According to medical literature the gall stones are most commonly seen in the gall bladder and rarely found in the biliary ductal system. In this context, we took reference from the standard medical books viz. Bellay and Loves Surgery, the Surgical Pathology by Ackerman. As per the medical text Stones in common bile duct is known as Choledocholithiasis. It is one of the complications of cholelithiasis (gallstones), so the initial step is to confirm the diagnosis of cholelithiasis. 

Common Bile Duct (CBD) stones are seen in approximately 7%-12% of patients who undergo cholecystectomy for symptomatic cholelithiasis and are a common indication for referral to a biliary endoscopist. They vary in size ranging from rather small (approximately 1-2 mm) to very large (> 3 cm). Endoscopic retrograde cholangiopancreatography (ERCP) with endoscopic sphincterotomy (ES) and basket or balloon extraction are well established therapeutic procedures for the management of CBD stones. It is estimated that nearly 85%-95% of all CBD stones can be managed effectively by these conventional endoscopic methods. The diagram shows different locations of gall stone: [Para 10]

It was submitted by the complainant, Sachhikant Tripathi, (‘the patient’) underwent operation for removal of gall bladder stone. It was performed by Dr. Vikash Singh/OP in his private clinic at Ara, Bihar, India. The patient did not get sufficient relief and he was suffering continuous abdominal pain, thence, approached the OP-doctor.

Few blood tests and ultrasonography (USG) of abdomen were performed. The investigations revealed jaundice to the patient and a stone was still present in the abdomen. Therefore, the OP- doctor without issuing any referral letter, advised the patient to consult Dr. Manoj Kumar at Patna, who performed second operation and thereafter the patient became normal.

It was alleged that the OP-doctor failed to remove the gall stone during the first operation and it was a clear case of deficiency in service and unethical practice on the part of the OP-doctor.

NCDRC observed that in the instant case the complainant failed to establish negligence against OP- doctor. Complainant’s case is neither supported by any expert opinion nor by any medical literature. The OP-doctor followed the accepted line of treatment and we do not find any fault or imperfection in performing laparoscopic cholecystectomy, when the CBD stone was found after a week, which could be managed effectively by the conventional endoscopic method (ERCP). Accordingly, the patient, who referred to an expert at Patna, who recorded CBD stone by ERCP. Thus, referring the patient for ERCP was not a wrong decision of OP. [Para 11]

The District Forum allowed the complaint and directed the OP to pay Rs.59000/- along with interest @10% per annum from the date of filing of the complaint.  [Para 3]

Being aggrieved, the OP-doctor filed the first appeal before the State Commission. The State Commission allowed the appeal and consequently, the complaint was dismissed. [Para 4]  

Being aggravated by the impugned order of State Commission the complainant filed this instant revision petition. [Para 5]