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appellant has been informed that the treatment to be undertaken is
"diagnostic and operative laparoscopy. Laparotomy may be needed." The
case summary dictated by respondent and written by Dr. Lata Rangan
also clearly says "admitted for Hysteroscopy, diagnostic laparoscopy and
operative laparoscopy on 10.5.1995." (Note : Hysteroscopy is inspection
of uterus by special endoscope and laproscopy is abdominal exploration
by special endoscope.)
39. In this context, we may also refer to a notice dated 5.6.1995 issued
by respondent to the appellant through counsel, demanding payment of
Rs.39,325/- towards the bill amount. Paras 1, 3, and 4 are relevant which
are extracted below :
"1. You were admitted to our clinic Dr. Manchanda, No.7, Ring
Road, Lajpat Nagar, New Delhi for diagnostic and operative
laparoscopy and Endometrial biopsy on 10.5.1995." \005\005\005..
"3. The findings of laparoscopy were : a very extensive lesion of
the endometriosis with pools of blood, extensive adherence involving
the tubes of the uterus and ovaries, a chocolate cyst in the right ovary
and areas of endometriosis on the surface of the left ovary but no cyst."
"4. The findings were duly conveyed to Ms. Somi Kohli who was
also shown a video recording of the lesion. You and Mrs. Somi Kohli
were informed that conservative surgery would be futile and removal
of the uterus and more extensive surgery, considering your age and
extensive lesion and destruction of the functions of the tubes, was
preferable."
This also makes it clear that the appellant was not admitted for
conducting hysterectomy or bilateral salpingo-oopherectomy, but only for
diagnostic purposes. We may, however, refer to a wrong statement of fact
made in the said notice. It states that on 10.5.1995 after conducting a
laparoscopic examination, the video-recording of the lesion was shown to
appellant’s mother, and the respondent informed the appellant and her
mother that conservative surgery would be futile and removal of uterus
and more extensive surgery was preferable having regard to the more
extensive lesion and destruction of the function of the tubes. But this
statement cannot be true. The extensive nature of lesion and destruction
of the functions obviously became evident only after diagnostic
laparoscopy. But after diagnostic laparoscopy and the video recording of
the Lesion, there was no occasion for respondent to inform anything to
appellant. When the laparoscopy and video recording was made, the
appellant was already unconscious. Before she regained consciousness,
AH-BSO was performed removing her uterus and ovaries. Therefore, the
appellant could not have been informed on 10.5.1995 that conservative
surgery would be futile and removal of uterus and extensive surgery was
preferable in view of the extensive lesion and destruction of the function
of the tubes did not arise.
40. The admission card makes it clear that the appellant was admitted
only for diagnostic and operative laparoscopy. It does not refer to
laparotomy. The consent form shows that the appellant gave consent only
for diagnostic operative laparoscopy, and laparotomy if needed.
Laparotomy is a surgical procedure to open up the abdomen or an
abdominal operation. It refers to the operation performed to examine the
abdominal organs and aid diagnosis. Many a time, after the diagnosis is
made and the problem is identified it may be fixed during the laparotomy
itself. In other cases, a subsequent surgery may be required. Laparotomy
can no doubt be either a diagnostic or therapeutic. In the former, more
often referred to as the exploratory laparotomy, an exercise is undertaken
to identify the nature of the disease. In the latter, a therapeutic laparatomy
is conducted after the cause has been identified. When a specific
operation say hysterectomy or salpingo-oopherectomy is planned,
appellant has been informed that the treatment to be undertaken is
"diagnostic and operative laparoscopy. Laparotomy may be needed." The
case summary dictated by respondent and written by Dr. Lata Rangan
also clearly says "admitted for Hysteroscopy, diagnostic laparoscopy and
operative laparoscopy on 10.5.1995." (Note : Hysteroscopy is inspection
of uterus by special endoscope and laproscopy is abdominal exploration
by special endoscope.)
39. In this context, we may also refer to a notice dated 5.6.1995 issued
by respondent to the appellant through counsel, demanding payment of
Rs.39,325/- towards the bill amount. Paras 1, 3, and 4 are relevant which
are extracted below :
"1. You were admitted to our clinic Dr. Manchanda, No.7, Ring
Road, Lajpat Nagar, New Delhi for diagnostic and operative
laparoscopy and Endometrial biopsy on 10.5.1995." \005\005\005..
"3. The findings of laparoscopy were : a very extensive lesion of
the endometriosis with pools of blood, extensive adherence involving
the tubes of the uterus and ovaries, a chocolate cyst in the right ovary
and areas of endometriosis on the surface of the left ovary but no cyst."
"4. The findings were duly conveyed to Ms. Somi Kohli who was
also shown a video recording of the lesion. You and Mrs. Somi Kohli
were informed that conservative surgery would be futile and removal
of the uterus and more extensive surgery, considering your age and
extensive lesion and destruction of the functions of the tubes, was
preferable."
This also makes it clear that the appellant was not admitted for
conducting hysterectomy or bilateral salpingo-oopherectomy, but only for
diagnostic purposes. We may, however, refer to a wrong statement of fact
made in the said notice. It states that on 10.5.1995 after conducting a
laparoscopic examination, the video-recording of the lesion was shown to
appellant’s mother, and the respondent informed the appellant and her
mother that conservative surgery would be futile and removal of uterus
and more extensive surgery was preferable having regard to the more
extensive lesion and destruction of the function of the tubes. But this
statement cannot be true. The extensive nature of lesion and destruction
of the functions obviously became evident only after diagnostic
laparoscopy. But after diagnostic laparoscopy and the video recording of
the Lesion, there was no occasion for respondent to inform anything to
appellant. When the laparoscopy and video recording was made, the
appellant was already unconscious. Before she regained consciousness,
AH-BSO was performed removing her uterus and ovaries. Therefore, the
appellant could not have been informed on 10.5.1995 that conservative
surgery would be futile and removal of uterus and extensive surgery was
preferable in view of the extensive lesion and destruction of the function
of the tubes did not arise.
40. The admission card makes it clear that the appellant was admitted
only for diagnostic and operative laparoscopy. It does not refer to
laparotomy. The consent form shows that the appellant gave consent only
for diagnostic operative laparoscopy, and laparotomy if needed.
Laparotomy is a surgical procedure to open up the abdomen or an
abdominal operation. It refers to the operation performed to examine the
abdominal organs and aid diagnosis. Many a time, after the diagnosis is
made and the problem is identified it may be fixed during the laparotomy
itself. In other cases, a subsequent surgery may be required. Laparotomy
can no doubt be either a diagnostic or therapeutic. In the former, more
often referred to as the exploratory laparotomy, an exercise is undertaken
to identify the nature of the disease. In the latter, a therapeutic laparatomy
is conducted after the cause has been identified. When a specific
operation say hysterectomy or salpingo-oopherectomy is planned,
