Dr. Shrinivas Narayan, MBBS, MS (GEN SURGERY), MCH (UROLOGY), consultant Urologist and Andrologist, FORTIS HOSPITAL, #730, Eastern Metropolitan Bypass Road, Anandapur, Kolkata – 700 100, (West Bengal), Phone: 033- 6628 4200, Airtel : 9831315185, E-mail : drnarayans@gmail.com

BY THE REGISTERED POST WITH ACKNOWLEDGEMENT DUE

TO,

1.   Mr. Deep Sen,

Aged about 66 years,

S/o Late Mr. _________

R/o 7B, Corfield Road,

Kolkata – 700 019 (West Bengal)

Fortis UHID : FHL0000189514

2.   Mr. Arnab Sinha,

Advocate,

NPS Business Centre,

7A, Kiran Shankar Roy Road,

Kolkata – 700 001 (West Bengal)

Vodafone : 9051630075/ Airtel : 9831479647

E-mail : arnab8822@gmail.com

Subject : Your speed post legal notice No. NIL dated 28.02.2017 sent by you notice No. 2 on behalf of you noticee No. 1.

Dear Sir (S),

Under instructions from my client Dr. Shrinivas Narayan, MBBS, MS (GEN SURGERY), MCH (UROLOGY), consultant Urologist and Andrologist, FORTIS HOSPITAL,  #730, Eastern Metropolitan Bypass Road, Anandapur, Kolkata – 700 100, (West Bengal), Phone: 033- 6628 4200, Airtel : 9831315185, E-mail : drnarayans@gmail.com, I, serve you noticees with the reply of your notice under reference, as under :

1.   Nothing in the notice under reference shall deemed to admitted unless it has been specifically admitted in this reply.

PRELIMINARY OBJECTION

2.   That the present notice is wholly misconceived, groundless, false, frivolous, vexatious, scrupulous and sponsored, on NO BASIS which is unsustainable in the eyes of law as the same is sent without justified reasons. The notice sent against my client is just to harass, defame and extort money- illegal sum from my client (SUPRA) and hence the notice is liable to be withdrawn.

3.   That no specific, scientific and justified allegations in regard to negligence or deficiency in providing services has been made by the you noticee against my client. You noticee have totally failed to explain “as to how the my client were negligent”, the notice is based on nonspecific, unscientific and laymen conjectures and is liable to be withdrawn outright.

4.   That the present Notice is not supported by any medical expert opinion by the Complainant. As per the settled law in i) Apex court CS no 3541/2002 Martin F D’Souza vs. Mohd. Ashfaq, ii) Apex court CS no 1385/2009 A. Kriplani vs Ku. I. Malhotra it is essential to annex medical expert opinion before a notice is issued to the alleged doctor/hospital in order to enable the Courts/Consumer Fora to analyze whether prima facie evidence of medical negligence is made out against the alleged doctor. The present notice has been filed without   support of any opinion from the expert of the subject- specialist and hence the same is not maintainable. 

5.   That you noticee have sent the notice without support of any expert view of subject specialist and further the Complainant has made these allegations without support of any scientific literature in this regard, which indicates / denotes / supports the allegations made by the Complainant with clear specification/ stipulation of nature, type, quality and quantity of negligence or deficiency in services provided by the My client to the Complainant, hence the notice is liable to be withdrawn.

6.   That the Complainant has sent this notice with false allegations directly to my client by claiming exorbitant amounts with no basis. This shall waste the valuable time, create harassment and will all the more defame my client. Although it is a fact that the My client have acted in accordance to medically sanctioned steps and has not committed even a bit of negligence in this case while providing the said treatment, the allegations are nothing but a mockery of law hence notice is liable to be withdrawn.

7.   That as such no cause of action arose against my client, in this case, no negligence or deficiency in services has been made/ provided by the My client to the patient while providing the said prescribed treatment/services as per norms, and hence this notice is not maintainable in present form and is liable to be withdrawn outright with heavy costs.

8.   That the present notice is totally false, frivolous, fabricated, sponsored, wrong and baseless which is synthesized on the basis of unscientific laymen conjectures, assumptions and presumptions and in this case no negligence (either in form of commission or omission) has been committed by the My client and hence the Notice is liable to be withdrawn.

9.   That in this case patient was properly examined, investigated, diagnosed and treated by the My client as per prescribed norms of practice, which are mentioned in the textbooks and journals of the subject of SURGERY AND UNDER RIGHT TO INFORMATION FROM ESTEEMED INSTITUTIONS. Further my client never deviated from normal/prescribed line and norms of treatment & has not experimented on the patient (Copies and excerpts from medical literature are filed as “ANNEXURE OP-  ”.

10.                That the Complainant was well informed about quality, infrastructure and hospital facility available with Fortis hospital, which is of repute prestige and satisfactory quality & there is no deficiency in services, hence the notice is liable to be withdrawn.

11.                That even after having taken all precautions and using requisite skills, diligence, knowledge and expertise, no warranty or guarantee was ever given by the My client to the patient about the Surgical procedure and its result, nowhere depicted in “ANNEXURE (filed by the Complainant,)”, “NO GOOD DOCTOR EVER DOES IT” since the procedural complication/results is a matter of fact and not a matter of speculation hence the notice is liable to be withdrawn.

12.                That the My client is SENIOR SURGEON of repute and is a well qualified doctor. Dr. Shrinivas Narayan, an Andrologist and Urologist by profession, offers his expertise in Endourology, Urology and Renal Transplant at Fortis Hospital (Anandpur) and Fortis Hospital and Kidney Institute (Rash Behari Avenue). He is highly skilled in TURP, TURBT, URSL and PCNL and open urological surgeries including Radical Cystectomy and Radical Prostectomy and has handled all routine and emergency urological cases with immense dexterity and competency. An MBBS graduate from Rajendra Institute of Medical Sciences (Ranchi), Dr. Narayan holds MS (General Surgery) and M Ch (Urology) degrees from Institute of Medical Sciences, Varanasi and IPGMER (Kolkata) respectively. A bright student, Dr. Narayan topped his MBBS examinations and consequently posted huge academic success. Dr. Narayan holds extensive work experience through past professional associations such as Sir Sunderlal Hospital- Institute of Medical Sciences (Varanasi), Indraprastha Apollo Hospital (New Delhi), IPGMER -SSKM Hospital (Kolkata), R N Tagore Hospital (Kolkata) and Mission Hospital (Durgapur). Dr. Narayan keeps himself abreast of the latest medical developments through active participation in medical conferences and workshops. He can be credited with several publications and paper presentations relevant to his field of speciality.

POINTWISE REPLY

13.                My client have seen patient only in OPD and patient was never admitted under his care. Prostatic malignancy can be there with normal serum PSA. He was advised TRUS guided prostatic biopsy as he was having prostatic nodule on USG which can be malignant The procedure was done on OPD basis by Dr Gunjan Gupta under local anesthesia and proper antibiotic cover. Urinary tract infection is common after effect of TRUS prostatic biopsy. These usually develop within 72hrs of procedure. Only urine culture can conclusively diagnose urinary tract infection. Patient consulted My client in OPD after 7 days with urine culture report which was sterile meaning no documented urinary tract infection.

14.                Patient never came back to My client thereafter. He was diagnosed urosepsis by another doctor on 20th Sep i.e about 2 weeks after procedure and was treated with IV antibiotics for 4 days but even this treatment failed to control his problem. He was again treated with IV antibiotics for 4 days starting 4th Oct i.e 26 days after procedure. My client was not privy to reports on which basis he was treated by another doctor. Patient was treated based upon scientific facts and he should have reported to My client when problem recurred.  No one can guarantee that urinary tract infection will not happen after TRUS guided prostatic biopsy despite procedure being done under antibiotic cover. My client cannot be held responsible for unusually prolong and repeated IV antibiotic treatment done outside. He would have been better managed, had he come back to me.

Transrectal ultrasonography (TRUS)

15.                Transrectal ultrasound create an image of organs in the pelvis. The most common indication for transrectal ultrasound is for the evaluation of the prostate gland in men with elevated prostate specific antigen or prostatic nodules on digital rectal exam. Ultrasound may reveal prostate cancer, benign prostatic hypertrophy, or prostatitis. Ultrasound may also be used to help guide a biopsy of the prostate.

16.                In view of the above discussion, it is crystal clear like light of the day that my client did his duty with utmost care and caution therefore there is no question of medical negligence or deficiency in service, the same is specifically denied.  In order to decide whether negligence is established in any particular case, the alleged act, omission, or course of conduct that is the subject of the complaint must be judged not by ideal standards nor in the abstract but against the background of the circumstances in which the treatment in question was given. The true test for establishing negligence on the part of a doctor is as to whether he has been proven guilty of such failure as no doctor with ordinary skills would be guilty of if acting with reasonable care. Merely because a medical procedure fails, it cannot be stated that the medical practitioner is guilty of negligence unless it is proved that the medical practitioner did not act with sufficient care and skill and the burden of proving this rests upon the person who asserts it. The duty of a medical practitioner arises from the fact that he does something to a human being that is likely to cause physical damage unless it is not done with proper care and skill. There is no question of warranty, undertaking, or profession of a skill. The standard of care and skill to satisfy the duty in tort is that of the ordinary competent medical practitioner exercising an ordinary degree of professional skill. As per the law, a doctor charged with negligence can clear himself if he shows that he acted in accordance with the general and approved practice. It is not required in the discharge of his duty of care that he should use the highest degree of skill, since this may never be acquired. Even a deviation from normal professional practice is not necessary in all cases evident of negligence.

17.                In view of the above discussion, you noticees are therefore advised not indulge in unlawful and illegal activities of extortion, cheating and threat otherwise my client would have no option but knock the doors of justice for the redressal of his grievances at your costs and risks. It is specifically denied that you noticee are entitled for a sum of Rs. 2,00,000/- (Rs. Two Lacs Only) as damages and compensation or any other amount from my client.

18.                Kindly pay Rs. 2,00,000/- (Rs. Two Lacs Only) within a period of one month from the date of receipt of this notice or alliteratively withdraw the notice by submitting the unconditional apology to my client as you noticee have caused loss of reputation of my client and defamed them in the city or town concerned.

Cost of this reply notice is Rs. 5,000/- to be paid by you noticee No. 1 to my client.

Please take notice and act accordingly and fail not.

Thanking you

PLACE : KOLKATA                                              Yours faithfully

DATED : 26.03.2017                                   [