SAILABALA BALIARSINGH vs PROFESSOR DR RAJ KISHORE SARANGI

-THIS is a complaint claiming compensation of rupees 8,95,000 attributing medical negligence in the treatment of the complainant.

THE opposite party No. 1 was at the relevant time the Professor and Head of the Department of Experimental Surgery, S. C. B. Medical College and Hospital, Cuttack. He was the consultant surgeon in Ideal Nursing Home, Cuttack whose proprietor is opposite party No. 2. It appears that the complainant consulted the opposite party No. 1 on 14. 2. 1996 for pain in her adomen. It was diagnosed as acute cholecystitis. The opposite party No. 1 accordingly prescribed medicines. On being advised for removal of gallbladder, she approached opposite party No. 1 on 9. 7. 1996 for undergoing operation for removal of gallbladder. Opposite party No. 1 advised her to take admission in the Ideal Nursing Home. She took admission in the said Nursing Home on 15. 7. 1996. The opposite party No. 1 performed cholecystectomy operation on 17. 7. 1996 and removed gallbladder stones. It is an admitted case of both parties that on 21. 7. 1996 i. e. , the 4th day of operation, the complainant developed jaundice. According to her, opposite parties advised her for re-operation as it was felt that the ''drain'' sucked into abdomen accidentally but she did not agree for re-operation as the drain was removed by one Dr. Ghosh on the 4th day after operation. The specific allegation of the complainant is that the operation conducted on 17. 7. 1996 was defective. After she was discharged from the Nursing Home on 28. 7. 1996 jaundice deepened and she developed itching in her body. On 18. 8. 1996, she was re-admitted in the Ideal Nursing Home under the opposite party No. 1 for jaundice. On 25. 8. 1996 she was again operated upon by the opposite party No. 1. The opposite parties assert that the drain was found in the abdomen and there was cystic collection of bile. Hepatico jejunostomy and jejuno-jejuncostomy was done. On 11. 9. 1996, she was discharged from the Nursing Home. The grievance of the complainant is that because of second operation, her longevity has come down and she is deprived of giving birth to children and is unable to do household works and has become a burden on the family.

In course of hearing considering the nature of the case, we requested the Professor and Head of the Department of Surgery, S. C. B. Medical College and Hospital, Cuttack to render his expert opinion. All papers relevant for the purpose were sent to him. After perusing the case history of the complainant and the version of the opposite parties, he has submitted his opinion on 27. 2. 2006. The complainant has filed objection to the expert opinion. We are not inclined to attach any importance to the objection filed by the complainant as she is a lay person and not a medical expert.

IN the written version, the opposite parties have explained about the cholecystitis and the ''drain'' and the cause of jaundice suffered by the complainant on the 4th day of her operation. Their case is that the complainant consulted opposite party No. 1 on 14. 2. 1996 for the first time with pain in abdomen which was diagnosed as acute cholecystitis and she was prescribed medicines. Cholecystitis is a condition in which due to formation of stones inside the gallbladder function of the gallbladder ceases. The function of gallbladder is to retain bile from liver, concentrate it and secrete it to the alimentary canal as and when required. Formation of stones restricts the functions of the gallbladder and in severe cases the gallbladder becomes dysfunctional requiring remvoal of the same by surgical procedure known as cholecystectomy. As mentioned above, the opposite party No. 1 conducted cholecystitis operation on 17. 7. 1996. The operation was successful removal of gallbladder with stones. On the fourth day of operation (i. e. , 21. 7. 1996), she developed jaundice and on the same day, it was noticed during dressing that the ''drain'' was not in its place. The complainant asserts that the ''drain'' was removed that day by one Dr. Ghosh. The above allegation cannot be accepted inasmuch as if the drain was removed on that day, it could not have been found in the abdomen which was removed on the second operation conducted on 25. 8. 1996. At this stage, it is relevant to know about the ''gallbladder'' and the ''drain''. The opposite parties have explained in their version that a part of the gallbladder is attached to the liver and during removal of the gallbladder, its attachment to the liver is also separated. Because there remains chance of bleeding and bile leakage from liver bed, a corrugated systhetic silastic material is put under liver with one end of it coming out of small hole made on the side of patient''s body separately where the said corrugated material is stitched to the skin to keep it in place. This attachment drains, blood or bile coming out of the raw liver bed outside through the hole. This is known as a ''drain''. The ''drain'' is taken out once the bleeding or bile discharge stops with healing of the wound. In case of the complainant since there was discharge the drain was retained and dressing was changed every day. It is explained by the opposite parties that some times during coughing or sighing or intestical movement the drain gets detached from stitch and sucked inside due to negative pressure. The complainant was having cough after operation and the drain sucked in. Such ''sucking'' is not due to any defect in the first operation. As a matter of fact there was slippage of drain into the abdomen not on account of any defect in operation but due to the fact that the complainant was having cough and in course of coughing the drain got detached from the stitch.

WE have carefully perused the expert opinion rendered by Dr. D. K. Roy, Professor and Head of the Department, Surgery, S. C. B. Medical College and Hospital, Cuttack. He has stated that cholecystitis with cholelithiasis is a common disease but cholecystectomy is not a minor operation. He has opined that post operative complications after cholecystectomy include haemorrhage, bileduct injury, post-operative bile leaks and biliary fistula, electrolyte imbalance, atelectasis lungs (Farquaharson''s operative surgery) and there are documented complications which occur in best circumstances. He has also opined that slippage of ''drain'' into the abdomen is also a recognised complications which can cause the problems in the patient which occurred to the complainant after first operation. According to the expert, the second operation was a more difficult, complicated one involving bigger magnitude which was done successfully by the opposite party No. 1. Keeping in view the opinion of the expert and for the reasons mentioned above, we have no hesitation to hold that the allegation of the medical negligence made by the complainant had no basis. In the result, we do not find any merit in this complaint which is dismissed. Complaint dismissed.