken care of well. 3. But alas! The tragedy that unfolded subsequently was much more than what could be endured by the respondents – Smt.Valli died merely four days later on account of septicemia arising out of post-surgery complications. 4. The suit in question was, thereafter, filed by the plaintiffs/respondents alleging that after the surgery was conducted on 26.1.1995 by the 6th appellant herein — at a camp conducted by the Primary Health Centre — Smt.Valli was discharged but that she developed aggravated health issues a day later; and that on 28.1.1995, the 1st respondent found his wife to be in excruciating pain, with an enlarged abdominal condition. The plaintiffs averred in the plaint that they approached the 3rd appellant herein, who directed them to take Smt.Valli to a better facility and that she was thus rushed to a private hospital by name 'Darul Shifa' at Kunnumpuram. They say that the doctors who examined her in the said hospital opined that her laproscopic sterilization procedure was the cause for the complication; and that when her condition became worse the next day, namely on 29.1.1995, she was shifted to the Taluk Head Quarters Hospital at Tirur and later, at the advice of the doctors of the said hospital, to the Medical College Hospital, Kozhikode. 5. The plaint averments state that, on 30.01.1995, Smt.Valli was admitted to the Medical College Hospital, Kozhikode and that an emergency surgery was carried out on her on 31.01.1995, but that in spite of it, she breathed her last on that day, leaving behind her distraught husband and five small children. 5. The plaint averments state that, on 30.01.1995, Smt.Valli was admitted to the Medical College Hospital, Kozhikode and that an emergency surgery was carried out on her on 31.01.1995, but that in spite of it, she breathed her last on that day, leaving behind her distraught husband and five small children. Based on the Medical Reports and the opinions of the doctors, the plaintiffs assert that Smt.Valli died because of Septicaemia consequent to the sterilization surgery and allege that this was on account of the negligence and carelessness of appellants 2, 3, 5 and 6, namely, the doctors and nurses, who were in charge of the said surgery. They also accuse that adequate post operative care had not been given to Smt.Valli, thus causing her untimely death; and therefore, prayed that an amount of Rs.1,50,000/-be awarded to them as compensation. 6. The records show that defendants 1 to 4 — who are appellants 1 to 4 — filed a written statement contending that the suit is not maintainable and that the averments in the plaint are not true. They maintained the position that the death of Smt.Valli was not on account of any latches or negligence on the part of defendants 2 and 3 and that defendant No.6 was, in fact, a doctor of great repute, who had conducted several such surgeries without any event in the past. They also stated that there were 16 surgeries performed, including that on Smt.Valli, on 26.01.1995 in the sterilization camp at the Public Health Centre and that all the other 15 patients were discharged similarly like Smt.Valli, without any post operative complication or cause thereafter. They say that, therefore, the probable reason why Smt.Valli must have contracted infection was because she had not taken full care of herself after she had been discharged from the hospital, subsequent to the procedure. They further contended that the amounts claimed by the plaintiffs were grossly disproportionate and therefore, prayed that the suit be dismissed. 7. As regards defendants 5 and 6, they filed a separate written statement, asserting their professional competence and predicating that nothing can be found against them, since they had performed their duties diligently and professionally. They also thus prayed that the suit be dismissed. 8. 7. As regards defendants 5 and 6, they filed a separate written statement, asserting their professional competence and predicating that nothing can be found against them, since they had performed their duties diligently and professionally. They also thus prayed that the suit be dismissed. 8. I notice that the suit was, thereafter, taken to trial by the Trial Court and Exts.A1 to A2 were marked on the side of the plaintiffs; while Exts.B1 to B3 were marked on the side of 3rd the defendants. The Court also marked Exts.X1 to X3 as party exhibits, which are the medical records of Smt.Valli and her Postmortem Certificate; and recorded the testimonies of PW1 to PW5 on the side of the plaintiffs and that of DW1 to DW4 on the side of the defendants. After an exhaustive evaluation of the evidence so gathered, the Trial Court decreed the suit, finding that the death of Smt.Valli was on account of post operative complications and thus awarding an amount of Rs.46,000/-to the 1st plaintiff — the husband of Smt.Valli — and Rs.26,000/-each to plaintiffs 2 to 5 — who are her children; and directed the 4th defendant — State of Kerala to deposit the amounts, holding them vicariously liable for these amounts. 9. It is this judgment and decree of the Trial Court which has been challenged by the State and the other defendants in this appeal. 10. I commenced this judgment by saying that this is an appeal that should have never been filed because, the death of Smt.Valli is conceded. It is also admitted that she underwent a laparoscopic sterilization procedure four days prior to her death. The fact that she suffered acutely on account of pain and infection, leading to septicemia, is not disputed by any of the defendants/appellants. The amounts awarded by the Trial Court is also certainly justified taking note of the loss suffered by the respondents/plaintiffs, particularly the young children, who lost their mother, which loss can never be weighed in terms of money. 11. That being so, the fact that this appeal has been filed and that the plaintiffs/respondents have been made to wait endlessly for more than 25 years, is itself shocking to the conscience of anyone and more so to that of this Court. 12. 11. That being so, the fact that this appeal has been filed and that the plaintiffs/respondents have been made to wait endlessly for more than 25 years, is itself shocking to the conscience of anyone and more so to that of this Court. 12. That said, I do not propose to dispose of this appeal on ad hominem considerations, but when I evaluate the evidence and materials on record, it become indisputable that the suit was deserving to be decreed in the manner as has been done by the Trial Court. 13. I say as afore because, Ext.X3, which is the postmortem report issued by the Assistant Police Surgeon, Medical College, Calicut, has noticed the incision on Smt.Valli's body on account of the laparoscopic surgery and has then entered his findings as under: “Brain 1250g, Lungs right 700g:left 650g both lungs showed evidence of consolidation. There was only a little area for aeration. Liver 1450g, spleen 100g, kidneys 150g kidneys were pale and swollen, stomach weighed 150g, contained 35 ml of mucoid fluid, mucosa normal, no unusual smell noticed. Peritoneal cavity inflammed and there was pockets of pus in between the coils of intestine. Coils of intestine adherent to each other and peritoneal cavity. There was partial resolution of pus. The desending colon at places showed organization of exucdate. Bladder contained, about 5ml of cloudy urine Bladder wall outer surface inflammed and showed organisation of exudate. Uterus weighed 75g tubes were tied by a plastic rings and showed inflamation.” 14. After recording the afore, the Assistant Police Surgeon, who has been examined as PW3, opined in Ext.X3 that Smt.Valli 'died due to septicemia secondary to laparoscopic sterilization'. 15. Pertinently, the findings and opinion of the Assistant Police Surgeon has not been contested or sought to be impeached by any of the appellants at any stage, including in this appeal; and therefore, the death of Smt.Valli on account of a post surgery complication is irrefutely established and rendered beyond any doubt. 16. Therefore, the only surviving question is whether the death of Smt.Valli was on account of any mishap at the time of surgery or on account of complications thereafter. 16. Therefore, the only surviving question is whether the death of Smt.Valli was on account of any mishap at the time of surgery or on account of complications thereafter. It is true that the Trial Court has found, after a careful analysis of the various factors and evidence available, that there was no cause of negligence as regards the surgery on Smt.Valli, since four hours subsequent to the procedure, the doctors found her fit enough to be discharged. The Trial Court, however, has found that the post operative support for Smt.Valli was wanting and that defendants 2 and 3, who are the doctor and the nurse attached to the laparoscopic camp, were not diligent in advising Smt.Valli as to the post operative requirements and care to be taken by her; and consequently, that she must have contracted infection subsequent to her discharge, which finally led to her death. The Trial Court has also, relying on various judgments of the Hon'ble Supreme Court and of this Court, held that the State of Kerala, namely, the 4th appellant herein, is vicariously liable for the death of Smt.Valli, especially, because it is expressly conceded by them that Smt.Valli died on account of post operative trauma and complications. 17. I have examined the evidence and the documents on record very carefully. Exts.X1 and X2 are the medical reports of Smt.Valli issued by the Taluk Hospital and the Medical College Hospital respectively and the entries therein are in conformity with the opinion of PW3 -Assistant Police Surgeon; while the diagnosis of the doctors in the said hospitals are also to the effect that Smt.Valli acutely suffered from complications consequent to the laparoscopic sterilization surgery. As I have already said above, the postmortem report, namely, Ext.X3 confirms this without doubt and therefore, it cannot be heard by the appellants/defendants to say that Smt.Valli did not succumb to such complications, but to an infection on account of her own negligence. To say so, would be shockingly uncharitable to the deceased, especially when she had voluntarily gone to the sterilization programme, responding to the call of the Government for family planning, consequent to the birth of her fifth child. I cannot, therefore, find the conclusions and holdings of the Trial Court to be, in any manner, in error because the evidence indisputably establishes her cause of death. 18. I cannot, therefore, find the conclusions and holdings of the Trial Court to be, in any manner, in error because the evidence indisputably establishes her cause of death. 18. The afore being so concluded, the memorandum of this appeal essentially impells six grounds. The first four assert that there can be no case of negligence against the appellants; while grounds 5 and 6 are with respect to the quantum of damages with the appellants contending that what has been now granted is excessive and exorbitant. 19. I cannot find favour with the afore contentions of the appellants, that there was no negligence leading to the death of Smt.Valli, since the medical records and the evidence on record speaks crystally to the contrary. 20. The surviving question is thus whether the amounts now ordered by the Trial Court can be seen to be 'excessive and disproportionate', as alleged by the appellants. 21. I notice from the impugned judgment that an amount of Rs.1,50,000/-, has been awarded, apportioning it as Rs.46,000/-payable to the 1st plaintiff -the husband of Smt.Valli; and Rs.26,000/-each to plaintiffs 2 to 5, who are her children. I cannot find this award to be disproportionate by any count; and on the contrary, I am of the view that it would have been certainly possible, had the plaintiffs sought a higher amount, that the Trial Court would have granted more than what has been done now. The amounts granted to the husband and children of Smt.Valli, which have been ordered to carry interest at the rate of 6% per annum, would be of little succour to them, since the loss suffered by them is one that cannot be replaced and can never be measured in pecuniary terms. 22. This Court, therefore, would certainly be found justified in having expected the appellants to have accepted the judgment of the Trial Court with grace and to have deposited the money; but unfortunately, on account of several contributing factors, the respondents/plaintiffs have been forced to wait an agonizing 25 years in their quest for legitimate justice. The fact that this appeal has remained on the files of this Court for 17 out of the said years, it is also something to be taken note of very seriously, particularly in cases of this nature. The fact that this appeal has remained on the files of this Court for 17 out of the said years, it is also something to be taken note of very seriously, particularly in cases of this nature. I choose to say nothing further and I am certain that it must be the endevour of this Court to ensure that the plaintiffs obtain due justice at least now and without any further delay. In the afore circumstances, I dismiss this appeal with costs to the respondents; and direct the 4th appellant -State of Kerala, to deposit the amounts due to the respondents/plaintiffs within a period of two months from the date of receipt/production of a copy of this judgment, so that their lives spent these years in despair can at least now find some solace; failing which, they will be entitled to recover it as per law. At this time, the learned Senior Government Pleader submitted that half of the decree amount has, in fact, already been deposited before the Trial Court; and therefore, that the 4th appellant may be permitted to deposit the balance in terms of this judgment. If the afore submission is correct, then certainly the 4th appellant will be liable to deposit only the balance amount, along with interest as per the decree, in terms of this judgment. It is so clarified.