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procedure involved, and answered appellant’s queries. The appellant
stated that she was in acute discomfort and wanted a permanent cure and,
therefore whatever was considered necessary, including a hysterectomy
may be performed. When appellant\022s mother called on her on the same
evening, the respondent explained to her also about the nature of disease
and the proposed treatment, and appellant’s mother stated that she may do
whatever was best for her daughter. According to the accepted medical
practice, if endometriosis is widespread in the pelvis causing adhesions,
and if the woman is over 40 years of age, the best and safest form of cure
was to remove the uterus and the ovaries. As there is a decline in
fecundity for most women in the fourth decade and a further decline in
women in their forties, hysterectomy is always considered as a reasonable
and favoured option. Further, endometriosis itself affected fertility
adversely. All these were made known to the appellant before she
authorised the removal of uterus and ovaries, if found necessary on
laparoscopic examination.
10. On 10.5.1995, the appellant\022s consent was formally recorded in the
consent form by Dr. Lata Rangan - respondent’s assistant. Dr. Lata
Rangan informed the appellant about the consequences of such consent
and explained the procedure that was proposed. The appellant signed the
consent forms only after she read the duly filled up forms and understood
their contents. All the requisite tests to be conducted mandatorily before
the surgery were performed including Blood Grouping, HIV,
Hemoglobin, PCV, BT, CT and ECG. The laparoscopic examination of
the uterus surface confirmed the provisional diagnosis of endometriosis.
The right ovary was enlarged and showed a chocolate cyst stuck to the
bowel. Right tube was also involved in the lesion. The left ovary and tube
were also stuck to the bowel near the cervix. A few small cysts were seen
on the left ovary. The pelvic organs were thick and difficult to mobilize.
Having regard to the extent of the lesion and the condition of appellant’s
uterus and ovaries, she decided that conservative surgery would not be
sufficient and the appellant\022s problem required removal of uterus and
ovaries. The respondent sent her assistant, Dr. Lata Rangan to explain to
appellant\022s mother that the lesion would not respond to conservative
surgery and a hysterectomy had to be performed and took her consent.
The surgery was extremely difficult due to adhesions and vascularity of
surface. A \021sub-total hysterectomy\022 was done followed by the removal of
\021rest of the stump of cervix\022. As the right ovary was completely stuck
down to bowel, pouch of douglas, post surface and tube, it had to be
removed piecemeal. When appellant regained consciousness, she was
informed about the surgery. The appellant felt assured that heavy
bleeding and pain would not recur. There was no protest either from the
appellant or her mother, in regard to the removal of the ovaries and
uterus.
11. However, on 15.5.1995, Commander Zutshi to whom appellant
was said to have been engaged, created a scene and got her discharged.
At the time of discharge, the summary of procedure and prescription of
medicines were given to her. As the bill was not paid, the respondent
filed Suit No.469/1995 for recovery of the bill amount and the said suit
was decreed in due course.
12. Respondent performed the proper surgical procedure in pursuance
of the consent given by the appellant and there was no negligence,
illegality, impropriety or professional misconduct. There was real and
informed consent by the appellant for the removal of her reproductive
organs. The surgery (removal of uterus and ovaries), not only cured the
appellant of her disease but also saved her intestines, bladder and ureter
from possible damage. But for the surgical removal, there was likelihood
of the intestines being damaged due to extension of lesion thereby
causing bleeding, fibrosis and narrowing of the gut; there was also
likelihood of the lesion going to the surface of the bladder penetrating the
wall and causing haematuria and the ureter being damaged due to fibrosis
and leading to damage of the kidney, with a reasonable real chance of
procedure involved, and answered appellant’s queries. The appellant
stated that she was in acute discomfort and wanted a permanent cure and,
therefore whatever was considered necessary, including a hysterectomy
may be performed. When appellant\022s mother called on her on the same
evening, the respondent explained to her also about the nature of disease
and the proposed treatment, and appellant’s mother stated that she may do
whatever was best for her daughter. According to the accepted medical
practice, if endometriosis is widespread in the pelvis causing adhesions,
and if the woman is over 40 years of age, the best and safest form of cure
was to remove the uterus and the ovaries. As there is a decline in
fecundity for most women in the fourth decade and a further decline in
women in their forties, hysterectomy is always considered as a reasonable
and favoured option. Further, endometriosis itself affected fertility
adversely. All these were made known to the appellant before she
authorised the removal of uterus and ovaries, if found necessary on
laparoscopic examination.
10. On 10.5.1995, the appellant\022s consent was formally recorded in the
consent form by Dr. Lata Rangan - respondent’s assistant. Dr. Lata
Rangan informed the appellant about the consequences of such consent
and explained the procedure that was proposed. The appellant signed the
consent forms only after she read the duly filled up forms and understood
their contents. All the requisite tests to be conducted mandatorily before
the surgery were performed including Blood Grouping, HIV,
Hemoglobin, PCV, BT, CT and ECG. The laparoscopic examination of
the uterus surface confirmed the provisional diagnosis of endometriosis.
The right ovary was enlarged and showed a chocolate cyst stuck to the
bowel. Right tube was also involved in the lesion. The left ovary and tube
were also stuck to the bowel near the cervix. A few small cysts were seen
on the left ovary. The pelvic organs were thick and difficult to mobilize.
Having regard to the extent of the lesion and the condition of appellant’s
uterus and ovaries, she decided that conservative surgery would not be
sufficient and the appellant\022s problem required removal of uterus and
ovaries. The respondent sent her assistant, Dr. Lata Rangan to explain to
appellant\022s mother that the lesion would not respond to conservative
surgery and a hysterectomy had to be performed and took her consent.
The surgery was extremely difficult due to adhesions and vascularity of
surface. A \021sub-total hysterectomy\022 was done followed by the removal of
\021rest of the stump of cervix\022. As the right ovary was completely stuck
down to bowel, pouch of douglas, post surface and tube, it had to be
removed piecemeal. When appellant regained consciousness, she was
informed about the surgery. The appellant felt assured that heavy
bleeding and pain would not recur. There was no protest either from the
appellant or her mother, in regard to the removal of the ovaries and
uterus.
11. However, on 15.5.1995, Commander Zutshi to whom appellant
was said to have been engaged, created a scene and got her discharged.
At the time of discharge, the summary of procedure and prescription of
medicines were given to her. As the bill was not paid, the respondent
filed Suit No.469/1995 for recovery of the bill amount and the said suit
was decreed in due course.
12. Respondent performed the proper surgical procedure in pursuance
of the consent given by the appellant and there was no negligence,
illegality, impropriety or professional misconduct. There was real and
informed consent by the appellant for the removal of her reproductive
organs. The surgery (removal of uterus and ovaries), not only cured the
appellant of her disease but also saved her intestines, bladder and ureter
from possible damage. But for the surgical removal, there was likelihood
of the intestines being damaged due to extension of lesion thereby
causing bleeding, fibrosis and narrowing of the gut; there was also
likelihood of the lesion going to the surface of the bladder penetrating the
wall and causing haematuria and the ureter being damaged due to fibrosis
and leading to damage of the kidney, with a reasonable real chance of
