A. NARAIN RAO vs G. Ramakrishna Reddy

- THE appellant Shri A. Narain Rao was the complainant before the State Consumer Disputes Redressal Commission, Andhra Pradesh, Hyderabad. His complaint was registered in that Commission as C.D. No. 6/90 of 1990. THE complaint was filed against the present respondent No. 1, Dr. G. Ramakrishna Reddy, who is Director of Jagadamba Nursing Home, Gandhinagar, Hyderabad and No. 2 Dr. K.V. Ramana Rao, who is Director of Nagarjuna Blood Bank, Secunderabad. Later on, on the application of the complainant, the State Commission had impleaded National Insurance Company Ltd. and United Insurance Company Ltd. as Nos. 3 & 4 but now they are not before us in this appeal. THE State Commission vide order dated 22.6.1991 dismissed the complaint. It may be mentioned here that the complainant had also filed an application before the State Commission for impleading Dr. P. Ramachandra Murthy, Anaesthetist and Dr. P.V. Ramaraju Surgeon as opposite parties but the said application was also dismissed by the impugned order. Feeling aggrieved by the decision of the State Commission the appellant has filed this appeal.

THE case of the complainant as gathered from the pleadings and evidence is that he is a retried Upper Division Clerk of the Central Government. He was 62 years old when he filed the complaint on 29th January, 1990 before the State Commission. He was suffering from some ailment for a period of about six months before he consulted Dr. B. V. Ramaraju, Urologist (RW-3) on 10th April, 1989 for an ailment of his prostate gland. Dr. Ramaraju advised surgery and recommended that the complainant should undergo seven pre-surgery tests (vide exhibit A- 1) to decide his fitness for surgery. THE complainant underwent those tests and showed the reports to Dr. Ramaraju who after perusing them advised the complainant to get himself admitted in the Jagadamba Nursing Home, Gandhi Nagar, Hyderabad for surgery, which in medical parlance is referred to as ''TURP'' (i.e. Trans Urethral Resection of prostate gland). Accordingly the complainant got himself admitted in the above Nursing Home on 15.4.1989 for the surgery which was to take place on the following date in the said Nursing Home. On the same date i.e. 15.4.1989 the Nursing Home prepared the complainant for surgery and obtained his blood sample for necessary tests and collected Rs.200/- from him towards the cost of the blood to be obtained for transfusion. While paying the amount the complainant had insisted that the blood be obtained only from the Institute of Preventive Medicine, Narayanaguda where donor''s blood is most scrupulously subjected to all the required mandatory pathological tests to ensure that the blood is free from any infection or contamination. THE Nursing Home promised to do so but it obtained the blood from a private blood bank namely Nagarjuna Blood Bank. THE complainant came to know about that fact only on the date of discharge when the receipts Issued by the blood bank were handed over to him by the Nursing Home. On 16th April, 1989 Dr. Ramaraju performed surgery upon the complainant. Simultaneously with the commencement of the surgery, blood transfusion was also stateted. Respondent No. 1 Dr. Ramakrishna Reddy was also present in the operation theatre while Dr. Murthy was Anaesthetist. It is the appellant''s case that towards the end of the surgery, as the influence of anaesthesia almost waned, he heard the Anaesthetist, Dr. Murthy remarking that the tongue of the complainant had turned black and thereupon Dr. Ramaraju hurriedly gave instruction to stop the transfusion forthwith in view of the adverse reaction. The Nursing Home levied a charge of Rs. 4219.20 (Ex.A-16.) and discharged the complainant an 21st April, 1989.

In the last week of August, 1989 i.e. after four months of surgery the complainant started becoming progressively weak accompanying prodromal symptoms like (1) predominating malaise, (2) vague abdominal unrest, (3) loss of appetite, (4) lack of digestion, (5) belchings, (6) itching, (7) vomiting sensation, (8) dark urine etc. with their intensity increasing day by day. He consulted Dr. Sethu Babu (CW-1) on 6th September, 1989 at the C.D.R. Hospital. Dr. Sethu Babu is said to have diagnosed the disease as ''post-transfusion-hepatitis'' and told the complainant that infected and contaminated blood was transfused when he was operated upon and that the incubation period of the virus was 1 to 6 months and it required prolonged treatment. The said doctor also advised the complainant to undergo Liver Function Test and HBs Ag. test. The complainant accordingly underwent the said tests which revealed that he was suffering from Hepatitis B infection and was having high serum bilirubin.

IN the last week of September, 1989 the complainant got himself admitted in Arya Nursing home on the advice of Dr. Sethu Babu and underwent treatment in that Nursing Home for five days. The complainant had to incur huge expenditure of Rs. 10,725/-as detailed by him in Annexure 1 to the complaint. According to him, he suffered untold misery as he and his family was subjected to a great deal of mental torture, anxiety and agony and were thrown in a permanent state of fear, tension, anxiety, agony, wondering at what point of time in future the much feared liver cancer and cirrhosis of liver might strike the complainant fatally with a lurking fear as to when the infection of the viral disease might be handed down to other members of the family. The grievance of the complainant was that the Nagarjuna Blood Bank had supplied infected blood and Jagadamba Nursing Home transfused that blood to him using contaminated equipment and apparatus. It was also the case of the complainant that the Jaggadamba Nursing Home had not used disposable syringes despite has insistence and that the standard of-hygiene in the Nursing Home was very low. He further mentioned that by negligently transmitting the dreadful virus into his ageing body of 62 years the Nursing Home and the Blood Bank nearly killed him at one stage, exposed him to cancer or cirrhosis of lever, made him a permanent patient for life, as the virus of the serum hepatitis stays in the blood-stream of the patient for life. Not only he, even his spouse, children and grandchildren, with whom he comes in contact every minute of the day are exposed to the risk of this virus. Thus, they exposed the entire family to the risk of this virus. On these allegations the complainant has claimed compensation of Rs. 1.00 lakh from each of the opposite party (now respondent) together with expenses incurred by him.

THE case was contested by both the opposite parties who filed separate counters. Dr. G. Ramakrishna Reddy (Respondent No. 1 who was opposite party No. 1 in the complaint) took some preliminary objections with which we are not concerned here as those were overruled by the State Commission and were not raised before us. On merits he averred that he has no personal knowledge about the truth or otherwise of any of the allegations made in the complaint. He is in no way concerned about the treatment of the patients who are admitted in the Nursing Home by other consultants. Of course, as Administrative Head of the Nursing Home he is in overall management of the staff of the Nursing Home and visits every patient twice a day i.e. in the morning and again in the evening only for the purpose of checking whether the instructions given by the consultants were being properly implemented by the Duty Doctors and staff of the Nursing Home. During the said visits he enquires about the general well being of the patients and also makes notes of any complaint which might be made by the patients or their attendants. Such visits are also made for knowing the sanitary conditions of the Nursing Home. As regards sterilisation of instruments the Nursing Home follows the techniques prescribed. THE surgical theatres at the Nursing home are equipped with germicidal ultraviolet lamps and automist-aersol disinfector/fumigator. THE surgical theatres are fumigated every day with automist-aerosol disinfector and germicidal ultraviolet lamps and left overnight for surgery the next day. THE Nursing Home has been utilising disposable needless and syringes only in case where the patients are able to purchase disposable syringes and needles. In other cases adequately sterilised syringes and needless are being used. THE complainant never requested for using disposable syringes and needles. No equipment or apparatus is required to transfuse blood. A blood transfusion set is provided by the blood bank with every bottle of blood and the same is used and disposed of immediately after use in a prescribed manner. Every bottle delivered by the blood bank is labelled and the said label contains the details of the blood, the details of the donor, the name of the recipient, blood groups of the recipient and donor, Rh factor, date of collection, date of expiry etc. THE said label is signed by the Medical Officer, In charge of the Blood Bank. Before transfusion, the Duty Doctor checks and verifies the information given on the label with respect to the patient in addition to the visual and mechanical inspection. THE visual inspection discloses the presence of blood clots, if any. THE mechanical inspection helps to detect any leakage from the bottle. If any defect is discovered, the bottle is rejected and returned to the Blood Bank. In the case of the complainant, there was neither mechanical nor visual defects in the bottle of blood. THE label pasted on the bottle of the blood gives particulars of the complainant, blood group etc. THE Nursing Home is not supposed to take out any blood from the bottle sent by the blood bank as the blood bank is bound to conduct all the necessary pathological and serological tests on the blood under the -supervision of a qualified doctor and only then release the blood for the purpose of transfusion. THE blood banks are licensed and work under the supervision and control of Central and State Drug Controllers who check the blood bank periodically. On the basis of information supplied by Dr. Ramaraju, Surgeon, Dr. Murthy, Anaesthetist, and Dr. Chary, Duty Doctor and the concerned staff of the Nursing Home, Opposite Party No. 1 further averred that the complainant had produced a routine urine examination report before Dr. Ramaraju which was normal and, therefore, the said doctor excluded the routine urine examination from the pathological tests recommended by him on 10.4.1989. The urine examination report dated 11.4.1989 (Ex. A2) now filed by the complainant was never brought to the notice of Dr. Ramaraju or Dr. Murthy. It can be seen from the said report (Ex. A2) that the complainant had bile-salts and bile-pigments in urine on 11th April, 1989. The complainant got urine examination for bile-salts and bile-pigments done without the doctor recommending the same. Had the complainant brought to the notice of Dr. Ramaraju or Dr. Murthy the said urine examination report (Ex.A2) the said doctors would have recommended the complainant to undergo several pathological and serological tests including Liver Function Test. The presence of bile-salts and bile-pigments in the urine indicates that the complainant had Hepatitis even on 11.4.1989 i.e. before the surgery. This is further supported by the raised ESR (Erythrocyte Sedimentate Rate) in the pathological report (Ex,A4). Raised ESR confirms the presence of some infection (this report is also dated 11.4.1989). The blood sample was drawn from the complainant not for the purpose of carrying out any tests but to forward the same to the blood bank for the purpose of getting blood for transfusion. The Nursing Home did not collect Rs. 200 /- from the complainant towards the costs of the blood. It is a usual practice of Nursing home to request the patient who would be undergoing surgery to arrange for voluntary donors from amongst their family members. The complainant was also requested by the management of the Nursing Home to provide a voluntary donor but the complainant could not do so. The Duty Doctor directed the complainant to go to the Institute of Preventive Medicine for the purpose of securing blood for transfusion and also informed him that the said Institute would give blood for the purpose of transfusion only if the complainant was able to furnish blood of voluntary donor of any blood group to them. The attendant of the complainant had gone to the Institute of Preventive Medicine for blood but the said Institute refused to deliver blood for failure of the complainant to provide a voluntary blood donor. The attendant of the complainant then approached the Duty Doctor who informed him that there were four reputed private blood banks in the twin cities of Hyderabad and Secunderabad. On the asking of the attendant the Duty Doctor furnished the particulars of the blood banks. The attendant of the complainant approached the Nagarjuna Blood Bank and obtained the blood from them. The management of the nursing home did not collect any amount from the complainant towards the cost of the blood nor handed over to him any receipt about its purchase.

THE transfusion of blood is never started simultaneously with the commencement of the surgery particularly an T.U.R.P. surgery, if patients who have sufficient percentage of Haemoglobin, blood is only kept ready by way of abundant caution to transfuse to the patient in case of loss of blood during surgery. THE complainant was given transfusion of the blood only after the surgery was successfully completed under general anaesthesia. After general anaesthesia is administered, there is no possibility of the patient''s knowing when the transfusion has been started. He (Dr. Ramakrishna Reddy) was not present in the operation theatre when the surgery upon the complainant was performed. In fact he is never present in the theatre when the other surgeon is operating upon the patent as it is against the medical convention, except when a patient, who is known to him, he would be present in the theatre with the permission and consent of the operating surgeon. This is only done to satisfy the relatives of the patient. THE allegation of the complainant that he had heard Dr. Murthy, Anaesthetist telling Dr. Ramaraju that the tongue of the complainant had turned black was denied. According to the said respondent there was no blood reaction in the case of the complainant.

RESPONDENT No.2 (who was opposite party No. 2 in the complaint) Dr. K.V. Ramana Rao, Director, Nagarjuna Blood Bank (for short Blood Bank) also filed a counter. It was pleaded that the blood of each donor has to be screened for about eight tests as provided under Schedule ''F'' of Drugs and Cosmetics Act, 1945. The Blood Bank is subjected to regular check by the Drug Controller of Andhra Pradesh and Central Drug Controller. The Blood Bank has qualified personnel and the laboratory is well-equipped for conducting the necessary tests regularly. Blood of each donor is taken into two sample bottles and the Blood Bank subjects one sample to the tests (enumerated in para 10 of the counter). The report of these tests is normally ready in about 24 hours. The other sample bottle is sent to Indian Council for Medical Research (TCMR) Unit at Osmania General Hospital for further confirmation of the absence of HBs Ag. virus. On obtaining information with regard to the tests conducted by the ICMR, if the result is negative and the blood is acceptable, the Blood Bank draws the blood from the donor on the next day or day after as per the requirement. The ICMR Unit in Hyderabad was established as a research unit and also with the objective of ensuring supply and transfusion of blood free of HBs Ag. The Blood Bank enrolled itself to the ICMR project in the month of March, 1989 and has been regularly supplying the sample bottle of the donor since then. The ICMR Unit follows the test called Enzyme Linked Immuno Assay (ELISA) and the Blood Bank in question follows the test called Reversed Passive Haemagglutination (RPHA) Test. Both these tests are third generation tests and by testing sample blood by two different methods the possibility of getting any false report about Hepatitis B virus (HBs Ag) is completely ruled out. The Blood supplied for transfusion in this case was subjected to both these tests. The Blood Bank supplies blood to many prestigious hospitals like Appolo Hospital, C.D.R. Hospital, Osmania General Hospital, Gandhi Hospital etc. where more complicated operations like open heart and bypass surgeries are conducted. The blood supplied to the complainant was drawn from the donor on 12.4.1989 in two bottles of 3 ml. each. The first sample bottle was tested in the laboratory of the Blood Bank while the second bottle was sent to ICMR Unit of Osmania General Hospital along with other reports. The results of the tests about HBs Ag was negative. The Blood Bank also referred to the various entries of their record in respect of the donor (Ramesh) and the supply of the donor''s blood to the complainant''s attendant. According to this respondent the blood supplied to the complainant by the Blood Bank was free from any contamination and infection. Respondent No. 2 also referred to the urine examination report dated 11th April, 1989 (Ex. A2) produced by the complainant and averred that the presence of bile salts and bile pigments in urine indicate that the serum bilrubin was 3.0 mg/ml or more thereby indicating that the complainant had infective Hepatitis even on the above date. In addition to the presence of bile salts and bile pigments in urine, the blood examination report dated 11th April, 1989 filed by the complainant shows E.S.R. first hour-40 mm, Second hour-65 mm which is far above expected rate. The raised E.S.R. is again a pointer towards infection anywhere in the body more so in the present case when the complainant was carrying Hepatitis B virus infection.

The parties were heard in detail. The State Commission''s record was also called for and has been carefully perused.

BEFORE we proceed further we may mention here that the State Commission has written a very detailed order in this case and every aspect of the evidence in the case has been thoroughly considered and it was only thereafter that it came to the conclusion that the complainant had failed to prove that the blood transfused was infected with Hepatitis B virus. In addition, a positive finding has been given to the effect that the complainant was suffering from jaundice even before the date of the blood transfusion. After perusal of the records and the detailed order of the State Commission we are of the opinion that the impugned order does not suffer from any infirmity. However, as this is first appeal we will briefly discuss the evidence. The complainant vehemently argued that while he was regaining consciousness after the surgery he heard Dr. Murthy Anaesthetist telling Dr. Ramaraju, Surgeon that his (complainant''s) tongue as turning black and thereafter the blood transfusion was stopped. Both Dr. Murthy and Dr. Ramaraju have appeared in the witness box and have denied this allegation of the complainant. It is not necessary to discuss this part of the evidence because it is not in the case of the complainant that his tongue had turned black and on account of the contamination of the transfused blood with HBs Ag virus. The complainant also did not cross-examine any of the doctors examined in the present case to establish that if transfused blood has HBs Ag virus then the tongue can turn black. In the present case as many as seven doctors have been examined i.e. R.W.I Dr. G. Ramakrishna Reddy, RW2 Dr. K. V. Ramana Rao, RW3 Dr. B. V. Ramaraju (Surgeon), RW4 Dr. P. Ramachandra Murthy (Anaesthetist), RW5 Dr. Manu Tandon, who holds a doctorate Degree in Gastroenterology, CW1 Dr. Sethu Babu who holds a Doctorate Degree in Gastroenterology and CW2 Dr. V. Prabhakar. The tongue of a patient can turn black if there is blood reaction but not on account of any contamination in it. It would not be out of place to mention here that the complainant in cross-examination had admitted that he did not enquire from Dr. Ramaraju about the reasons for reaction said to have been experienced by him due to blood transfusion. He has also admitted that he was not administered any medicine by the said doctor for the alleged reaction. In such circumstances we cannot attach any credence to the story put forward by the complainant that his tongue turned black due to transfusion of contaminated blood.

AT this stage we may also take up another allegation of the complainant that the sanitary conditions in the Jagadamba Nursing Home are not upto the mark and the instruments and needles are not properly sterilised and that he had asked for using disposable needles but his request was not complied. Exhibit A-10 is the notice given by the complainant to the Jagadamba Nursing Home before filing this complaint. That notice does not contain any of these allegations. Respondent No.1 Dr. G. Ramakrishna Reddy and Dr. Ramaraju who had been visiting the complainant after the operation have stated on oath that the complainant never made any complaint on these points. We have no hesitation to accept their testimony as true. Therefore, this part of the story of the complainant is also to be rejected. It is also the allegation of the complainant that he had specifically instructed the Nursing Home on 15th April, 1989 that the blood for transfusion should be purchased only from the Institute of Preventive Medicines but inspite of those specific instructions the Nursing home purchased the blood from a private blood bank. This allegation has been categorically denied by Respondent No. 1 who has stated that the Institute of Preventive Medicine, Hyderabad supplies blood only if a voluntary donor is provided in the first instance to replenish the blood sought to be purchased and as the complainant was unable to procure a voluntary donor he could not get blood from the Institute of Preventive Medicine and the attendant of the complainant after inquiring the names of the various blood banks from the Duty Doctor approached the Nagarjuna Blood Bank and obtained the blood from it. The complainant in the witness box has not denied the assertion of the Opposite Party No.1 that the Institute of Preventive Medicine provides blood only to such persons who will be in a position to replenish the blood with the blood of a voluntary donor of any blood group. It is also not his case that he could procure a voluntary donor. There is a dispute between the complainant and the Nursing Home on the story that whether some attendant of the complainant purchased the blood from the Nagarjuna Blood Bank or it was purchased by the Jagadamba Nursing Home through one of its attendants. It is not necessary to dilate upon this part of the case as the main question in the present case is whether the blood supplied by the Nagarjuna Blood Bank was infected with Hepatitis B virus. It may, however, be mentioned here that according to the complainant only his wife was with him when he was admitted in the Nursing Home. She has not been examined to prove who had purchased the blood for transfusion. Now we take up the main question. As noticed earlier the grievance of the complainant is that the blood transfused was contaminated with Hepatitis B virus and as a result of transfusion of such blood he was afflcited with Hepatitis B virus. As noticed earlier in the counter filed by the said Blood Bank the procedure followed by it in testing the blood sample taken from the donor has been described in detail. The blood supplied to the complainant was obtained by the bank from one donor named Ramesh who was first given code No.6. The numbers and names of the donors are entered in the work book of the technician (Ex.B-6). On April 12, 1989, samples of nine donors including Ramesh, were taken. The Blood Bank follows the test called RPHA test to determine the presence of HBs Ag. The entry Ex. B-6(a) shows that the test in respect of Ramesh having code No. 6 was negative in respect of HBs Ag virus. The Blood Bank has also produced Exs. B-2, B-3 and B-5 to show that it has entered into an agreement with the Indian Council of Medical Research (ICMR) Unit at Hyderabad for screening of Hepatitis B virus in blood donors by ELISA technique. Exhibit B-8 shows that nine samples of blood which were taken from the donors on April 12, 1989 by the Blood Bank were sent to the ICMR Unit for testing and all those nine samples were found to be negative in respect of HBs Ag virus. The complainant vehemently argued that Exhibit B8 is a fabricated document because the original date of the report has been changed from some other date to 14.4.1989. Of course, the date appears to have been over-written but other particulars in that report sent by the ICMR Unit are correct. The total number of samples sent is given as 9, time and date of collection has been given as 12.4.1989, date of supply has been given as 14.4.1989. Therefore, it is futile to argue that the date of the report has been tampered with to suit the present story of the Blood Bank.

AFTER the receipt of the report from the ICMR on April 14, 1989 the blood of the donor (Ramesh) is said to have been taken. Exhibit B-7 is a donor''s register while B-7(a) is the relevant entry in that register relating to the donor, Ramesh. He was given donor No. 1751. The relevant test reports of the donor were entered in that register. Exhibit B-1 is the blood supply register and Ex. B-1(a) is the entry relating to the donor. In that register the date of collection of the blood from the donor, the date of expiry, the name of the recipient of the blood, the address where blood transfusion has to be undertaken, the signature of the technician, signature, of the Medical Officer and the signature of the person receiving the blood bottles are recorded. The blood group of the donor and the recipient are also mentioned therein. The complainant has not been able to show that this record of the Blood Bank has in any way been manipulated. All these documents have been proved by Dr. K.V. Ramana Rao (P.W. 2) the Medical Officer, In charge of the Nagarjuna Blood Bank.

CW-1, Dr. Sethu Babu has stated that there is a project with ICMR in Gastroenterology in the Osmania General Hospital and he was associated with that project. According to him the purpose of that project is to screen the blood donors for the prevalence of Hepatitis B infection in their blood. He has further stated that Nagarjuna Blood Bank is one of the Banks chosen by ICMR project and that Bank regularly sends its sample for testing. He has also stated that the tests called ''ELISA'' is conducted in that project for testing the presence of HBs Ag, According to him the tests ELISA and RPHA are known as third generation tests and are very sensitive and if both those tests indicate negative results there is no likelihood of the sample of blood being contaminated with Hepatitis B virus. The complainant placed much reliance upon Ex. A-18 in which Dr. Sethu Babu (CWl) has recorded some prescription. It is dated 6.9.1989. In this prescription the said doctor recorded prodromal symptoms and history narrated to him by the complainant. On the basis of those symptoms he diagnosed that the complainant had post transfusion Hepatitis which is also called Hepatitis B and serum hepatitis. The said doctor therefore, advised the complainant to undergo HBs Ag and Lever Function/tests. The complainant was subjected to those tests. He has filed the reports of those tests. The complainant was found to be suffering with Hepatitis B virus and he remained under the treatment of the said doctor from 25th September to 29th September, 1989. Dr. Sethu Babu (CW-1) has stated that in this country Hepatitis B infection can be transmitted by either blood transfusion or pin pricks or bed bugs or mosquito bites or sexual intercourse or mother to child during pregnancy. To the same effect are the statements of R.W. 1, Dr. G. Ramakrishna Reddy, R.W. 2 Dr. K. V. Ramana Rao and R.W. 5 Dr. Manu Tandon. According to Dr. Sethu Babu (C.W.I) even an open wound contaminated with the saliva or secretion of a person suffering with Hepatitis B infection can transmit Hepatitis B infection to another person and it can also be acquired in a barber''s shop or hospital. He has further stated that he had prepared Ex. A-18 only on the basis of information furnished by the complainant and it was not prepared on the basis of any serological and pathological tests reports and at that stage his opinion that the complainant had Hepatitis B infection was only provisional and not confirmative. The said doctor has also admitted that a person can be positive of HBs Ag tests without any blood transfusion or undergoing any surgery or without taking any injection. Therefore, on the basis of the prescription Ex. A18 above it cannot be concluded that the complainant suffered from Hepatitis B virus on account of blood transfusion.

In the light of the foregoing discussion we do not find it possible to accept the complainant''s case that the blood transfused to him was contaminated with Hepatitis B virus. There is one document on the file which belies the contention of the complainant/appellant that he contracted Hepatitis B infection on account of transfusion of contaminated blood on 16.4.1989. Ex. A-2 is pathological report issued by Indira pathological laboratory in respect of urine analysis examination of the complainant. According to this report the colour of the urine was dark yellow while it was positive in respect of bile salts and bile pigments. This report is dated 11.4.1990 (the original date is not legible but this date has been written by the complainant himself and underlined by him as admitted by him in his statement). Later on the complainant changed his stand and took up the plea that this report is in fact dated 24.4.1989. This contention is based upon the fact that in the prescription Ex.A-1 dated 10th April, 1989 Dr. Ramaraju had not prescribed any urine analysis examination though other tests were prescribed. According to the said doctor, the complainant had produced a routine urine examination report and therefore, he did not again prescribe that test. The State Commission has discussed this question in detail and has come to a finding that though the urine test was not prescribed by Dr. Ramaraju on 10th April, 1989, the complainant got it done himself of his own accord on 11th April, 1989. We agree with the view of the State Commission that this report is dated 11th April, 1989. The presence of the bile salts and bile pigments in the urine of the complainant on 11th April, 1989 and the fact that the colour of the urine was dark yellow shows that even before the surgery the complainant was suffering from jaundice. Of course from this report it cannot be concluded that the jaundice caused to the complainant was on account of Hepatitis B virus but the subsequent tests undertaken by the complainant under the advice of Dr. Sethu Babu (CW-1) confirmed that the jaundice was on account of HBs Ag virus. Exhibit A /2 which shows the presence of some virus in the body of complainant further finds corroboration from Ex. A4 another blood examination report issued by the laboratory. The raised readings of E.S.R. show that the complainant had some infection in his body. That infection could be HBs Ag virus or some other infection but if both reports A-2 & A-4 are considered then it can be safely concluded that the infection was on account of jaundice and as noticed earlier it was found to have been caused by HBs Ag virus.

EVEN if we accept that the contention of the complainant that A-2 is dated 24.4.1989, still it does not help the complainant. It is clear from the statements of CW-1 Dr. Sethu Babu and other witnesses that the minimum incubation period for manifestation of Hepatitis B infection is one month. If the complainant got infected by Hepatitis B virus on 16th April, 1989, it could not have been reflected in this urine examination report on 24.4.1989 meaning thereby that virus got into the body of the complainant much before the surgery performed upon him. It may be mentioned here that vide statement of C.W. 1 Dr. Sethu Babu, the complainant has since been completely cured of that infection and there is no danger of his transmitting it to any body in f1uture. In the light of what we have discussed above we do not find any merit in the present appeal. We confirm the findings of the State Commission and dismiss this appeal. As the appellant has made unfounded allegations against the doctors, the hospital and the Blood Bank, we direct that he should pay Rs. 5,000/- to the respondents as costs of this appeal. Complaint dismissed with costs.