HARNEK SINGH & ORS. versus GURMIT SINGH & ORS. on 18 May 2022

ORDER

1. Leave granted.

2. These appeals arise out of the decision of the NationalConsumer Disputes Redressal Commission, New Delhi[1] dismissingthe appeal of the complainant and allowing the appeal of the doctorand the hospital by holding that no medical negligence was proved.Having examined the evidence, medical records and the report ofthe ethics committee of the Medical Council of India[2], we haveconcluded that a case of deficiency of service is made out againstthe doctor and the hospital, Respondents 1 and 2, herein for medicalnegligence. Allowing the appeal of the complainants, we have directedpayment of compensation. We will first refer to the facts leading tothis case.

Facts:

3. Facts as stated in the complaint filed before State ConsumerDisputes Redressal Commission[3] are as follows. Appellant 1, thecomplainant, is a retired Semi-Government employee and his wifeLate Mrs. Manjit Kaur, aged 47 years had been working as aGovernment teacher. Mrs. Manjit Kaur, the patient, developedabdominal pain for which an ultrasound examination was done and itrevealed the presence of gall bladder stones. On 13.07.2004 the patientapproached Respondent 1, a laparoscopic surgeon at Preet SurgicalCentre & Maternity Hospital, Respondent 2. After due examinationsand medical tests, Respondent recommended surgery for removingthe gall bladder stones and prescribed certain tests to be carried outin advance.

4. The complainant got the advised investigations done andshowed the results to Respondent 1. He then asked the complainantto get yet another USG examination from a specific centre as hewas not satisfied with the earlier USG dated 14.7.2004. Thecomplainant complied with this instruction of Respondent 1 and againmedical tests were done from a specific USG centre on 23.7.2004.Respondent 1 was satisfied with the results and advised the 1 hereinafter referred to as ‘the NCDRC’.

2 hereinafter referred to as ‘the MCI’.

3 hereinafter referred to as ‘the SCDRC’.

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Acomplainant to get the opinion of a cardiologist as the tests revealedthe patient’s blood pressure to be slightly high. On 26.07.2004,Dr. Dharamvira Gandhi, the cardiologist cleared the patient forsurgery.

5. On the morning of 28.07.2004, Respondent 1 performed aBlaparoscopic cholecystectomy and placed a drain in the patient’sabdomen. On 29.07.2004, the patient complained of abdominal painand distension. The drainage tube was showing a discharge of fluidwhich was slightly green in colour, which later on turned greenish-brown. When the complainant informed Respondent 1 about this, hewas told that such fluid was expected and that is why the tube hadCbeen inserted. Respondent 1 also informed the complainant that hehad reviewed the operative CD and assured that there was noindication of any injury, even in the operative video.

6. On the next day, the patient became very serious and theabdominal distension and pain was compounded by difficulty inDbreathing.

Respondent 1 reassured the complainants and started oxygeninfusion to the patient and prescribed some blood tests and ultrasoundexamination. The request for a second opinion or referral to RajindraHospital, Patiala attached to Medical College was dismissed by aEfurther assurance that the patient was in safe hands. Later thatevening, Respondent 1 informed the complainants the cause of theproblem was acute pancreatitis and that there was nothing wrongwith the surgery. However, the complainants remained unconvinced,especially because of the dirty brown discharge coming through theFdrain and the persistent pain, distension and breathlessness whichwere indicative of some major intestinal or bile duct injury, which thestaff of Respondent 1 had hinted. The complainant again requestedRespondent 1 to seek another opinion or shift the patient to anotherhospital.

G7. At around 9 P.M. on 30.07.2004, Respondent 1 decided toshift the patient to Dayanand Medical College and Hospital, Ludhiana,Respondent No. 4 herein and refer the patient to Dr. Atul Mishra,Respondent No. 3 herein. Respondent 1 declined the request by thecomplainant to give detailed patient records and operation notes bystating that the patient’s condition had been adequately explained toH

Respondent 3. Dr. Punit Gupta was the doctor on duty when thepatient was admitted. As per his assessment, there was suspicion ofan iatrogenic injury to the bile duct and possibly also to the intestine,during the previous surgery. He advised an urgent abdomen CT scanto get a clearer picture. A CT scan was done and as per the report,the small and large intestines were normal. However, it revealedmoderate intra-abdominal and sub-phrenic collection. Respondent 3examined the patient and the CT scan report the next morning at 9A.M. Since the patient was suffering from multiple ailments likepneumonia, high blood pressure and coagulopathy, immediate surgicalintervention was not advised.

8. On 02.08.2004, the patient’s condition became critical andshe showed signs of colonic perforation. The bilious drain fluid becamefeculent and foul-smelling. On 03.08.2004, an emergency laparotomywas performed. Respondent 3 informed the complainants that therewas a large collection of intestinal contents in the abdomen due to aninjury to the colon and in addition to that there was also a bile ductinjury, which would be repaired in a subsequent surgery. The patient’scondition kept deteriorating and she went into multi-organ failureincluding failure of the respiratory system, cardiovascular system andrenal failure.

9. The patient died on 11.08.2004.

10. The complainant discussed the cause of death and the needfor autopsy with Respondent 3, however, he was told that the patientdied due to intra-operative injuries to the colon and bile duct resultingin Peritonitis, Peritoneal Collection, Septicaemia and Multi-Organfailure.

Proceedings before the State Commission:

11. It is in the above-referred circumstances that thecomplainant filed a consumer complaint before the SCDRC, Punjabon 14.02.2005, which was subsequently transferred to StateConsumer Commission, U.T. Chandigarh. The complainant prayedfor monetary compensation quantified at Rs. 62,85,160 from theRespondents for negligence and deficiency of services.

12. Respondents 1 and 2 filed a reply stating that Respondent1 is an experienced surgeon and has performed more than 2,500

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Alaparoscopic operations successfully. It was explained that thepatient’s surgery was performed with proper care, but after thesurgery, she developed epigastrial pain and slight distension in theabdomen. Immediately conservative treatment was started and thepatient got some relief from the same. However, on the night of30.07.2004, the patient’s condition got critical, as a result of whichBshe was referred to Respondent 4 hospital to be treated by Respondent3.

13. Respondents 3 and 4 in their reply denied the allegations ofnegligence and stated that the hospital provided due and proper careto the patient. It was further stated that most of the iatrogenic injuriesCto the bile duct during the cholecystectomy were not recognised inthe operating room but were detected after a few days as biliaryfistula or bile peritonitis. It was stated that the initial response ofRespondent 3 was to not operate immediately as it was decided toevaluate the nature of the leak and attempt to control the fistula.DAlso, conducting the operation earlier was not medically advised.The operation was conducted on 03.08.2004 to tackle perforation inthe large bowel.

14. A reply was also filed by Dr. Dharamvir Gandhi, thecardiologist who stated that the patient was 47 years old and wasEreferred to him by Respondent 1. It was found that she was a patientof hypothyroidism and was taking treatment for the same for the lastthree years. She complained of chest pain and breathlessness forwhich she was treated with due care. Her cardiovascular status wasstable.

F15. Both Respondents 1 and 3 were duly cross-examined bycounsel of the complainant on 06.07.2006. The complaint also cross-examined Dr. Inderjit Singh and Dr. Navdeep Singh as experts beforethe SCDRC.

16. The SCDRC after considering the evidence and hearingGboth the parties, allowed the complaint and held Respondents 1 and 2negligent and exonerated Respondents 3 and 4. Respondents 1 and 2were directed to pay Rs. 15,44,000 jointly and severally and Rs. 10,000as costs.

17. The SCDRC found that the CT scan which was performedon 31.07.2004 showed pneumo peritoneum which meant a significantH

amount of free air in the abdomen outside the intestines was presentwhich is not normally present. During laparoscopic surgery, gas isintroduced into the peritoneal cavity and all the gas does not getremoved at the end of the surgery. It is a known fact that this residualgas gets absorbed and does not stay in the abdomen for more than24 hours. The only other area from where the gas can enter theperitoneal cavity is the intestines if they are ruptured at any place.The CT scan was performed three days after the laparoscopic surgeryand significant air was present even after three days which is a clearsign of an intestinal injury. There was also some subphrenic abscessfound below the diaphragm which has to be removed, otherwise,diaphragm movements cannot be restored. SCDRC found that it wasthe direct consequence of the intra-operative injury to the bile ductand colon caused by Respondent 1 during the laparoscopiccholecystectomy that later led to the death of the patient. With respectto Respondent 3, the only allegation was a delay in operating on thepatient. SCDRC found that Respondent 3 could not detect anyimportant sign of bowel perforation on 31.07.2004 or 01.08.2004 andtherefore he decided against any surgical intervention at that point oftime and hence there was no negligence on the part of Respondent3.

18. The complainants filed an appeal before the NCDRC.Simultaneously Respondents 1 and 2 also filed an appeal for dismissalof the Complaint.

Proceedings before the MCI:

19. It is necessary to mention at this stage that while theproceedings were pending before the SCDRC, the complainants alsomade a complaint to the Punjab State Medical Council against theprofessional misconduct of the Respondents, which was summarilydisposed of on 13.06.2006. The complainants filed an appeal to theMCI. The MCI considered the appeal of the complainant and askedRespondents 1 and 3 to appear before the Ethics Committee. Boththe Respondents submitted their detailed replies. The EthicsCommittee considered the matter and held Respondent 1 medicallynegligent and issued a strict warning to be more careful duringthe procedure and to be more diligent in treating and monitoringhis patients during and after the operation. Respondent 3 wasexonerated as no medical negligence was proved against him.

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AProceedings before the NCDRC:

20. Coming back to the appeal before NCDRC, it heard boththe appeals together, i.e. the appeal filed by the complainants as wellas Respondents 1 and 2. The NCDRC observed that the patient wasoperated on by Respondent 1 on 28.07.2004 and the injuries wereBdetected after six days. The CT scan report of 31.07.2004 ruled outany evidence of injury or perforation peritonitis and thereforeRespondent 1 did not ignore any signs of biliary and fecal peritonitis.Further, the complainant relied on the paramedic staff of theRespondent 2 hospital who informed him about the operative injury,it was held that there was no evidence in this regard. There was noCnegligence found on the part of Respondents 1 and 2.

21. In the case of Respondents 3 and 4, it was found that thepatient was not fit for diagnostic laparoscopy immediately since therewere no signs of any obstructive lesion or proximal dilation. On02.08.2004, there was a sudden deterioration in the patient’s generalcondition and she was then diagnosed with bowel leak with peritonitis.She was operated on 03.08.2004 to repair the colonic perforation.The patient’s condition started weakening and she died on 11.08.2004due to cardiac arrest. It was held that Respondents 3 and 4 actedwith due care and hence there was no negligence.

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22. The NCDRC by way of the impugned decision on05.06.2020 allowed the appeal of Respondents 1 and 2 and set asidethe order of the SCDRC holding that negligence was not proved bythe complainants. It is from this decision that the present appealsarise.

FSubmissions:

23. In these appeals, we have heard Mr. Raj Kiran Talwarlearned advocate for the Appellants and Dr. Sushil Kumar Gupta,Ms. Suruchi Suri and Mr. Anuj Chauhan, learned advocates for theRespondents.

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24. Mr. Raj Kiran Talwar, learned advocate for the Appellantsmade the following submissions. At the outset, he would submit, thatthe patient suffered two iatrogenic injuries during her first surgery,one to the colon and the other to the bile duct. From these two injuries,fluids from the bile started to accumulate in the peritoneal cavity of H

the patient while the overflowing fluid started to come out of thedrain. Secondly, after the patient became critical, Respondent 1referred the patient to Respondents 3 and 4 at Ludhiana which is ata distance of 100 KMs instead of a local hospital at a nearer distance.Thirdly, strong reliance was placed on the statement of Respondent1 in his cross, where he categorically stated that it did not occur tohis mind that the injuries could take place. Fourthly, Respondent 3negligently delayed the re-exploration surgery even after receivingthe CT scan report. Finally, the NCDRC gave its decision withoutreferring to the MCI findings. In support of his submission, he reliedon a judgment of this Court in Maharaja Agrasen Hospital andOrs. v. Master Rishabh Sharma and Ors.[4]

25. On the other hand, Dr. Sushil Kumar Gupta, learned counselappearing for Respondents 1 and 2 made the following submissions.The presence of a biliary leak does not signify injury of a bile duct asit can occur from the liver bed from the cholecycto-hepatic duct,slippage of a clip from cystic duct stump which are not injuries. Second,for there to be a presence of a leakage from the large intestine, thereare some specific symptoms which were not shown and thereforeleakage of the colon was ruled out. Finally, since there was no bileduct or colon injury, the presence of rent in the hepatic flexure of thecolon may be either a result of delayed manifestation due to thermalinjury because of the electro-cautery, or it may be a rare case ofinjury to the hepatic flexure of the colon because of the drainagetube.

26. Ms. Suruchi Suri, learned counsel appearing forRespondents 3 and 4 submitted that, the only allegation is of the delayin diagnosis of colonic perforation and corrective surgery. Thisaccording to her is proved incorrect as per the findings of the MCI,SCDRC and the NCDRC as well. Second, the surgery was performeddiligently and with due care. The bile leak coming out of the drainafter the gall bladder surgery had occurred during the first surgeryperformed by Respondent 1. The patient was already critical whenshe was admitted to Respondent 4 hospital and therefore immediatesurgical intervention was not called for. However, when the fecalmatter leak was found in the drain, the patient was immediatelyoperated on.

4 Maharaja Agrasen Hospital and Ors. v. Master Rishabh Sharma and Ors. (2020) 6SCC 501.

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AAnalysis:

27. The primary question is whether the complainant hasestablished professional negligence on the part of Respondents asper the standards governing the duty to care of a medical practitioner.The SCDRC in its detailed decision considered the oral andBdocumentary evidence including medical journals and concluded thatRespondents 1 and 2 acted negligently in performing the operation.SCDRC also held that there is no evidence of negligence in so far asRespondents 3 and 4 are concerned.

28. What we have noticed in the impugned decision of theCNCDRC is that a substantive part of the decision refers only to judicialprecedents on the question of medical negligence. Reference is madeto the decisions in the case of Kusum Sharma & Others v. BatraHospital & Medical Research Centre and others[5]; Jacob Mathewv. State of Punjab[6]; Achutrao Haribhau Khodwa and others v.State of Maharashtra and others[7]; and S.K. Jhunjhunwala v.DDhanwanti Kaur[8]. Apart from the case laws on facts, the NCDRCdevoted its attention substantially to the allegations againstRespondent 3 who was anyway exonerated by the SCDRC. In sofar as Respondent 1 is concerned, the NCDRC did not meet thespecific allegations of negligence in the performance of the surgery.E29. There was sufficient material indicative of large bowelperforation after the laparoscopic operation. It is true that it may nothave manifested immediately in the normal course. However, therewere sufficient indicators to a diligent professional, to detect andtake immediate steps for restitution. Instead of examining the material Fthat was placed on record, NCDRC seemed satisfied with raisingand rejecting the plea of res ipsa loquitur and holding that it isimpermissible to assume that any sensible professional wouldintentionally commit an act which would result in an injury to thepatient. In these proceedings for damages due to professionalnegligence, the question of intention does not arise. Unfortunately,G

5 Kusum Sharma & Ors. v. Batra Hospital and Medical Research Centre & Ors.,

(2010) 3 SCC 480.

6 Jacob Mathew v. State of Punjab & Anr. (2005) 6 SCC 1.

7 Achutrao Haribhau Khodwa and Others v. State of Maharashtra and others (1996) 2SCC 634.H8 S.K. Jhunjhunwala v. Dhanwanti Kaur & Anr. (2019) 2 SCC 282.

the NCDRC did not even refer to the report of the MCI. In fact, areference to the MCI report would have been sufficient to come tothe right conclusion.

30. The MCI examined the matter in the context of an appealfiled by the complainants against the decision of the Punjab MedicalCouncil dated 13.6.2006. MCI referred the appeal filed by thecomplainant to the Ethics Committee. The Committee recorded thestatement of the complainant, and the doctors Respondents 1 and 3.The Ethics Committee also sought the opinion of Experts on theconduct of these Respondents. The two Experts were Professorsand HODs of AIIMS, New Delhi and KGMC, Lucknow. We willnow refer to each of their opinions.

31. In the opinion of Professor and HOD, Department ofSurgery, AIIMS, extracted in the MCI report is as under:

“The findings at laparotomy confirmed it to be a case oflarge bowel perforation, which could be iatrogenic, relatedto the laparoscopic procedure. Appropriate surgicalintervention was done on a by now very sick patient. Patientdied on 11.8.2004.

Comment: It appears on the basis of available records thatthe diagnosis and operative intervention for generalisedperitonitis as a result of bowel perforation was significantlydelayed first at the localhospital and subsequently at DMCLudhiana and lead to the unfavourable outcome.”

32. In the opinion of Professor and HOD, Surgery, KGMCLucknow, extracted in the MCI report is as under:

“In case of Dr. Gurmit Singh also, as per records it appearsthat he is not negligent his duties towards Mrs. ManjeetKaur during her stay in his hospital and has given care tobest of his proficiency and available facilities. However,following relevant observations are made: -

1. Pre-operative clearance from Cardiologist was taken.

2. Pre-operative correction of anaemia by three unit ofblood done.

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A3. Pre-operative consent paper has been signed whichmentions the possibility of fatality and likelihood ofcomplication.

4. Post-operative second opinion was taken by Dr. GurmitSingh.B

5. Records of Preet Hospitals are present in document sentby you, but recorded CD of Surgery is not available.

6. In his statement of complaint, he mentions that both Dr.Gurmit Singh and Dr. Atul Mishra are qualified medicalprofessionals.C

7. Shifting of patient was done in distant hospital wherebetter GI and ventilatory facilities are claimed. However,availability of these facilities in local city is matter ofsurvey, which should be sought for.

8. Minor bile leak during surgery is accepted byDr. Gurmit Singh, which kept on increasing in post-operative period.

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9. Bowel perforation and bile duct injuries were noted insurgery done by Dr. Atul Mishra at Ludhiana.”

E33. After considering the material on record as well as theopinions of the Professors as indicated above, MCI concluded asunder:- “In addition to that the Ethics Committee has decided torequest Prof. & HOD of Surgery, AIIMS, New Delhi andFProf. & HOD of Surgery, KGMC, Lucknow to kindly assistthe Ethics Committee by going through all the records ofthe case and give their opinion regarding this matter.Accordingly, Prof. & HOD of Surgery, AIIMS, New Delhihas given his opinion in writing and also Prof. & HOD,KGMC, Lucknow has sent his opinion.GThe Ethics Committee after perusal of all the abovedocuments have come to the conclusion that –

1. In the case of Dr. Atul Mishra, no case of medicalnegligence can be established against him. Therefore,H

the Ethics Committee decided to drop the matter againstDr. Atul Mishra and exonerate him from the charges.

2. Ethics Committee found that Dr. Gurmit Singh has failedto exercise adequate medical competence in treating thepatient as is apparent from the following points:-

(a) There was a large bowel perforation after thelaparoscopic operation. This complication whichthough not known in the normal course of time,had occurred in this particular case. Thiscomplication could have been prevented if care hadbeen exercised during the procedure by Dr. GurmitSingh.

(b) More important Dr. Gurmit has failed to suspectthe occurrence of complications despite followingwarning, signs/symptoms-

i)the patient not recovering after the operation.

ii)the patient increasingly deteriorating.

iii)there was a strong indication of a complicationoccurring after the procedure. Thereafter, hisfailure to detect all these conditions led to delay indiagnosis all perforation of the bowel and has tolead a situation of avoidable delay which causesincreased deterioration of the patient.”

34. In view of the clear findings, the MCI decided to issue astrict warning to Respondent 1 to be more careful during theprocedure and to be more diligent in treating and monitoring hispatients during and after the operation. As against Respondent 3,the MCI dropped the case and exonerated him.

35. So far as present proceedings are concerned, as they ariseout of a claim for compensation on the basis of medical negligence,the opinion and findings of the MCI regarding the professional conductof Respondent 1 have great relevance. The findings of the MedicalCouncil, which is a statutory regulator have been extractedhereinabove, may be formulated as under:

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222SUPREME COURT REPORTS

A1.Existence of Generalized peritonitis as a result of bowelperforation. (per the opinion of Professor & HOD,Department of Surgery, AIIMS).

2. There was a significant delay in its diagnosis andoperative intervention, first at the local hospital andBsubsequently at DMC, Ludhiana. (per the opinion ofProfessor & HOD, Department of Surgery, AIIMS).

3. This has led to the unfavourable outcome. (per theopinion of Professor & HOD, Department of Surgery,AIIMS).

C4.Shifting of the patient by Respondent 1 was done in adistant hospital where better GI and ventilatory facilitiesare claimed. However, the availability of these facilitiesin the local city is a matter of survey, which should besought for. (per the opinion of Professor & HOD,DDepartment of Surgery, KGMC, Lucknow).

5. Minor bile leak during surgery is accepted by Dr. GurmitSingh. This kept on increasing in the post-operativeperiod. Bowel perforation and bile duct injuries werenoted in surgery done by Dr. Atul Mishra at Ludhiana.E(per the opinion of Professor & HOD, Departmentof Surgery, KGMC, Lucknow).

6. Dr. Gurmit Singh has failed to exercise adequate medicalcompetence in treating the patient as is apparent fromthe facts. (Experts Common Opinion)F7. There was a large bowel perforation after the laparoscopicoperation. (Experts Common Opinion)

8. The complication which though not known in the normalcourse of time, had occurred in this particular case. Thiscomplication could have been prevented if care had beenGexercised during the procedure by Dr. Gurmit Singh.(Experts Common Opinion)

9. Dr. Gurmit Singh failed to suspect the occurrence of thecomplication despite warning signs/symptoms. (ExpertsCommon Opinion)

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10. Dr. Gurmit Singh ignored the following factors namely, (a) the patient was not recovering after the operation, (b) the patient’s condition was increasingly deteriorating,and

(c) there was a strong indication of a complicationoccurring after the procedure. (Experts CommonOpinion)

11. Failure of Dr. Gurmit Singh to detect the warning signs/symptom led to a delay in diagnosis of bowel perforationand this has, in turn, led to a situation of avoidable delaywhich eventually cause increased deterioration of thepatient. (Experts Common Opinion)

36. The above-referred findings of the MCI on the conduct ofRespondent 1 leave no doubt in our mind that this is certainly a caseof medical negligence leading to deficiency in his services. NCDRC,except referring to the general principles of law as laid down in thejudgments of this Court has not attempted to draw its conclusionfrom the oral and documentary evidence available on record.

37. Apart from the facts that clearly emerge from the reportof the MCI, there is sufficient evidence to reiterate the same findingsof deficiency. In the oral evidence, the following answers were elicitedfrom Respondent 1 in the cross-examination which fortify the reportgiven by the MCI.

Q) Did you consider during your investigation that therewas possible intra-operative injury to bile duct or intestines?

A) No it did not occur to my mind. In-fact there was nosuch injury while the patient was in my hospital.

Q) Did you think it necessary to take opinion/consultationof another Surgeon?

A) I did not think it necessary in the circumstances of thiscase to consult another surgeon.

Q) Why did you consider it proper to refer the patient toanother Surgeon instead of a Chest Specialist as accordingto your opinion, the patient was not having any surgicalproblem but was having chest problem.

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AA) The patient was referred to a Surgeon because wewanted to know that why the abdomen pain has developedas also why there was excessive discharge from the drain.”

38. Having considered the matter in detail, we are of the opinionthat the NCDRC has committed an error in reversing the findings ofBthe SCDRC and not adverting to the evidence on record includingthe report of the MCI. The decision of the NCDRC deserves to beset aside and we hold that the complainants have made out a case ofmedical negligence against Respondents 1 and 2 and are entitled toseek compensation on the ground of deficiency of service.

39. The State Commission as well as the National CommissionCand even the MCI have not found Respondents 3 and 4 negligent inperforming their services, and we are in agreement with such findingsand therefore, confine our conclusion and directions to Respondents1 and 2. To this extent, we reject the appeal of the complainant againstall except Respondents 1 and 2.D40. In view of the findings as indicated above we are of theopinion that the appeal filed by the complainants deserves to beallowed. The complainants had claimed an amount ofRs. 62,85,160/- on various counts such as amounts paid to the doctorsand the hospitals for treatment, loss of income of the patient whowas a Government servant with the salary of Rs. 37,150 per monthEwith 10 years remaining service, damages for trauma and shock andon certain other grounds. Having considered the matter in detail, weare of the opinion that the interest of justice would be subserved ifRespondents 1 and 2 are directed to pay to the complainants a totalamount of Rs. 25,00,000 (Rupees Twenty Five Lakhs only) withFinterest @ 6% per annum from the date of SCDRC order ascompensation. Respondents 1 and 2 will be entitled to adjust anyamount already paid or deposited in favour of the complainantspending proceedings. The amount shall be deposited within a periodof 6 months from today, failing which it shall carry an interest of 9%per annum.G