State Consumer Disputes Redressal Commission
Mrs. Pooja A. Bhatnagar vs Motherhood Hospital on 8 May, 2023
Cause Title/Judgement-Entry KARNATAKA STATE CONSUMER DISPUTES REDRESSAL COMMISSION BASAVA BHAVAN, BANGALORE. Complaint Case No. CC/120/2012 ( Date of Filing : 04 Oct 2012 ) 1. Mrs. Pooja A. Bhatnagar W/o. Aakash P. Bhatnagar, Aged about 30 years, R/at No. 15/6, G-8th Street, Jogapalayam, Halasuru, Bangalore 560008 . ...........Complainant(s) Versus 1. Motherhood Hospital No. 324, CMH Road, Indiranagar 1st Stage, Bangalore 560038 Rep. by Dr. Mohammad Rehan Sayeed & Mr. Vijay, Administrative Officer . 2. Dr. Vijayalakshmi M. working at Motherhood, No. 324, CMH Road, Indiranagar 1st Stage, Bangalore 560038 . 3. Dr. Thara Menon Working at Motherhood, No. 324, CMH Road, Indiranagar 1st Stage, Bangalore 560038 . ............Opp.Party(s) BEFORE: HON'BLE MR. Ravishankar PRESIDING MEMBER HON'BLE MRS. Smt.Sunita Channabasappa Bagewadi MEMBER PRESENT: Dated : 08 May 2023 Final Order / Judgement BEFORE THE KARNATAKA STATE CONSUMER DISPUTES REDRESSAL COMMISSION, BANGALORE (ADDL. BENCH) DATED THIS THE 8th DAY OF MAY 2023 PRESENT MR. RAVISHANKAR : JUDICIAL MEMBER MRS. SUNITA CHANNABASAPPA BAGEWADI : MEMBER CONSUMER COMPLAINT NO. 120/2012 Mrs. Pooja .A. Bhatnagar, W/o Mr. Aakash.P.Bhatnagar, Aged about 30 years, R/at No.15/6, G-8th Street, Jogapalayam, Halasuru, Bangalore 560 008. (By Sri B. Chandrashekar) .......Complainant/s V/S 1. Motherhood Hospital, No.324, CMH Road, Indiranagar 1st Stage, Bangalore 560 038, Rep. by Dr. Mohammad Rehan Sayeed and Mr. Vijay, Administrative Officer. ....Opposite Party/s 2. Dr. M. Vijayalakshmi, Husband/Father's name Not known to the complainant, Adult, Working at Motherhood Hospital, No.324, CMH Road, Indiranagar 1st Stage, Bangalore 560 038. (By Sri G.R. Anantharam for OPs 1 & 2) 3. Dr. Thara Menon, Husband / Father's name Not know to complainant, Adult, Working at Motherhood Hospital, No.324, CMH Road, Indiranagar 1st Stage, Bangalore 560 038. (By Sri G. Devaraj & Sri G.H. Arun) O R D E R
BY MRS. SUNITA CHANNABASAPPA BAGEWADI : MEMBER
1. This is a complaint filed by the complainant alleging deficiency in service on the part of the Opposite Parties and prayed to direct the Opposite Parties to pay Rs.One Crore for all great mental pain and sufferings cost of baby's life, treatment, care and other recurring expenses in the interest of justice and equity.
2. The brief facts of the complaint is hereunder;
It is the case of the complainant that the Complainant visited Opposite Party/Respondent no.1 on the 24 January 201 and registered herself according to per their procedure. Opposite Party/ Respondent no.1 upon collecting all details, referred to their doctor, who upon examination confirmed pregnancy of the complainant. Further upon the Opposite Party/Respondent No.1 doctor's advice, the Complainant visited them as per their directions and underwent all required examinations including for Diabetes, Hypertension, Genetic Disorders, Mental Retardation, Twins, Epilepsy, Asthma Bleeding Disorders, Thrombo Embolic Disorders -Risk Factors. Apart from the above, doctors specially carried out investigations like CBC Complete Blood Count (CBC) Breath Sounds, VDRL, HBs Ag, HIV I & II Rubella 1g G, TSH (Thyroid stimulating Hormone), Urine R/n and more importantly further carried out GCT/OGTT (Glucose Challenge Test & Oral Glucose Tolerance Test) and was told that everything is normal and good.
3. Initially when Complainant visited Opposite Party Respondent no. s' 1 they referred to the One Dr. Sharma who initially checked her up and later passed on the complainant thoroughly on several occasions. During that period, once when the Complainant was suffering from serious sickness was in real need of emergency medical assistance, hence complainant called on Opposite Party/Respondent no.'s 1's phone and in turn Opposite Party/Respondent no.'s 1 provided the personal phone no of Dr. Disha Sridhar's since she knew complainant's medical history well. The said Dr. Disha Sridhar's who never ever picked up the phone, and later late evening also Opposite Party/Respondent no.'s 1's never received the phone calls from the Complainant. Later on following day, the Complainant when she visited Opposite Party/Respondent no.'s 1's, they informed that Dr. Disha Sridhar was on holiday. Complainant knowing the same complainant about this to the Opposite Party/Respondent no.1, thereupon, the Complainant was referred to check up with Respondent No. 2 & 3 for further medical examination and for Scan who conducted all the above said Scans and Tests on time to time basis on regular period.
4. Eventually during the 5th month of the Complainant's Pregnancy, the Complainant had asked Respondent No.3 to do all the possible Scans to make sure of no deformities. The Respondent No.3 was very confident and repeatedly told the Complainant that not to worry about anything or any problems and further said that everything was absolutely fine and normal. Further thereupon during 8th month of the pregnancy of the Complainant, she was asked to do a 4 D Test, though it was optional. Inspite of getting a clear and distinct picture of the 4D test, Respondent No. 3 gave the Complainant and her family a positive answer informing that the Complainant's Child is doing well and it is fine. On the 25.08.2011, Respondent No.2 conducted the delivery on the Complainant who gave birth to boy baby in Opposite Party/Respondent No.1 Hospital. The said delivery was done by Respondent No.2 herself with her team members and other nursing staff. After the delivery, Pediatrics and Neonatologist visited the new born Child of the Complainant and the husband of the Complainant noticed that the said Pediatrics and Neonatologist wanted the Child under Observation and accordingly it was done. The Complainant's husband was totally devastated to know that new born Child was suffering from some problem. Upon asking what were the problems with Opposite Party No.1 doctors, the Complainant's husband was told that the Child had a single crease on the left hand and suspected with Down's syndrome and was told to carry out for a Blood Test known as Karotyping to confirm the suspicion of Down's syndrome.
5. The Complainant and her husband were totally left helpless and devastated. The Respondents have carried out all the Medical Checkup from day one of the pregnancy of the Complainant. The Respondents have also done all the above said Tests including NT Scan and all the other investigations. Had the Respondents carried out the investigations with due care at every point of time, then the Respondents would have noticed that foetus is not normal and was suffering from abnormality of Down's syndrome. And obviously the Complainant would have gone in for further Medical Consultation and would have been prepared for the consequences. Today's Medical technology is so advanced that there is no doubt that every part of the foetus can be tested and found out that everything is proper and well. Inspite of this, the Respondents have failed to conduct all the Tests and Scans without ascertaining the precision and accuracy of that Test and Scan. This clearly shows that the Respondents have not shown any reasonable degree of skill, knowledge and care in conducting and ascertaining all the above mentioned Tests and Scans, Since NT scan which would first trimester scan will confirm that the foetus is alive, they assess the gestational age by measuring the crown-rump length and will look for any major problems. This is a routine ultrasound examination done at 10 to 14 weeks of gestation. The whole pregnancy are to be assessed, including by calculating amount of liquor (amniotic fluid), the position and appearance of the placenta and a detailed scan of the baby itself. The baby will be measured and the anatomy examined in detail.
6. Further the respondent should have carried out more appropriately the scan in the first trimester at around 12 weeks pregnancy to confirm their dates. First trimester ultrasonic scans may show 'soft' markers for chromosomal abnormalities, such as an increased fetal nuchal translucency (back of the neck) to enable detection of Down's syndrome foetuses. Thus Respondents have totally failed to conduct examinations without ascertaining the precision and accuracy of that Test and Scan by not following proper medical guidelines. Further Respondent No.2 & 3 has not acted in accordance with practice accepted as proper by a reasonable body of medical skill, which clearly shows that the Respondents has fallen short of the standard of reasonable medical care & skill. Hence, Respondents jointly and severally liable for breach of duty, medical negligence and have caused deficiency in service which has caused Petitioner and her husband lot of trauma for the rest of his life.
7. Now that the negligence of all the above Respondents i.e., Hospital & doctors have resulted to the Complainant' baby to be born with Down's Syndrome and thus the Child has to suffer all its life with no fault on part of the Complainant nor her family, the new born Baby that is born requires lifelong care and attention which complainant/parent would have to bestow on the minor child, on all grounds, complainant is entitled for compensation including for the future welfare of the complainant's child. Therefore the Respondents are liable to pay complainant sum of Rs. One Crore to the Baby for the above mentioned reasons, the award in favor of child taking into account the cost of baby's life, treatment, care and other recurring expenses that would be necessary for the said minor child who is merely having a vegetative life. To this demand, the complainant had issued a demand letter dated 24 July 2012. In the said letter, complainant had made it clear that the complainant would take necessary legal steps for the compensation of the negligence caused by the respondents. The said letter has been served upon the respondents. Immediately, after service of the above demand letter, respondent admitted the services and denied the negligence in their letter dated 28th August 2012. Hence the complainant has no other go except to make complaint before the Hon'ble authority where the respondents have caused great mental pain & sufferings and for the above said reasons. Hence, the complaint.
8. After service of notice, the Opposite Party Nos. 1 to 3 appeared through counsel. The Opposite Party Nos.1 & 2 filed their common version and Opposite Party No.3 filed version separately. The Opposite Party Nos. 1 to 3 admitted that the complainant has approached the Opposite Party No.1 hospital on 24.01.2011 when the complainant found the signs of pregnancy and contended that the Opposite Parties have attended the complainant and also needed medical attention in conducting periodical tests, scans, investigations in accordance with the procedure laid down in the Act and there is no negligence or deficiency in service on the part of the Opposite Parties. Further contended that when the complainant suffering from serious sickness during the period of her pregnancy, the Opposite Party Nos. 2 & 3 who are visiting and consulting doctors of the hospital have promptly attended to the complainant for her ailment. The Opposite Party No.1 had given the complainant an experienced consultant doctor's phone number to ease her anxiety instead of letting it dealt by duty doctors. The complainant was only 29 years of age and physically strong and fit and furthermore it was admittedly her second time pregnancy, all scan protocols and tests were carried out from time to time with reasonable degree of care and skills as per the standard medical practice following by Motherhood and the results were normal.
9. The opposite parties further humbly submit that this prenatal test (also called the NT or nuchal fold scan) can help the healthcare practitioner assess the baby's risk of having Down's syndrome (DS) and some other chromosomal abnormalities as well as major congential heart problems. The NT test is not invasive. It uses ultrasound to measure the clear (translucent) space in the tissue at the back of the developing baby's neck. Babies with abnormalities tend to accumulate more fluid at the back of their neck during the first trimester, causing this clear space to be larger than average. The NT scan must be done when the female is between 11 and 14 weeks pregnant, because this is when the base of the baby's neck is still transparent. Like other screening tests, an NT scan won't give a diagnosis. But it can assess one's baby's risk for certain problems and help the lady concerned to decide whether she would want to have chorionic villus sampling (CVS) or amniocentesis to find out whether her baby is actually affected. The baby's chances of having a chromosomal abnormality are suspected by an increased nuchal fold measurement, age of the patient.
10. The gestational age is factored in because although anyone can have a baby with a chromosomal abnormality, the risk increases as one would age. In general, the thicker the fold at a given gestational age higher the chance of a chromosomal problem. A pregnant woman will get her results in the form of a ratio that expresses her baby's chances of having a chromosomal defect. For example, a pregnant lady may be told that her baby's chances of having Down's syndrome are 1 in 30 or 1 in 4,000. The higher the second number, the lower the risk. The depiction that the results are "normal" or abnormal," depending upon whether they are below or above a specified cut-off. For example, some tests use a cut-off of 1 in 250. Mrs. Pooja Bhatnagar's background risk 1:713 and adjusted risk is 1:552. So a result of 1 in 4,000 would be considered normal because that risk is higher than 1 in 250. A normal screening result (screen negative) isn't a guarantee that the baby has normal chromosomes, but it does suggest that a problem is unlikely. Likewise, an abnormal screening result (screen positive) doesn't mean that your baby has a chromosomal problem - just that he's more likely to have one. In fact, most screen-positive babies turn out not to have a problem. Screening tests aren't perfect. They don't detect all cases of Down's Syndrome, so they may identify the female as being at low risk when the baby really does have Down's Syndrome.
11. The NT scan alone will detect about 70 to 80 percent of babies with Down's Syndrome. Combined NT scan + double marker detects 95%. If no nasal bone is seen in the developing baby, this increases the likelihood for chromosomal abnormalities. These tests also have a 5 percent false-positive rate. Based on this false-positive result, their mothers may go ahead with invasive diagnostic testing that they otherwise might not have. The overall risk is calculated using a combination of ultrasound and the measurement of hormones in your blood the risk of your baby having Down's syndrome can be predicted. The ultrasound scan records your baby's nuchal translucency measurements, and can examine your baby in some detail to check whether many of the main organs are developing normally. The only way to be sure whether the foetus has a chromosomal abnormality is by having an invasive test such as an amniocentesis or chorionic villus sampling, but such tests carry a risk of causing a miscarriage estimated variously as ranging between 1% or 0.06%. Based on maternal age.
12. The opposite parties further humbly submit that Amniocentesis (also referred to as amniotic fluid test or AFT) is a medical procedure used in prenatal diagnosis of chromosomal abnormalities and fetal infections, in which a small amount of amniotic fluid, which contains feral tissues, is sampled from the amnion or amniotic sac surrounding a developing foetus, and the fetal DNA is examined for genetic abnormalities. Complications of amniocentesis include preterm labor and delivery, respiratory distress, postural deformities, chorioamnionitis, fetal trauma and alloimmunisation of the mother (rhesus disease). Studies from the 1970s originally estimated the risk of amniocentesis-related miscarriage at around 1 in 200 (0.5%). The Chorionic villus sampling (CVS), sometimes misspelled "chorionic villous sampling" is a form of prenatal diagnosis to determine chromosomal or genetic disorders in the foetus. It is the preferred technique before 15 weeks. The possible reasons for having a CVS can include:
Abnormal first trimester screen results Increased nuchal translucency or other abnormal ultrasound findings Family history of a chromosomal abnormality or other genetic disorder Parents are known carriers for a genetic disorder Advanced maternal age (maternal age above 35) AMA is associated with increase risk of Down's syndrome and at age 35, risk is 1:400. Screening test is usually carried out first before deciding if CVS should be done.
13. Risk of miscarriage in CVS is about 0.5 - 1%. Apart from a risk of miscarriage, there is a risk of infection and amniotic fluid leakage. The resulting amniotic fluid leak can develop into a condition known as oligohydramnios, which is low amniotic fluid continues to leak it can result in the baby developing hypoplastic lungs. The suffering of the Complainant's baby from 'Down's syndrome' cannot be attributed as negligence or deficiency in service rendered by opposite parties; the opposite parties had conducted all the tests and scan and investigations revealed no abnormalities in the physical appearance as it does happen in several cases of pregnancy and only after child's birth on the Neonatologists and Pediatrician examining the baby, they suspected that the baby was having Down's syndrome and the same was confirmed on testing the blood sample of the baby. The complainant has been rendered all the medical assistance needed right from her diagnosing of pregnancy on 24/1/2011 till she delivered a male baby on 28/8/2011 and discharged on 31/8/2011.
14. However, the said syndrome is limited to only the left hand of the baby with 'Simian crease' and the same is attributable only to the reason specified in REGULATIION OF THE PRE-NATAL DIAGNOSTIC TECHNIQUES ACT clause 3 (iv) cited above which was not disclosed by the complainant or her family members at any time prior to her delivery, and because of that reason the complainant has mischievously alleged in para 7 of her complainant that she had allegedly 'asked the Opposite Party No.2 to do all possible scans to make sure of no deformities' as she herself was suspecting of her child having deformity. Since this Opposite Party has not been either negligent or deficient in rendering the service. The complaint is liable to be dismissed with exemplary and compensatory costs to these opposite parties for unnecessarily dragging them to this Commission on false and vexatious pleas.
15. The Opposite Party No.3 in their version contended that the averments made in Para No.6 of the complaint that during the 5th month of the complainant's pregnancy; the complainant had asked respondent No.3 to do all possible scans to make sure of no deformities. Further this Respondent No.3 states that a 4D scan was done on the foetus as requested by the complainant, not for Diagnosis of Mental Retardation, with 4D scan, one can see the changes on the face of the Foetus, like-yawning, sucking the fingers, opening and closing the eyes etc., as alsocleft lip and pallet, any abnormalities in the nose eyes etc., it is usually done on request by the patients and definitely not done to look for Mental Retardation. There was no Medical Mistake Done during the 4D scan, because the baby does not have any abnormality on the face.
16. The first C.R.L. was done on 20th Feb 2011 where I thought it was early for N.T. so I asked the complainant to report at the later date, she came 8 days later when the C.R.L. was repeated again and I found that I could measure the N.T. which was 2 millimeter will within the normal limits, so no further test was requested for, we must also remembers that we had no reasons to ask for any further test as the Foetus was normal and in the first Trimester Scan the head, spine neck, limbs, abdomen all appeared normal and none of the above part of the baby was abnormal at birth. The nasal bone is the other part that is checked during the N.T Scan the mother being from North Eastern States the Nasal bone can appear is little smaller than the normal, but the same was repeated in the 22 to 23 week scan and found be normal. There was no other prior risk like the mother age which was well below 35 years no previous history of abnormal child, no history of repeated abortions (1 abortions) no family history of abnormal children, the risk for Down's Syndrome Calculated in N.T measurement on Jan 13 2012 which shows the risk of to have a down baby to be 1 in 552, (out of 552 children born 1 can be a down baby) in no way the N.T scan done by the Respondent be wrong for then the calculated risk would have shown. The Respondent has performing Obstetric Ultra Sound from 1984. In one of the leading hospital with never having missed a Down Foetus and submits that there is no any deficiency in service on their part and prayed to dismiss the complaint.
17. The complainant has filed affidavit evidence and marked documents at Ex.C1 to C43. Opposite Party Nos. 1 & 2 files affidavit evidence and marked documents at Ex.R1 to R3. Opposite Party No.3 not filed affidavit evidence and also not marked any documents. The complainant files written arguments with some citations. Opposite Parties have also filed some citations. Heard the arguments of both parties.
18. On perusal, the following points will arise for our consideration;
(i) Whether the complainant has proved the alleged medical negligence on the part of the Opposite Parties.
(ii) Whether the complainant is entitled for any reliefs as sough? (iii) What order? 19. The findings to the above points are; (i) Negative (ii) Negative (iii) As per final order REASONS
20. Perused the contents of the complaint, objections of the Opposite Parties, documents and affidavit evidence of both parties including medical records and handbook of infertility and ultra sound, we noticed that the Opposite Party No.2 is a qualified expert obstetrician and gynecologist and Opposite Party No.3 is a well established sinologist/ radiologist . It is not in dispute that the complainant approached the Opposite Party No.1 Motherhood Hospital on 24.01.2011 as she found pregnancy signs. It is also not in dispute that the complainant underwent all required examinations and Dr. Disha Sridhar examined the complainant and had some signatures on the forms. The Opposite Party No.1 had referred the complainant to Opposite Party No.2 & 3 doctors. It is also an admitted fact that the Opposite Parties advised all required tests and treatments which all done by the complainant. It is also not in dispute that when the complainant entered her tenth week of pregnancy, she requested the doctors to take all the measures/treatments and also signatures. It is also not in dispute that the complainant has delivered a male child on 25.08.2011 with Down's Syndrome of single simian crease.
21. The allegations of the complainant is that inspite of treatment and on account of negligence of the Opposite Parties, the complainant had delivered the baby having Down's Syndrome and the Opposite Parties failed to conduct the examinations without ascertaining the procedure and accuracy tests and scans by not following the proper medical guidelines and also failed to give proper reasons regarding the abnormalities that happened to the baby. It is necessary to the pregnant woman to go for atleast two ultra sound scans. One scan is between 8 to 14 weeks which includes NT scan and another scan is between 18 to 21 weeks known as anomaly scan. However, no such scan had taken place on complainant. There is no document regarding NT scan done by the Opposite Parties which is very much required to check the physical abnormalities in the foetus. Hence, it is a clear cut negligence on the part of the Opposite Parties which amounts to mental agony, stress throughout her life.
22. We have gone through the document produced by the Opposite Parties and references from the handbook of infertility and ultrasound for practicing gynaecologists. We noticed that the NT scan will detect about 70% to 80% of baby's Down's Syndrome and combined NT scan + double marker detects 95%. If no nasal bone is seen in the developing baby, this increases the likelihood for chromosomal abnormalities. There is another way to sure the foetus as abnormality is by way of invasive tests. However, there is also 1% to .06% risk of miscarriage. Amniotic fluid test is also prenatal diagnosis of chromosomal abnormality and fetal infections and it has also risk at around 1 in 200 (0.5%). The Chorionic Villus Sampling (CVS) is also to determine chromosome abnormalities. However, it is the preferred technique before 15 weeks of pregnancy and it has also a risk of miscarriage.
23. Perused the documents/hospital records. As per the Discharge Summary dt.20.08.2011 and radiology investigations reveals that the Opposite Parties have done four USGs dt. 25.01.201 SLF at 6 weeks 4 days, on 20.02.2011 SLF - 10 weeks 3 days, minimal retrochorionic collection seen in the lower pole, cervix 2.8 cm long, on 16.05.2011 SLF at 22 weeks 6 days, placenta-Ant, LL, no anomalies seen, NT-N, NB-N, on 23.07.2011 SLF at 34 weeks 4 days, AFI-13.2, breech presentation, liquor-Adequate. As per USG dt.20.02.2011 it is written as NT .2 cm (N).
As per USG dt.16.05.2011 OB - 2/3 Trimesters Scan Report written as Extended Biometry : Nasal Bone - Normal Fetal Anatomy : Intracranial structures appeared normal Midline falx seen.
Both lateral ventricles appeared normal.
Posterior fossa appeared normal.
No identifiable intracranial lesion seen.
Neck appeared normal. Fetal neck appeared normal.
Spine appeared normal. No evidence of significant open neural tube defect entire spine visualised in longitudinal and transverse axis.
Vertebrae and spinal canal appeared normal.
Fetal face appeared normal fetal face seen in the coronal and profile views.
Both orbits, nose and mouth appeared normal.
Both lungs seen.
No evidence of pleural or pericardial effusion.
No evidence of SOL in the thorax. Both lungs appeared normal.
Heart appears in the mid position.
Normal cardiac situs. Four chamber view normal.
Outflow tracts appeared normal. Heart appeared normal.
Abdominal situs appeared normal.
Stomach and bowel appeared normal.
Normal bowel pattern appropriate for the gestation seen.
No evidence of ascites.
Abdominal wall intact. Abdominal situs appeared normal.
Both kidneys and bladder appeared normal. Right and Left kidneys appeared normal.
Bladder appeared normal.
All fetal long bones visualized and appear normal for the period of gestation.
Both feet appeared normal. All long bones appeared normal for the period of gestation.
Estimated fetal weight according to BPD, AC :- 587 + / - 58.7 FL, AC :- 538 + / - 53.8 BPD, HC, AC, FL :- 531 + / - 53.1 gms.
IMPRESSION I Dr. Thara Menon, declare that while conducting ultrasonography on Mrs. Pooja, I have neither detected nor disclosed the sex of her foetus to anybody in any manner.
Nasal Bone Normal.
No obvious gross anamolies.
No obvious NTD Single intrauterine gestation corresponding to a gestational age of 22 weeks 6 days.
Gestational age assigned as per biometry (BPD, HC, AC, FL) Menstrual age 21 weeks 5 days.
Estimated fetal weight according to BPD, AC :- 587 + / - 58.7 FL, AC :- 538 + / - 53.8 BPD, HC, AC, FL :- 531 + / - 53.1 gms.
USG dt.23.07.2011 SURVEY :
Presentation - Breech Placenta - Anterior left lateral posterior GR 1-2 Liquor - Adequate Amniotic fluid index = 13.2 cms Umbilical Cord - Normal Fetal activity present Cardiac activity present IMPRESSION :
FM = 2, NST = 2, FT = 2, LIQ = 2 = 8/10 I Dr. Thara Menon, declare that while conducting ultrasonography on Mrs. Pooja, I have neither detected nor disclosed the sex of her foetus to anybody in any manner.
No evidence of any collection seen.
No obvious gross anamolies.
No obvious NTD Single intrauterine gestation corresponding to a gestational age of 34 weeks 4 days.
Gestational age assigned as per biometry (BPD, HC, AC, FL) Menstrual age 31 weeks 3 days.
Estimated fetal weight according to BPD, AC :- 587 + / - 58.7 FL, AC :- 538 + / - 53.8 BPD, HC, AC, FL :- 531 + / - 53.1 gms.
24. Hence, it is apparent on the face of the record which was produced by the complainant, the treating doctors Opposite Party Nos. 2 & 3 have attended to the complainant with due diligence and also rendered medical attention in conducting tests, scans and investigations in accordance with procedure laid down. The alleged NT Scan increases chances of antenatal detection of Down's syndrome compared to maternal age test scan. The NT scan was performed by qualified Radiologist Opposite Party No.3 at 10 weeks 3 days, 22 weeks 6 days and 34 weeks 4 days. It was found normal limits. The transveginal scan was preferred till 10 weeks and NT scan is always done by abdominal route. The second CRL (Crown Rumps Length) was done in which NT was two milimeter which was even normal limit. Such being the case, no further tests such as invasive test, AFT (Amniotic Fluid Test), Chorionic Villus Sampling (CVS) tests are not required or suggested to the complainant. Moreover, if in NT scan some high risk of infection in foetus was seen only those tests will suggested to the complainant. The NT scan shows normal foetus, then it is not necessary to suggest to do these tests. The Down's syndrome is a congenital chromosomal disorder. These occur when the person has an extra copy of chromosome - 21 and same was admitted by the complainant in reply of interrogatories in question No.34. Usually baby get an extra chromosome by chance, because of a change in sperm/egg before baby is born. This change does not happen because of anything anyone did before/during pregnancy. Also in reply of interrogatories, the complainant answered to the Question No.22, 23 & 24 that "No NT or NTD tests were done by the Opposite Party" and on the other side in Question No.29 she was answered that "the scan was not done in depth". There are contractual answers of the complainant in the reply of interrogatories. Moreover, the allegation of the complainant is that no NT or NTD scans were done by the Opposite Party/treating doctors. However, perused the documents produced by the complainant herself discloses that the Opposite Parties have done three USG including NT and anomaly tests and each report was normal. If the complainant denied the said reports, she has to prove her allegations by producing expert evidence, but, the complainant has not produced expert evidence or produced relevant documents. As per the medical literature, Nasal bone of 2 mm is normal. It is worth to rely upon few decisions of the Hon'ble Apex Court on medical negligence. In the case of Kusum Sharma & others v/s Batra Hospital & Medical Research Centre & others which reads as under;
"The medical professionals are entitled to get protection so long as they perform their duties with reasonable skill and competence and in the interest of patients. The interest and welfare of the patients have to be paramount for the medical professionals."
Hence, based on the discussion, we are of the opinion that the Opposite Parties have accepted standard practice to render the service to the complainant and the complainant failed to prove the act of omission or medical negligence of the Opposite Parties. We found no merits in the complaint. Hence, the following;
ORDER The complaint is dismissed.
Forward free copies to both the parties.
Sd/- Sd/- MEMBER JUDICIAL MEMBER KCS* [HON'BLE MR. Ravishankar] PRESIDING MEMBER [HON'BLE MRS. Smt.Sunita Channabasappa Bagewadi] MEMBER