Neerja Singh, Member:

1. These three appeal, Nos. 340/2005 by the complainant, Smt. Battibai Jharia, 1063/2005 by opposite party No. 1, Dr Ajay Bose, and 553/2005 by opposite party No. 2, Dr. R.S. Tiwari, arise from the order dated 17.1.2005, passed by District Consumer Dispute Redressal Forum, Jabalpur, directing Dr. Ajay Bose and Dr. R.S. Tiwari along with the Oriental Insurance Company to pay, र 50,000 as compensation and र 1,000 as cost, to Smt. Battibai Jharia, on the ground of medical negligence allegedly committed by them in the treatment of her son.

2. Brief facts of the case as portrayed by the complainant. Battibai Jahria are that her son Ganesh Jharia (hereinafter referred to as the patient), consulted Dr Ajay Bose for pain in his abdomen. Dr. Bose advised him to get a sonography done, and after seeing the report, he advised an operation. The operation was performed at Vrinda Nursing home, run by Dr. Bose on 1.7.1997. The surgery was done by Dr. Ajay Bose and Dr. R.S. Tiwari. According to the complainant, the patient's condition deteriorated steadily after the operation, and on 8.7.1997 he was advised to be shitted to Jabalpur Medical Collage. The Jabalpur Medical College discharged him on 10.7.1997. Dr. Bose then took him to Royal Nursing Home run by Dr. Meena Jain. She demanded र 15,000 for his treatment but he expressed his inability to pay such an amount. From there, the patient was shifted back to Vrinda Nursing Home on 15.7.1997, where his treatment continued till he died on 22.7.1997. A complaint was lodged with the appropriate authority against Dr. Bose, for wrong treatment by an incompetent and unqualified doctor.

3. Dr. Ajay Bose, states that he is a qualified homeopath. He denies treating Ganesh Jharia or advising him to get an operation done. He states that Dr. R.S. Tiwari, who is a visiting surgeon, took the decision to operate. After the successful operation, the biopsy report showed that Ganesh Jharia was suffering from tuberculosis. The hospital nurse, Madhu Burman and ward boy Deolal, have given affidavits stating that Dr. Tiwari performed the operation. He further states that the septic peritonitis could have occurred due to air water, open place or treatment in medical college and Royal Hospital. There was no negligence on the part of the doctor or the hospital. The operation notes show that he had perforation in the peritonitis before the operation. The ruptured appendix was legated. The patient had mesenteric lymph nodes which were collected and sent for biopsy. Dr Ajay Bose also states that he also called Dr. Kapil Jain for a second opinion so there was no question of any negligence on his part.

4. Opposite party No. 1, Dr. R.S. Tiwari denies treating the patient at all. He admits that he is a visiting surgeon at Vrinda Nursing Home and states that the only time he saw Ganesh Jharia was on 8.7.1997 at 5 p.m. On seeing his condition he advised shifting him to Medical College. He further alleges that the treatment papers filed by the Nursing Home are false and manipulated.

5. We have heard the respective contentions of the learned Counsel for the parties and perused the documents filed on record.

6. The entire contention of Dr. R.S. Tiwari is that he did not perform the operation on Ganesh Jhana, but on another person by the name of Ganesh. He states that some other doctor operated Ganesh Jharia for appendix, whereas he operated upon Ganesh for tubercular perforate peritonitis.

7. One consent form and six other hospital treatment sheets have been filed. We have examined these documents very carefully. Dr. Tiwari admits that all the documents filed on record are in his handwriting and are of the operation and treatment given to Ganesh, and have no connection with the treatment of Ganesh Jharia. He states that only document R4 relates to the treatment of Ganesh Jharia.

8. Dr. R.S. Tiwari's story has a large number of holes in it. First, it is a too much of a coincidence that two persons of the same first name were admitted in the same hospital at the same time and that both were diagnosed with perforate peritonitis. Secondly, what, it absolutely not believable is that both were operated on 1.7.1997, and then both were readmitted on 15.7.1997. During arguments, Dr. R.S. Tiwari vehemently argued that he operated upon Ganesh on 1.7.1997 for tubercular peritonitis and the patient went away hale and hearty. In that case how can he explain Annexure R8, in which he writes that Ganesh, who had been operated for tubercular peritonitis was admitted again on 15.7.1997. He further alleges that the person he treated, Ganesh, was 21 years old, whereas Ganesh Jharia was aged 25 years. Yet in every single treatment papers he has mentioned the age of Ganesh as 25. Only one document of the Bhalia Pathology Centre mentions the age as 21, an obvious mistake on the part of the pathology centre.

9. Dr. R.S. Tiwari also argued that Dr. Sakelley's post mortem report clearly states that there was no evidence of tuberculosis in Ganesh Jharia. He contends that Ganesh was suffering from tuberculosis of the mesenteric lymph nodes. The dead person, who had no tuberculosis, was Ganesh Jharia and not Ganesh. The argument is without merit. A bare perusal of the post mortem report shows that Dr. Sakelley has written that there is no evidence of tuberculosis of the the lungs. He has not said that there was no tuberculosis of the mesenteric lymph nodes. In our considered view, Ganesh and Ganesh Jharia are one and the same person and the treatment to Ganesh @ Ganesh Jharia was given by Dr. R.S. Tiwari.

10. From the internet we get the information that problems of the mesenteric lymph nodes are very often mistaken for appendix.

"swollen mesenteric lymph nodes can be a source of abdominal pain and may sometimes be misdiagnosed as appendicitis. There have been a number of cases where patients have gone in to get their appendicitis out only to discover that it is not the appendix but the mesenteric lymph nodes that is causing the problem. It can be a source of abdominal pain as that is the only indicator of an underlying inflammation or infectious process."

(health top 54 u.com/post/mesenteric-Lymph- Nodes. aspx)

11. In all probability, during the exploratory laprotomy, Dr. R.S. Tiwari must have realised that the patient was having problem in the mesenteric lymph node. Perhaps, as Dr. Bose alleges, the appendix was also diseased. So he must have removed the appendix also, which even otherwise is a redundant organ. The lymph node was also taken out and sent for examination. The histopathology report, dated 4.7.1997, states that the lymp node showed 'tuberculous lymphadenitis.

12. We can only deduce what must have happened, as the so-called operation notes are so cursory that nothing can be gathered from them. Other than a crypic note 'Peritonium lavage done with normal saline' there is no other description or the steps taken during the operation. Whether the appendix was removed or the mesenteri node was removed is left to the imagination. The operation note gives the diagnosis as tubercular perforate peritonitis, and the operation done as 'exploration with closure of perforation with mesenteric biopsy'. The conditions of the organs, the abdominal fluid, or the procedure adopted finds no mention in the operation note.

13. The consent form, which has the signatures of the patient's elder brother, has no mention of the operation to be pertormed on the patient. In fact, it makes a mockery of the concept of informed consent.

14. Medical literature is quite clear on the point that perforation peritonitis with tuberculosis of the mesenteric lymph node is a very serious ailment. However, in this case, instead of explaining the medical facts and the steps taken to deal with the ailment and its complications, Dr. R.S. Tiwari wants to totally deny the surgery. It is this denial, which raises doubt about the quality of treatment meted out to the patient. Neither has the Nursing Home maintained any detailed records of the patient, nor the treatment given from 15.7.1997 till his deat

h a week later. We find the role of both the operating surgeon and the hospital deceptive and ambiguous. 15. In view of the aforesaid, we find no infirmity in the order of the Forum below in awarding compensation to the complainant. However, considering the facts and circumstances of the case, the sum of र 50,000 is too meagre an amount and deserves to be enhanced to र 1,00,000. 16. In the result, Appeal No 340/2005 succeeds and is allowed. The opposite parties shall jointly and severally pay to the complainant a sum of र 1,00,000. The rest of the order of the Forum below remains unaltered. Appeal Nos. 553/2005 and 1063/2005 are dismissed. We make no order as to costs. This order be retained in Appeal No. 340/2005, and copies be placed in the records of Appeal No. 553 of 2005 and 1063/2005. Appeal No. 340/2005 allowed, Appeal Nos. 553 and 1063/2005 dismissed.