National Consumer Disputes Redressal
K. Srinivas vs Dr. A. Prabhakar on 13 February, 2013
NATIONAL CONSUMER DISPUTES REDRESSAL COMMISSION NATIONAL CONSUMER DISPUTES REDRESSAL COMMISSION NEW DELHI CIRCUIT BENCH AT HYDERABAD, A.P. REVISION PETITION NO. 2366 OF 2008 (Against the order dated 22.02.2008 in Appeal No. 196/2005 of the A.P. State Consumer Disputes Redressal Commission) K. Srinivas S/o Shri Chandraiah H.No. 7-6-48, Gouthamnagar Ferozeguda, Secundrabad Petitioner Versus` Dr. A. Prabhakar Sandhya Maternity Nursing Home Near Savarkar Statute Savarkar Nagar, Nalgonda Andhra Pradesh Respondent BEFORE: HON'BLE MR. JUSTICE ASHOK BHAN, PRESIDENT HON'BLE MRS. VINEETA RAI, MEMBER For Petitioner : Mrs. K. Radha, Advocate For Respondent : Mr. D. Devender Rao, Advocate Pronounced on 14th of February, 2013 ORDER
PER VINEETA RAI, MEMBER
1. K. Srinivas, Petitioner herein, has filed the present revision petition being aggrieved by the order of the Andhra Pradesh State Consumer Disputes Redressal Commission, Hyderabad (hereinafter referred to as the State Commission), rejecting the complaint of medical negligence against Dr. A. Prabhakar, Respondent herein.
2. Petitioner, who was the original complainant before the District Consumer Disputes Redressal Forum, Nalgonda (hereinafter referred to as the District Forum), had submitted that his late wife Smt. K. Sridevi (hereinafter referred to as the Patient) aged about 23 years had been visiting respondent-Doctor for periodical check-ups after having become pregnant. On 5.8.2002 she developed labour pain and was admitted by her family members in the respondents hospital where she delivered a stillborn male child at 6.00 p.m. due to the folding of umbilical cord around the childs neck. Immediately after delivery, Patient experienced Post Partum Haemorrhage (PPH) i.e. bleeding through the vagina and family members as per advice of Respondent donated blood for transfusion. Despite this, PPH could not be controlled. Petitioner, who reached the Respondents Hospital from Hyderabad at about 10.00 p.m., requested the Respondent to permit him to shift his wife to a better medical facility at Hyderabad but Respondent delayed giving this permission till 11.15 p.m. on the ground that it could be controlled in Respondents Hospital. Petitioner admitted the Patient, who was accompanied by Respondents compounder alongwith facility for blood transfusion, to Yashoda Super Speciality Hospital in an unconscious and critical condition at 1.00 p.m. on 06.08.2002 with bleeding and in spite of resuscitative and medical measures undertaken in that hospital, she expired about 30 hours later at 7.00 a.m. on 07.08.2002. Petitioner contended that both his wife and child lost their lives because Respondent did not take reasonable care nor exhibit reasonable skill in conducting the delivery and controlling the PPH. The placenta was not completely expelled and D&C for controlling the bleeding was not conducted. Respondent also caused delay in giving permission to shift the Patient to a better equipped hospital, which proved fatal. Petitioner, therefore, issued a legal notice to Respondent seeking compensation for the medical expenditure and for the loss of his wife, who had just got admission in MBA course and there were chances of her securing a lucrative job had she been alive. Petitioner above all would suffer a life-long loss for the loss of his spouse. On not receiving a satisfactory response, Petitioner filed a complaint before the District Forum on grounds of medical negligence and deficiency in service and requested that the Respondent be directed to pay a compensation of Rs.5 Lakhs with interest @ 18% per annum from 15.12.2003 till date of realization, Rs.10,000/- as cost and any other relief as deemed appropriate.
3. Respondent on being served filed a counter reply in which he denied the allegations of medical negligence and deficiency in service. It was stated that all necessary care was taken in the treatment of the Patient and necessary diagnosis and examinations conducted right from the time she was visiting the Respondent till when she was admitted in the hospital on 05.08.2002. On that date her blood pressure, heart, lungs and other vital organs as also that of the fetus were normal. The progress of labour was monitored very closely and all these facts were recorded in the case sheet, which also included the details of the clinical examination and the monitoring during the course of the pregnancy. The delivery was normal with a spontaneous Episiotomy and a live male child with umbilical cord round the neck was delivered at 6.00 p.m. The placenta and membranes had also expelled entirely. The Episiotomy and cervical tears were sutured with chronic catgut and because there was moderate bleeding vaginal packing was done. All necessary care in resuscitating the new born, who had Tachycardia and Apnea, was also started, which included mouth to mouth respiration, oxygen inhalations, injection etc. but unfortunately the child could not be saved because of the trauma caused due to the umbilical cord round the neck. It was further contended that since Patient had vaginal bleeding, blood was transfused, after which the flow of blood was somewhat restricted. When the Patient complained of breathlessness and vaginal bleeding again started and continued in gushes, rigorous treatment which included oxygen inhalation and also administration of various injections, which included Methergine, Prostadine etc., as also blood transfusion was started and continued. Respondent denied that he refused permission to the Petitioner to shift the Patient.
However, he admitted that because of the pressure exerted by the Petitioner and other relatives, he permitted the Patient to be shifted to Hyderabad at 11.15 p.m. Respondent also made available a compounder alongwith necessary medical assistance to enable the Patient to undertake the long journey to Hyderabad. It was specifically contended that at the time of her being transported there was some improvement in the Patients condition. Respondent further stated that PPH is an unfortunate complication of delivery, which can occur despite all possible care having been taken and for which necessary medical treatment as per standard procedure was given. It was also contended that though the Respondents Hospital had adequate facilities, when the Petitioner and other relatives insisted on the Patient being shifted, they were advised to take the Patient to Government Headquarters Hospital, Nalgonda, which was best hospital in the District and was at a lesser distance from Hyderabad, to which the Petitioner did not agree. Respondent contended that the Yashoda Super Speciality Hospital authorities in Hyderabad did not indicate that when Patient was shifted there was any negligence on the part of Respondent and the allegation made that the PPH occurred because the placenta was not entirely expelled after the delivery was found to be incorrect. It was also specifically contended that Hysterectomy and D&C are not the procedures to be undertaken for controlling bleeding. All necessary measures to check PPH were taken as per standard medical procedure.
4. The District Forum inter alia by drawing adverse inference to the fact that necessary documents, including case history, were not supplied to the Petitioner while taking the Patient for treatment to Yashoda Super Speciality Hospital, partly allowed the complaint and directed the Respondent to pay Rs.1,50,000/- towards compensation and Rs.5000/- as costs within 30 days of the receipt of the order.
5. Being aggrieved Respondent filed an appeal before the State Commission, which allowed the same and set aside the order of District Forum. The relevant part of the order of State Commission in this connection is reproduced:
The complainant failed to adduce evidence that there was medical negligence on the part of the opp.party hospital authorities . As per the Yashoda Hospital medical record disclose that the wife of the complainant died on account of post partum hemorrhage. Dr. Maleena Raoof , Gynecologist in Yashoda Hospital who attended the complainants wife stated that PPH may not leads to death. The District Forum without considering the evidence of PW.2 had given finding that the opp.party hospital is not having infrastructure facilities and expert treatment and on account of that the patient developed complications and blood transfusion was given. The District Forum has relied on the medical literature wherein it is stated that the PPH can be controlled with the medical methods and injections to be given step by step. The said medical literature taken into consideration as the PW.2 who has treated the complainants wife in Yashdoa Super Speciality hospital himself did not support the case of the complainant. On the other hand the opp.party has clarified in his evidence that he has taken all precautionary steps and blood transfusion was also given to her and there was no medical negligence on his part. The District Forum has not properly appreciated the documentary evidence and given finding holding that there was medical negligence on the part of the opp.party. For the afore said evidence discussed and reasons mentioned the medical negligence alleged against the opp.party is not proved.
Hence, the present revision petition.
6. Learned counsels for both parties were present and made oral submissions.
7. Learned counsel for the Petitioner stated that the State Commission erred in setting aside the order of District Forum by not taking note of the fact that the Patient at the time of her delivery as per the Respondents admission did not suffer from any complications and had a normal delivery. Though the child could not survive because of umbilical cord around his neck, there was no reason for the Patient who was in normal health to have expired. This happened because of medical negligence and lack of care on the part of Respondent who did not take due care to check the PPH and properly suture the Episiotomy because of which bleeding continued. This was also the observation of Dr. Maleeha Raoof, the Gynaecologist who was working at Yashoda Super Speciality Hospital and who was appointed as Court Commissioner in this case. Counsel for the Petitioner inter alia stated that the cervical tear occurred because the Patients pelvic structure vis-a-vis the size of baby was also not properly assessed prior to the delivery which necessitated the Episiotomy. Further, even though the Respondents hospital did not have adequate infrastructure and facilities to give in the instant case, Respondent delayed giving permission to shift the Patient which proved fatal. It was also reiterated that PPH was treated in a conservative manner although conducting a D&C may have saved the Patients life by checking the bleeding.
8. Counsel for the Respondent on the other hand stated that the State Commission rightly dismissed the complaint after taking into account the evidence on record including the detailed case history filed in evidence which clearly indicated the medical treatment of the Patient by the Respondent in the Respondents hospital. As can be seen in these documents necessary diagnostic care was taken at the time of Patients admission in the hospital and also during the delivery which was normal and thereafter to check the PPH which resulted in bleeding from the vagina and from the cervical tears. It was pointed out that apart from blood transfusion, oxygen inhalation and necessary injections as per standard medical treatment to deal with the PPH was administered in the Respondents hospital. It was specifically pointed out that the consulting Gynaecologist working at Yashoda Super Speciality Hospital, who had been appointed as Court Commissioner, had clearly opined that there was no medical negligence or deficiency in the treatment of the Patient and that the Respondent had taken all necessary measures including corrective measures in dealing with this case to save the Patient and also while she was being shifted to a better medical facility, necessary supportive measures were taken. Petitioners contention that the PPH occurred because of retained products of conception in the uterus was found to be incorrect by the Court Commissioner. Respondent was a well-qualified Gynaecologist and it is totally incorrect that the Respondents hospital where Patient was admitted did not have the necessary facilities to deal with such cases. The present Revision Petition having no merits needs to be dismissed.
9. We have heard learned counsels for both parties and have carefully gone through the evidence on record including the case history of the Patient filed in evidence before the fora below. The fact that the Patient was admitted to the Respondents hospital for a delivery, during the course of which she delivered a male child through the normal process but the child could not survive because of trauma/distress caused due to the umbilical cord being bound around the neck despite resuscitative measures, is not in dispute. It is also a fact that the Patient suffered from PPH. In this connection, we have perused the case history filed in evidence and note that treatment to check the same was given as per standard medical procedure, which included blood transfusion, giving of oxygen and the required injections. The case history filed in evidence also indicates other steps taken by the Respondent right from the time of her admission till her discharge and from this there does not appear to be any lapse or negligence in the treatment and care. All necessary diagnostic and clinical tests were done as required and the Petitioners allegation that the recorded case history of the Patient is not a true record of the medical treatment actually given has not been confirmed by any evidence filed to this effect except oral contentions. On the other hand, there is evidence of an independent medical expert, who was a Gynaecologist in the Yashoda Super Speciality Hospital, where the Patient was admitted by the Petitioner, and who was appointed as a Court Commissioner in this case. In her deposition on oath, she has stated that there was no medical negligence in this case and the Respondent-Doctor had done everything in his capacity to save the Patient. The relevant part of her statement in cross-examination is reproduced:
During the course of a normal vaginal delivery a medico lateral Episiotomy is given at the crowing of the head. If there is delay in the second stage of labour an outlet forceps might been applied. After the delivery of the baby it is seen that the placenta and membranes are expelled completely and the uterus was retracted. The vagina and the cervix are cleaned and inspected for any tears and lacerations. I have gone through the case sheet of delivery (Ex-A 7) and in my opinion the doctor who conducted the delivery according to normal procedure as a doctor anywhere else. He also recognized the cervical tear and sutured it. The sudden loss of blood consequently could have been due to atonic PPH (Post Partum Hammottarge). He also took corrective measures by giving blood transfusion and injections prystadine. The doctor has done everything in his capacity to save the patient and the condition was not improved. He shifted to higher centre with supportive measures. It is true after going through the case sheet and the treatment given by the doctor it is my opinion that there was no negligence on the part of the doctor. It is true as my finding there were no retained products of conception in the uterus.
10. After considering the above evidence of the Court Commissioner as also other evidence on record, we are, thus, unable to conclude that there was any medical negligence or deficiency in service in the treatment of the Patient on the part of the Respondent and the State Commission in its well-reasoned order taking into account all these facts and also the settled law on what constitute medical negligence had rightly concluded that there was no medical negligence in this case.
11. We, therefore, uphold the order of the State Commission in toto. The present Revision Petition having no merit is dismissed.
.
(ASHOK BHAN, J.) PRESIDENT (VINEETA RAI) MEMBER Mukesh