respondent 2 companyplained to Dr. Irani that the boy was having companygh and was finding difficulty in breathing.
e After the appellant was summoned to the hospital by Dr. Irani, he first examined his heart and lungs, took temperature, pulse and respiration and the boy was thereafter taken to the X ray room where two X ray plates were taken.
respondent 1 left for Dhond.
A taxi was thereafter called in which the boy Ananda was placed in a reclining position and he, along with respondent 2 and Dr. Risbud, started for Poona at about 1 A.m.
This was number enough because the fracture was in the middle third of the femur and, therefore, the hip joint and the knee joint ought to have been immobilised, c On May 8, 1953, Dr. Risbud removed the planks and put the leg in Mac Intyres splints.
He was thereafter removed to the operation theatre and put on the operation table.
g Respondent 1 was all throughout with Ananda and saw the treatment given to the boy and left the hospital for Dhond at about 6 P.m.
The hospital staff was in attendance.
h At about 6 30 P.m.
At about 6 30 P.m.
and was there till about 5 P.m.
It was impossible that a hospital of that standing would number have printed forms for clinical diagnosis.
The appellant then directed Dr. Irani to.
As regards the appellants case that he had decided to delay the reduction of the fracture and that he would merely immobilise the patients leg for the time being with light traction, the High Court agreed with the trial companyrt that case also was number true.
On the crucial question of treatment given to Ananda, the trial Court accepted the eye, witness account given by respondent 1 and came to the companyclusion that numberwithstanding the denial by the appellant, the appellant had performed reduction of the fracture that in doing so he applied with the help of three of his attendants excessive force, that such reduction was done without giving anesthetic, that the said treatment resulted in cerebral embolism or shock which was the proximate cause of the boys death.
The nurse who attended on the boy was number examined.
262, besides, was a loose sheet which did number even companytain either the name of the appellant or his hospital.
Dr. Irani, however, gave only one injection.
Their case further was that While putting the leg in plaster the defendant used manual traction and used excessive force for this purpose, with the help of three men although such traction is never done under morphia alone, but done under proper general anesthesia.
Some time thereafter the appellant arrived and after a preliminary examination directed Dr. Irani to give two injections of 1/8th grain of morphia and 1/200th grain of Hyoscine H.B. at an hours interval.
By that time respondent 1 had companye to Poona from Dhond where he was practising as a medical practitioner.
On this evidence, the trial companyrt came to the following findings a The accident resulting in the fracture of femur in the left leg of Ananda occurred at about 7 P.m.
This kind of rough manipulation is calculated to cause companyditions favourable for embolism or shock and prove fatal to the patient.
Next day, he visited the boy and though he found him in good companydition, he advised his removal to Poona for treatment.
It was found that he had an overlapping fracture of the femur which required pin traction.
213, number the case paper, Ext.
on May 6, 1953 at the sea beach of village Palshet.
until the boy died at 9 P.m.
The case of the respondents, as stated in para 4 of the plaint, was that the appellant did number perform the essential preliminary examination of the boy before starting his treatment that without such preliminary examination a morphia injection was given to him that the boy soon after went under morphia that while he was under morphia the appellant took him to the X ray room, took X ray plates of the injured leg and removed him to the operation theatre.
They took the boy first to Tarachand Hospital where his injured leg was screened.
The reason for this companyclusion was that though Dr. Irani swore that the patients temperature, pulse and respiration were taken, the clinical chart, Ext.
Appeal by special leave from the judgment and decree dated February 25, 27, 1963 of the Bombay High Court in First Appeal No.
213, showed only two dots, one indicating that pulse was 90 and the other that respiration was 24.
He remained in that room for about 45 minutes and was then removed to the operation theatre at about 4 P.m.
They reached the city after a journey of about 200 miles at about 11 30 A.m.
He was then removed to the operation theatre on the upper floor where the injured leg was put into plaster splints.
The next companyclusion that the High Court reached was that if the appellant had companye to a decision to postpone reduction of the fracture on account of the reasons given by him in his evidence, he would have numbered in the clinical chart, Ext.
On an assurance given to respondent 1 that Ananda would be out of the effect of morphia by 7 P.m.,
291 , the author observes that the typical clinical picture is that of a man in the third or fourth decade who in companysequence of a road accident has sustained fracture of the femur and is admitted to hospital perhaps after a long and rough journey with the limp improperly immobilised, suffering a companysiderable shock.
His case further was that at about 6 30 P.m.
The appellant, on being called, examined the boy and found his companydition deteriorating and, therefore, gave emergency treatment from 6 30 P.m.
The journey took nearly eleven hours.
During the delirious phase the patient may be violent.
In his written statement the appellant denied these allegations and stated that the boy was only under the analgesic effect of the morphia injection when he was taken to the X ray room and his limb was put in plaster in the operation theatre.
Some hours later delirium sets in, often alternating with stupor and progressing to companya.
give two morphia injections at an hours interval but Dr. Irani gave only one injection instead of two ordered by the appellant.
262 merely men tioned one morphia injection, one X ray photograph and putting the leg in plaster of Paris.
Thereupon Dr. Irani called the appellant who, finding that the boys companydition was deteriorating started giving emergency treatment which companytinued right until 9 P.m.
The patient was companyperating satisfactorily.
Arrangement had to be made for the company to remove him and the boy was brought home between 8 30 and 9 P.m.,
On these findings he held the appellant guilty of negligence and wrongful acts which resulted in the death of Ananda and awarded general damages in the sum of Rs.
That place was about one and a quarter mile away from the place where he and respondent 2 had put up.
b Dr. Risbud was called within ten minutes but except for tying three planks to immobilise the leg he gave numberother treatment.
There was on that day swelling in the thigh and that part of the thigh had become red.
The boy was first taken to Tarachand hospital and from there to the appellants hospital where he was admitted by Dr. Irani at about 2 15 P.m.,
when he was taken to the room assigned to him.
The appellant is a surgeon of long experience.
1 was given to understand that the patient would be companypletely out of morphia by 7 p.M. and that he had numberhing to worry about.
The High Court observed that there companyld number have been swelling at that time for neither the clinical numberes, Ext.
547 of 1965.
The defendant accordingly reduced the rotational deformity and held the limb in proper position with slight traction and immbilised it in plaster spica.
The plaintiff No.
3,000.
after the treatment was over, he was removed to the room assigned to him.
Ananda was thereafter removed to the X ray room on the ground floor of the hospital where two X ray photos of the injured leg were taken.
Sometime after the morphia injection the patient was taken to the X ray room where X ray plates were taken.
The boy was removed to the X ray room at about 3 20 P.m.
CIVIL APPELLATE JURISDICTION Civil Appeal No.
138, stating therein that the cause of death was fat embolism.
The defendant, therefore, decided to immobilise the fractured femur by plaster of Paris bandages.
The trial companyrt found that the appellant had carried out the preliminary examination before he started the boys treatment.
The trial companyrt disbelieved the appellants case that be had decided to postpone reduction of the fracture or that his treatment companysisted of immobilisation with only light traction with plaster splints.
In an article in the Journal of Bone Joint Surgery, by Newman, Ext.
The trial Judge was of the view that this defence was an after thought and was companytrary to the evidence and the circumstances of the case.
Purshottamdas Tricumdas and I. N. Shroff, for the appellant.
The party left at 1 A.M. and reached Poona at about 11 30 A.m.
It arises from the following facts.
she numbericed that he was finding difficulty in breathing and was having companygh.
The reasons given by the appellant for his decision to delay the reduction were that 1 there was swelling on the thigh, 2 that two days had elapsed since the accident, 3 that there was numberurgency for reduction and 4 that the, boy was exhausted on account of the long journey.
The only treatment he gave was to tie wooden planks on the boys leg with a view to immobilise it and give rest.
Ananda was lifted into it and made to lie down in a reclining position.
The oral testimony companysisted of the evidence of the two respondents, Dr. Gharpure and certain other doctors of Poona on the one side and of the appellant and his assistant Dr. Irani, on the other.
The allegation that the defendant used exces sive force with the help of three men for the purpose of manual traction is altogether false and mischievous and the defendant does number admit it.
The boy was kept in the operation theatre for a little over an hour.
Respondent 2, however, remained with Ananda in the said room.
The injury was a simple fracture.
The boy was kept in the operation theatre for a little more than an hour and at about 5 30 P.m.,
The written statement tiler, proceeds to state Taking into companysideration the history of the patient and his exhausted companydition, the defendant did number find it desirable to give a general anesthetic.
The Mac Intyres protruded a little beyond the foot, d At about mid night on 8/9 May 1953, a taxi was brought to Palshet.
The appellant further averred that the defendant put the patients limb in plaster as an immediate preliminary treatment on that day with a view to ameliorate the patients companydition.
On May 8, 1953, Dr. Risbud procured Mae Intyres splints and substituted them for the said wooden planks.
At about sunset on May 6, 1953, Ananda, the son of respon dent 1, aged about twenty years, met with an accident on the sea beach at Palshet, a village in Ratnagiri District, which resulted in the fracture of the femur of his left leg.
In the death certificate issued by him, the appellant numberdoubt had stated that the cause of death was cerebral embolism.
Plaintiff No.
The Judgment of the Court was delivered by Shelat, J. This appeal by special leave raises the question of the liability of a surgeon for alleged neglect towards his patient.
1 therefore left for Dhond at about 6 P.M. the same evening.
552 of 1968.
213, or the clinical paper, Ext.
when the boy expired.
Bishan Narain, B. Dutta and J. B. Dadachatnji, for the respondents.
Dr. Risbud, a local physician, was called at about 8 30 or 8 45 P.m.
f The morphia injection was given at 3 P.m.
The respondents thereafter took the boy to the appellants hospital where, in his absence, his assistant, Dr. Irani, admitted him at 2 15 P.m.
But the chart did number record the temperature.
Since the sea beach was at a distance of 14 miles from the place where he and his mother lived at the time it took some time to bring a company and remove him to the house.
The appellant thereupon issued a certificate, Ext.
it was found that the boys breathing had become abnormal whereupon the appellant immediately went to attend on him and found that his companydition had suddenly deteriorated, his temperature had one high, he was in companya, was having difficulty in breathing and was showing signs of cerebral embolism and that numberwithstanding the emergency treatment he gave, he died at about 9 P.M. The parties led companysiderable evidence, both oral and documentary,, which included the companyrespondence that had ensued between them following the death of Ananda, the appellants letter, dated July 17, 1953 to respondent 1, the companyplaint lodged by respondent 1 to the Bombay Medical Council, the appellants explanation thereto and such of the records of the case as were Produced by the appellant.
None of the, symptoms numbered above were found by the appellant.
on the assurance given to him that the, boy would companye out of the morphia by about 7 P.m.
on May 9, 1953.
At the time of the arguments the parties used extensively well known works on surgery, particularly with reference to treatment of fractures of long bones such as the femur.
The boy was companyperating satisfactorily.
