State Consumer Disputes Redressal Commission
Gyan Prakash Chouhan vs S E M O Military Hospital on 3 June, 2024
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1- SEMO fefyVªh gkWfLiVy] tks/kiqj A
2- Lt. Col. (AMC) R.N.BANERJEE, fefyVªh gkWfLiVy]] tks/kiqj A
3- Lt. Col. (AMC) Rita Singh, fefyVªh gkWfLiVy] tks/kiqj A
4- xks;y gkWLihVy ,.M fjlpZ lsaVj izkbosV fyfeVsMÞ] tks/kiqj tfj;s Mk;jsDVjA
5- Mk- jktho ekFkqj] U;wjksfQftf'k;u] xks;y gkWfLiVy] tks/kiqj A
6- lapsrh gkWLihVy ,.M dsalj baLVhV~;wV ¼jktLFkku dsalj ds;j gkWLihVy izkbZosV fy-
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8- Mk;jsDVj lsUVªy vkxsZukbZts'ku] LECHS, A.G. Branch, IHQ of MOD (Army),
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vizkFkhZ la[;k ,d ls rhu o lkr] vkB dh vksj ls vf/koDrk Jh jkes'oj nosA
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fu.kZ; lquk, tkus dh fnukad%&03-06-2024
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1- ifjoknh Kku izdk'k pkSgku us ;g ifjokn vizkFkhZx.k ds fo:) miHkksDrk laj{k.k
vf/kfu;e 1986 dh /kkjk 12 ,oa 17 ds varxZr fnukad 08-04-2009 dks bl vk'k; dk
izLrqr fd;k gS fd ifjoknh HkwriwoZ lSfud gS rFkk ,d eq'r jkf'k HkwriwoZ lSfud
va'knk;h LokLF; ;kstuk esa tek fd;s tkus ds dkj.k Lo;a rFkk ifjokj ds lnL; dks
fpfdRlk ykHk izkIr djus dk dkuwuh vf/kdkj izkIr gS A ,d eq'r jkf'k 1800&18000
:i;s ds chp bl ;kstuk ds varxZr lsokfuo`fr ls iwoZ vfuok;Z :i ls jsd
a ds vuqlkj
tek djkus iM+rs gS A ifjoknh o mlds ifjokj ds lnL;ksa gsrq fpfdRlk ykHk dh
lqfo/kk izkIr djus ds fy, dkMZ tkjh fd;k x;k] ftldk uacj ih,u 0050299 gS A
bl dkMZ ds ek/;e ls ifjoknh Lo;a ,oa ifjokj ds lnL;ksa dh fpfdRlk ykHk fefyVªh
gkWfLiVy] ,oa ECHS Polyclinic ls izkIr dj ldrk gS A ifjoknh dh iRuh lfjrk
daoj pkSgku ECHS dh lnL; gksus ds dkj.k fpfdRlk ykHk izkIr djus dh vf/kdkfj.kh
gS A Jherh lfjrk daoj dh fnukad 08-03-2009 dks e`R;q gks x;h ,oa ifjoknh dks
dkuwuh izfrfuf/k gksus ls ifjokn is'k djus dk vf/kdkj gS A
2- fnukad 08-04-2007 dks lfjrk daoj us fefyVªh gkWfLiVy esa xk;uksdksyksftLV ls ijke'kZ
dj :X.kky; esa laidZ fd;k vkSj fefyVªh gkWfLiVy }kjk mlh fnu nkf[ky dj fy;k
x;k A tc lfjrk daoj dks HkrhZ fd;k x;k ml le; og fcYdqy lkekU; Fkh vkSj
ml le; MkWDVj }kjk Diagnosis-Labour Pain i.e.Full Term Normal
Delivery (FTND) (For Delivery) Admission form Hkjdj HkrhZ fd;k A fefyVªh
gkWfLiVy] tks/kiqj }kjk tkjh fMLpktZ lfVZfQdsV fnukad 18-04-2007 dh izfr izn'kZ&2
gS A Jherh lfjrk daoj dks HkrhZ fd;s tkus ds ckn fpfdRld ysf¶VusVa duZy vkj-
,u-cuthZ dh Hka;dj ykijokgh] vn{krk] vlko/kkfu;ka rFkk lsok esa deh ds dkj.k
fnukad 10-04-2007 dks yxHkx nksigj 12-30 cts Uterus Rapture gks x;k
vkSj yEcs le; rd Uncontrolled Profuse Bleeding dk u rks le; ij bykt
fd;k x;k] u gh dksbZ bejtsalh esfMlu nsdj :dko gh fd;k x;k rFkk lfjrk daoj
pkSgku Hypovolmic Shock esa pyh x;h A ifj.kkeLo:i dkfMZ;d vjsLV ds ckn
gkbZiksfDld czsu Msest ds dkj.k dksek esa pyh x;h vkSj vizkFkhZ la[;k ,d ls rhu
ds lapkyu ,oa izca/ku dh lsok esa deh] fpfdRlk ykijokgh ds dkj.k fnukad 10-04-
2007 ls 08-03-2009 rd dksek esa jgrs gq, fnukad 08-03-2009 dks yxHkx lka; 05-
15 cts e`R;q gks x;h A blh lsok esa deh ds dkj.k fnukad 10-04-2007 dks gh iq= dk
Hkh nsgkUr gks x;k] tcfd iq= rFkk ekrk dk thou fjtuscy ds;j ds }kjk cpk;k
tk ldrk Fkk A ifjoknh ds iq= dk e`R;q izek.ki= fnukad 10-04-2007 ,oa ifRu dk
e`R;q izek.ki= fnukad 08-03-2009 izn'kZ 3 o izn'kZ 3¼,½ gS A ifjoknh }kjk jkf'k tek
djok;s tkus ij vizkFkhZ la[;k vkB }kjk ECHS dkMZ tkjh fd;k x;k Fkk A vizkFkhZ
la[;k ,d] nks o rhu dk nkf;Ro vizkFkhZ la[;k 8 ds v/khu gSA vizkFkhZ la[;k ,d]
nks o rhu }kjk lgh le; ij ifjoknh dh iRuh dk bykt ugha fd;s tkus ds dkj.k
mldh e`R;q gqbZ gS A HkrhZ ds le; Hkh MkWDVj }kjk dksbZ Abnormal igyw O;Dr ugha
fd;k x;k A e`rdk ds uterus rupture ls iwoZ mldh Abnormality dks tkuus dk
iz;kl ugha fd;k x;k vkSj u gh vYVªk lksuksxzkQh izlo dky vFkok chrs 9 eghuksa ds
nkSjku dh x;h A lgh le; ij LSCS conduce dj ifjoknh ds iq= o iRuh
dks cpk;k tk ldrk Fkk A esfMdy dsl 'khV fnukad 18-04-2007 ls Li"V gS fd
dksek ds ejht dks lgh mipkj ugha fn;k x;k A fefyVªh gkWfLiVy ls xks;y gkWfLiVy]
tks/kiqj fnukad 18-04-2007 dks VªkalQj fd;s tkus rFkk xks;y gkWfLiVy }kjk HkrhZ
fd;s tkus dk dkxtkr fnukad 18-04-2007 izn'kZ 5 ,oa 5¼,½ gS A
3- vizkFkhZ la[;k pkj o ikap us ;g tkurs gq, fd ejht dk bykt laHko ugha gS] flQZ
iSlk cukus ds mn~ns'; ls ifjoknh dks /kks[ks esa j[kdj ejht dks HkrhZ dj fy;k A tc
5 eghuk iwjk gqvk rks fcuk ejht dh condition analysis fd;s dksek esa serious
rFkk critital gkyr esa gh fMLpktZ dj fn;k] tcfd ejht dks Artificial
Respiration, Trachostomy, Urine Bag] xaHkhj Bed sore rFkk Tube feeding
ds }kjk thfor j[kus ds fy, Fluid vkgkj fn;k tk jgk Fkk A ,slh fLFkfr esa fefyVªh
gkWfLiVy us ifjoknh dh iRuh ds thou dks lnk ds fy, [krjs esa Mky fn;k vkSj
fnukad 26-11-2007 dks xks;y gkWfLiVy dks ejht dks fMLpktZ djus dk vkns'k tkjh
fd;k vkSj fnukad 27-11-2007 dks xks;y gkWfLiVy us ejht dks fMLpktZ dj
fMLpktZ lfVZfQdsV fnukad 27-11-2007 izn'kZ 6 tkjh fd;k A fMLpktZ vkns'k esa
fMLpktZ dk dkj.k ;g crk;k fd ejht dk ifr isjk esfMdy LVkQ gS] ejht ds
bykt ls ns'k dks {kfr gksxh A feYVªh gkWLihVy esa M~;wVh ij rSukr gkWfLiVy LVkQ
rFkk fnukad 08-04-2007 ls 18-04-2007 rd dk VªhVesaV fjiksVZ ifjoknh }kjk vkj-Vh-
vkbZ- ds rgr ekaxh xbZ] ftls gkWfLiVy us nsus ls euk dj fn;k A
4- fnukad 28-11-2007 dks gkWfLiVy rFkk xks;y gkWfLiVy ds fo:) fjV fifV'ku uacj
7801@2007 is'k dh] ftlds fu.kZ; esa ekuuh; mPp U;k;ky; us gkWfLiVy ij
5000@&:i;s dksLV ds lkFk VªhVesaV nsus dh lkjh lqfo/kk eqgS;k djkus dk vkns'k
ikfjr fd;k A fefyVªh gkWfLiVy }kjk ,El] ubZ fnYyh esa ejht ds bykt ds fy,
iwjk izca/k djuk iM+k vkSj vizkFkhZ la[;k ,d ls rhu dk dksrkghiw.kZ dk;Z txtkfgj
gqvk A mPp U;k;ky; ds fu.kZ; fnukad 12-02-2008 dh izfr izn'kZ 10 gS A
ifjoknh dh iRuh lfjrk daoj pkSgku dh xks;y gkWfLiVy esa yxkrkj bykt ds fy,
fnukad 29-08-2007 dks l{ke vf/kdkjh }kjk iwoZ esa Lohd`r 6 eghus ds lekfIr ij 3
eghus vkSj yxkrkj bykt dh Lohd`fr iznku dh x;h] ftlds vuqlkj 9 vDVwcj
2007 rd igys ls Lohd`r Fkk vkSj Mh Vh th 12 flrEcj 2007 ds }kjk 9 tuojh]
2008 rd xks;y gkWfLiVy esa yxkrkj bykt dh Lohd`fr iznku dh x;h A fdUrq
fefyVªh gkWfLiVy }kjk euekus <ax ls fnukad 26-12-2007 dks ejht dks fMLpktZ djus
ds fy, xks;y gkWfLiVy dks funsZ'k fn;k] ftlds vk/kkj ij xks;y gkWfLiVy us fcuk
is'ksUV dh condition analysis fd;s fnukad 28-11-2007 dks dksek esa gh fMLpktZ
dj fn;k A foo'k gksdj ifjoknh fnukad 28-11-2007 ls yxkrkj Lo;a ds [kpsZ ij
bykt djokrk jgk A
5- csl gkWfLiVy] nsgyh dsUV ds dek.MsUV us ejht dks fcuk esfMdy vVsUMsUV ds
euekus <+ax ls ifjoknh ls fcuk dUlsUV izkIr fd;s fMLpktZ dj fn;k A ifjoknh dks
rc irk pyk tc ejht dks ,Ecqysl
a esa Mkydj fnYyh LVs'ku igqapk fn;k x;kA csl
gkWfLiVy] fnYyh dsUV }kjk tkjh fMLpktZ izek.ki= fnukad 04-03-2008 gS A ifjoknh
dh iRuh ds bed sore dkQh cM+k ik;s tkus ls reconstructive surgery dh lykg nh
x;h] ftls xks;y gkWfLiVy ,oa lapsrh gkWfLiVy nksuksa us gh fefyVªh gkWfLiVy ls
fpfdRlk ykHk nsus ds oS| djkj ds ckotwn ejht dks fpfdRlk ykHk nsus ls euk dj
fn;k A ECHS Polyclinic vius i= esa Lohdkj djrk gS fd ,Ecqysl
a esa ejht dks
Mkydj lapsrh gkWfLiVy Hkstk x;k Fkk] ogha lapsrh gkWfLiVy ds Mk;jsDVj bls Lohdkj
ugha djrs A bl izdkj vizkFkhZx.k }kjk cjrh x;h Hk;adj fpfdRlk ykijokgh] vn{krk
,oa vlko/kkfu;ksa ds dkj.k ,oa Medical Negligency rFkk lsok esa deh ds dkj.k
ifjoknh dh iRuh ds LokLF; dks cn ls cnrj cukus ds dkj.k vizkFkhZx.k ftEesnkj
gS A
6- vr% ifjoknh dk ifjokn Lohdkj fd;k tkdj ifjoknh dks ifjokn esa of.kZrkuqlkj
foLr`r :i ls dqy eqvkotk jkf'k 97]41]328@&:i;s esa ls 79]54]800@&:i;s vizkFkhZS
la[;k ,d] nks] rhu o vkB ls i`Fkd&i`Fkd ;k la;qDr :i ls] 13]36]528@&:i;s
vizkFkhZ la[;k pkj o ikap ls i`Fkd&i`Fkd ;k la;qDr :i ls] 2]50]000@&:i;s vizkFkhZ
la[;k N% ls ,oa 2]00]000@& :i;s vizkFkhZ la[;k lkr ls fnyk;s tkos ,oa ifjoknh
dh iRuh ds fefyVªh gkWfLiVy esa ?kVuk ?kfVr gksus dh fnukad 10-04-2007 ls rkolwyh
rd 18 izfr'kr okf"kZd nj ls C;kt Hkh fnyk;k tkos A
7- vizkFkhZ la[;k ,d dh vksj ls tokc is'k dj izkjfEHkd vkifŸk;ksa ds rkSj ij of.kZr
fd;k x;k fd] ifjoknh Kku izdk'k us bUgha vk/kkjksa ij jktLFkku mPp U;k;ky;]
tks/kiqj ds le{k ,d fjV ;kfpdk la[;k 7801@2007 Kku izdk'k pkSgku cuke
;wfu;u vkWQ bf.M;k o vU; nk;j dh A mDr fjV ;kfpdk esa f'kdk;rdRrkZ }kjk
lSU; vLirky] tks/kiqj ds vf/kdkfj;ksa ds f[kykQ fofHkUu vkjksi yxk;s Fks A mDr
fjV ;kfpdk dk fu.kZ; fnukad 12-02-2008 dks fd;k x;k A
8- ekuuh; mPp U;k;ky; }kjk ;g Li"V :i ls ns[kk x;k fd ;kfpdkdrkZ dh iRuh
dh gkyr fefyVªh gkWfLiVy dh ykijokgh ds dkj.k xaHkhj ugha gqbZA lSU; vLirky
ds vf/kdkfj;ksa dks fpfdRlk mipkj iznku djus dk ek= funsZ'k tkjh fd;k x;k A
lfjrk daoj dksek esa Fkh vkSj mUgsa ,sls vLirky esa LFkkukarfjr djus dk vkns'k fn;k
x;k] tks csgrj vkSj i;kZIr lsok,a iznku djus esa l{ke gks A lSU; vLirky] tks/kiqj
us lfjrk daoj dk ,Q-,e-Vh- dk bykt fd;k A fefyVªh gkWfLiVy esa dke djus okys
esfMdy LVkQ dh dksbZ ykijokgh ugha gqbZ] blfy, ifjoknh dk ifjokn [kkfjt fd;s
tkus ;ksX; gS A ,lchlhMCY;wih la[;k 7801@2007 esa ikfjr fo}ku ,dy
U;k;k/kh'k ds vkns'k ds f[kykQ Mhch flfoy Lis'ky vihy la[;k 191@2008 nh
xks;y gkWfLiVy ,.M fjlpZ lsVa j] tks/kiqj cuke ;wfu;u vkWQ bf.M;k o vU; is'k
dh x;h] ftlesa ekuuh; jkt- mPp U;k;ky; tks/kiqj ds fo}ku ,dy U;k;k/kh'k }kjk
tkjh fd;s x;s dqN funsZ'kksa ij fMohtu csap }kjk jksd yxk nh x;h A
9- inokj tokc nsrs gq, dFku fd;k fd f'kdk;rdrkZ ECHS ;kstuk dk lnL; gS vkSj
bl ukrs og lSU; vLirky ,oa ECHS ikWyhfDyfud esa bykt ikus dk gdnkj gS A
ECHS ;kstuk ds rgr reimbursement vf/kdre 6 ekg dh vof/k rd lhfer gS A
jksxh dks mDr vof/k dh lekfIr ds ckn mipkj dh ykxr Lo;a ogu djuh gksrh gS
A f'kdk;rdrkZ dh iRuh Jherh lfjrk daoj dh xaHkhj fLFkfr dks ns[krs gq, ECHS
;kstuk ds izko/kkuksa esa <hy nh x;h vkSj mls lhek ls vf/kd fpfdRlk lqfo/kk,a iznku
dh x;h A Jherh lfjrk daoj ds mfpr mipkj gsrq xks;y gkWfLiVy esa HkrhZ djk;k
x;k A tc ejht esa dksbZ egRoiw.kZ lq/kkj utj ugha vk;k rks mls xks;y gkWfLiVy
ls NqÍh ns nh x;h A vizkFkhZ us jksxh dks gj laHko lgk;rk vkSj ns[kHkky iznku dh A
VfeZuy ekeyksa dks ECHS ;kstuk ds rgr iznku fd;s x;s fn'kk&funsZ'kksa vkSj izfØ;k
ds vuqlkj fuiVk;k tkrk gS A f'kdk;rdrkZ dh iRuh yxHkx 40 o"kZ dh vk;q dh
efgyk Fkh] mldks fMyhojh dh fu;r rkjh[k 08-04-2007 dks lqcg 09-30 cts lSU;
vLirky HkrhZ djk;k x;k A HkrhZ ds le; eq[; f'kdk;r isV esa gYdh ijs'kkuh Fkh
A ejht ds ijh{k.k ls irk pyk fd mls izlo ihM+k ugha gks jgh Fkh vkSj xHkkZoLFkk
laca/kh dksbZ tfVyrk ugha Fkh] bl ij mldh lkekU; fMyhojh dh ;kstuk cuk;h x;h
vkSj mlh fnu HkrhZ djk;k x;k A pwfa d vxys fnu ;kfu fnukad 09-04-2007 rd mlesa
izlo ihM+k dk dksbZ y{k.k ugha fn[kk ,oa fnukad 10-04-2007 dks 10-00 cts rd nnZ
mRiUu gqvk vkSj 13-00 cts rd og izlo ds dxkj ij Fkh A ejht vpkud izlo
dh Vscy ij fxj x;h] ;g ik;k x;k fd ejht dk xHkkZ'k; QV x;k gS] vr% ejht
dks rqjUr vks-Vh- esa ys tk;k x;k vkSj iquthZfor dj csgks'k fd;k x;k ,oa vkWijs'ku
fd;k x;k A xHkkZ'k; ds QVus ds dkj.k isV ds vanj dkQh ek=k esa jDrL=ko gqvk]
Hkzw.k dh e`R;q gksus ls eka dks lnek yxk A vkWijs'ku ds ckn fuxjkuh ds fy, vkbZ-lh-
;w- esa j[kk x;k] tgka vpkud dkfMZ;d vjsLV gqvk] mls iqu%psru fd;k x;k] ysfdu
ejht dks laHkor% hypoxic encephalopathy dk lkeuk djuk iM+k vkSj blds
pyrs og dksek esa pyh x;h A FkksM+k lq/kkj gksus ij mls fo'ks"k ns[kHkky nh x;h A
xHkkZ'k; dk VwVuk izlwfr foKku esa ,d Kkr] ysfdu nqyZHk tfVyrk gS A Hkzw.k dh e`R;q
,d vifjorZuh; tfVyrk gS] blfy, fnukad 13-04-2007 dks ejht dks U;wjksltZu
MkWDVj uxsUnz 'kekZ ,oa MkWDVj 'kqHkdj.k dks fn[kk;k x;k rFkk rn~uqlkj bykt fd;k
x;k A
10- fnukad 18-04-2007 dks xks;y gkWfLiVy ds U;wjksfQftdy MkWDVj ls ijke'kZ ds ckn
ejht dks xks;y vLirky esa LFkkukarfjr dj fn;k x;k tks ECHS lwphc) vLirky
gS A hypoxic encephalopathy ds ckn jksxh yxkrkj v)Zpsru voLFkk esa Fkk A rst
vkokt] rkyh ctkus ij mlus cl vka[ksa >idkbZ vkSj og [kk&ih ugha jgh Fkh A
U;wjksfQftf'k;u dh jk; Fkh fd] mlesa T;knk lq/kkj ugha fn[ksxk A blesa mipkj dh
vafrerk fufgr Fkh ,oa fu/kkZfjr fn'kk funsZ'kksa ds vuqlkj ECHS vf/kdkfj;ksa dks lwfpr
fd;k x;k A fpfdRlk deZpkfj;ksa dh vksj ls dksbZ fpfdRldh; ykijokgh ugha dh
x;h A nksuksa MkWDVjksa us f'kdk;rdrkZ dh iRuh dk loksZŸke {kerk ls bykt fd;k A
ekuuh; mPp U;k;ky; us fjV ;kfpdk la[;k 7801@2007 esa lSU; vLirky ds
vf/kdkfj;ksa ds f[kykQ dsoy dqN funsZ'k tkjh fd;s Fks fd] tc f'kdk;rdrkZ dh
iRuh dk lSU; vLirky esa bykt py jgk Fkk rks mldk LokLF; xaHkhj gks x;k Fkk A
ekuuh; mPp U;k;ky; us lSU; vLirky ds MkWDVjksa dks viuk dŸkZO; fuHkkus esa
ykijokg ugha ik;k A ifjoknh }kjk vizkFkhZ ij yxk;s x;s vkjksi Lohdkj ugha gS A
ekuuh; mPp U;k;ky; us vkns'k fnukad 12-02-2008 ds rgr Jherh lfjrk daoj dks
tks dksek esa Fkh] mls ,El] ubZ fnYyh ;k i;kZIr mipkj iznku djus esa l{ke fdlh
vU; vLirky esa LFkkukarfjr djus dk vkns'k fn;k A mDr funsZ'kksa ds vuqlkj
10]000@&:i;s ds psd ds lkFk ih,uvkj uacj 234&6780409 dk fVfdV fn;k x;k
A lSU; vLirky }kjk f'kdk;rdrkZ ds lkFk ubZ fnYyh rd tkus ds fy, ,d ifjpkjd
Hkh fu;qDr fd;k x;k A f'kdk;rdrkZ dh iRuh dks fnYyh igqapus ij igys ECHS
csl vLirky] fnYyh dsaV esa LFkkukarfjr fd;k x;k] mlds ckn fnukad 04-
03-2008 dks bykt ds fy, ,El] ubZ fnYyh ys tk;k x;k A ,El esa MkWDVjksa us ejht
dh fLFkfr dh tkap djus ds ckn mls ;g dgrs gq, HkrhZ djus ls badkj dj fn;k
fd] gLr{ksi dh vko';drk ugha gS A okfil mls ECHS ikWyh fDyfud csl vLirky
fnYyh dsaV yk;k x;k] ogka gjlaHko fpfdRlk ns[kHkky miyc/k djk;h x;h A vr%
vizkFkhZ dh lsok esa fdlh izdkj dh =qfV ugha crkrs gq, ifjoknh dk ifjokn gtkZus
lfgr [kkfjt djus dh izkFkZuk dh x;h A
11- vizkFkhZ la[;k nks dh vksj ls dksbZ Tkokc izLrqr ugha gqvk gS] fdUrq nkSjkus lk{; fnuakd
19-07-2010 dks rS;kj 'kiFk&i= fnuakd 12-08-2010 dks lk{; ds :Ik esa izLrqr fd;k
x;k] tks vfHkys[k ij ekStwn gS rFkk ftldh iqf"V vknsf'kdk fnukad 12-08-2010 ls
Hkh gks jgh gS A mDr 'kiFki= vknsf'kdk fnukad 12-08-2010 ds vuqlkj vizkFkhZ la[;k
,d] nks] rhu] lkr o vkB dh vksj ls la;qDr :i ls izLrqr fd;k x;k gS A
12- vizkFkhZ la[;k rhu dh vksj ls tokc is'k dj of.kZr fd;k x;k fd] fnukad 10 vizsy
2007 dks mls lwfpr fd;k x;k fd iwoZ lSfud Kkuizdk'k pkSgku dh iRuh izlo ihM+k
ls xqtj jgh Fkh ,oa xHkkZ'k; QVus ls vpkud csgks'k gks x;h A vizkFkhZ us rqjar fFk;sVj
vkSj Vhe dks rS;kj fd;k ,oa L=h jksx fo'ks"kK ysf¶VusaV duZy vkj-,u-cuthZ ds lkFk
ejht dks fFk;sVj esa ys tk;k x;k A tkap djus ij og lkal ysus esa gkaQ jgh Fkh]
mldh ukM+h eglwl ugha gks jgh Fkh] og BaMh vkSj fpifpih Fkh ,oa lnes esa Fkh A
vizkFkhZ us ejht dks cpkus ds iz;kl 'kq: fd;s A mldk rqjar vkWijs'ku djuk
vko';d Fkk D;ksfa d xHkkZ'k; ds QVus ds dkj.k mlds isV ds vanj xaHkhj jDrL=ko
gks jgk Fkk A isV [kksyus ij irk pyk fd mldk yxHkx 4 yhVj [kwu cg pqdk Fkk
A yxHkx 60 fdyksxzke otu okys jksxh esa jDr dh dqy ek=k 4-2 yhVj gksus dh
mEehn gS A ltZu us jDrL=ko jksddj ejht dks cpkus dh iwjh dksf'k'k dh] ysfdu
chih dks 70&80 feeh ,pth flLVksfyd rd yk lds A xaHkhj gkyr esa mls xgu
fpfdRlk bdkbZ esa LFkkukarfjr dj fn;k x;k A mls fnu Hkj 20 ;wfuV jDr vkSj jDr
mRikn fn;s x;s A xaHkhj fLFkfr ds dkj.k mls] mlh fnu 17-30 cts dkfMZ;d vjsLV
gqvk] ftlls iwjh Vhe ds iz;klksa ls mls iquthZfor fd;k x;k A nks fnuks a esa ejht esa
fjdojh ns[kh x;h] ysfdu og ekSf[kd vkns'kksa dk tokc ugha ns jgh Fkh A mlds
efLr"d esa dqN gkbZiksfDld pksV yxh Fkh A vizkFkhZ us mls iquthZfor djus dh iwjh
dksf'k'k dh vkSj laHkkfor {kfr ls cpkus ds fy, mipkj Hkh fn;k] fQj Hkh ejht ds
efLr"d dks {kfr igqaph Fkh A mls flfoy U;wjksltZu vkSj U;wjks fQftf'k;u dks fn[kk;k
x;k] lHkh us feydj loksZŸke laHko ns[kHkky dh A ejht dh gkyr esa lq/kkj gksus ij
mls 18 tqykbZ 2007 dks xks;y gkWfLiVy esa LFkkukarfjr dj fn;k rkfd og
U;wjksfQftf'k;u dh lh/kh ns[kHkky es jg lds A mldk thlh,l la[;kRed :i ls
ntZ fd;k x;k D;ksafd og osfa VysVj ij Fkh vkS j mldh ekSf[kd izfrfØ;k uksV ugha
dh tk ldh Fkh A vizkFkhZ o mlds lgdfeZ;ksa us ejht ds feyus ij rqjar mldk
bykt fd;k vkSj gj lHko ns[kHkky dh A vizkFkhZ ij fdlh Hkh Lrj ij ykijokgh dk
lansg ugha fd;k tk ldrk A vizkFkhZ dh vksj ls lsok esa dksbZ =qfV ugha dh x;h gS A
vr% vizkFkhZ dks ml ij yxk;s x;s vkjksiksa ls eqDr djs A
13- vizkFkhZ la[;k pkj o ikap dh vksj ls tokc is'k dj izkjfEHkd vkifŸk;ksa ds rkSj ij
dFku fd;k x;k fd] xks;y gkWfLiVy ,.M fjlpZ lsaVj izk-fy- daiuh dks i{kdj ugha
cuk;s tkus ls ifjokn [kkfjt fd;s tkus ;ksX; gS A ekuuh; mPp U;k;ky; dh ,dy
ihB }kjk fn;s x;s fu.kZ; izn'kZ 10 esa ,slk dgha ij Hkh vafdr ugha gS fd ekuuh;
mPp U;k;ky; us MkWDVj xks;y ,oa MkWDVj ekFkqj ds fo:) dM+s dne mBkus ds
funsZ'k fn;s gks vkSj xks;y gkWfLiVy }kjk Hk;adj ykijokgh] vn{krk ,oa vlko/kkuh
cjrus ij ukjktxh tkfgj dh x;h gks A ekuuh; jktLFkku mPp U;k;ky; dh ,dy
ihB }kjk fn;s x;s mijksDr fu.kZ; ds f[kykQ xks;y gkWfLiVy dh vksj ls ekuuh;
jktLFkku mPp U;k;ky; dh [k.MihB ds le{k fo'ks"k vihy la[;k 191@08 nk;j
dh x;h] ftlesa ifjoknh dh vksj ls dsfo;V nkf[ky dh xbZ rFkk [k.MihB us fnukad
10-03-2008 dks nksuksa i{kdkjku dks lquus ds i'pkr vU; i{kdkjku dks uksfVl tkjh
djrs gq, ,dy ihB ds fu.kZ; fnukad 12-02-2008 ds funsZ'k Øekad 3] 4] 5 ,oa 6 ij
LFkxu vkns'k tkjh fd;k rFkk fnukad 01-05-2008 dks LFkxu vkns'k dks vihy ds
fuiVku rd cjdjkj j[kus dk vkns'k tkjh fd;k] ysfdu ifjoknh us tkucw> dj
LFkxu vkns'k fnukad 10-03-2008 ,oa vkns'k fnukad 01-05-2008 dk gokyk ifjokn esa
ugha fn;k A bl izdkj egRoiw.kZ rF;ksa dks fNikus ds dkj.k ifjoknh dk ifjokn
[kkfjt fd;s tkus ;ksX; gS A
14- xks;y gkWfLiVy esa lHkh izdkj ds fo'ks"kK MkWDVj miyC/k gS A fefyVªh gkWfLiVy dh
vksj ls iwoZ lSfudksa o muds ifjtu dks bl vLirky esa jsQj djus ij mudk gj
izdkj dk bykt fd;k tkrk gS A MkWDVj jktho ekFkqj vkSlru 50 U;wjksyksth ls
lacfa /kr ejhtksa dk bykt djrs vk jgs gSa A fnukad 18-04-2007 dks fefyVªh gkWfLiVy
ls xks;y gkWfLiVy lwpuk vkus ij MkWDVj jktho ekFkqj mlh le; fefyVªh gkWfLiVy
x;s] tgka MkWDVj 'kqHkdj.k] lgk;d izksQslj] U;wjksyksth foHkkx egkRek xka/kh vLirky]
tks/kiqj rFkk MkWDVj- uxsUnz 'kekZ] U;wjks ltZu Hkh ejht dh tkap dj jgs Fks A vizkFkhZ
la[;k ikap us Hkh ejht dh tkap dh vkSj ik;k fd ejht ds dksek esa gksus ls mldh
gkyr vR;ar gh uktqd o [kjkc fLFkfr esa gS A vizkFkhZ la[;k ikap us ejht dk cSMgSM
fVfdV ns[kus ij ik;k fd ejht dks fnukad 08-04-2007 dks fefyVªh gkWfLiVy esa
xHkkZoLFkk esa HkrhZ fd;k x;k Fkk rFkk fnukad 10-04-2007 dks izlo gksus ls iwoZ gh
mldk uterus QV x;k rFkk vkWijs'ku ds nkSjku ân; xfr :d tkus o mlesa O;ko/kku
vkus dh otg ls ejht ,dk,d dksek esa pyh x;hA fefyVªh gkWfLiVy ls ejht dks
xks;y gkWfLiVy jsQj fd;s tkus ij fnukad 18-04-2007 dks HkrhZ fd;s tkus ij mldk
bykt esfMdy ,fFkDl rFkk esfMflu ,lksfl,V vkWQ fQftfl;Ul vkWQ bf.M;k dh
text book esa fn;s x;s fn'kk funsZ'kkuqlkj gh mldk vPNs ls vPNk bykt fd;k x;k
A mDr iqfLrdk ds ist la[;k 760 o 761 dk foLr`r fooj.k tokc ds iSjk&3 esa
of.kZrkuqlkj gS A xks;y gkWfLiVy esa HkrhZ ds le; ejht dh GCS 3@15 Fkh rFkk
Ms<+ ekg ds bykt ds nkSjku gh mldh GCS 3@15 ls 6@15 gks x;h rFkk ejht
tks dksek esa futhZo gkyr esa Fkh] mldh gkyr esa dkQh lq/kkj gksdj og viuh nksuksa
vka[ksa [kksyus yxh rFkk jsLiksal nsus dh fLFkfr esa vk x;h o lq/kkj gksus ij twu] 2007
esa osaVhysVj gVk fn;k x;k o fcuk osaVhysVj ds mldh 'olu izfØ;k lkekU; :i ls
fuckZ/k pyrh jgh A blls T;knk ejht ds lq/kkj esa dksbZ xqatkb'k ugha gksus ls fnukad
14-07-2007 dks fefyVªh gkWfLiVy dks fLFkfr Li"V djus ckcr lwfpr fd;k] bl ij
ejht dk bykt cjdjkj j[ks tkus dh lykg nh x;h A fnukad 04-10-2007 dks fQj
fefyVªh gkWfLiVy dks ejht dh v)Zpsru fLFkfr ds ckjs esa crkus o lykg fn;s tkus
ij feYVªh gkWfLiVy ds i= fnukad 05-10-2007 ds funsZ'kkuqlkj ejht dk fnukad 27-
11-2007 dks fMLpktZ fVfdV cuk;k x;k] ysfdu ifjoknh ds vuqjks/k ij fd og vkxs
vLirky dk O;; vius vki Hkjsxk] ejht dks ekuoh; vk/kkj ij fnukad 28-12-2007
rd fj;k;rh nj ij HkrhZ j[kk x;k ,oa :e rFkk vU; fpfdRlh; O;; esa 50 Qhlnh
NwV Hkh iznku dh x;h A fnukad 28-12-2007 dks ifjoknh ds vuqjks/k ij ejht dks
xks;y gkWfLiVy ls NqÍh nh x;h ml le; ejht dh gkyr v)Zpsru ls csgrj fLFkfr
esa gks x;h FkhA ifjoknh dh iRuh dh e`R;q xks;y gkWfLiVy ls NqÍh fn;s tkus ds dksbZ
lok lky ckn ;kfu fnukad 08-03-2009 dks gqbZ A ifjoknh us ;g Lohdkj fd;k gS
fd fefyVªh gkWfLiVy esa vizkFkhZ la[;k ,d ls rhu dh ykijokgh] vn{krk o vlko/kkuh
rFkk lgh le; ij lgh bykt ugha fd;s tkus ls ejht o mlds iq= dh e`R;q gqbZ A
ifjoknh }kjk gh fefyVªh gkWfLiVy dks xks;y gkWLihVy dk uke lq>k;k x;k Fkk] bl
ij ejht dks jsQj fd;s tkus ij HkrhZ fd;k x;k A
15- ifjoknh dk ;g dFku xyr gS fd vizkFkhZ la[;k pkj us /ku dekus dh fu;r ls
ejht dks vLirky esa HkrhZ dj fy;k A MkWDVj vkuan xks;y us ejht dk dksbZ bykt
ugha fd;k vkSj u gh dHkh dksbZ tkap dh A vizkFkhZ vLirky esa fo'ks"kK MkWDVjksa dh
Hkjekj gS rFkk bykt dh vk/kqfud ,oa iw.kZ lqfo/kk ns[krs gq, gh dsUnzh;@jkT; ljdkj
ds fofHkUu foHkkxks]a cSad] chek daiuh rFkk fefyVªh gkWfLiVy us Hkh xks;y gkWfLiVy dks
vius iSuy esa 'kkfey fd;k gqvk gS A ifjoknh }kjk ekuuh; jktLFkku mPp U;k;ky;
esa izLrqr fjV ;kfpdk la[;k 7801@07 esa xks;y gkWfLiVy dks vizkFkhZ i{kdkj ugha
cuk;k x;k gS A ejht dks fnukad 28-12-2007 dks gkWfLiVy ls fMLpktZ fd;s
tkus ds ckn dHkh Hkh xks;y gkWfLiVy esa okfil ugha yk;k x;k A ifjoknh us ECHS
Polyclinic ds izHkkjh dks tks i= fnukad 15-03-2008 fy[kk gS mlesa lapsrh gkWfLiVy
dh f'kdk;r dh x;h gS fd lapsrh gkWfLiVy us ejht dks HkrhZ ugha fd;k A izn'kZ 14
o 14&, esa ,Ecqyl
sa Mªkboj truflag jkBkSM+ dk tks 'kiFki= is'k fd;k x;k gS mlesa
Hkh mlus l'kiFk dFku fd;k fd ejht dks fnukad 15-03-2008 dks lh/ks ,Ecqysal esa
lapsrh gkWLihVy tks/kiqj ysdj x;k Fkk] ysfdu mUgksua s ejht dk bZykt djus ,oa HkrhZ
djus ls euk dj fn;k A rc og okfil ejht dks mlh ,Ecqysal esa ECHS Polyclinic
tks/kiqj ysdj vk x;k vkSj bl nkSjku ejht ds lkFk ifjoknh ,oa mldh nks iqf=;kWa
Hkh ekStwn Fkh A bl izdkj Li"V gS fd ejht dks fnukad 15-03-2008 dks xks;y
gkWLihVy esa bykt o HkrhZ ds fy, okfil ugha yk;k x;k A ifjoknh us ifjokn ds
lkFk rFkkdfFkr jkf'k 86]528@&:i;s ds dksbZ fcy uRFkh ugha fd;s gS A vr% ifjoknh
;g jkf'k izkIr djus dk vf/kdkjh ugha gS A ifjoknh us crkSj fpfdRldh; O;;
22]950@&:i;s dk gh xks;y gkWfLiVy dks Hkqxrku fd;k Fkk A vizkFkhZ la[;k pkj o
ikap dh vksj ls lsok esa fdlh izdkj dh dksbZ =qfV dkfjr ugha dh x;h gS A vr%
ifjoknh dk ifjokn vizkFkhZ la[;k pkj o ikap ds fo:) lO;; [kkfjt fd;k tkos A
16- vizkFkhZ la[;k N% dh vksj ls tokc is'k dj izkjfEHkd vkifŸk;ksa ds rkSj ij dFku
fd;k fd] ifjoknh fnukad 15-03-2008 dks ECHS ds rgr viuh iRuh ds bykt gsrq
jsQjy QkWeZ ysdj vizkFkhZ gkWLihVy esa vkus ij jsQjy QkWeZ esa fy[ks x;s etZ ds
bykt Hypoxic Encephalopathy ds fy, jsQj fd;k x;k A vizkFkhZ }kjk ifjoknh
dks lq>ko fn;k x;k fd] og viuh ifRu ds vU; chekjh Twice Cardic arrest
attempt ds dkj.k mlds fgr esa rqjUr ECHS vf/kdkjh o fpfdRld ls laidZ dj
lykg djds mfpr fu.kZ; ysos] ijUrq ifjoknh okrkZ dk fu"d"kZ le>s cxSj gh pyk
x;k A mDr ckrphr dh le;kof/k ek= 2 ls 5 feuV ds varj esa ?kfVr gqbZ A bl
izdkj ifjoknh dk ;g dFku fujk/kkj gS fd vizkFkhZ }kjk fpfdRlh; ykijokgh ,oa
lsok esa deh dh x;h gks A inokj tokc esa mijksDr dFkuksa dks nksgjkrs gq, ifjoknh
dk ifjokn xyr feF;k o vk/kkjghu gksus ls lO;; [kkfjt fd;s tkus dh izkFkZuk dh
x;h A
17- ifjoknh dh vksj ls ifjoknh Kku izdk'k pkSgku dk 'kiFki= is'k fd;k x;kA vizkFkhZ
la[;k pkj o ikap dh vksj ls MkWDVj jktho ekFkqj dk 'kiFki= is'k fd;k x;k]
ftUgksua s vizkFkhZ la[;k pkj o ikap }kjk nk;j tokc dks 'kiFki= dk vax 'kqekj le>k
tkus dk dFku fd;k A vizkFkhZ la[;k 6 dh vksj ls MkWDVj lqjs'k lapsrh dk 'kiFki=
is'k fd;k x;k A ysf¶VusaV duZy vkj ,u cuthZ dh vksj ls vfrfjDr 'kiFki= is'k
fd;k x;k A ysf¶VusaV duZy cyfoanj flag cstok dk dkm.Vj 'kiFki= is'k fd;k
x;k A mHk; i{k dh vksj ls fookn ls lacfa /kr lkFkZd nLrkostkr dh Nk;k izfr;ka
is'k dh x;h A izfrizs"k.k ds i'pkr ysf¶VusaV duZy jfoUnz izHkkr frokM+h ,oa vizkFkhZ
la[;k rhu ysf¶VusaV duZy jhrk flag dk 'kiFki= Hkh izLrqr fd;k x;k gS A
18- ;g izdj.k iwoZ esa fnukad 08-04-2009 dks ifjokn la[;k 3@2009 ds :i esa ntZ gqvk
A ftldk rRdkyhu jkT; miHkksDrk fookn izfrrks"k vk;ksx] lfdZV csap] tks/kiqj }kjk
fnukad 06-06-2011 dks fu.kZ; fd;k tkdj ifjoknh dk ifjokn vLohdkj fd;k x;k
A mDr fu.kZ; ds fo:) ekuuh; jk"Vªh; miHkksDrk fookn izfrrks"k vk;ksx] ubZ fnYyh
esa vihy izLrqr dh x;h] ftldk fu.kZ; ekuuh; jk"Vªh; vk;ksx fnukad 02-11-2016
dks fd;k tkdj ,oa izdj.k iqu% izfrizsf"kr fd;k tkdj rduhdh lk{; ds vk/kkj ij
fu.khZr djus ds funsZ'k jkT; vk;ksx dks iznku fd;s x;s A bl izdkj mDr izdj.k
fnukad 14-12-2016 dks izdj.k la[;k 14@2016 ij ntZ fd;k x;k A
19- cgl fo}ku vf/koDrk mHk;i{k lquh xbZ A
20- ifjoknh dh vksj ls rdZ fn;k x;k fd] ifjoknh ukSlsuk ls lsokfuo`Rr lSfud gS rFkk
og ECHS ¼,Dl lfoZleSu gsYFk dkWUVªhC;wVjh Ldhe½ Ldhe esa bykt ds fy, jftLVMZ
Fkk A mDr ;kstuk esa bykt ds fy, vizkFkhZ vLirky vf/kd`r FkkA o"kZ 2006 esa
ifjoknh dh iRuh xHkZorh Fkh A ifjoknh dh iRuh dk CyM xzqi *vks* usxsfVo Fkk ,oa
ifjoknh dk CyM xzqi *vks* iksftfVo gS ftldk VsLV vizkFkhZ }kjk dHkh Hkh ugha fd;k
x;k A fnukad 08-04-2007 dks ifjoknh dh iRuh dks yscj isu gksus ij ,UVh us Vy
dkMZ fefyVªh gkWfLiVy tks/kiqj esa tek djk;k o iRuh dks HkrhZ Hkh djk;k A vizkFkhZ
gkWfLiVy esa fuf'pr le;kof/k ds vykok fdlh ls feyus Hkh ugha fn;k tkrk gS A
ifjoknh dh iRuh o cPpk nksuksa LoLFk Fks A ifjoknh dh iRuh 38 lky dh Fkh ,oa
mldh fMyhojh QksfVZl Fkh A ifjoknh dh iRuh dks tYnh fMyhojh gksus ds le;
dksbZ complication ugha gksuk rFkk cq[kkj ugha gksuk crk;kA ejht ds dsl dk laf{kIr
bfrgkl izn'kZ&4 ds vuqlkj gS A ifjoknh dh iRuh dks HkrhZ gksrs le; MkWDVj dkosZM
us vko';d funsZ'k fn;s Fks A ejht Jherh lfjrk daoj dk ,Mfe'ku dkMZ e;
'kiFk&i= vkehZ }kjk jk'Vªh; miHkksDrk fookn izfrrks"k vk;ksx ds le{k miyC/k djok;k
x;k Fkk A izkjEHk esa ifjokn ds lkFk izn'kZ&4 ds vykok vkSj dksbZ nLrkost is'k ugha
fd;k x;k gS A ifjoknh dh vksj ls MkWDVj tx:Ik eg: dk 'kiFk&i= izLrqr fd;k
x;k gS] ftudh jk; lkFk esa layXu i`"B la[;k 1 ls 123 ds vk/kkj ij nh xbZ gS A
mDr 'kiFk&i= ds i`"B la[;k 11¼K½ ds iSjk la[;k 11 rFkk ifjokn ds iSjk la[;k 4
o 9 ij bl laca/k easa vko';d dFku fd;s x;s gSa A ifjoknh dks dsoy bykt dh
lejh nh xbZ Fkh vkSj ekaxs tkus ij Bed Head Ticket (BHT) miyC/k ugha djok;k
x;k A ifjoknh dh iRuh Jherh lfjrk daoj dks fnuakd 08-04-2007 dks
HkrhZ djok;k x;k Fkk vkSj nkSjkus bykt fnuakd 08-03-2009 dks mldh e`R;q gks xbZ
A bl nkSjku ifjoknh dh iRuh Jherh lfjrk daoj dks xEHkhj voLFkk esa vizkFkhZ la[;k
4 xks;y gkWfLiVy ,.M fjlpZ lsUVj izk-fy- esa HkrhZ djok;k x;k Fkk] ml le; og
dksek esa gksrs gq, vkWDlhtu liksVZ ij Fkh A 'kiFk&i= ds inkad la[;k 5 esa vizkFkhZ
la[;k 2 ofj"B fpfdRld Jh vkj-,u-cuthZ ds lac/a k esa dgk x;k fd Partograph
la/kkfjr ugha fd;k x;k A fpfdRlk esa gqbZ ykijokgh ifjoknh dks lkfcr ugha djuh
Fkh] cfYd gkWfLiVy dks lkfcr djuh Fkh fd mudh vksj ls fpfdRlk esa dksbZ ykijokgh
ugha dh x;h gS A ifjoknh dh iRuh Jherh lfjrk daoj dks Anti "D" Injection"
ugha fn;k x;k] tcfd ;g R.H.Negative izlwrk dks fn;k tkuk vko';d gksrk gS A
'kiFk&i= ds iSjk la[;k 6 esa dgk x;k fd Pitocin Injection vko';d ugha Fkk A
'kiFk&i= ds inkad 11(H) ist la[;k 13 vkSj 14 rFkk iSjk la[;k 11¼K½ dk voyksdu
djk;k rFkk dgk x;k fd] ;g ekStwnk izdj.k ds fuLrkj.k gsrq vko';d gS] vr% bu
ij xkSj fd;k tkuk pkfg;s A 41 lIrkg ls igys xSlslu dh vko';drk ugha gS] fQj
Hkh 41 lIrkg esa fd;k x;k gS] ,slk fd;s tkus ls iwoZ ejht o mlds
ifjtuksa dh bPNk vkSj lgefr fy;k tkuk vko';d gksrk gS] ijUrq ,slk ugha fd;k
x;k A ftl efgyk dks vkWfDlVksflu fn;k x;k gks mls fcuk ns[kjs[k ds ugha NksM+k
tk ldrk] ijUrq bl ckr ij Hkh /;ku ugha fn;k x;k A 'kiFk&i= ds iSjk la[;k
11¼M½ vkSj iSjk la[;k 16 Hkh xkSj fd;s tkus ;ksX; gS A ifjokn dk iSjk la[;k 3 vkSj
4 rFkk i`"B la[;k 37 ij fLFkr izn'kZ&9 lwpuk ds vf/kdkj ds rgr izkIr nLrkost
gS A i`"B la[;k 38 jktLFkku esfMdy dkSafly dh vksj ls tkjh ljkguk dk i= gS]
tks dekUMsUV fefyVªh gkWfLiVy] tks/kiqj dks fy[kk x;k gS A ml nLrkost dh udy
ifjoknh dks ugha nh xbZ A ekuuh; jktLFkku mPp U;k;ky; ds le{k fjV
;kfpdk o"kZ 2007 esa izLrqr dh xbZ Fkh] tks nLrkost mles a izkIr gq,] mu nLrkotksa
dks iw.ks vkWfWQl ugha Hkstk x;k A ,drjQ nLrkost u"V djuk crk;k x;k gS] nwljh
rjQ ekuuh; jk"Vªh; miHkksDrk fookn izfrrks"k vk;ksx ds le{k funsZ'k ds ckn os
nLrkost is'k fd;s x;s A ;g rdZ Hkh fn;k x;k fd] uterus rupture gks tkus ds ckn
Hkh ifjoknh dh iRuh Jherh lfjrk daoj dks fefyVªh gkWfLiVy easa gh j[kk x;k A
ifjoknh dh iRuh ds tc cPps dk tUe gqvk ml le; dksbZ f'k'kq jksx fo'ks"kK ekStwn
ugha Fkk A ifjoknh dh iRuh dk cPps ds tUe ds le; vaxwBk yxok;k x;k] tcfd
ifjoknh dh iRuh i<+h fy[kh Fkh A ifjoknh dks ejht ds ikl vUnj ugha tkus fn;k
x;k A i`"B la[;k 67 ds vuqlkj vizkFkhZ la[;k 4 xks;y gkWfLiVy ,.M fjlpZ lsUVj
izk-fy- us Qksu ij gh bykt djus ls bUdkj dj fn;k] tcfd fefyVªh gkWfLiVy ds
lkFk gq, vuqcU/k ds vuqlkj og bykt ds fy, euk ugha dj ldrk A bl laca/k esa
i`"B la[;k 70 Hkh ns[kk tkuk pkfg;s A ejht dh fLFkfr dks jsQjy QkWeZ ij fy[kus
ls euk dj fn;k x;k A i`'B la[;k 71 ds vuqlkj vizkFkhZ la[;k 6 lapsrh gkWfLiVy
,.M dSalj bULVhV~;wV fy[k fn;k fd Brain Dead dk bykt ugha djrs A i`"B la[;k
75 ds vuqlkj ECHS ,EcqysUl ds Mªkboj us vius 'kiFk&i= esa dgk gS fd fnukad
15-03-2008 dks og] Jherh lfjrk daoj dks vizkFkhZ la[;k 6 lapsrh gkWfLiVy ,.M
dSalj bULVhV~;wV ysdj x;k Fkk A ejht lfjrk daoj ds Bed Sore gks tkus ds dkj.k
ls fefyVªh gkWfLiVy ls lEidZ fd;k x;k A ifjokn ds i`"B la[;k 12 o 13 esa
vizkFkhZx.k dh mis{kk ds ckjs esa vko';d vfHkopu fd;s x;s gSa A vizkFkhZ la[;k 4
xks;y gkWfLiVy ,.M fjlpZ lsUVj izk-fy- us bl vk/kkj ij fd] eqdnek py jgk gS
Bed Sore dk bykt djus ls bUdkj dj fn;k] tcfd og ,slk ugha dj ldrk vkSj
bl lac/a k esa dFku dj fn;k fd] IykfLVd ltZjh dh lqfo/kk miyC/k ugha Fkh A
;g Hkh rdZ fn;k x;k fd] fnuakd 12-01-2023 dks ,d izkFkZuk&i= izLrqr dj fuosnu
fd;k x;k Fkk fd bl laca/k esa vkWy bf.M;k esfMdy bULVhV~;wV ds fo'ks"kK MkWDVj
vFkok esfMdy dkWyst ls jk; yh tkos A ifjoknh dk ,d 'kiFk&i= fnuakd 09-10-
2017 dks Hkh izLrqr fd;k x;k gS] ftlesa vizkFkhZx.k dh vksj ls dh xbZ mis{kkvksa dk
mYys[k fd;k x;k gS A blds [k.Mu esa tks [k.MukRed 'kiFk&i= izLrqr fd;k x;k
gS] mlesa bl laca/k mYys[k fd;k x;k gS fd fefyVªh gkWfLiVy }kjk ejht ds jDrpki]
Partograph bR;kfn dh tkap fujUrj dh tk jgh Fkh] ysfdu bl laca/k esa dksbZ
nLrkost is'k ugha fd;k x;k gS A
21- fo}ku vf/koDrk ifjoknh dh vksj ls ;g rdZ Hkh fn;k x;k fd] lfjrk daoj dks yscj
isu 'kq: gks x;k Fkk] mls M~;w MsV dks HkrhZ djk;k x;k Fkk] ml le; og fcYdqy
LoLFk Fkh A e`rdk lfjrk daoj dh og pkSFkh fMyhojh Fkh A igys ds rhu cPps
iw.kZr% LoLFk ,oa thfor gS A igyh fMyhojh ds le; dksbZ Complication ugha gqbZ
Fkh A 8 rkjh[k dks LVªhfiax 'kq: fd;k x;k] mlls iwoZ dksbZ dUlsUV ugha yh x;h A
9 rkjh[k dks Gel Hkh ,IykbZ fd;k Fkk ,oa 9 rkjh[k dks gh direction ns fn;k fd 10
rkjh[k dks pitocine batsD'ku yxk;k tkos A fnukad 26-04-2023 dks dh xbZ cgl esa
fo}ku vf/koDrk ifjoknh dh vksj ls ;g rdZ fn;k x;k fd] ejht dks fnukad
08-04-2007 dks HkrhZ fd;k rFkk fnukad 09-04-2007 dks Gel yxk;k ,oa fnukad 10-04-
2007 dks 2-5 ,e,y pitocine batsD'ku yxk;k A 14 MªkWi izfr feuV ds fglkc ls
jkf= esa 'kq: fd;k] bl chp vU; dksbZ bykt ugha fn;k A Jherh lfjrk daoj dk
lhtsfj;u djuk pkfg, Fkk] tks ugha fd;k x;kA fnukad 08-04-2007 ls Induction of
Labour dj jgs Fks] vr% rhu fnu ckn cPpsnkuh QV x;h A mlds ckn vkWijs'ku
fFk;sVj esa ys x;s A xHkZLFk f'k'kq dh e`R;q gks x;h A cPps dk psLV estjes aV cky
fo'ks"kK ls ugha djok;k] mlh ls irk py ldrk Fkk fd cPps dh e`R;q lkal ysus ds
ckn gqbZ ;k tUe ls igys gh gks x;h A chekj lfjrk daoj ds LFkku ij mlds ifr
Kku izdk'k dk uke fy[kk gS A ;g rdZ Hkh fn;k x;k fd] i`"B la[;k 45 ij ekStwn
nLrkost ls irk pyrk gS fd] cky fo'ks"kK dks ughaa cqyk;k x;k Fkk A tx:Ik dh
vksj ls fn;s x;s [k.MukRed 'kiFk&i= dk inkad 11 xkSjryc gS A TPR (Temperory
Pulse Respiration) fnukad 08-04-2007 ls la/kkfjr ugha fd;k tkdj fnuakd 10-04-
2007 ls la/kkfjr fd;k x;k A Partograph eSUVsu fd;k tkrk gS A gekjs MkWDVj dh
vksj ls fd;s x;s dFkuksa dk dksbZ fof'k"B [k.Mu ugha fd;k x;k gS A
22- fnuakd 27-04-2023 dks dh xbZ cgl esa fo}ku vf/koDrk ifjoknh }kjk rdZ fn;k x;k
fd] ifjokn ds inkad la[;k 1 esa Li"V vfHkopu fd;k x;k fd ifjoknh HkwriwoZ lSfud
gS rFkk ,deq'r jkf'k HkwriwoZ lSfud va'knk;h LokLF; ;kstuk esa tek fd;s tkus ds
dkj.k jkf'k Lo;a rFkk ifjokj ds lnL; fpfdRlk ykHk izkIr djus ds vf/kdkjh gS A
bl ;kstuk esa 1800&18000 :i;s ds chp jkf'k vfuok;Z :Ik ls deZpkjh dks Rank
ds vuqlkj tek djokuk iM+rk gS] vr% ;g ugha dgk tk ldrk fd] ljdkj gkWfLiVy
gksus ls ifjokn iks"k.kh; ugha gS A mUgksaus ;g Hkh rdZ fn;k fd tgka rd iz'u
vizkFkhZx.k dh ykijokgh ls ifjoknh dks gqbZ {kfr dk gS] bl laca/k esa vko';d
vfHkopu ifjokn esa fd;s x;s gSa rFkk 'kiFk&i= :ih lk{; ls mu rF;ksa dks lkfcr
Hkh fd;k x;k gS A ifjoknh dh vksj ls ftl fo'ks"kK MkWDVj dk 'kiFk&i= izLrqr
fd;k x;k gS] mldk fof'k"B [kaMu vizkFkhZx.k dh vksj ls ugha fd;k x;k gS A
bu fcUnq dks fookfnr ugha fd;k x;k gS fd Induction of Labour 40 lIrkg ckn
gksuk pkfg;s] tcfd e`rdk lfjrk daoj ds 38 lIrkg ckn gh Induction of Labour
gks x;k Fkk A ;g izfrj{kk Hkh vizkFkhZx.k dh vksj ls ugha yh xbZ gS fd dsoy 38
lIrkg gh ugha gq, Fks ;k xyrh ls fy[k fn;k A bl ckr dk Hkh [k.Mu ugha
fd;k x;k gS fd Partograph la/kkfjr ugha fd;k x;k A ;g rdZ Hkh fn;k x;k fd
ifjoknh] tks fd e`rdk lfjrk daoj dk ifr gS] mldk Hkh CyM xzqi pSd ugha fd;k
x;k A e`R;q ds i'pkr~ e`rdk dk CyM xqzi **ch** fy[k fn;k x;k] tcfd **vks** usxsfVo
CyM xzqi Fkk A fefyVªh gkWfLiVy us xks;y gkWfLiVy ,.M fjlpZ lsUVj izk -fy-
,oa lapsrh gkWfLiVy ,.M dSalj bULVhV~;wV esa Serious Bed Sore ds fy, jsQj fd;k
x;k Fkk A xks;y gkWfLiVy ,.M fjlpZ lsUVj izk-fy- us ekuuh; mPp U;k;ky; esa
dsl yfEcr gksus ds vk/kkj ij bykt ugha fd;k vkSj lapsrh gkWfLiVy ,.M dSalj
bULVhV~;wV us Hkh fcuk fdlh U;k;ksfpr dkj.k ds lfjrk daoj dk bykt ugha fd;k
A bl laca/k esa vko';d vfHkopu inkad 13 esa fd;k x;k gS A var esa mUgksua s ifjokn
Lohdkj djus dh izkFkZuk djrs gq, vius rdksZa ds leFkZu esa fuEufyf[kr U;kf;d
n`"Vkar is'k fd;s %&
1- ekuuh; jk"Vªh; miHkksDrk fookn izfrrks"k vk;ksx&fjfotu fifV'ku uacj
2489&2490@2018 fuf.kZr fnukad 05-08-2019 fd'ku flag cuke
fefyVªh gkWLihVy o vU;
2- jkt- jkT; miHkksDrk fookn izfrrks"k vk;ksx t;iqj&QLVZ vihy uacj
1596@2011 ds-th-'kekZ cuke vkWfQlj bapktZ] ,Dl lfoZlesu dkWUVªhC;wWVjh
gsYFk Ldhe
3- LVs'ku dek.Mj ,Dl&lfoZlesu dkWUVªhC;wVjh gsYFk Ldhe bZlh,p,l
ikWfyfDyfud cuke Hktu flag] izdj.k la[;k ,@14@716
4- iapkc o gfj;k.kk mPp U;k;ky;] p.Mhx<+&lh MCY;w ih uacj
5865@2007 fuf.kZr fnukad 16-10-2008 duZy gjca'k flag ¼fjVk;MZ½ cuke
nh ;wfu;u vkWQ bf.M;k o vU;
5- ekuuh; loksZPp U;k;ky;&MANU/SC/1749/2019 egkjktk vxzlsu
gkWLihVy o vU; cuke _"kHk 'kekZ o vU;
6- ekuuh; loksZPp U;k;ky;&1969 , vkbZ vkj 128 y{e.k ckyfd'ku tks'kh
cuke f=Ecd ckiw xksycksys o vU; fu.kZ; fnukad 02-05-1968
7- ekuuh; loksZPp U;k;ky;&flfoy vihy uacj 2641@2010 oh-fd'ku jko
cuke fuf[ky lqij Lisf'k;fyVh gkWLihVy o vU; fu.kZ; fnukad 08-03-2010
8- NCDRC, F.A.No. 208/2008 - Mohan Dai Oswal Cancer Treatment &
Research Foundation & Ors. Vs Prashant Sareen & Ors.,
F.A.No.292/2008 - Orienctal Insurance Co.Ltd. Vs Prashant Sareen
& Ors., F.A.No. 373/2008 - National Insurance Co.Ltd. Vs Prashant
Sareen & Ors., Decided on 24.05.2019
9- NCDRC, Pankaj R. Toprani & 3 Ors. Vs Bombay Hospital and
Research, Decided on 04.07.2019
10- SCDRC, Gujarat, Ahmedabad, A.No.1146/2013 - Chirag Jitendrabhai
Gajjar Vs Dr. Shefali Shah, Decided on 25.01.2022
11- NCDRC, F.A.No.275/2007 and F.A.No.178/2008 - Manipal Hospital,
Bangalore and Ors. Vs Alfred Benedict and Ors.,Decided on
22.05.2013
12- Supreme Court of India, C.A.No.227-228/2019 - Arun Kumar
Manglik Vs Chirayu Health and Medicare Private Ltd. & Anr,
Decided on 09.01.2019
13- Supreme Court of India, C.A.No.2641/2010 - V.Kishan Rao Vs
Nikhil Super Supeciality Hospital and Anr., Decided on 08.03.2010
14- Supreme Court of India, Civil Appeal No.1949/2004 - Samira Kohli
Vs Dr. Prabha Manchanda & Anr, Decided on 16.01.2008
15- Supreme Court of India, C.A.No.7620/2014 - Alfred Benddict Vs
Manipal Hospital, Decided on 11.08.2014
16- blds vykok ifjoknh dh vksj ls Legal and Ethical Issues in Obstetric
Practice dh Nk;kizfr izLrqr dh x;h A
23- blds foijhr vizkFkhZ la[;k 4 yxk;r 6 ds fo}ku vf/koDrk Jh vfuy Hk.Mkjh
}kjk rdZ fn;k x;k fd] ekuuh; jk"Vªh; miHkksDrk fookn izfrrks"k vk;ksx us izdj.k
;g dgrs gq, iqu% bl vk;ksx dks izsfr&iszf"kr fd;k Fkk fd fpfdRldh; fo'ks"kKksa
dh lk{; dks n`f"Vxr j[krs gq, izdj.k dk u;s fljs ls fuLrkj.k fd;k tkos A
ifjoknh us ftl fo'ks"kK MkWDVj dk 'kiFk&i= izLrqr fd;k gS] mlus MkWDVj jktho
ekFkqj ,oa lapsrh gkWfLiVy ,.M dSalj bULVhV~;wV ds fo:) ,d 'kCn Hkh vius
'kiFk&i= esa ugha dgk gS A ifjokn esa ekuuh; jktLFkku mPp U;k;ky; dh ,dy
ihB ds vkns'k dk mYys[k rks ifjoknh }kjk fd;k x;k gS] ijUrq ekuuh; jktLFkku
mPp U;k;ky; dh [kaMihB }kjk ikfjr LFkxu vkns'k ds laca/k esa vfHkopu ifjokn
esa ugha fd;s x;s gSa vkSj mu rF;ksa dks fNikrs gq, ifjokn izLrqr fd;k x;k gS A
bl izdkj ls ifjoknh LoPN gkFkksa ls vk;ksx ds le{k ugha vk;k gS A pwfa d ekuuh;
jk"Vªh; miHkksDrk fookn izfrrks"k vk;ksx }kjk bl vk;ksx dh vksj ls ikfjr iwoZ
fu.kZ; dks vikLr fd;k x;k gS vkSj u;s fljs ls fu.kZ; ikfjr djus dk funsZ'k fn;k
x;k gS A
24- ;g rdZ Hkh fn;k x;k fd] igys ifjokn fefyVªh gkWfLiVy ds vko';d nLrkostkr
ds vHkko esa [kkfjt fd;k x;k Fkk A xks;y gkWfLiVy ,.M fjlpZ lsUVj izk -fy- ,oa
lapsrh gkWfLiVy ,.M dSalj bULVhV~;wV ds lac/a k esa dksbZ fu.kZ; gh ikfjr ugha fd;k
x;k Fkk A lapsrh gkWfLiVy ,.M dSalj bULVhV~;wV ds fy, MkWDVj lqjs'k lapsrh dk
'kiFk&i= fnuakd 10-02-2010 dk izLrqr gqvk gS A ECHS ds Mªkboj tru flag
jkBkSM+ us l'kiFk dFku fd;k gS fd xks;y gkWfLiVy ,.M fjlpZ lsUVj izk -fy- us
jsQjy QkWeZ ij gh euk dj fn;k Fkk] ogka ejht dks ugha ysdj x;k Fkk A fnuakd
15-03-2008 dk 'kiFk&i= ysf¶VusaV duZy ch-,l-jkBkSM+ dk is'k gqvk gS] mlesa vk;k
gS fd nksuksa gkWfLiVy us bykt djus ls euk dj fn;k vFkkZr~ tc nksuksa vLirkyksa
esa lfjrk daoj dk bykt gqvk gh ugha rks bykt esa ykijokgh fd;s tkus dh ckr
dSls lkfcr ekuh tk ldrh gS A lapsrh gkWfLiVy ,.M dSalj bULVhV~;wV ,d dSalj
gkWfLiVy gS rFkk e`rdk lfjrk daoj dks dSalj ds vykok fHkUu chekfj;k¡ Fkha A
Mªkboj us ;g ugha dgk fd ejht dks gkWfLiVy ds Hkhrj ys x;k Fkk] ,Ecqysal
vLirky ds ckgj gh gks rks irk ugha A xks;y gkWfLiVy ,.M fjlpZ lsUVj izk -fy-
us vius tokc esa ifjoknh }kjk yxk;s x;s vk{ksiksa dk fof'k"B [k.Mu fd;k gS A
vius dFkuksa ds leFkZu esa izn'kZ vkj&4@5&1 ekuuh; jktLFkku mPp U;k;ky;
dh [k.MihM }kjk ikfjr LFkxu vkns'k dh izfr izLrqr dh gS A e`rdk lfjrk daoj
dks xks;y gkWfLiVy ,.M fjlpZ lsUVj izk-fy- esa iw.kZ fu'psruk dh voLFkk esa yk;k
x;k Fkk A xks;y gkWfLiVy ,.M fjlpZ lsUVj izk-fy- esa gq, bykt ds dkj.k ls og
v)Zpsru fLFkfr esa vkbZ] vkxs dksbZ bykt lEHko ugh gkssus ls fefyVªh gkWfLiVy dh
lgefr ls fMLpktZ fd;k x;k Fkk A MkWDVj jktho ekFkqj }kjk iwoZ esa izLrqr
'kiFk&i= ds vuqlkj fnuakd 27-11-2007 dks fMLpktZ cuk fn;k Fkk] mlds ckn Hkh
ifjoknh }kjk vius [kpsZa ij vkxs bykt tkjh j[kus dk fuosnu djus ij bykt esa
gksus okys [kpZ esa 50 izfr'kr NwV fn;s tkus ds vk/kkj ij bykt tkjh j[kk x;k
Fkk A ifjoknh us izdj.k ds izfr&izsf"kr gksus ds i'pkr~ tks 'kiFk&i= izLrqr fd;k
gS] mlesa nksuksa vLirkyksa o mlds fpfdRldksa ds fo:) dqN ugha dgk x;k gS A
bl vk;ksx }kjk iwoZ esa ikfjr fu.kZ; Hkh xks;y gkWfLiVy ,.M fjlpZ lsUVj izk -fy-
,oa lapsrh gkWfLiVy ,.M dSalj bULVhV~;wV ds laca/k esa [kkfjt fd;k x;k gS A var
esa mUgksaus ifjokn [kkfjt fd;s tkus dh izkFkZuk djrs gq, vius rdksZa ds leFkZu essa
fuEufyf[kr U;kf;d n`"VkUr izLrqr fd;s %&
¼1½ I (2010) CPJ 29 (SC) dqlqe 'kekZ o vU; cuke c=k gkWLihVy
,.M esfMdy fjlpZ lsVa j o vU;
¼2½ II (2019) CPJ 41 (SC) Mk- ,l-ds- >qu>quokyk cuke /kuoarh
dqekj o vU;
¼3½ AIR 2021 SUPREME COURT 4690 Mk- gjh'k dqekj
[kqjkuk cuke tksfxUnj flag o vU;
¼4½ Hon'ble Rajasthan Highcourt, Jodhpur, D.B.Spl. Appl.
Writ No. 191/2008 - Goyal Hospital and Research Centre
& Anr. Vs The Union of India through Secretary,
Minister of Defence and Anr., Decided on 02.03.2022
25- vizkFkhZ la[;k 1 yxk;r 3 rFkk 7 ,oa 8 dh vksj ls fo}ku vf/koDrk Jh
jkes'oj nos us rdZ fn;k fd] vizkFkhZx.k ds tokc ds inkad la[;k 1 ls 3 esa ifjokn
esa fn;s x;s lacfa /kr vfHkopuksa dk fof'k"B [k.Mu ugha fd;k x;k gS A e`rdk lfjrk
daoj ds bykt esa fefyVªh gkWfLiVy }kjk iw.kZ lko/kkuh cjrh xbZ Fkh A MkWDVj vkj-
,u-cuthZ ¼vizkFkhZ la[;k 2½ }kjk tks 'kiFk&i= izLrqr fd;k x;k gS] mlds vuqlkj
lfjrk daoj dh pkSFkh fMyhojh Fkh A lfjrk daoj ds igys rhu cPps Fks] mlds ckn
,d ckj xHkZikr Hkh gqvk Fkk A ekuuh; jk"Vªh; miHkksDrk fookn izfrrks"k vk;ksx
}kjk izdj.k izfr&izsf"kr fd;s tkus ds i'pkr~ ysf¶VusaV duZy jfoUnz izHkkr frokM+h
us vius 'kiFk&i= ds inkad 6¼lh½ i`"B la[;k 2 esa vko';d dFku fd; gSa A ;g
dguk xyr gS fd gj ekeys esa bykt ds iwoZ ejht vFkok mlds ifjpkjd dh
lgefr fy;k tkuk vko';d gks A dbZ ckj esfMdy lkbal ds vuqlkj rRdky
fu.kZ; ysuk iM+rk gS A vizkFkhZx.k dh vksj ls izLrqr 'kiFk&i= esa izR;sd dFkuksa dk
fof'k"B [k.Mu fd;k x;k gS A ysf¶VusVa duZy jhrk flag ¼vizkFkhZ la[;k 3½ dk
'kiFk&i= Hkh izLrqr fd;k x;k gS] ftlds eqrkfcd esfMdy lkbal ds vuqlkj
tks&tks lko/kkfu;k¡ cjrh tkuh pkfg;s Fkh] lc cjrh xbZ gSa A ;g dguk xyr gS
fd vizkFkhZx.k }kjk e`rdk lfjrk daoj ds bykt esa dksbZ vlko/kkuh cjrh xbZ gks
vkSj bl dkj.k mldh e`R;q gqbZ gks A var esa mUgkaasus ifjokn [kkfjt fd;s tkus dh
izkFkZuk djrs gq, vius rdksZa ds leFkZu esa fuEufyf[kr U;kf;d n`"VkUr izLrqr fd;s%&
1.Supreme Court of India (Full Bench), 2005 (6) SCC 1, Criminal Appeal NO. 144-145/2004 - Jacob Mathew Vs State of Punjab, Decided on 05.08.2005
2. Supreme Court of India (Full Bench), 2005 (2) WLC 500, C.A.No. 5128/2002 - State of Punjab Vs Shiv Ram and Ors. Decided on 25.08.2005
3. Supreme Court of India, (2022) 6 Scale 546 - Dr. (Mrs.), C.A.No.(s) 6507/2009 - Dr (Mrs.) Chanda Rani Akhouri and Ors. Vs Dr. M.A.Methusethupathi and Ors., Decided on 20.04.2022
4. AIR 2022 Supreme Court 204, C.A.No.1658/2010 with 2322/2010 - Bombay Hospital and Medical Research Centre Vs Asha Jaiswal and Ors., Decided on 30.11.2021
5. 2020 DNJ (CC) 89 (NC), C.C.No.185/2011 - Saud Abbasi (Dr.) Vs Gargi Hospital and Ors. Decided on 17.06.2020 26- bu rdksZa dk tokc nsrs gq, fo}ku vf/koDrk ifjoknh }kjk rdZ fn;k x;k fd ifjoknh dh iRuh Jherh lfjrk daoj dks HkrhZ djokrs le; gkWfLiVy dh vksj ls tks uksV yxk;k x;k Fkk] mlds vuqlkj ,slh dksbZ rdyhQ ugha crkbZ xbZ gS] ftldk bykt fd;k tkuk lEHko ugha gks A ifjoknh dh iRuh dks Anti "D" Injection" ugha fn;k x;k Fkk A izfrizs"k.k ds i'pkr~ fo'ks"kK MkWDVj dk tks 'kiFk&i= izLrqr fd;k x;k] mlds fcUnq la[;k 11 esa vko';d dFku fd;k x;k gS A bldk dksbZ Li"V [k.Mu ugha fd;k x;k gS A ejht dh fLFkfr lkekU; izlo ;ksX; ugha Fkh rks lhtsfj;u Iyku djuk pkfg;s Fkk A izlwrk usxsfVo CyM xzqi dh Fkh] mldk CyM cPps esa ugha tk;s blds fy, uky dks nck;k tkuk pkfg;s Fkk A lgefr&i= ij vaxq"B fu'kku fdldk gS] ;g lkfcr ugh fd;k x;k gS A e`rd i<+h fy[kh Fkh o gLrk{kj djrh Fkh] blfy, mldk vaxq"B fu'kku fy;s tkus dh vko';drk ugha Fkh A ;g dguk i;kZIr ugha gS fd og gLrk{kj djus dh fLFkfr esa ugha Fkh A lgefr ughaa ysus dk vkSj dksbZ dkj.k ugha crk;k x;k gS A fcuk mlds gh Induction of Labur dj fn;k x;k A 40 o"kZ dh efgyk gks rks 40 lIrkg ,oa 07 fnu ds ckn gh Induction of Labour djuk pkfg;s A 'kiFk&i= ds inkad 11¼K½ o L ds vuqlkj cPpsnkuh QVus dh Qksjsafld tkap djuh pkfg;s Fkh] tks ugha dh xbZ A 'kiFk&i= ds inkad 11¼R½ Hkh ns[k tkuk pkfg;s A pwfa d xks;y gkWfLiVy ,.M fjlpZ lsUVj izk- fy- ,oa lapsrh gkWfLiVy ,.M dSalj bULVhV~;wV esa dksbZ bykt gqvk gh ugha] vr% mlds laca/k esa fo'ks"kK ds 'kiFk&i= esa vk/kkj tksM+s tkus dh vko';drk ugha jgh gS A fjek.M ds le; iwoZ fu.kZ; dks vikLr fd;k x;k gS A fnuakd 15-03-2008 dks ysf¶VusaV duZy ch-,l-jkBkSM+ us LVs'ku gSMDokVZj] tks/kiqj Hkstk Fkk A izn'kZ&13 esa Refer to Sancheti Hospital reconstructive surgery gsrq fy[kk gqvk gS A MkWDVj lapsrh us vius 'kiFk&i= esa ftl etZ ds fy, jsQj djuk crk;k gS] jsQj i= ds vuqlkj ml etZ ds fy, jsQj gqvk Fkk ;k ugha] ;g ns[kk tkuk gS A var esa rdZ fn;k x;k fd] ifjoknh us vius ifjokn dks viuh lk{; ls lkfcr fd;k gS A vizkFkhZx.k dh lk{; ls muds }kjk yh xbZ izfrj{kk lkfcr ugha gksrh gS] vr% ifjokn Lohdkj fd;k tkdj pkgs x;s vuqrks"k fnyk;s tk;s A 27- geus mDr rdksZa ij euu fd;k rFkk i=koyh ,oa i=koyh ij miyC/k nLrkostksa dk voyksdu fd;k x;k vkSj mHk;i{k dh vksj ls izLrqqr U;kf;d n`"VkUrksa dk llEeku v/;;u fd;k A 28- ekStwnk ifjokn dk fuLrkj.k fd;s tkus gsrq mHk;i{k ds vfHkopuks]a lk{;] izLrqr fd;s x;s rdksZa ,oa U;kf;d n`"VkUrksa ds vuq:Ik fu/kkZj.k fd;s tkus ;ksX; fuEu fcUnq cuk;s tk jgs gSa%& 1- D;k ifjoknh dh iRuh Jherh lfjrk daoj dh e`R;q ifjoknh ds dFkukuqlkj vizkFkhZx.k }kjk bykt esa cjrh xbZ ykijokgh ds dkj.k gqbZ gS vFkok vizkFkhZx.k ds dFkukuqlkj ifjoknh dh iRuh Jherh lfjrk daoj dh e`R;q iwoZ ds rhu izlo ,oa ,d xHkZikr ds dkj.k gqbZ gS rFkk vizkFkhZx.k }kjk ifjoknh dh iRuh Jherh lfjrk daoj ds bykt esa dksbZ ykijokgh ugha cjrh xbZ gS \ 2- ifjoknh dh iRuh lfjrk daoj dh e`R;q gsrq dkSu&dkSu fdl gn rd mŸkjnk;h gS A 29- mHk;i{k }kjk mDr nksuksa fopkj.kh; fcUnqvksa ds lac/a k esa yxHkx la;qDr :Ik ls lk{;
izLrqr dh xbZ gS vkSj nksuksa iz'uksa dk fofu'p; ,d&nwljs ij fuHkZj gS] vr% lqfo/kk dh n`f"V ls mDr nksuksa iz'uksa ij la;qDr :Ik ls foospu fd;k tk jgk gS A 30- ekuuh; jk"Vªh; miHkksDrk fookn izfrrks"k vk;ksx us bl vk;ksx }kjk iwoZ esa ikfjr fu.kZ; fnuakd 06-06-2011 dks vius fu.kZ; fnuakd 02-11-2016 esa vikLr djrs gq, izdj.k bl funsZ'k ds lkFk izfrizsf"kr fd;k gS fd] **izdj.k dks rduhdh lk{; ds vk/kkj ij fu.khZr fd;k tkos** D;ksafd ekStwnk izdj.k fpfdRldh; ykijokgh ds dkj.k ls ifjoknh dh iRuh Jherh lfjrk daoj ,oa muds uotkr f'k'kq dh e`R;q gksus ds vk{ksiksa ds vk/kkj ij vizkFkhZx.k ds fo:) izLrqr fd;k x;k gS vkSj iwoZ esa ifjoknh dh vksj ls fpfdRldh; ykijokgh dks lkfcr fd;s tkus ds laca/k esa ;Fkksfpr lk{; izLrqr ugha dh xbZ Fkh A 31- gLrxr izdj.k esa ifjoknh ds HkwriwoZ lSfud gksus ds dkj.k mlds }kjk HkwriwoZ lSfud va'knk;h LokLF; ;kstuk esa ,d eq'r okafNr jkf'k tek djokdj vius Lo;a ,oa vius ifjokj ds lnL;ksa gsrq fpfdRlk ykHk lqfo/kk izkIr djus ds fy, dkMZ la[;k ih,u 0050299 tkjh djokuk vkSj bl dkMZ ds ek/;e ls vius Lo;a ,oa ifjokj ds lnL;ksa dh fpfdRlk ykHk fefyVªh gkWLihVy ,oa ECHS Polyclinic ls izkIr djuk fookfnr ugha gS A fnukad 08-04-2007 dks ifjoknh dh iRuh Jherh lfjrk daoj dk foi{kh la[;k 1 fefyVªh gkWLihVy esa xk;uksdksyksftLV ds ijke'kZ ls HkrhZ gksuk vkSj vizkFkhZ la[;k 1 fefyVªh gkWfLiVy esa dk;Zjr fpfdRld vizkFkhZ la[;k 2 ,o 3 }kjk ifjoknh dh iRuh dk bykt djuk Hkh fufoZokfnr gS A ifjoknh dh iRuh ds igys ls rhu cPps gksuk Hkh fookfnr ugha gS A vizkFkhZ la[;k 1 gkWfLiVy easa HkrhZ jgus ds nkSjku ifjoknh dh iRuh dk fnukad 10-04-2007 dks Uterus Rapture gks tkus ls fCyfMax ugh :dus ls mlds Hypovolmic Shock esa pys tkuk vkSj blds ifj.kkeLo:i dkfMZ;d vjsLV ds ckn gkbZiksfDld czsu Msest ds dkj.k ifjoknh dh iRuh ds dksek esa pys tkuk Hkh fookfnr ughaa gS A ifjoknh dh iRuh dk xks;y gkWfLiVy ,.M fjlpZ lsUVj izk-fy- ¼vizkFkhZ la[;k 5½] lapsrh gkWfLiVy ,.M dSalj bULVhV~;wV ¼vizkFkhZ la[;k 6½ rFkk dekMsUV cSl gkWfLiVy] fnYyh dsUV] fnYyh ¼vizkFkhZ la[;k 7½ esa bykt izkIr djuk vkSj fnuakd 08-03-2009 dks ifjoknh dh iRuh Jherh lfjrk daoj dh e`R;q gks tkuk Hkh fookfnr ugha gS A 32- izdj.k bl vk;ksx dks izfrizs"k.k ds i'pkr~ ifjoknh dh vksj ls MkWDVj tx:Ik eg:
dk 'kiFk&i= Hkh izLrqr fd;k x;k gS] tks iwoZ esa jktLFkku ljdkj es MBBS, MS(Gynec & Obst.) dh lsok,sa nsdj lsokfuo`Ÿk gq, Fks A mDr xokg us ifjoknh ds }kjk izLrqr vfHkys[kh; lk{; ds vk/kkj ij vius 'kiFk&i= esa fuEu vk'k; ds dFku fd;s gSa%& 1- e`rdk dk CyM xzqi **vks** usxsfVo Fkk A case history ds i`"B la[;k 35 ,oa 36 ds vuqlkj Patient was having Labor pains, with mentioning of 38 years old with G-4, P-3 lady with 38 weeks period of gestation presented with pain in lower abdomen sinch today morning. mlds iwoZ esa cq[kkj ,oa jDrL=ko ¼bleeding - PV) dh f'kdk;r ugha Fkh A vfHkYks[k ds vuqlkj ejht dk HkrhZ djokrs le; fnuakd 08-04-2007 dks fdlh chekjh ds y{k.k ugha n'kkZ;s x;s Fks A HkrhZ djkrs le; ofj"B fpfdRld ysf¶VusUV duZy vkj-,u-cuthZ }kjk cuk;s x;s uksV ds vuqlkj fn;s x;s funsZ'kksa esa ejht dks izR;sd 6 ?kaVs ds i'pkr~ Fatal Heart Rate (FHR) with DFMC ds funsZ'k fn;s x;s Fks vkSj bl laca/k esa dksbZ nLrkosth lk{; fefyVªh gkWfLiVy esas miyC/k ugha Fkk A ;gka ;g Hkh fy[kk tkuk lqlaxr gS fd] tks Hkh fpfdRldh; lk{; miyC/k Fkh] og ifjoknh us mDr gkWfLiVy dks miyC/k djokbZ] u fd fefyVªh gkWfLiVy us A vfHkys[k ds vuqlkj ,slk Li"V ugha gS fd] mDr fpfdRld us vLirky ls nLrkostksa dh ekax dh gks vkSj vLirky }kjk miyC/k djokus esa vleFkZrk tkfgj dh xbZ gks A 2- vfHkys[k ds vuqlkj fnuakd 09-04-2007 dks MkWDVj cuthZ us vius ejht dk ijh{k.k fd;k ,oa 10-04-2007 ls 2-5 ;wfuV Pitocin Injection nsus ds funsZ'k fn;s Fks] tks fd 40 drops/min. ds fglkc ls fn;k tkuk Fkk A ijh{k.k uksV ds vuqlkj ejht dks vlguh; nnZ Fkk 3- 'kiFk&i= ds inkad 07¼g) esa ;g Hkh fy[kk x;k gS fd] vfHkys[k esa active labour with monitor progress dk mYys[k fd;k gqvk ugha Fkk vkSj bl laca/k esa i`"B la[;k 38] vusDlpj&1 dks ml jk; vk/kkj cuk;k x;k gS A 4- 'kiFk&i= ds inkad 08 esa fnuakd 10-04-2007 dks nksigj **1300 hrs"
cts cuk;s x;s uksV esa bl vk'k; dk uksV yxk;k x;k gS fd] ** Patient collapsed in the II stage of Labor, No bleedning-PV, Diagnosed- Rapture Uterus ,oa Blood demand for shown to be 4 units"
5- blds vfrfjDr mDr 'kiFk&i= esa MkWDVj us bykt ds nkSjku ftu&ftu fpfdRldksa }kjk ejht dk ijh{k.k fd;k x;k] tks tkapsa dh xbZ vkSj tks&tks uksV~l fpfdRld }kjk cuk;s x;s] mudk foLr`r mYys[k fd;k x;k gS] ftlesa vizkFkhZ la[;k 2 ysf¶VusUV duZy ¼MkWDVj½ vkj-,u-cuthZ ,oa vizkFkhZ la[;k 3 ysf¶VusUV duZy ¼MkWDVj½ jhrk flag }kjk cuk;s x;s uksV~l eq[; :Ik ls of.kZr fd;s x;s gSa A 6- 'kiFk&i= ds inkad la[;k 11 esa ;g dgk x;k gS fd] **mDr vk/kkjksa ij eSa ;g ikrk gwa fd ejht ds bykt esa xEHkhj =qfV jgh gS] tks fefyVªh vLirky ds fpfdRldksa dh ykijokgh dks n'kkZrh gS D;ksafd mu fpfdRldksa }kjk jk"Vªh; ,oa vUrjkZ"Vªh; Lrj ij tkjh fn'kk&funsZ'kksa vkSj vk/kkfjr fl)kUrksa dh ikyuk ugha dh xbZ gS A** ejht dk bZykt fnuakd 08-04- 2007 ls 'kq: gqvk vkSj mldk Uterus Rupture gksus dh fnuakd 10-04- 2007 rd bykt fd;k x;k A fpfdRld }kjk fn;s x;s funsZ'kksa ds ckotwn agj N% ?kaVs ckn FHR (Fetal Heart Rate) ntZ ugha fd;k x;k A ejht dk mls HkrhZ djok;s tkus dh fnuakd ls fMyhojh dh fnuakd rd D.C.Dutta's dh textbook ds i`"B la[;k 606&607 ds vuqlkj "Partograph" la/kkfjr fd;k tkuk pkfg;s] tks ugha fd;k x;k A vr% vk/kkj ij ;g dgk tk ldrk gS fd] fefyVªh gkWfLiVy ds fpfdRldks }kjk ykijokgh cjrh xbZ gS vkSj Word Heath Orgnisation (W.H.O.) }kjk o"kZ 1994 esas tkjh fd;s x;s fn'kk&funsZ'kksa dh ikyuk Hkh ugha dh xbZ gS A 7- 'kiFk&i= esa ;g Hkh vafdr fd;k x;k gS fd] ejht dks HkrhZ djrs le; fefyVªh gkWfLiVy ds fpfdRldksa us ;g ik;k Fkk fd] ekrk Rh Negative gS] mlds ckotwn fu/kkZfjr izksVksdkWy ugha viuk;k x;k A nLrkost vusDlpj&1 ds voyksdu ls ;g izdV gksrk gS fd bykt esa tks xEHkhjrk cjrh tkuh pkfg;s Fkh] og ugha cjrh xbZ A ejht ds ifr ds CyM xzqi dk ijh{k.k fd;k tkuk pkfg;s Fkk] tks ugha fd;k x;k A ejht dks Anti- D Injection Hkh ugha fn;k x;k A 8- 'kiFk&i= ds inkad la[;k 11¼k½ esa xokg us ;g Hkh dFku fd;k fd] **Induction of labor is permissible after 40 weeks + 7 days of gestation and it is clearly restriction of induction of labor for woman with an uncomplicated pregnancy at gestation age less than 41 weeks, while the documents with Annexure-1 clearly shows that the patient was with gestation of 38 Weeks only and as per W.H.O. Recommendations, the Hospital Doctors have not cared to consider the standard recommendation and the parametres prescribed for induction labor."
9- 'kiFk&i= ds inkad la[;k 11¼s½ esa ;g vfHkfyf[kr fd;k x;k gS fd] ejht ds ifr Jh Kku izdk'k pkSgku ds dFkukuqlkj mlds CyM xzqi dh tkap dHkh ugha dh xbZ vkSj xyrh ls mldk CyM xzqi vusDlpj&1 ds ist la[;k 20 ij **ch** ikWthfVo fy[k fn;k x;k] tcfd okLro esa mldk CyM xzqi **,** ikWthfVo Fkk A 10- MkWDVj tx:Ik eg: us vius 'kiFk&i= ds var esa ;g dFku fd;k gS fd] vusDlpj&1 ds voyksdu ls ;g Li"V :Ik ls izdV gksrk gS fd jk"Vªh; vkSj vUrjkZ"Vªh; Lrj ij tkjh fn'kk&funsZ'kksa dh ikyuk fefyVªh gkWfLiVy ds fpfdRldksa }kjk ugha dh xbZ 33- ;gka ;g fy[kk tkuk Hkh lqlaxr gS fd] ifjoknh dh vksj ls fnuakd 10- 11-2022 dks ,d izkFkZuk&i= nLrkost miyC/k djok;s tkus ds laca/k esa izLrqr fd;k x;k A izkFkZuk&i= esa iwoZ vkns'k fnuakd 17-09-2015 dk mYys[k djrs gq, dFku fd;k x;k fd] esfMdy dsl'khV QkWeZ la[;k 7A ] tks dqy 18 i`"B dk nLrkost gS] essa ls dsoy i`"B la[;k 10 o 11 gh miyC/k djok;s x;s] 'ks"k miyc/k ugha djok;s x;s] bu rF;ksa dh tkudkjh mUgsa dy gh cgl vafre dh rS;kj ds nkSjku gqbZ A vr% izkFkZuk&i= Lohdkj fd;k tkdj vizkFkhZ la[;k 1 yxk;r 3 dks funsZf'kr fd;k tkos fd] os esfMdy dsl'khV leLr 18 i`"Bksa esa miyC/k djokbZ tkos A ifjoknh }kjk izLrqr mDr izkFkZuk&i= ij cgl lquh tkdj mlh fnu izkFkZuk&i= dk fuLrkj.k fd;k x;k vkSj pwfa d nLrkost vizkFkhZ la[;k 1 yxk;r 3 }kjk fnuakd 02-11-2016 dks gh miyC/k djok fn;s x;s Fks] blds i'pkr~~ 'kiFk&i= Hkh izLrqr fd;s tk pqds gSa vkSj cgl vafre Hkh lquh tk pqdh gS] blfy, ;g ekurs gq, fd] ifjoknh dk ;g dguk xyr gS fd mls bl rF; tkudkjh dy gh gqbZ gS fd QkWeZ la[;k 7A ds lHkh 18 i`"B miyC/k ugha djok;s x;s A vizkFkhZx.k dh ?kksj vkifŸk ds vk/kkj ij ifjoknh }kjk izLrqr izkFkZuk&i= [kkfjt fd;k x;k A lkj :Ik esa vizkFkhZx.k dh ykijokgh dks lkfcr djus ds fy, tks nLrkost izLrqr djok;s tk ldrs Fks] os le; jgrs izLrqr ugha djok;s x;s gSa A ifjokn ewy :Ik ls o"kZ 2009 esa izLrqr gqvk Fkk A lkekU; Øe esa ;g ckr ekuus ;ksX; ugha gS fd izkFkZuk&i= izLrqr fd;s tkrs le; o"kZ 2022 rd o"kZ 2007 ds bykt ds nLrkost vLirky }kjk la/kkfjr j[ks tkos A ifjoknh Lo;a dk nkf;Ro Fkk fd] ewy ifjokn ds yfEcr jgus ds nkSjku gh le; jgrs og fefyVªh gkWfLiVy ls vko';d nLrkost izkIr dj izLrqr djrk vFkok bl vk;ksx ds ek/;e ls fefyVªh gkWfLiVy ls izLrqr djokrk] tks ifjoknh }kjk ugha fd;k x;k vkSj yEcs varjky ds ckn nLrkost u"V fd;s tkus vFkok vU; fdlh dkj.k ls bl vk;ksx ds le{k izLrqr ugh gks lds A bl gsrq lEiw.kZ :Ik ls vizkFkhZx.k dks nks"kh ugha Bgjk;k tk ldrk A viz kFkhZx.k bl ckr dh vis{kk ugha dj ldrs Fks fd] nLrkost ifjoknh }kjk ckn esa fdlh Hkh le; izLrqr djokus dk izkFkZuk&i= is'k fd;k tk ldsxk A 34- ;gka ;g fy[kk tkuk Hkh lqlaxr gS fd] MkWDVj tx:Ik eg: us ifjoknh }kjk muds le{k izLrqr dh xbZ nLrkosth lk{; ds vk/kkj ij viuh jk; nh gS A mlus ifjoknh dh iRuh Jherh lfjrk daoj dk bykt vFkok ijh{k.k ugha fd;k Fkk] vr% MkWDVj tx:Ik eg: dks fo'ks"k :Ik ls ejht ds laca/k esa O;fDrxr tkudkjh ugha gksus ls dsoy ifjoknh }kjk muds le{k izLrqr nLrkosth lk{; ds voyksdu ds vk/kkj ij esfMdy ds fl)kUrksa dks vk/kkj cukdj MkWDVj tx:i eg: }kjk jk; izLrqr dh xbZ gS A 35- ifjoknh dh vksj ls izLrqr lk{; ds [k.Mu esa fnuakd 14-11-2022 dks vizkFkhZ la[;k 1 yxk;r 3 rFkk 7 o 8 dh vksj ls fo'ks"kK lk{; ds :Ik esa ysf¶VusUV duZy ¼MkWDVj½ jfoUnq izHkkr frokM+h dk 'kiFk&i= izLrqr fd;k x;k] ftUgksua s vius 'kiFk&i= esa Li"Vr% dFku fd;k gS fd] ejht LoxhZ; lfjrk daoj dh pkSFkh fMyhojh Fkh A mlds igyh larku chl o"kZ dh] nwljh larku pkSng o"kZ dh ,oa rhljh larku <kbZ o"kZ dh thfor :Ik esas ekStwn Fkh A fnuakd 08-04-2007 dks ysf¶VusaV duZy cuthZ us tc ejht dk ijh{k.k fd;k] rc mldh Fatal Heart Rate (FHR) 130/per minute ntZ dh xbZ Fkh] tks muds dsl uksV fnuakd 09-04-2007 ls izdV gks jgh gS A fnuakd 10-04-2007 ds dsl uksV d vuqlkj mDr Fatal Heart Rate (FHR) nj 130/per minute Fkh] ftldh iqf"V i`"B la[;k 38 ls gks jgh gS A ysf¶VusUV duZy vkuUn cuthZ ds Introductive Statement ds inakd la[;k 6 fnuakd 09-04-2007 ds vuqlkj ejht dh voLFkk dks ns[krs gq, mls fnuakd 10- 04-2007 dks 2-5 ;wfuV Pitocin Injection fn;s tkus dk fu.kZ; fy;k x;k Fkk A blesa fdlh izdkj dh vfu;ferrk ugha Fkh A Introductive Statement ds inkad la[;k 7 ds vuqlkj ejht ds Labour Progress dks fu;fer :Ik ls la/kkfjr fd;k tk jgk Fkk A ejht dk TPR, BP rFkk FHR gj N% ?kaVs esa la/kkfjr fd;k tk jgk Fkk A ejht dk Indirect Combo Test (ICT) fu;fer :Ik ls fd;k tk jgk Fkk A Antenatal Card ds i`"B la[;k 22 ls izdV gS fd ejht dk Indirect Combo Test (ICT) Negative Fkk] ftldh iqf"V i`"B la[;k 37 ls gks jgh gS A blds vfrfjDr RH Negative Status ,oa Rapture to Uterus ijLij lacaf/kr@vk/kkfjr ugha gS A ejht dks igys Anti-D Injuction ugha fn;k x;k Fkk A Uterus dk Rapture gksuk Threatening Emergency Fkh vkSj tgka ejht dh tku cpkus ds fy, mldk vkWijs'ku fd;k tkuk vko';d gks] ,slh fLFkfr esa tc ejht vf/kd jDrL=ko gksus ds dkj.k csgks'kh dh vOkLFkk esa gks] rc ejht dh lgefr dh vo/kkj.kk dh tk ldrh gS ¼,slh fLFkfr esa gekjs fouez er esa ejht ds gLrk{kj ds LFkku ij mlds vaxq"B fu'kku fy;ss tkus dks Hkh xyr ugha ekuk tk ldrk gS½ A pwfa d ejht ds Øe'k% chl] pkSng ,oa <kbZ o"kZ ds thfor cPps ekStwn Fks] ,slh fLFkfr esa ifjoknh dh vksj ls izLrqr fo'ks"kK dk ;g dguk lgh ugha gS fd] ejht RH Negative Fkk vkSj mlds fy, fujUrj izksVksdkWy dh ikyuk ugha dh xbZ A ml le; rd bykt ds nkSjku ejht ds [kwu dh dksbZ deh ugha ikbZ xbZ Fkh D;ksfa d ejht dk fu;fer :Ik ls Indirect Combo Test (ICT) fd;k tk jgk Fkk A 'kiFk&i= ds inkad 11¼e½ esa fd;s x;s dFku lkekU; izd`fr ds gS] muesa ls fdlh Hkh vk/kkj ij jk"Vªh; vFkok vUrjkZ"Vªh; Lrj ij LSCS djus dh vko';drk gksuk ugha ekuk tk ldrk A 36- ifjoknh dh vksj ls izLrqr fo'ks"kK us lkekU; ifjfLFkfr;ksa ds vuqlkj viuh jk;
izLrqr dh gS A MkWDVj vkj-,u-cuthZ }kjk rS;kj fd;s x;s case note ds voyksdu ls Kkr gksrk gS fd] fefyVªh gkWfLiVy ds fo'ks"kK ,oa uflZax LVkQ }kjk ejht dh fujUrj ns[kHkky dh tk jgh Fkh A Pitocin Injection fnuakd 10-04-2007 dks lqcg fn;k x;k Fkk ,oa Lo;a fo'ks"kK ds vuqlkj Labor Progress tkap djus ds ckn jksd fn;k x;k Fkk A ;g t:jh ugha gS fd] Uterus dk Rapture gksuk iw.kZ :i ls fpfdRldkas dh ykijokgh ls lacfa /kr gks A Antinatle Notes ds vuqlkj ejht dk LMP fnuakd 01-07-2006 dk Fkk A ejht fnuakd 08-04-2007 dks Lo;a vkdj gkWfLiVy esa HkrhZ gqbZ Fkh vkSj ejht dk EDD fnuakd 08-04-2007 dk gS A ftl le; ejht gkWfLiVy ess HkrhZ gqbZ] ml le; mlds 40 lIrkg dk xHkZ Fkk A xHkZorh dk lgh vkdyu LMP ,oa EDD Dates ls fd;k tk ldrk gS] ftldk ifjoknh dh vksj ls izLrqr fo'ks"kK ds dFkuksa ds vuqlkj [k.Mu gks jgk gSA avizkFkhZ la[;k ,d ls rhu ds vuqlkj World Health Organisation (W.H.O.) ds fn'kk&funsZ'kksa ,oa vuq'kavksa dh ikyuk dh xbZ Fkh A ejht dks dHkh&Hkh misf{kr voLFkk esa ugha NksM+k x;k Fkk rFkk mldh fo'ks"kKksa }kjk fujUrj ns[kHkky dh tk jgh Fkh A Hkwz.k dh e`R;q Uterus Rapture ds dkj.k gqbZ Fkh A ejht dh dsl fgLVªh ds vuqlkj mldh fu;fer :Ik ls tkap dh tkdj gLrk{kfjr dh tk jgh Fkh A bu rF;ksa dh iqf"V i`"B la[;k 24 ls gks jgh gS A Raptured Uterus dks Histopathological tkap ds fy, iz;ksx'kkyk Hkstk x;k Fkk] ftldh fjiksVZ Hkh 330&331@2007 fnuakd 27-04-2007 gS A pwfa d ejht dk CyM xzqi *vks* usxsfVo Fkk vkSj mldks Indirect Combo Test (ICT) Negative ik;k x;k Fkk] vr% ifr dk CyM xzqIk Rh Positive ekuk x;k A ifjoknh dh vksj ls yxk;k x;k ;g vkjksi xyr gS fd fpfdRldksa us mldh iRuh ds bykt ds nkSjku ykijokgh cjrh gks ijUrq bl laca/k esa lqn`<+ nLrkosth lk{; is'k ugha gqbZ gS A 37- vizkFkhZ la[;k 6 lapsrh gkWfLiVy ,.M dSalj bULVhV~;wV dh vksj ls MkWDVj lqjs'k lapsrh ,oa vizkFkhZ la[;k 4 ,oa 5 dh vksj ls vizkFkhZ la[;k 5 MkWDVj jktho ekFkqj us fnuakd 12-05-2022 dks 'kiFk&i= izLrqr fd;s x;s gSa] ftUgksua s vius 'kiFk&i=ksa esa ;g dFku fd;k gS fd] MkWDVj tx:Ik eg: ds 'kiFk&i= esa vizkFkhZ la[;k 6 lapsrh gkWfLiVy ,.M dSalj bULVhV~;wV ,oa vizkFkhZ la[;k 4 xks;y gkWfLiVy ,.M fjlpZ lsUVj izk-fy- ds }kjk u rks dksbZ fpfdRldh; ykijokgh cjruk crk;k x;k gS vkSj u gh muds fo:) ejht ds bykt esa fdlh izdkj dh ykijokgh vkSj vlko/kkuh cjruk crk;k x;k gS A MkWDVj lqjs'k lapsrh ds vuqlkj ejht dHkh&Hkh muds vLirky esa bykt gsrq ugha vkbZ Fkh A vr% mUgksaus vius lanHkZ esa ifjokn [kkfjt fd;s tkus dh izkFkZuk dh A 38- ifjoknh dh vksj ls fnuakd 15-06-2022 dks vizkFkhZ la[;k 4 ds uke dk la'kks/ku djokus gsrq ,d izkFkZuk&i= izLrqr fd;k x;k] ftl ij fnuakd 16- 06-2022 dks cgl lquh xbZ A vkns'k fnuakd 17-06-2022 ds tfj;s izkFkZuk&i= Lohdkj fd;k tkdj vizkFkhZ la[;k 4 dk lgh uke xks;y gkWfLiVy ,.M fjlpZ lsUVj izk - fy- djus dk vkns'k nsrs gq, la'kksf/kr okn 'kh"kZd izLrqr djus ds vkns'k fn;s x;s A bl izdkj ls vizkFkhZ la[;k 4 dh vksj ls mBkbZ xbZ rduhdh =qfV dks Hkh nq:Lr fd;k tk pqdk gS A 39- mijksDr foospu ds ifjizs{; esa vizkFkhZx.k }kjk ifjoknh dh iRuh Jherh lfjrk daoj ds bykt ds nkSjku fpfdRldh; ykijokgh cjrh xbZ gS vFkok ugha] bl laca/k esa mHk;i{k dh vksj ls izLrqr U;kf;d n`"VkUrksa dk Hkh geus llEeku v/;;u fd;k gS A ge fo}ku vf/koDrk ifjoknh dh vksj ls izLrqr U;kf;d n`"VkUrksa esa izfrikfnr fl)kUrksa ls fl)kUrr% iw.kZr% lgefr j[krs gSa] fdUrq rF;ksa dh fHkUurk ds dkj.k mDr U;kf;d n`"VkUrksa dks gLrxr izdj.k esa ;Fkk:Ik pLik fd;k tkuk mfpr vkSj vko';d izrhr ugha gksrk gS A 40- ifjoknh dh vksj ls izLrqr U;kf;d n`"VkUrksa jktLFkku jkT; miHkksDrk fookn izfrrks"k vk;ksx] t;iqj] QLVZ vihy uacj 1596@2011&ds-th- 'kekZ cuke vkWfQlj bapktZ] ,Dl lfoZlesu dkWUVªhC;wWVjh gsYFk Ldhe] izdj.k la[;k ,@14@716&LVs'ku dek.Mj ,Dl&lfoZleSu dkWUVªhC;wVjh gsYFk Ldhe bZlh,p,l ikWfyfDyfud cuke Hktu flag] iatkc o gfj;k.kk mPp U;k;ky;] p.Mhx<+] lh MCY;w ih uacj 5865@2007 & duZy gjca'k flag ¼fjVk;MZ½ cuke nh ;wfu;u vkWQ bf.M;k o vU;] fu.kZ; fnukad 16-10-2008 ,oa ekuuh; loksZPp U;k;ky;] MANU/SC/1749/2019 - egkjktk vxzlsu gkWfLiVy o vU; cuke _"kHk 'kekZ o vU; esa izfrikfnr fl)kUrksa ds vuqlkj ifjoknh ECHS dk lnL; gksus lss miHkksDrk dh ifjHkk"kk esa vkrk gS ,oa miHkksDrk vk;ksx ds le{k ifjokn izLrqr djus ds fy, l{ke O;fDr gS A bl ckr dk fof'k"B fojks/k Lo;a vizkFkhZx.k dh vksj ls Hkh ugha fd;k x;k gS] vr% bu U;kf;d n`"VkUrksa dks bl gn rd ifjoknh ds i{k esa ekuk tkrk gS rFkk bu U;kf;d n`"VkUrksa ds 'ks"k rF; ekStwn izdj.k ls fHkUurk j[kus okys gSa A ekuuh; loksZPp U;k;ky; ds egkjktk vxzlsu gkWfLiVy o vU; cuke _"kHk 'kekZ o vU; okys ekeys esa {ks=kf/kdkj ds vykok gkWfLiVy esa MkWDVjksa dks blfy, nks"kh ekuk x;k D;ksafd vkWijs'ku ls iwoZ ejht dk Retinopathy of Prematurity (ROP) check-up ugha fd;k x;k Fkk] bl dkj.k fu/kkZfjr le; ls iwoZ tUe ysus okys cPps dks iw.kZ va/krk ¼Total Blindness½ dk lkeuk djuk iM+k Fkk A 41- ifjoknh dh vksj ls izLrqr ekuuh; jk"Vªh; miHkksDrk fookn izfrrks"k vk;ksx ds U;kf;d n`"VkUr fjohtu fiVh'ku uacj 2489&2490@2018& fd'ku flag cuke fefyVªh gkWfLiVVy o vU;] fu.kZ; fnukad 05-08-2019 esa ejht dk iw.kZ ekufld fodkl ugha gqvk Fkk o mls o"kZ 1999 ls vfodflr efLr"d dk jksxh ik;k x;k Fkk A HkrhZ djkus ds le; ejht dks gYdk cq[kkj Fkk] dQ rFkk 'olu ra= esa Hkh fiNys dqN fnuksa ls rdyhQ Fkh] ejht 6&7 fnuksa ls eqag ls xzg.k ugha dj ik jgk Fkk vkSj ejht vius vki ls cSBus ;k [kM+s gksus dh fLFkfr esa Hkh ugha Fkh] mlds ckotwn mls DNS-IV dh nks cksrysa 500 ,e-,y] eYVhfoVkfeu batsD'kUl ,oa ,aVhck;ksfVDl nh xbZ A DNS-IV 10-20 ih-,e- ij fn;k x;k A [kwu dh tkap mlds ckn dh xbZ] ml le; og e/kqesg dk jksxh ik;k x;k vkSj ejht esa e/kqesg dh izkjfEHkd voLFkk ds y{k.k ik;s x;s A fueksfu;k dk vlj mlds cka;s QsQM+ksa esa ik;k x;k vkSj pwfa d fjiksVZ vkus ls iwoZ ejht dks DNS-IV futZfyr voLFkk ¼dehydrated state½ ls cpkus ds fy, fn;k x;k Fkk] vr% bls fpfdRld dh ykijokgh ugha ekuk x;k A 42- ifjoknh dh vksj ls izLrqr ekuuh; loksZPp U;k;ky; ds U;kf;d fofu'p; 1969 , vkbZ vkj 128 & y{e.k ckyfd'ku tks'kh cuke f=Ecd ckiw xksycksys o vU;] fu.kZ; fnukad 02-05-1968 esa ekuuh; loksZPp U;k;ky; us ;g fn'kk&funsZ'k tkjh fd;s gSa fd] fo'ks"kK fpfdRldksa dks bykt ds nkSjku D;k&D;k lko/kkfu;ka cjruh pkfg;s A muds eq[; nkf;Ro D;k gksx a s] ftlesa izFke nkf;Ro ;g gS fd os bl ckr dk /;ku j[ks fd D;k mls dsl bykt ds fy, xzg.k djuk pkfg;s] f}rh; nkf;Ro ejht dk D;k bykt fd;k tkuk pkfg;s vkSj r`rh; ejht ds bykt esa D;k lko/kkfu;ka cjrh tkuh pkfg;s A ml izdj.k esa ifjoknh ds iq= ds cka;s iSj dh Qhej gM~Mh dk vfLFk Hkax nq?kZVuk esa gqvk Fkk A 9 ebZ dks ejht dks vihykFkhZ vLirky esa HkrhZ djok;k x;k] tks ogka ls 200 fdyksehVj nwj Fkk A mDr nwjh VSDl esa 11 ?kaVs ;k=k+ djds r; dh xbZ A vihykFkhZ us nks batsD'ku nsus ds funsZ'k fn;s Fks] tcfd dsoy ,d gh batsD'ku fn;k x;k A mlds ckn vkWijs'ku fFk;sVj esa dqN bykt fd;k x;k A ifjpkjd dks ;g vk'oLr fd;k x;k fd] 5-30 ih-,e- rd ejht dh fu'psruk nwj gks tk;sxh] ijUrq ,slk ugha gqvk A ejht dh gkyr fujUrj fcxM+rh jgh A ejht dks nwljk batsD'ku ugh fn;k x;k vkSj u gh funsZ'kksa ds vuqlkj 'ks"k bykt fd;k x;k A bykt djus okyk MkWDVj bykt iw.kZ gksus ls iwoZ gh vLirky dks NksM+dj vU; txg] tgka og viuh izkbosV izsfDVl djrk Fkk] ogka pyk x;k vkSj bykt ds nkSjku jkr 9-00 cts ejht dh e`R;q gks xbZ rFkk fo'ks"kK lk{; ds vuqlkj ejht dh e`R;q ds laca/k esa fo'ks"kK dh jk; ;g Fkh fd] **death was due to shock resulting from reduction of the fracture attempted by the appellant without taking the elementary caution of giving anaesthetic to the patient."0 43- ifjoknh dh vksj ls izLrqr ekuuh; loksZPp U;k;ky; ds U;kf;d n`"VkUr flfoy vihy uacj 2641@2010&oh-fd'ku jko cuke fuf[ky lqij Lisf'k;fyVh gkWfLiVy o vU;] fu.kZ; fnukad 08-03-2010 okys izdj.k esa Hkh ifjoknh dh iRuh dks fnuakd 20-07-2002 dks HkrhZ djok;k x;k Fkk] ftls :d&:d dj cq[kkj vkus dh f'kdk;r Fkh A mldh dqN tkapsa dh xbZ] ftleasa og eysfj;k dh ejht ikbZ xbZ A bykt ds nkSjku tks nokbZoka mls nh xbZ] mlls ejht dh gkyr esa lq/kkj ugha ik;k x;k A fnuakd 22-07-2002 dks mls izR;FkhZ la[;k 2 ds ;gka HkrhZ fd;k x;k] tc mls Saline (yo.k;qDr ?kksy) fiyk;k x;k A Lo;a ifjoknh us ns[kk Fkk fd Sline dh cksry essa dqN Particles (d.k) ik;s x;s Fks A vxys fnu fnuakd 23-07-2002 dks ifjoknh dh iRuh dks lkal dh rdyhQ eglwl gqbZ A ;g rF; vLirky ds MkWDVj dh tkudkjh esa yk;k x;k A ejht dks vkWDlhtu nsus dh fgnk;r nh xbZ A ejht dh gkyr fujUrj fcxM+rh xbZ A ekuuh; loksZPp U;k;ky; us ekuuh; jk"Vªh; miHkksDrk fookn izfrrks"k vk;ksx ds fu.kZ; dks vikLr djrs gq, ftyk miHkksDrk fookn izfrrks"k vk;ksx ds fu.kZ; dks bl vk/kkj ij lgh ekuk fd] vkWDlhtu miyC/k ugha gksus dks MkWDVj dh deh ugha ekuh tk ldrk] ;g vLirky dh deh gS vkSj vLirky ls ifjoknh dks eqvkotk fnykus ds vkns'k dks cgky j[kk x;k A 44- ifjoknh dh vksj ls ekuuh; jk"Vªh; miHkksDrk fookn izfrrks"k vk;ksx ubZ fnYyh ds izLrqr U;kf;d n`"Vkar izFke vihy la[;k 208@2008 eksgu nk; vksloky dsalj VªhVesVa ,.M fjlpZ Qkm.Ms'ku o vU; cuke iz'kkar ljhu o vU; ,oa vU; vihy la[;k 292@2008 o 373@2008 vihyksa ds la;qDr ekeys esa izdj.kksa ds rF; Hkh fHkUurk j[kus okys gSa A mDr U;kf;d n`"Vkar ds inkad&3 ds vuqlkj ejht ds dSalj Fkk mls pkj pØksa esa dheks FkSjis h nh tkuh Fkh ftlesa 11 batsD'ku vincristine 1 mg ds intravenously ¼varf'kZjh; ½ fof/k ls ufy;ksa esa yxk;s tkus Fks vkSj 14 batsD'ku Methotrexate ds intrathecally ¼var efLrdkoj.kh;½ rjhds ls yxk;s tkus Fks A mDr bZykt ikap eghus esa iw.kZ gksuk Fkk A MkDVj jeu vjksM+k ejht ds bZykt djus ds le; izHkkjh Fks ] tks fd esfMlu foHkkx ds v/;{k Hkh Fks A ejht dks dsoy rhu pØ dheks FkSjis h nh x;h A bl chp ejht dk fnukad 13-03-2004 dks bone marrow VsLV Hkh gqvk Fkk A mDr U;kf;d n`"Vkar ds inkad&4 ds vuqlkj MkDVlZ dks mDr bZykt ds fy, tks izksVksdksy fu/kkZfjr Fkk mudk v/;;u djuk pkfg, Fkk ftldh le; lhek fu/kkZfjr dh gqbZ Fkh A batsD'ku ftl izdkj ls fn;s tkus Fks] ml izdkj ls ugha fn;s x;s] bZykt ftl izdkj ls fd;k tkuk Fkk ml izdkj ls ugha fd;k x;k] vr% MkDVj y{e.k cky d`".k tks'kh cuke MkDVj f=Ecd ckcw xksMcksys okyk izdj.k tks ,-vkbZ-vkj- 1969 ,l-lh- 128 esa izdkf'kr gqvk Fkk] esa izfrikfnr bZykt ds nkSjku fpfdRld }kjk cjrh tkus okyh lko/kkfu;ksa dk mYys[k djrs gq, ;g izfrikfnr fd;k x;k fd buesa ls fdlh Hkh 'krZ dk mYya?ku fd;k tkuk fpfdRldh; ykijokgh ekuk tk,xk vkSj ;g izfrikfnr fd;k x;k fd Failure to act in accordance with the medical standards in vogue and failure to exercise due care and diligence are generally deemed to constitute medical negligence.
45- U;kf;d n`"Vkar iadt vkj-Vksijkuh o rhu vU; cuke cksEcs gkWLihVy ,.M fjlpZ o vU; okyk izdj.k ekuh; jk"Vªh; vk;ksx }kjk fnukad 04-07-2019 dks ikfjr fd;k x;k Fkk A mDr izdj.k esa 73 o"khZ; ejht Fkk mls vLirky esa fnukad 26-06-2004 dks vkWijs'ku ds fy, HkrhZ djk;k x;k Fkk A ejht vkSj mlds ifjtuksa dks ;g crk;k x;k Fkk fd ejht dks okMZ esa f'k¶V fd;k tk jgk gS ijUrq ejht dks iksLV vkWijsfVo vkbZ-lh-;w-esa f'k¶V fd;k x;k vkSj ;g lwfpr fd;k x;k fd ejht dks vkWCtjos'ku esa j[kus ds fy, vkbZ-lh-;w- esa f'k¶V fd;k tk jgk gS] tcfd ejht dh gkyr vPNh ugha Fkh] mls xys esa nnZ eglwl gks jgk Fkk] lkal ysus esa rdyhQ gks jgh Fkh] laosnuk ckj&ckj :d jgk Fkk g`n~; xfr vlkekU; gksdj ean Lianu dh Fkh] csgks'kh o ,saBu tSlh fLFkfr Fkh ftl dkj.k mldh l?ku ns[kHkky djus dh vko';drk Fkh A mls lakl ysus esa gks jgh dfBukbZ ds fy, Ambu bag dh lgk;rk yh x;h ] ckn esa osVa hysVj ij f'k¶V fd;k x;kA ,slh fLFkfr esa g`n~; jksx fo'ks"kK MkDVj ok?kys dks cqyk;k x;k ijUrq oks yEcs le; rd miyC/k ugha gq,] vU; miyC/k g`n~; jksx fo'ks"kK MkDVj }kjk mldk bZykt fd;k x;k A ejht dks Bradycardia Attack dh f'kdk;r crk;h x;h A fear or anxiety dh f'kdk;r Hkh crk;h x;hA blfy, mls U;wjksyksftLV dks Hkh fn[kk;k x;k A vr% MkDVj y{e.k cky d`".k tks'kh cuke MkDVj f=Ecd ckcw xksMcksys okys izdj.k esa izfrikfnr fl)kar ds vk/kkj ij ;g izfrikfnr fd;k x;k gS fd %& Failure to act in accordance with the medical standards in vogue and failure to exercise due care and diligence are generally deemed to constitute medical negligence. vkSj ;g Hkh ik;k x;k fd ejht dh ns[kHkky fu;fer :i ls ugha dh tk jgh Fkh] blfy, ekuk x;k fd ejht ds izfr ykijokgh cjrh x;h gS vkSj ;g fpfdRldh; ykijokgh dk ekeyk gS A 46- U;kf;d n`"Vkar fpjkt ts-xTtj cuke Mk- 'kSQkyh 'kkg tks fd vihy la[;k 1146@2013 xqtjkt jkT; miHkksDrk vk;ksx vgenkckn }kjk fnukad 25-01-2022 dks fuf.kZr dh x;h Fkh A xHkZorh efgyk dks yscj isu gksus ij foi{kh vLirky esa fnukad 12-08-2010 dks lqcg 10-00 cts ls 12-00 cts ds chp HkrhZ djk;k x;k Fkk] vko';d tkapsa dh x;h fpfdRld us vkWijs'ku djk;s tkus ij tksj fn;k tcfd lkekU; izlo dh laHkkouk Fkh] ;g Hkh Fkk fd ejht ds 'kjhj esa i;kZIr jDr ugha Fkk] 2-15 ih-,e- ij izlwrk dks vkWijs'ku fFk;sVj esa ys tk;k x;k tgka mlus nks tqM+ok yM+dksa dks tUe fn;k] vkWijs'ku ds rqjUr ckn vkWijs'ku djus okyk MkDVj vLirky ls fudy x;k tcfd vkWijs'ku ds ckn ls izlwrk dks vlguh; nnZ gks jgk Fkk vkSj mls jDrL=ko Hkh gks jgk Fkk mlds jDrpki c<+ x;k Fkk A vxys fnu rd ew=L=ko ugha gqvk Fkk] ckj&ckj lwfpr djus ds ckotwn Hkh uflZax LVkWQ us izlwrk dh ns[kHkky ugha dh ,oa fpfdRld Hkh jkf= 7-000 cts rd vLirky ugha ykSVs ,oa dsoy ulZ dks nnZ de gksus dk batsD'ku nsus dk funsZ'k fn;kA izlrw k dh mfpr ns[kHkky ugha gksus ls ejht dh gkyr fcxM+hA izlwrk dk 11 ckj Mk;ysfll fd;k x;k ijUrq mldh gkyr esa lq/kkj ugha gqvk ,slh fLFkfr esa fnukad 07-09-2010 dks lqcg 10-00 cts izlwrk dks fdMuh gkWLihVy esa HkrhZ djk;k x;k tgka mls rRdky vkWDlhtu nh x;h vkSj fnukad 08-09-2010 ls 18-12-2010 rd yxkrkj osaVhysVj ij j[kk x;k A ejht dksek esa pyk x;k Fkk A ,slh fLFkfr esa fpfdRldh; ykijokgh dk ekeyk ekuk x;k Fkk A 47- ekuuh; jk"Vªh; vk;ksx us vihy la[;k 178@2008 tks fd euhiky gkWLihVy cSaxyksj o vU; cuke vyÝsM csusfMDV o vU; ntZ gqbZ Fkh] dks vius fu.kZ; fnukad 22-05- 2013 ds }kjk fuf.kZr fd;k A mDr izdj.k esa fpfdRldh; nLrkostksa ds vuqlkj intra-arterial ¼/kefu;ksa ds Hkhrj yxus okyk½ batsD'ku tks fd radial artery (branch of artery elbow to forearm and wrist) esa yxkuk xsx a jhu ¼gangrene ½ dk eq[; dkj.k jgk A ejht dh mfpr ns[kHkky ugha dh x;h] tkap fjiksVksZa dk lgh la/kkj.k ugha fd;k x;k] pkVZ ,oa xzkQ cukus esa =qfV j[kh x;h vr% ;g ekuk x;k fd ;g fpfdRldh; ykijokgh dk ekeyk gS A blds vfrfjDr ml izdj.k esa izR;FkhZ vLirky ds MkDVj ;g Li"V djus esa vlQy jgs fd ejht ds lh/ks gkFk esa xsx a jhu fdl dkj.k ls gqvk A 48- ekuuh; loksZPp U;k;ky; us nhokuh vihy la[;k 227&228 @2019 fo'ks"k vuqefr ;kfpdk la[;k 30119&30120@2016 v:.k dqekj ekaxfyd cuke fpjk;q gsYFk ,.M esfMds;j o vU; ds ekeys esa ikfjr fu.kZ; fnukad 09-01-2019 esa bl dkj.k ls Hkh vihykFkhZ dh iRuh e/kq ekaxfyd tks fd 56 o"khZ; efgyk Fkh] dks Msx a w cq[kkj dh otg ls fnukad 14-11-2009 dks HkrhZ djk;k x;k Fkk] mls tks bZykt fn;k x;k mlds ckotwn mlesa lq/kkj ugha gqvk Msaxw cq[kkj ds vfrfjDr ejht dks flj nnZ] cnu nnZ dh f'kdk;r Hkh Fkh ejht dh igys dh esfMdy fgLVªh Fkh ftlds vuqlkj mls catheter ablation ¼ew= ufydk½ yxk;h gqbZ Fkh ] ejht dh gkyr g`n~;?kkr ds lehiLFk Fkh] g`n~; dh /kM+du cgqr vlkekU; :i ls rst Fkh ] ejht dks fn;s x;s bZykt ds ckotwn 'kke 6-00 cts ejht dh gkyr esa fu{ksi ¼sinking½ gksrk x;k A mldk jDrpki ukius ;ksX; ugha jgk] mldh ukM+h Hkh lkekU; ugha py jgh Fkh A 24 ?k.Vs esa 2500 ,e,y ¶ywM fudkyuk fu/kkZfjr fd;k x;k] igys 1200 ,e,y ¶ywM dks fudkyk x;k] ckn esa 1-5 yhVj vksj ¶ywM fudkyk x;k A ejht dh gkyr] bradycardia and cardiac arrest - tSlh gks x;h A ejht dks dopamine & non adrenaline nsuk iM+k A 'kke 6-45 ij ejht dks g`n~;k?kkr gqvk A 6-55 ij mldh tkap dh x;h A The Ethics Committee of the Medical Council of India us ekeys dh tkap dh] ftlds vuqlkj ejht dk le;kuqlkj vko';d bZykt ugha fd;k x;k A vLirky ds MkDVj ,oa funs'kd Mk- vt; xks;udk izR;FkhZ la[;k nks vkSj MkDVj vHk; R;kxh dks ,fFkDl desVh }kjk izksQs'kuy fel d.MDV dk nks"kh ik;k x;k A MkDVj vt; xks;udk cqykus ds ckotwn Hkh ejht dks ns[kus ugha vk;s tcfd ejht dks muds fo'okl ij gh vLirky esa HkrhZ djk;k x;k Fkk A mDr U;kf;d n`"Vkar esa ;g ekuk x;k gS fd fpfdRldh; ykijokgh ds ekeys esa Hkkjr esa vkadyu Bolam test ds vk/kkj ij fd;k tkrk gS A blesa ;g ns[kk tkrk gS fd D;k fpfdRldksa }kjk ejht dh mfpr o vko';d ns[kHkky dh x;h ;k ugha] mldk mfpr o vko';d bZykt fd;k x;k ;k ugha A pwfa d mDr izdj.k esa bldk vHkko ik;k x;k ,oa WHO }kjk tkjh funsZ'kksa dh ikyuk fd;k tkuk ugha ik;k x;k vr% fpfdRldh; ykijokgh dk ekeyk cuuk ik;k x;k A 49- U;kf;d n`"Vkar lek;jk dksgyh cuke MkDVj izHkk eupank o vU; nhokuh vihy la[;k 1949@2004 esa ekuh; loksZPp U;k;ky; us vius fu.kZ; fnukad 16-01-2008 esa bl dkj.k ls fd 44 o"khZ; vfookfgr efgyk dks ekfld /keZ nsjh ls vkus ,oa 9 fnu ls jDrL=ko gksus dh f'kdk;r ij HkrhZ fd;k x;k Fkk mlds dqN tkaps dh x;h ,oa ejht dks vxys fnu ysizksLdkWih VsLV v.Mj tujy ,usfLFkfl;k djkus dh lykg nh x;h ] tks vxys fnu fnukad 10-05-1995 dks fd;k x;k A mlls iwoZ bl lac/a k esa ejht dh lgefr yh x;h A nkSjkus bZykt ejht dk tujy ,usfLFkfl;k ds v.Mj esa ysizksLdksfid ijh{k.k fd;k x;k ] ejht vpsr jgh blfy, fpfdRld us vkWijs'ku fFk;sVj ls ckgj vkdj ds ejht dh ekrk ls lgefr ysuk crkrs gq, ejht dh hysterectomy dj nh A lkFk gh mlds xHkkZ'k; dks gVk fn;k ,oa vksojht o Qsyksfi;u V~;wc dks Hkh gVk fn;k A ftl dkj.k ls ;g ekuk x;k fd efgyk dk thou lekIr gks x;k mlds ,sls vax dks gVkus ls iwoZ ejht dh lgefr ugha yh x;h A mDr vax gVk;s tkus dh otg ls og fookfgr thou dk lq[k Hkksxus ls oafpr gks x;h vkSj larku mRifRr ls oafpr gks x;h blfy, MkDVj dks fpfdRldh; ykijokgh dk nks"kh ekuk x;k A 50- U;kf;d n`"Vkar vyÝsM csfUMDV cuke euhiky gkWLihVy MANU/SC/ 0779/2014 okys ekeys esa vihykFkhZ@ifjoknh us eqvkotk jkf'k c<+kus ds fy, vihy izLrqr dh Fkh pwfa d ml ekeys esa ek= nks o"khZ; ckyd ds vLirky dh ykijokgh dh otg ls xsx a jhu gks x;k Fkk vkSj mldh nk;ha Hkqtk dkVuh iM+h Fkh vr% ekuk x;k fd ml ckyd dk 13 o"kZ dk thou cqjh rjg ls izHkkfor jgk gS blfy, vihykFkhZ dh vihy dks Lohdkj djrs gq, 80]000@&:i;s dks c<+kdj 20]00]000@&:i;s fd;k x;k vkSj vLirky dh vihy [kkfjt dh x;h A 51- blds vfrfjDr ifjoknh dh vksj ls Textbook of Obstetrics ds i`"B la[;k 727 o 728 dh Nk;kizfr izLrqr dh x;h gS ftlesa psIVj&40 Current Topics in Obstetrics fy[krs gq, LEGAL AND ETHICAL ISSUES IN OBSTETRIC PRACTICE dk mYys[k fd;k x;k gSA ftlds vuqlkj fpfdRld dk nkf;Ro gksrk gS fd og vius ejht dh ns[kHkky vPNh rjg ls djs mlds LokLF; dh rjQ iwjk /;ku j[ks ;fn MkDVj vius nkf;Ro dk fuoZgu Hkyh Hkkafr djus esa vlQy jgrk gS ;k mldh v{kerk ;k ykijokgh dh otg ls fdlh d`R; vFkok d`R; ds ykHk ds dkj.k ls ejht dk LokLF; fcxM+rk gS rks mls fpfdRldh; ykijokgh ekuk tk,xk A blesa ;g Hkh crk;k x;k fd dkSu lh pksVksa dks fpfdRldh; ykijokgh ekuk tk,xk ftlesa (iii) Injury following vaginal breech delivery (Ch.26),
(iv) Operactive vaginal delivery (Ch.37) dk Hkh lekos'k fd;k x;k gS A 52- tgka rd vizkFkhZ la[;k 4 yxk;r 6 }kjk ejht lfjrk daoj ds bykt esa ykijokgh cjrs tkus dk iz'u gS] ekuuh; jk"Vªh; miHkksDrk fookn izfrrks"k vk;ksx }kjk izdj.k dks izfrizsf"kr fd;s tkus ds i'pkr~ MkWDVj tx:Ik eg: us tks 'kiFk&i= izLrqr fd;k gS] mlesa vizkFkhZ la[;k 4 yxk;r 6 ds fo:) muds }kjk ejht ds bykt esa fdlh izdkj dh fpfdRldh; ykijokgh cjrs tkus dk dksbZ dFku ugha fd;k x;k gS A bl rF; dh iqf"V vizkFkhZ la[;k 5 MkWDVj jktho ekFkqj o vizkFkhZ la[;k 6 dh vksj ls izLrqr MkWDVj lqj's k lapsrh ds 'kiFk&i= ls Hkh gks jgh gS A bl vk;ksx }kjk iwoZ esa Hkh tks fu.kZ; fnuakd 06-06-2011 ikfjr fd;k x;k gS] mlesa Hkh vizkFkhZ la[;k 4 yxk;r 6 dks nks"kh ugha Bgjk;k x;k gS A blds vfrfjDr Lohd`r :Ik ls ejht dks Pitocin Injection fn;s tkus] Induction of Labour ,oa Uterus Repture gksus ds laca/k esa tks Hkh vk{ksi yxk;s x;s gSa] os vizkFkhZ la[;k 1 yxk;r 3 ds fo:) yxk;s x;s gSa vkSj ejht dks vizkFkhZ la[;k 4 ds ;gka Bed Sore ds fy, fcYdqy dksek dh voLFkk esa HkrhZ djok;k x;k Fkk vkSj yEcs le; rd bykt ds nkSjku ejht dh gkyr essa lq/kkj gqvk] mlus vka[ksa >idkuk o izfrfØ;k nsuk izkjEHk fd;k Fkk A pwfa d vfHkys[k ij ekStwn lk{; ds vuqlkj ejht esa vkSj vf/kd lq/kkj dh vis{kk ugha dh tk ldrh Fkh] blfy, fefyVªh gkWfLiVy dh jk; ij gh ejht dks Discharge fd;k x;k Fkk A vizkFkhZ la[;k 4 vkSj 5 dh vksj ls ckr dk Hkh Li"V dFku fd;k x;k gS fd] Discharge ds ckn Hkh ifjoknh us vius [kpsZ ij ejht dk bykt vizkFkhZ la[;k 4 gkWfLiVy esa djok;k vkSj mDr bykt essa ekuoh; n`f"Vdks.k dks viukrs gq, ifjoknh dks 50 izfr'kr dh NwV Hkh iznku dh xbZ] ckotwn blds ejht dh gkyr esa dksbZ lq/kkj ugha gqvk A bu dFkuksa dk dksbZ Li"V [k.Mu ifjoknh dh vksj ls ugha fd;k x;k gS A ;fn vizkFkh la[;k 4 o 5 ds bykt esa dksbZ deh ikbZ tkrh rks ;g lEHko ugha Fkk fd] Uterus Rapture gksus ds ckn ifjoknh dh iRuh Jherh lfjrk daoj dks vizkFkhZ la[;k 4 xks;y gkWfLiVy ,.M fjlpZ lsUVj izk -fy- esa HkrhZ djokus dh fnuakd 18-04-2007 ls Discharge fd;s tkus dh fnuakd 28-12- 2007 rd og thfor jg ikrh A 53- vfHkys[k ij ekStwn lk{; ds vuqlkj ifjoknh dh iRuh Jherh lfjrk daoj] vizkFkhZ la[;k 6 lapsrh gkWfLiVy ,.M dSalj bULVhV~;wV ds ;gka dHkh HkrhZ ugha jgh A fefyVªh gkWfLiVy ds Mªkboj ds dFkukuqlkj ejht ,EcqysUl esa gh Fkh vkSj vizkFkhZ la[;k 4 us ;g dgrs gq, euk fd;k Fkk fd] **ftl bykt ds fy, ejht dks jsQj fd;k x;k gS] ml bykt ds fy, fefyVªh gkWfLiVy vkSj muds e/; dksbZ vuqcU/k ugha gS A** pwfa d ifjoknh dh iRuh Jherh lfjrk daoj dk dksbZ bykt gh vizkFkhZ la[;k 6 ds }kjk ugha fd;k x;k gS vkSj ftl chekjh dk bykt fdlh vLirky esa miyC/k ugha gks rks ml chekjh ds fy, fdlh vLirky dks gekjs fouez er esa fdlh ejht dk bykt djus ds fy, ck/; ugha fd;k tk ldrk gS A 54- tgka rd iz'u ekuuh; jktLFkku mPp U;k;ky; dh ,dyihB }kjk fjV ;kfpdk esa bykt ds laca/k esa ikfjr funsZ'kksa ,oa vizkFkhZ la[;k 4 ds fo:) jkT; ljdkj dks tkap fd;s tkus ds funsZ'k fn;s tkus dk gS] mDr vkns'k dh ikyuk ds izHkko dks vizkFkhZ la[;k 4 xks;y gkWfLiVy ,.M fjlpZ lsUVj izk-fy- dh vksj ls izLrqr [k.MihB ;kfpdk esa LFkfxr dj fn;k x;k Fkk A bl lac/a k esa vizkFkhZ la[;k 4 yxk;r 6 dh vksj ls izLrqr U;kf;d n`"VkUrksa esa izfrikfnr fl)kUrksa dk mYys[k fd;k tkuk Hkh U;k;ksfpr izrhr gksrk gS 55- vizkFkhZ la[;k 4 yxk;r 6 dh vksj ls izLrqr ekuuh; loksZPp U;k;ky; ds U;kf;d n`"VkUr I (2010) CPJ 29 (SC) - dqlqe 'kekZ o vU; cuke c=k gkWfLiVy ,.M esfMdy fjlpZ lsaVj o vU; okys ekeys esa fpfdRldh; ykijokgh dks vkads tkus ds fy, fo'ks"k fn'kk&funsZ'k tkjh fd;s x;s gSa vkSj ;g ekuk x;k gS fd] fpfdRld dks fpfdRldh; ykijokgh ds fy, rc rd nks"kh ugha Bgjk;k tk ldrk] tc rd fd mlus viuh ;ksX;rk] cqf) ,oa foosd ds vuqlkj bykt ds laca/k esa tkjh ekin.Mksa vkSj fl)kUrksa ds vuq:Ik bykt djus esa dksbZ dksrkgh ugha cjrh gks A mDr fu.kZ; dks bl vk;ksx dh eq[; ihB }kjk vihy la[;k 661@2015&MkWDVj vkHkk efyd o vU; cuke Jherh dfork flag o vU; esa ikfjr fu.kZ; fnukad 09-03-2021 esa Hkh vk/kkj cuk;k x;k gS A ekuuh; loksZPp U;k;ky; us mDr U;kf;d n`"VkUr esa fpfdRldh; ykijokgh fdu ifjfLFkfr;ksa esa ekuh tk;sxh] bl laca/k esa fuEu fn'kk&funsZ'k ikfjr fd;s gSa%& "On scrutiny of the leading cases of medical negligence both in our country and other countries specially the United Kingdom, some basic principles emerge in dealing with the cases of medical negligence. While deciding whether the medical professional is guilty of medical negligence following well known principles must be kept in view:
I. Negligence is the breach of a duty exercised by ommission to do something which a reasonable man, guided by those considerations which ordinarily regulate the conduct of human affairs, would do, or doing something which a prudent and reasonable man would not do. II. Negligence is an essential ingredient of the offence. The negligence to be established by the prosecution must be culpable or gross and not the negligence merely based upon an error of judgment.
III. The medical professional is expected to bring a reasonable degree of skill and knowledge and must exercise a reasonable degree of care. Neither the very highest nor a very low degree of care and competence judged in the light of the particular circumstances of each case is what the law requires.
IV. A medical practitioner would be liable only where his conduct fell below that of the standards of a reasonable competent practitioner in his field.
V. In the realm of diagnosis and treatment there is scope for genuine difference of opinion and one professional doctor is clearly not negligent merely because his conclusion differs from that of other professional doctor.
VI. The medical professional is often called upon to adopt a Pprocedure which involves higher element of risk, but which he honestly believes as providing greater chances of success for the patient rather than a procedure involving lesser risk but highest chances of failure. Just because a professional looking to the gravity of illness has taken higher element of risk to redeem the patient out of his/her suffering which did not yield the desired result may not amount to negligence. VII. Negligence cannot be attributed to a doctor so long as he performs his duties with reasonable skill and competence. Merely because the doctor chooses one course of action in 13 preference to the other one available, he would not be liable if the course of action chosen by him was acceptable to the medical profession.
VIII. It would not be conducive to the efficiency of the medical profession if no doctor could administer medicine without a halter round his neck. IX. It is our bounden duty and obligation of the civil society to ensure that the medical professionals are not unnecessarily harassed or humiliated so that they can perform their professional duties without fear and apprehension.
X. The medical practitioners at times also have to be saved from such a class of complainants who use criminal process as a tool for pressurising the medical professionals/hospitals, particularly private hospitals or clinics for extractine uncalled for compensation. Such malicious proceedings deserve to be discarded against the medical practioners.
XI. 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 the patients. The interest and welfare of the patients have to be paramount for the medical professionals."
bl U;kf;d n`"VkUr esa ekuuh; loksZPp U;k;ky; us var esa ;g ekuk gS fd] mijksDr fl)kUrksa dks fpfdRldh; ykijokgh dk fcUnq r; djrs le; /;ku esa j[kk tkuk pkfg;s vkSj varr% ;g ekuk gS fd] jk"Vªh; miHkksDrk fookn izfrrks"k vk;ksx us ifjoknh dk ifjokn [kkfjt djus esa dksbZ =qfV ugha dh gS A 56- vizkFkhZ la[;k 4 yxk;r 6 dh vksj ls izLrqr ekuuh; loksZPp U;k;ky; ds U;kf;d n`"VkUr II (2019) CPJ 41 (SC) &Mk- ,l-ds- >qu>quokyk cuke /kuoarh dqekj o vU; okys izdj.k esa ;g fookn ugha Fkk fd] fpfdRld fu/kkZfjr ;ksX;rk j[kus okyk fpfdRld ugha gS A fpfdRld yEcs le; rd mDr vLirky esa dk;Zjr~ Fkk vkSj mlus dbZ ejhtksa dk bykt fd;k Fkk A orZeku izdj.k esa Hkh ejht dk bykt djus okys lHkh fpfdRld vko';d ;ksX;rk j[kus okys jgs gSa A muds }kjk yEcs le; ls MkWDVj dk O;olk; fd;k tk jgk Fkk vkSj bykt ds nkSjku ysizksLdkWih djus ij ejht ds xky CysMj esa iFkjh ik;s tkus ds dkj.k xkYk CysMj dks Remove djus dk fu.kZ; fy;k x;k A vkWijs'ku ds nkSjku ;fn dksbZ tfVyrk mRiUu gksrh gS rks vU; vkWijs'ku djus ds fy, ejht vFkok mlds ifjpkjd dh lgefr fy;k tkuk vfuok;Z ugha ekuk x;k gS vkSj Lohd`r :Ik ls xky CysMj fudkys tkus ds fy, vkWijs'ku dh lgefr nh xbZ Fkh A ,slh dksbZ lk{; ifjoknh dh vksj ls izLrqr ugha dh xbZ] ftlls ;g lkfcr gksrk gks fd fpfdRld }kjk bykt esa dksbZ ykijokgh cjrh xbZ gks A vr% fpfdRld }kjk izLrqr vihy dks Lohdkj fd;k x;k vkSj jk"Vªh;
miHkksDrk fookn izfrrks"k vk;ksx }kjk fd;s x;s fofu'p; dks lgh ugh ekuk x;k A 57- vizkFkhZ la[;k 4 yxk;r 6 dh vksj ls izLrqr ekuuh; loksZPp U;k;ky; ds U;kf;d fofu'p; AIR 2021 SUPREME COURT 4690 &MkWDVj gjh'k dqekj [kqjkuk cuke tksfxUnj flag o vU; okys izdj.k esa ekuuh; loksZPp U;k;ky; }kjk ;g izfrikfnr fd;k x;k gS fd] ;g vko';d ugha gS fd gj dsl esa ftlesa ejht dk bykt vFkok vkWijs'ku lQy ugha gks] mlds fy, fpfdRld dks nks"kh Bgjk;k tk lds A fpfdRld dh ykijokgh lkfcr djus ds fy, fo'ks"kK lk{; gksuk vfuok;Z gS A ifjfLFkfr;ka Lo;a cksyrh gS vFkkZr~ Res ipsa loquitur dk fl)kUr ykxw fd;k tk ldrk gS] ijUrq ifjdYiukvksa ds vk/kkj ij fpfdRld dks nks"kh ugha Bgjk;k tk ldrk gSA fpfdRldh; ykijokgh dks ifjoknh }kjk viuh lk{; ls lkfcr djuk vfuok;Z gksrk gS A 58- vizkFkhZ la[;k ,d ls rhu] lkr o vkB ds vf/koDrk Jh jkes'oj nos dh vksj ls izLrqr mijksDr U;kf;d n`"Vkarks dk geus llEeku v/;;u fd;k x;k A ge muds }kjk izLrqr mijksDr of.kZr U;kf;d n`"Vkarksa esa izfrikfnr fl)karksa ls iw.kZr% lgefr j[krs gSa ,oa egRoiw.kZ fn'kk funsZ'k izkIr djrs gSa A 59- ¼2005½ 6 ,l-lh-lh- 1 &tSdc eSF;w cuke iatkc jkT; o vU; okys U;kf;d n`"Vkar esa ekuuh; loksZPp U;k;ky; us ;g ekuk gS fd %& "Simply because of patient has not favourably responded to a treatment given by a physician or a surgery has failed, doctor cannot be held liable per se by applying. said doctrine."
Negligence dks ifjHkkf"kr djrs gq, vkxs ekuuh; loksZPp U;k;ky; us bl U;kf;d n`"VkUr esa ;g ekuk gS fd%& "Liability under the Civil and Criminal Law- Generally speaking it is the amount of damages incurred which is determinative of the extent of liability in tort,"
lkFk gh ;g Hkh ekuk gS fd%& "An error of judgment on the part of a professional is no negligence per so. Higher the acuteness in emergency and higher the complication, more are the chances of error of judgment."
ekuuh; loksZPp U;k;ky; us bl U;kf;d n`"VkUr esa vkxs ;g Hkh izfrikfnr fd;k gS fd %& "Mere failure of surgery or non-responding of patient to a particular treatment - Doctor per se cannot be held liable by applying res ipsa loquitor."
var esa bl U;kf;d n`"VkUr esa ekuuh; loksZPp U;k;ky; us ;g dgk gS fd] ifjoknh dk ;g dFku ugha gS fd MkWDVlZ] ftUgksua s ejht dk bykt fd;k og lk/kkj.k ;ksX;rk j[kus okys ugha gS A ejht dh e`R;q vU; dkj.kksa ls gqbZ Fkh] vr% MkDVlZ dh vksj ls izLrqr vihy dks Lohdkj fd;k x;k A** 60- ¼2005½ 2 MCY;w-,y-lh- 500&iatkc jkT; cuke f'kojkt o vU; U;kf;d n`"Vkar esa ekuuh; loksZPp U;k;ky; us izfrikfnr fd;k gS fd%& "Claim in tort can be sustained only if there was negligence on the part of the surgeon in performing surgery-Proof of negiligence has to satisfy Bolam's test."
lkFk gh bl U;kf;d n`"VkUr esa ekuuh; loksZPp U;k;ky; us ;g Hkh ekuk gS fd%& "Unless negligence is established, the primary liability cannot be fastened on medical practitioner - State cannot, therefore, be held vicariously liable - Court has cautioned that criminal law against medical profession be set in motion cautiously and on the basis of reasonable sure ground. "
61. (2022) 2 CPJ 51 - MkWDVj ¼Jherh½ pank jkuh v[kkSjh o vU; cuke MkWDVj ,e-,-
esFkqlFs kqiRFkh o vU; okys U;kf;d n`"Vkar esa ekuuh; loksZPp U;k;ky; us ;g izfrikfnr fd;k gS fd%& "Medical practitioner would be liable only where his conduct fell below that of the standards of a reasonable competent practitioner in his field."
lkFk gh ekuuh; loksZPp U;k;ky; us bl U;kf;d n`"VkUr esa ;g Hkh ekuk gS fd %& "Medical Practitioner is not to be held liable simply because things went wrong from mischance or misadventure or through an error of judgment in choosing one reasonable course of treatment in preference to another."
ekuuh; loksZPp U;k;ky; us ;g Hkh ekuk gS fd%& "There could be a genuine difference of opinion - However, while adopting a course of treatment, the duty cast, upon the medical practitioner is that he must ensure that the medical protocol being followed by him is to the best of his sill and with competence at his command."
ekuuh; loksZPp U;k;ky; us ;g Hkh ekuk gS fd %& "There was no negligence being committed by the respondents which may be a foundation for entertaining the complaint filed by the appellants."
62. AIR 2022 SUPREME COURT 204 - cksEcs gkWfLiVy ,.M esfMdy fjlpZ lsV a j cuke vk'kk tkW;loky o vU; okys U;kf;d n`"Vkar esa ekuuh; loksZPp U;k;ky; us ;g izfrikfnr fd;k gS fd %& "No doctor can assure life to his patient but can only attempt to treat his patient to the best of his ability which was being done in the present case as well. In spite of expert treatment, if patient not survived, doctor cannot be blamed as even doctors with best of their abilities cannot prevent inevitable. Hospital and the Doctor not held guilty of medical negligence."
lkFk gh ekuuh; loksZPp U;k;ky; us bl U;kf;d n`"VkUr esa ;g Hkh ekuk gS fd %& "If the patient does not survive, the fault cannot be fastened on the doctors as a case of medical negligence. It is too much to expect from a doctor to remain on the bed side of the patient throughout his stay in the hospital which was being expected by the complainant here. A doctor is expected to provide reasonable care which is not proved to be lacking in any manner in the present case."
63- 2020 DNJ (CC) 89 Saud Abbasi (Dr.) vs Gargi Hospital and others okys U;kf;d n`"Vkar esa ekuuh; jk"Vªh; miHkksDrk fookn izfrrks"k vk;ksx] ubZ fnYyh us ;g ekuk gS fd%& **ifjoknh dh iRuh izlo gsrq fnukad 21-01-2010 dks HkrhZ gqbZ&izlo gsrq 'kqYd olwy ugha fd;k rFkk fu%'kqYd lsok;sa iznku dh&ih-oh-fjlko ds fpUg ik;sa vkSj 19-01-2010 dks rqjUr vLirky esa HkrhZ djus dk funsZ'k fn;k&ysfdu ifjoknh us fn'kk funsZ'kksa dk ikyu ugha fd;k&ifjoknh Lo;a ch-;w-,e-,l- MkWDVj Fkk vkSj mlus vU; fpfdRldksa dks jksxh ds ijh{k.k dh vuqefr ugha nh vkSj ltZjh }kjk fMyhojh gsrq lgefr ugha nh&fojks/kh i{kdkj 3 us ifjoknh dks igys gh lwfpr fd;k fd og fnuakd 21-01-2010 dks miyC/k ugha gksxh A** mDr U;kf;d n`"Vkar 2020 DNJ (CC) 89 ds rF; orZeku izdj.k ds rF;ksa ls fHkUurk j[kus okys gksus ls bls ekStwnk izdj.k esa ykxw ugha fd;k tk ldrk A 'ks"k U;kf;d n`"Vkar ls iw.kZ lgefr j[krs gq, fn'kk funsZ'k izkIr gks jgk gS A 64- tgka rd iz'u ifjoknh dh vksj ls izLrqr bu fcanqvksa dk gS ge bu fcanqvksa rFkk fl)karksa ls iw.kZ lgefr j[krs gS fdUrq tSlk fd mijksDr foospu esa vk;k gS vizkFkhZ la[;k pkj ls N% ds vf/koDrk dh vksj ls izLrqr U;kf;d n`"Vkar I (2010) CPJ 29 (SC) dqlqe 'kekZ o vU; cuke c=k gkWLihVy ,.M esfMdy fjlpZ lsaVj o vU; esa fpfdRldh; ykijokgh ds fy, ekuuh; loksZPp u;k;ky; us foLr`r :i ls fn'kk funsZ'k tkjh fd;s gSa A mUgsa Hkh /;ku esa j[kk tkuk vfuok;Z gS A blds vfrfjDr Hkh vizkFkhZx.k dh vksj ls izLrqr U;kf;d n`"Vkarksa esa izfrikfnr fl)karksa ds vuqlkj le; le; ij ekuuh; loksZPp U;k;ky; rFkk ekuuh; jk"Vªh; miHkksDrk fookn izfrrks"k vk;ksx us fpfdRldh; ykijokgh dks lkfcr djus ds fy, ftu ftu ekin.Mksa dh vko';drk crk;h x;h gS mUgsa Hkh utj vankt ugha fd;k tk ldrk A 65- mijksDr foospu ds ifjizs{; esa ifjoknh dh vksj ls fn;s x;s rdksZa ij gekjk fu"d"kZ fuEukuqlkj gS %& ;g t:jh ugha gS fd ejht lfjrk daoj dks fnukad 18-04-2007 HkrhZ djkrs le; mldh gkyr lkekU; crk;h x;h Fkh vkSj bZykt ds nkSjku ckn esa fcxM+ ugha ldrh vkSj rch;r fcxM+us ls U;kf;d n`"Vkarksa esa izfrikfnr fl)karksa ds vuqlkj gj ekeys esa fpfdRld dh ykijokgh ugha ekuh tk ldrh D;ksafd dkWEIyhdslh Hkh bldk dkj.k gks ldrh gS A fpfdRldh; ykijokgh dks ifjoknh dks viuh lk{; ls lkfcr djuk gksrk gS A oSls Hkh ifjoknh dh vksj ls fof'k"V vkjksi fpfdRld ysf¶VusaV duZy MkDVj vkj-,u-cuthZ dh Hka;dj ykijokgh] vn{krk] vlko/kkfu;ka dk yxk;k x;k gS vkSj mDr dkj.kksa ls fnukad 10-04-2007 dks yxHkx nksigj 12-30 cts Uterus Repture gksuk crk;k gS A vU; fpfdRldksa ds ckjs esa bl laca/k esa fof'k"V vkjksi Lo;a ifjoknh dh vksj ls ugha yxk;s x;s gS A 66- tgka rd iz'u bl rdZ dk gS fd ejht ds Uncontrolled Profuse Bleeding dk le; ij bZykt ugha fd;k x;k ,oa dsoy bejtsalh esfMlu nsdj :dko fd;k x;k bl laca/k esa dksbZ lqn`<+ lk{; izLrqr ugha gqbZ D;ksfa d Lo;a ifjoknh dk dFku jgk gS fd bZykt ds nkSjku mls ejht ds ikl tkus ugha fn;k tkrk Fkk vU; fdlh fpfdRld vFkok uflZax dehZ dk Hkh ,slk dksbZ 'kiFki= izLrqr ugha gqvk gS ftlls ;g izekf.kr gks lds fd dsoy nokbZ nh x;h Fkh vkSj dksbZ iz;kl ugha fd;k x;k Fkk A ;g rF; Hkh gekjs fouez er esa lqn`<+ lk{; ls lkfcr ugha gqvk gS fd mDr dkj.kksa ls ejht lfjrk daoj pkSgku Hypovolmic Shock esa pyh x;h vkSj ckn esa dkfMZ;d vjsLV Hkh gqvk rFkk gkbZiksfDld czsu Msest ds dkj.k varr% ejht dksek esa pyh x;h A ;gka ;g fy[kk tkuk Hkh lqlaxr gS fd bl lac/a k esa Hkh ifjoknh ds vk{ksi vizkFkhZ la[;k ,d ls rhu ds fo:) yxk;s x;s gSaA 67- tgka rd iz'u bl rdZ dk gS fd izlwrk ,oa mlds Hkzw.k dk thou fjtuscy ds;j ls cpk;k tk ldrk Fkk blds laca/k esa ;g ns[kk tkuk t:jh gS fd D;k fjtuscy ds;j dh vko';drk Fkh ;k ugha] dsoy ifjoknh ds vk{ksiksa ls bl vkjksi dks lkfcr ugha ekuk tk ldrk A ifjoknh }kjk ;g Li"V vkjksi ugha yxk;k x;k gS fd vizkFkhZ la[;k ,d] nks o rhu }kjk fdl le; ij dkSulk bZykt ugha fd;k x;k] tks fd;k tkuk pkfg, Fkk A dsoy ekuuh; jk"Vªh; vk;ksx }kjk izdj.kksa esa izfrizs"k.k fd;s tkus ds i'pkr fdlh fo'ks"kK dh lykg ;k jk; ds vk/kkj ij lkekU; vk'k; ls gh vkjksi yxk;s x;s gSaA fof'k"V :i ls dsoy ;g dgk x;k gS fd Pitocin injection batsD'ku yxk;k x;k ,oa 38 lIrkg ckn gh Induction of Labour ns fn;k x;kA bl laca/k esa loZizFke rks ifjoknh dh vksj ls MkDVj tx:i eg:
us viuh lk{; ls ;g lkfcr ugha fd;k gS fd ,slk fd;k tkuk gj ekeys esa vkKkid gS A blds foijhr fpfdRldh; foKku ds vuqlkj izlwrk ds xHkkZ'; dh fLFkfr ns[krs gq, fpfdRld dks ;g fu.kZ; ysuk iM+k fd Pitocin injection batsD'ku dc fn;k tkuk gS dsoy bl vk/kkj ij Uterus Repture gksuk lkfcr ugha ekuk tk ldrk A fo'ks"k rkSj ls tc i=koyh ij miyC/k rF;ksa o lk{; ds vuqlkj e`rd 38 o"kZ dh efgyk Fkh mlds rhu cPps Øe'k% 20 o"kZ] 14 o"kZ ,oa <kbZ o"kZ dh mez ds ekStwn gS vkSj rhljs cPps ds ckn pkSFkh fMyhojh ds e/; ejht dk xHkZikr Hkh gqvk Fkk A gekjs fouez er esa ;g Hkh ugha ekuk tk ldrk fd ifjoknh ds dFkukuqlkj Induction of Labour 41 lIrkg ls iwoZ 38 lIrkg ckn gh fn;k tkuk Iyku fd;s tkus ds dkj.k gh ejht dk Uterus Repture gqvk A bl vk'k; dh dksbZ Li"V vkSj l`n`<+ lk{; vfHkys[k ij izLrqr ugha gqbZ gS A 68- bl laca/k esa ifjoknh dh vksj ls ;g vk{ksi Hkh yxk;k x;k gS fd Uterus Repture ls iwoZ mldh Abnormality dks tkuus dk iz;kl ugha fd;k x;k vkSj bl Øe esa vkxs ;g Hkh dgk x;k gS fd iwjs izlo dky vFkok chrs 9 eghus ds nkSjku ejht dh vYVªk lksuksxzkQh ugha djok;h A ;gka ;g fy[kk tkuk Hkh lqlaxr gS fd ifjoknh dh vksj ls fn;s x;s bl dFku dk dksbZ Li"V [k.Mu vizkFkhZ la[;k ,d ls rhu dh vksj ls ugha fd;k x;k gS] u gh dksbZ lksuksxzkQh fjiksVZ izLrqr dh x;h gS tcfd lkekU; Øe esa iwjs izlo dky esa ejht dh ,d ckj Hkh lksuksxzkQh ugha dh tk, ;g vlkekU; lh ckr izrhr gksrh gS A fo'ks"k rkSj ls tc bZykt djus okyk fpfdRld ;g tkurk gks fd ejht dh pkSFkh fMyhojh gS mldh vk;q Hkh 38 o"kZ gS A ,slh fLFkfr esa tks rdZ vizkFkhZ la[;k ,d ls rhu dh vksj ls izLrqr fd;s x;s gS mudks n`f"Vxr j[krs gq, ;g ekuk tk ldrk gS fd vizkFkhZ la[;k ,d ls rhu us ejht dh iwjs izlo dky esa lksuksxzkQh ugha djk;s tkus esa ykijokgh cjrh gS A ;fn lksuksxzkQh dh tkrh rks mlesa Uterus dh lgh fLFkfr fpfdRld ds /;ku esa vk ldrh Fkh D;ksfa d Lo;a vizkFkhZx.k ds vuqlkj Uterus dsoy Induction of Labour 38 lIrkg ckn gh fn;s tkus vFkok pitocin injection fn;s tkus ds dkj.k ugha QVk gS] cfYd ejht dh vk;q o mlds igys ds rhu izlo ,oa xHkZikr ds dkj.k ls QVk gS A bu lc ifjfLFkfr;ksa dks /;ku esa j[krs gq, gekjs fouez er esa ejht dh lksuksxzkQh o vU; vko';d VsLV le; le; ij fd;s tkus Fks vkSj mldk vfHkys[k vizkFkhZx.k dks vius tokc ds leFkZu esa izLrqr djuk pkfg, Fkk tks ugha fd;k x;k A 69- tgka rd iz'u bl rdZ dk gS fd esfMdy dsl lhV fnukad 18-04-2007 ls Li"V gS fd dksek ds nkSjku ejht dk lgh mipkj ugha fd;k x;k ,oa fnukad 18-04-2007 dks ejht dks xks;y vLirky esa VªkalQj fd;k x;k A ifjoknh ds bu dFkuksa dk Hkh dksbZ fof'k"V [k.Mu vizkFkhZx.k dh vksj ls djrs gq, ;g lkfcr ugha fd;k x;k gS fd fnukad 10-04-2007 dks Uterus Repture gksus ds i'pkr ,oa fnukad 18-04-2007 rd fefyVªh gkWfLiVy esa ejht dk dksek ds laca/k esa D;k mipkj fd;k x;k ,oa ;fn dksbZ mipkj fefyVªh gkWfLiVy esa fd;k tkuk laHko ugha Fkk rks ejht dks rRdky xks;y gkWfLiVy vFkok vU; fdlh fpfdRlky; es]a ftlesa ;ksX; o vuqHkoh fpfdRld gks] esa VªkalQj D;ksa ugha fd;k x;k A vfHkys[k ds vuqlkj ejht dks dksek esa LFkkukarfjr fd;k x;k Fkk vkSj ejht fnukad 18-04-2007 dks xks;y vLirky esa HkrhZ djrs le; iw.kZ :i ls dksek esa Fkk A 70- tgka rd iz'u ifjoknh }kjk vizkFkhZ la[;k 4 o 5 ds fo:) yxk;s x;s bl vkjksi dk gS fd] vizkFkhZ la[;k pkj o ikap us ejht dk bZykt laHko ugha gksus ds ckotwn flQZ iSlk cukus ds mn~ns'; ls ifjoknh dks /kks[ks esa j[kdj ejht dks HkrhZ dj fy;k vkSj tc ikap eghus iwjs gq, rks ejht dh d.Mh'ku fparktud gksus rFkk dksek esa gksus ds ckotwn xaHkhj gkyr esa fMLpktZ dj fn;k tcfd ge fo}ku vf/koDrk ifjoknh ds bu rdksZa ls lgefr ugha j[krs gS D;ksfa d Lohd`r :i ls ejht dks fnukad 18-04-2007 dks xks;y vLirky esa HkrhZ djk;k x;k Fkk vkSj fnukad 27-11-2007 dks fMLpktZ fd;k x;k Fkk ,oa vizkFkkhZx.k ds dFkukuqlkj ECHS ;kstuk esa ejht dk 6 ekg rd bZykt fd;k tkuk gh laHko gS A blds vfrfjDr vizkFkhZx.k ds bu rdksZa dk Hkh dksbZ fof'k"V [k.Mu ifjoknh dh vksj ls ugha fd;k x;k gS fd xks;y vLirky esa bZykt ds nkSjku ejht dks v)Zpsru dh voLFkk vk;h Fkh og viuh nksuksa vka[ksa [kksyus yxh vkSj jsLiksl a nsus dh fLFkfr esa vk x;h vkSj blfy, fnukad 07-06-2007 dks ejht dks osaVhysVj ls gVk fn;k x;k ,oa fQj ejht dh 'olu izfØ;k lkekU; :i ls fuckZ/k :i ls pyrh jgh A blds vfrfjDr xks;y vLirky esa HkrhZ djrs le; ejht dk GCS 3/15 Fkk tcfd Ms<+ ekg ds bZykt ds i'pkr GCS 3/15 GCS 6/15 gks x;k tcfd HkrhZ djkrs le; ejht iw.kZr% dksek esa Fkh A ,slh fLFkfr esa ifjoknh dk ;g dFku lgh ugha ekuk tk ldrk fd xks;y vLirky us dsoy iSlk dekus ds fy, ejht dks HkrhZ fd;k gks A ;gka ;g fy[kk tkuk Hkh lqlaxr gS fd ejht dks Lo;a ifjoknh us HkrhZ ugha djk;k cfYd fefyVªh gkWfLiVy us vius Lrj ij xks;y vLirky esa VªkalQj fd;k Fkk vkSj fefyVªh gkWfLiVy }kjk fu;ekuqlkj tkjh i= fnukad 05- 10-2007 ds vk/kkj ij gh xks;y vLirky }kjk ejht dk fnukad 27-11-2007 dks fMLpktZ fVfdV cuk;k x;k A ifjoknh }kjk vizkFkhZx.k dh vksj ls izLrqr rdksZa dk Hkh dksbZ fof'k"V [k.Mu ugha fd;k x;k gS fd fnukad 27-11-2007 dks fMLpktZ fVfdV cuk;s tkus ds ckotwn ifjoknh us vius vuqjks/k o [kpsZ ij ejht dk bZykt xks;y vLirky esa djk;k Fkk A mDr bZykt ds nkSjku ekuoh; n`f"Vdks.k dks /;ku esa j[krs gq, xks;y vLirky }kjk fpfdRlk O;; esa 50 izfr'kr NwV Hkh ifjoknh dks iznku dh x;h Fkh A bl rF; dks Hkh gekjs fouez er esa utj vankt ugha fd;k tk ldrk fd ejht dh e`R;q xks;y vLirky ls NqV~Vh fn;s tkus ds yxHkx lok lky ds ckn fnukad 08-03-2009 dks gqbZ Fkh A 71- tgka rd iz'u vizkFkhZ la[;k pkj o ikap ds laca/k esa fn;s x;s bu rdksZa dk gS fd ekuuh; jktLFkku mPp U;k;ky; us fjV ;kfpdk la[;k 7801@07 esa xks;y vLirky ,oa jkT; ljdkj ds fo:) egRoiw.kZ fn'kk funsZ'k tkjh fd;s gq, Fks ml laca/k esa vizkFkhZx.k dh vksj ;g lkfcr fd;k x;k gS fd mDr fn'kk funsZ'kksa dks xks;y vLirky dh vksj ls izLrqr Mh-ch- flfoy Lis'ky vihy la[;k 191@2008 esa ikfjr vkns'[email protected]; }kjk vikLr dj fn;k x;k Fkk ijUrq ifjoknh }kjk tkucw> dj ekuuh; jktLFkku mPp U;k;ky; }kjk tkjh LFkxu vkns'k fnukad 10-03-2008 rFkk vkns'k fnukad 01-05-2008 dk gokyk vius ifjokn esa ugha fn;k gS vFkkZr ifjoknh LoPNk gkFkksa ls vk;ksx ds le{k mifLFkr ugha vk;k gS vkSj mlus vf/kd eqvkotk ikus dh xjt ls egRoiw.kZ rF;ksa dks fNik;k gS A 72- vfHkys[k ij ekStwn rF;ksa ds vuqlkj ifjoknh }kjk xks;y vLirky ls vius Lrj ij djk;s x;s bZykt ds nkSjku 22]950@&:i;s vnk fd;s x;s Fks vkSj fcuk fdlh lk{; ds ;g ugha ekuk tk ldrk fd ,slh vYi jkf'k dks izkIr djus ds fy, dksbZ Hkh izfrf"Br vLirky ejht dks vuko';d rkSj ij HkrhZ j[ksxk A vxj okLro esa xks;y vLirky esa ejht dk bZykt lgh rjg ls ugha fd;k tk jgk Fkk vkSj muds bZykt ls ejht dh gkyr esa dksbZ lq/kkj ugha gqvk Fkk rks ifjoknh }kjk vius [kpsZ ij ejht dk bZykt xks;y vLirky esa vkxs ugha djk;k tkrk A ifjoknh dk ;g rdZ Hkh ekuus ;ksX; ugha gS fd vizkFkhZ la[;k pkj xks;y gkWLihyVy us Qksu ij bZykt djus ls euk dj fn;k gks A i=koyh ij miyC/k rF;ksa ds vuqlkj ifjoknh dh iRuh yEcs le; ls xks;y vLirky esa HkrhZ jgh gS mldk bZykt gqvk gS mldh gkyr esa lq/kkj Hkh gqvk ;gka rd fd ifjoknh muds bZykt ls ml gn rd larq"V Fkk fd ifjoknh us Lo;a vius [kpsZ ij Hkh xks;y vLirky esa bZykt djk;k gS vkSj ;fn xks;y vLirky ds bZykt ls larq"V ugha Fkk rks ogka ls fMLpktZ djkdj fdlh vU; vLirky esa bZykt djk ldrk Fkk A ifjoknh dh vksj ls fnukad 27-04-2023 dks fn;s x;s rdksZa esa ;g Hkh Lohdkj fd;k x;k fd fefyVªh gkWfLiVy us xks;y gkWfLiVy ,.M fjlpZ lsaVj izk-fy- ,oa lapsrh gkWfLiVy ,.M dsalj baLVhV~;wV esa Serious Bed Sore ds fy, jsQj fd;k x;k Fkk A ,slh fLFkfr esa mijksDr fd;s x;s foospu ,oa vizkFkhZ la[;k 4 ls 6 dh vksj ls izLrqr U;kf;d n`"Vkarksa esa izfrikfnr mijksDr mYysf[kr fl)karksa dks n`f"Vxr j[krs gq, gekjs fouez er esa e`rd Lo- lfjrk daoj ds bZykt esa vizkFkhZ la[;k 4 o 5 }kjk fdlh izdkj dh dksbZ fpfdRldh; ykijokgh cjrh tkuk lkfcr djus esa ifjoknh vlQy jgk gS A muds fo:) dksbZ vkjksi lkfcr ugha gqvk gS A 73- tgka rd iz'u vizkFkhZ la[;k 6 dk gS] Lo;a ifjoknh ds dFkukuqlkj fnukad 15-03- 2008 dks ejht lfjrk daoj dks ECHS ds rgr bZykt gsrq jsQj QkWeZ ds lkFk lapsrh gkWfLiVy ,.M dal s j baLVhV~;wV tks/kiqj Hkstk x;k Fkk A ;g Hkh Lohd`r fLFkfr gS fd e`rd u rks lapsrh vLirky esa HkrhZ jgh u gh lapsrh vLirky esa e`rdk dk dksbZ bZykt gqvk A muds fo:) ifjoknh }kjk ;g vk{ksi yxk;k x;k gS fd ECHS Ldhe ds rgr fefyVªh gkWfLiVy dk lwphc) gkWLihVy gksus ds ckotwn vizkFkhZ la[;k 6 us ihfM+rk lfjrk daoj dk bZykt djus ls euk dj fn;k x;k tcfd bl laca/k esa vizkFkhZ la[;k 6 dk Li"V dFku jgk gS fd Twice Cardic arrest attempt ds dkj.k ECHS vf/kdkjh o fpfdRld ls laidZ dj mfpr fu.kZ; ysus dh lykg nh x;h Fkh ijUrq ifjoknh okrkZ dk fu"d"kZ le>s cxSj gh ogka ls pyk x;k A Lo;a ifjoknh dh vksj ls izLrqr fefyVªh gkWfLiVy ds ,Ecwysal ds MªkbZoj tru flag jkBkSM+ ds dFkukuqlkj ejht ,Ecwysal esa gh jgh A vizkFkhZ la[;k 6 }kjk u rks ejht dks HkrhZ fd;k x;k] u gh jsQj fd;k x;k A gekjs fouez er esa fdlh Hkh vLirky dks dsoy bl vk/kkj ij fd mldk fefyVªh gkWfLiVy ds lkFk vuqca/k gS] bl izdkj dk bZykt djus ds fy, ck/; ugha fd;k tk ldrk ftldk bZykt mlds vLirky esa miyc/k ugha gks A fo'ks"k rkSj ls tc vuqca/k ftu chekfj;ksa ds bZykt ds laca/k esa gqvk gks] mlls fHkUu bZykt ls euk fd;k x;k gks A tSlk fd vizkFkhZ la[;k pkj lapsrh gkWfLiVy ds laca/k esa ifjoknh }kjk vk{ksi yxk;k x;k gS A blds vfrfjDr bl izdkj dk vk{ksi fefyVªh gkWfLiVy }kjk yxk;k tk, rks ml ij xkSj fd;k tk ldrk gS ysfdu ifjoknh ;g ckr ugha dg ldrk D;ksfa d vuqca/k ifjoknh vkSj futh vLirky ds chp ugha gqvk gS cfYd fefyVªh gkWfLiVy ,oa vizkFkhZ la[;k 4 o 6 ds chp gqvk gS A ifjoknh dk ;g dFku ekuus ;ksX; ugha gS fd xks;y gkWfLiVy us mPp U;k;ky; esa dsl yfEcr gksus ds vk/kkj ij bZykt ugha fd;k vkSj lapsrh gkWfLiVy esa fcuk fdlh U;k;ksfpr dkj.k ds lfjrk daoj dk bZykt ugha fd;k D;ksfa d xks;y vLirky ds vuqlkj fMLpktZ ds ckn ejht dks dHkh xks;y gkWfLiVy yk;k gh ugha x;k vkSj u gh jsQj fd;k x;k A lapsrh gkWfLiVy ds dFkuksa ds vuqlkj Hkh mls tks lykg lapsrh gkWfLiVy }kjk nh x;h Fkh mls iwjk lqus fcuk gh ifjoknh ykSV x;k A ;g Hkh Lohd`r fLFkfr gS fd igys ifjokn bl vk;ksx }kjk fefyVªh gkWLihVy ds vko';d nLrkost ds vHkko esa [kkfjt fd;k x;k Fkk ,oa xks;y gkWfLiVy vkSj lapsrh gkWfLiVy ds fo:) dksbZ fu.kZ; ikfjr ugha fd;k x;k Fkk A ;gka ;g fy[kk tkuk Hkh lqlaxr gS fd lk{; esa vizkFkhZ la[;k pkj o ikap dh vksj ls MkDVj jktho ekFkqj o vizkFkhZ la[;k 6 dh vksj ls MkDVj lqjs'k lapsrh }kjk izLrqr 'kiFki= esa Hkh Li"Vr% dFku fd;k x;k gS fd ifjoknh dh vksj ls izfrizs"k.k ds i'pkr izLrqr ek= fo'ks"kK xokg MkDVj tx:i esg:
us vius 'kiFki= esa vizkFkhZ la[;k 4 ls 6 ds }kjk bZykt esa fdlh izdkj dh ykijokgh cjrh tkus dk dksbZ vk{ksi ugha yxk;k gS ,oa dsoy fefyVªh gkWfLiVy ds fpfdRld Mk- vkj-,u-csuthZ ¼vizkFkhZ la[;k nks½ ds fo:) gh bZykt esa ykijokgh cjrs tkus ds fof'k"V vk{ksi yxk;s gSaA vf/kd ls vf/kd vizkFkhZ la[;k rhu }kjk iw.kZ izlo dky esa ejht dh vk;q] muds igys rhu cPpksa vkSj xHkzikr ds rF;ksa dks n`f"Vxr j[krs gq, dksbZ lksuksxzkQh ugha fd;s tkus vFkok partograph -bR;kfn la/kkfjr ugha fd;s tkus] ejht dh ns[kjs[k fu;fer :i ls ugha fd;s tkus ds dkj.k mlds dkQh cM+s Bed sore gks tkus ,oa mlds fy, fjdUlVªfDVo ltZjh dh lykg fn;s tkus ds fy, nks"kh ekuk tk ldrk gS ijUrq vizkFkhZ la[;k 4 ls 6 ds fo:) yxk;s x;s vkjksi fdlh Hkh :i esa izekf.kr ugha gq, gS vr% mijksDr fd;s x;s foospu ds vuqlkj ifjoknh dk ifjokn vizkFkhZ la[;k 4 ls 6 ds fo:) [kkfjt fd;s tkus ;ksX; gS A 74- tgka rd iz'u ifjoknh dh vksj ls fn;s x;s bl rdZ dk gS fd fefyVªh gkWfLiVy us euekus rjhds ls fnukad 26-11-2007 dks ejht dks vLirky ls fMLpktZ djus dk vkns'k tkjh fd;k bl laca/k esa fefyVªh gkWfLiVy dk Li"V dFku jgk gS fd ECHS ;kstuk esa ejht dk bZykt 6 ekg rd fd;k tk ldrk gS mldk Hkh dksbZ [k.Mu ifjoknh dh vksj ls ugha fd;k x;k gS vkSj tgka rd iz'u jktLFkku mPp U;k;ky; dh ,dy ihB }kjk 6 ekg dh vof/k ds i'pkr Hkh ejht dk bZykt fd;s tkus ds laca/k esa xks;y vLirky] fefyVªh gkWfLiVy o vU; jkT; ljdkj dks funsZ'k tkjh fd;s tkus dk gS] ekuuh; mPp U;k;ky; dh ,dy ihB }kjk ikfjr fu.kZ; esa xks;y vLirky }kjk izLrqr [k.M ihB ;kfpdk dks vikLr fd;k tk pqdk gS A bl ckr dks Hkh utj vankt ugha fd;k tk ldrk fd ejht dks xks;y vLirky ds ckn ,El fnYyh rFkk fefyVªh gkWfLiVy fnYyh esa Hkh HkrhZ j[kk x;k Fkk A ogka Hkh ejht dk bZykt laHko ugha ekuk x;k A 75- pwfa d fnukad 08-04-2007 dks izFke ckj HkrhZ djkrs le; tkap djus ij ejht ds xHkkZoLFkk esa dksbZ tfVyrk ugha ik;h x;h ,slh fLFkfr esa lkekU; fMyhojh dh ;kstuk cuk;s tkus dks Hkh fpfdRldksa dk xyr fu.kZ; ugha ekuk tk ldrk A fpfdRld dh ykijokgh vkaf'kd :i ls mlh gn rd ekuh tk ldrh gS fd iwjs izlo dky esa ihfM+rk dh vk;q] mlds igys dh rhu fMyhojh ,oa xHkZikr dks /;ku esa j[kus ds ckotwn mlds lksuksxzkQh ugha djk;h x;h A Uterus Repture gksus ds ckotwn fnukad 10-04-2007 dks ejht ds xaHkhj voLFkk esa jgrs gq, fnukad 18-04-2007 ls iwoZ xks;y vLirky jsQj ugha fd;k x;k vkSj bl laca/k esa bl laHkkouk ls badkj ugha fd;k tk ldrk fd ;fn le; jgrs ejht dks xks;y vLirky vFkok vU; fdlh l{ke vLirky ftlesa ejht dk bZykt fefyVªh gkWfLiVy ls c<+dj gks ldrk Fkk jsQj dj fn;k tkrk rks ejht dh gkyr esa rRdky visf{kr lq/kkj gks ldrk Fkk rFkk mldk thou cp ldrk Fkk vkSj ;fn fefyVªh gkWLihVy ds fpfdRldksa }kjk ejht ds bZykt ds nkSjku mfpr lko/kkfu;ka tks MkDVj tx:i eg: ds 'kiFki= esa crk;h x;h gS ,oa WHO rFkk jk"Vªh; vkSj varjkZ"Vªh; Lrj ij tks funsZ'k tkjh fd;s x;s gSa mudh ikyuk okLro esa l[rh ls dh x;h gksrh rks ejht ds cPps dks Hkh cpk;k tk ldrk Fkk A ;g lgh gS fd xHkkZ'k; dk QVuk Medical science esa mDr ikVZ nqyZHk tfVyrk ekuk tkrk gS ijUrq Hkzw.k dh e`R;q rks vifjorZuh; tfVyrk gS A 76- mijksDr foospu ds vuqlkj gekjs fouez er esa fefyVªh gkWfLiVy dh vksj ls fn;k x;k ;g rdZ ekuus ;ksX; ugha gS fd bZykt ds nkSjku ejht dh loksZRre ns[kHkky dh x;h] mls flfoy U;w;jksfQftf'k;u vkSj U;w;jksltZu dks fn[kk;k x;k vkSj ejht dh gkyr esa lq/kkj gksus ij fnukad 18-04-2007 dks xks;y vLirky esa LFkkukarfjr fd;k x;k rkfd ejht U;wjksyksftLV dh lh/kh ns[kjs[k esa jg lds D;ksfa d vfHkys[k ij ekStwn rF;ksa o lk{; ds vuqlkj ejht dks xks;y vLirky esa iw.kZr% dksek esa HkrhZ djk;k x;k Fkk og iw.kZ fu'psruk dh fLFkfr esa Fkh] v)Zpsru fLFkfr esa Hkh xks;y vLirky esa bZykt ds ckn vk;h A 77- tgka rd iz'u bl rdZ dk gS fd] ifjoknh dh iRuh dk CyM xzqi ÞvksÞ usxsfVo Fkk vkSj ifjoknh dk CyM xzqi ÞvksÞ iksftfVo gS ijUrq vizkFkhZx.k }kjk dHkh CyM xqzi VsLV ugha fd;k x;k A bl laca/k esa vfHkys[k ij ekStwn lk{; ls ,slk dgha izdV ugha gksrk gS fd HkrhZ djrs le; ejht ds 'kjhj esa ,slh dksbZ tfVyrk ik;h x;h gks] ftlls rRdky vkWijs'ku djus dh laHkkouk utj vkrh gks vkSj mlds fy, vfrfjDr jDr dh vko';drk vpkud xHkkZ'k; QVus ls iM+h gks A ifjoknh dk ;g rdZ Lohdkj fd;s tkus ;ksX; ugha gS fd ifjoknh dh iRuh ds tYnh fMyhojh gksus ds le; dksbZ dkWEIyhds'ku ugha gksuk crk;k x;k D;ksfa d ifjoknh ds dFkukuqlkj Induction of Labour 38 lIrkg ds i'pkr fn;k x;k Fkk A ifjoknh dh vksj ls fn;k x;k ;g rdZ Hkh ekuus ;ksX; ugha gS fd HkrhZ ds le; MkDVj dkosZM us vko';d funsZ'k fn;s Fks tcfd vfHkopuksa o lk{; ds vuqlkj MkDVj vkj- ,u-cuthZ vizkFkhZ la[;k nks }kjk funsZ'k fn;s x;s Fks A 78- tgka rd iz'u ifjoknh ds bl rdZ dk gS fd fpfdRlk esa gqbZ ykijokgh ifjoknh dks lkfcr ugha djuh Fkh] cfYd gkWfLiVy dks lkfcr djuh Fkh fd mudh vksj ls fpfdRlk esa dksbZ ykijokgh ugha dh x;h gS A gekjs fouez er esa ;g rdZ ekuus ;ksX; ugha gS A fof/k dk loZekU; fl)kar gS fd tks i{kdkj ftl vfHkopu dk dFku vius ifjokn esa djrk gS mls izFke n`"V~;k lkfcr djus dk fl)h Hkkj ml i{kdkj ¼ifjoknh½ ij gksrk gS vkSj izFke n`"V~;k lkfcr djus ds i'pkr gh mldk Hkkj foi{kh i{kdkj ij f'k¶V gksrk gS A A ;g rF; Hkh miyc/k lk{; ls lkfcr ugha gqvk gS fd NTD Injection Rh usxsfVo izlwrk dks fMyhojh ls iwoZ fn;k tkuk vkKkid Fkk A tSlk fd mijksDr foospu esa vk;k gS Pitocin injection fn;k tkuk Hkh esfMdy lkbZal ds vuqlkj xHkkZoLFkk esa mifLFkr rjy inkFkZ dh ek=k ij fuHkZj djrk gS A ;g rF; Hkh lqn`<+ lk{; ls lkfcr ugha gqvk fd 45 lIrkg ls igys xSlslu dh vko';drk ugha gksrh gS fQj Hkh dj fn;k x;k D;ksfa d esfMdy lkbZal ds vuqlkj ;g dsl Vw dsl fMisUM djrk gS A 79- tgka rd iz'u bl rdZ dk gS fd vkWfDlVªksflu fn;s tkus ds i'pkr ejht dh ns[kjs[k fujUrj fd;k tkuk vko';d gS mls ns[kjs[k ds fcuk ugha NksM+k tk ldrk A bl laca/k esa ,slh dksbZ lk{; izLrqr ugha gqbZ ftlls ;g rF; Li"V gksrk gks vkSj dsoy ifjoknh ds dFkukuqlkj ;g ckr ugha ekuh tk ldrh D;ksfa d Lo;a ifjoknh dk dFku gS fd mls ejht ds ikl tkus gh ugha fn;k tkrk Fkk A fo'ks"k rkSj ls tc ifjoknh }kjk izLrqr lk{; ls ;g izekf.kr ugha fd;k x;k gks fd ejht dk CyM xzqi vkj-,p-usxsfVo Fkk A 80- ifjoknh dk ;g rdZ ekuus ;ksX; gS fd tks nLrkost igys u"V djus crk fn;s x;s Fks mUgsa jk"Vªh; vk;ksx }kjk fn;s x;s funsZ'k ds ckn is'k fd;k x;k ,oa mu nLrkostkr dks iw.ks vkWfQl ugha Hkstk x;k A uterus repture gks tkus ds ckn Hkh ifjoknh dh iRuh lfjrk daoj dks fefyVªh gkWfLiVy esa gh j[kk x;k D;ksafd bu dFkuksa dk dksbZ [k.Mu vizkFkhZ la[;k ,d ls rhu dh vksj ls ugha fd;k x;k gS A ,slh fLFkfr esa vkaf'kd :i ls vizkFkhZ la[;k ,d ls rhu dh ykijokgh ekuh tk ldrh gS ijUrq ifjoknh dk ;g dFku ekuus ;ksX; ugha gS fd ifjoknh dh iRuh i<+h fy[kh Fkh vkSj cPps ds tUe ds le; mldk vaxwBk yxok;k x;k D;ksfa d i=koyh ij miyC/k lk{; ds vuqlkj ejht ,slh gkyr esa ugha Fkh fd og gLrk{kj dj lds A 81- ;g lgh gS fd ifjokn esa vizkFkhZx.k }kjk fpfdRldh; ykijokgh cjrh tkus ds laca/k esa vfHkopu fd;s x;s gSa ijUrq mUgsa mlh gn rd lkfcr ekuk tk ldrk gS ftl gn rd lkfcr fd;k x;k gks A dsoy vfHkopuksa ds vk/kkj ij vizkFkhZx.k dks nks"kh ugha Bgjk;k tk ldrk D;ksafd fof/k dk loZekU; fl)kar gS fd fy;s x;s vk{ksiksa dks lkfcr djus dk fl)h Hkkj Hkh vk{ksi yxkus okys i{kdkj ij gksrk gS blfy, tgka rd iz'u partograph ds laca/k esa fefyVªh gkWfLiVy ds dFku ij vfo'okl djus dk gS fd partograph la/kkfjr fd;s tkus dk nLrkost is'k ugha fd;k x;k gS] ;g ,slk fcanq gS ftlds laca/k esa gekjs fouez er esa vizkFkhZ dk nkf;Ro Fkk fd og vius dFkuksa ds lac/a k esa nLrkosth lk{; izLrqr djrs] flQZ bl vk/kkj ij fd o"kZ 2007 ds bZykt ds lac/a k esa jk"Vªh; vk;ksx }kjk 2016 esa izfrizs"k.k fd;s tkus ds i'pkr ifjoknh }kjk nLrkostkr dh ekax dh x;h] vizkFkhZx.k dks vius nkf;Ro ls iw.kZr% eqDr ugha fd;k tk ldrk A vizkFkhZ la[;k ,d ls rhu dk Hkh nkf;Ro Fkk fd og vius dRrZO; ds leFkZu esa miyC/k nLrkosth lk{; izLrqr djrs D;ksafd lk{; vf/kfu;e ds varxZr ;fn dksbZ nLrkost fdlh i{kdkj ds fu;a=.k o dCts esa gksrs gS vkSj og i{kdkjku ds e/; yfEcr fookn ij izdk'k@ izHkko Mkyus okyk gks rks ml i{kdkj dk nkf;Ro gksrk gS fd og ml nLrkost dks U;k;ky; ¼vk;ksx½ ds le{k izLrqr djs vU;Fkk mlds fo:) Hkkjrh; lk{; vf/kfu;e dh /kkjk 114 ds varxZr foijhr vk'k; fudkyk tk ldrk gS A Lo;a ifjoknh ds dFkukuqlkj HkrhZ djus dh 8 rkjh[k dks LVªhfiax 'kq: dh x;h] 9 rkjh[k dks Gel ,IykbZ fd;k x;k vkSj 10 rkjh[k dks pitocine batsD'ku yxk;s tkus dk fu.kZ; fd;k x;k tks ;g n'kkZrk gS fd vizkFkhZ la[;k ,d ls rhu }kjk vius cqf) o foosd ds vuqlkj Øekuqlkj izlwrk dk bZykt djus dk iz;kl fd;k x;k D;ksfa d ifjoknh }kjk ,slk dgha lkfcr ugha fd;k x;k gS fd esfMdy lkbZal ds vuqlkj LVªhfiax dc 'kq:
dh tkuh pkfg,] tsy dc yxk;h tkuh pkfg, vkSj pitocine batsD'ku dc yxk;k tkuk pkfg, vkSj dc ugha yxk;k tk ldrk A 82- tgka rd iz'u ifjoknh ds bl rdZ dk gS fd izlwrk lfjrk daoj dk fltsfj;u vkWijs'ku fd;k tkuk pkfg, Fkk tks ugha fd;k x;k bl lac/a k esa gekjs fouez er esa Lo;a ifjoknh vius vfHkopuksa esa ;g dgdj vk;k gS fd HkrhZ djrs le; izlwrk dh fLFkfr iw.kZr% lkekU; Fkh] fdlh izdkj dh dksbZ tfVyrk ugha Fkh iwoZ esa rhu fMyhojh lkekU; gks pqdh Fkh] ,slh fLFkfr esa ;fn MkDVlZ }kjk fltsfj;u vkWijs'ku fd;k tkrk rks bl ckr dk Hkh vk{ksi yxk;k tkrk fd fltsfj;u vkWijs'ku dh vko';drk ugha gksrs gq, Hkh fltsfj;u vkWijs'ku fd;k x;k A ijUrq ;g Hkh Lohd`r gS fd ifjoknh dh vksj ls fy;s x;s bl rdZ dk dksbZ [k.Mu vizkFkhZx.k dh vksj ls ugha fd;k x;k fd cPps dk psLV estjesaV cky fo'ks"kK ls ugha djok;k x;k ftlls ;g lkfcr ugha gks ldk fd cPps dh e`R;q lkal ysus ds ckn gqbZ ;k tUe ls igys gh gks x;h A xHkkZ'k; ds QVus ds dkj.k isV ds vanj dkQh ek=k esa jDrL=ko gqvk] Hkzw.k dh e`R;q gksus ls eka dks lnek yxk A vkWijs'ku ds ckn fuxjkuh ds fy, vkbZ-lh-;w- esa j[kk x;k] tgka vpkud dkfMZ;d vjsLV gqvk A ejht dks laHkor% blh dkj.k ls hypoxic encephalopathy dk lkeuk djuk iM+k vkSj blds pyrs og dksek esa pyh x;h A 83- vizkFkhZx.k dh vksj ls bl ckr dk [k.Mu ugha fd;k x;k gS fd ejht dh TPR (Temperory Pulse Respiration) fnukad 08-04-2007 ls la/kkfjr ugha fd;k tkdj fnukad 10-04-2007 ls la/kkfjr fd;k x;k Fkk A ;g Hkh fufoZokfnr gS fd lfjrk daoj dh pkSFkh fMyhojh Fkh] igys rhu cPps Fks] ftlesa igyk 20 o"kZ dh vk;q dk] nwljk 14 o"kZ dh vk;q dk ,oa rhljk <kbZ o"kZ dh vk;q dk gS vkSj mlds i'pkr ,d xHkZikr Hkh gqvk Fkk A ,slh fLFkfr esa esfMdy lkbZal ds vuqlkj ejht dh vk;q dks ns[krs gq, mldk xHkkZ'k; detksj gksus dh laHkkouk ls Hkh badkj ugha fd;k tk ldrk A 84- i=koyh ij fd;s x;s leLr foospu ds vuqlkj gekjs fouez er esa e`rdk lfjrk daoj ds bZykt ds nkSjku vizkFkhZ la[;k ,d ls rhu }kjk bZykt esa dq N vlko/kkfu;ka o ykijokgh cjrh tkuk mijksDrkuqlkj izekf.kr gqvk gS tks fd lsok esa =qfV esa vkrk gS A vr% ifjoknh dk ifjokn vkaf'kd :i ls vizkFkhZ la[;k ,d ls rhu ds fo:) ,ao pwfa d vizkFkhZ la[;k ,d ls rhu] vizkFkhZ la[;k 7 o 8 ds vf/kuLFk dke djrs gS vr% vizkFkhZ la[;k 7 o 8 ds fo:) Hkh la;qDr o i`Fkd&i`Fkd :i ls vkaf'kd Lohdkj fd;s tkus ;ksX; ik;k tkrk gS ,oa vizkFkhZ la[;k pkj ls N% ds fo:) ifjokn [kkfjt fd;s tkus ;ksX; ik;k tkrk gS A ekuuh; jktLFkku mPp U;k;ky; ds vkns'k fnukad 12-02-2008 dh ikyuk esa lfjrk daoj dks ubZ fnYyh ,El vFkok vU; fdlh l{ke vLirky esa bZykt djkus ds fy, tks 10]000@&:i;s dk pSd vFkok tks fVfdV cuokdj fn;k x;k Fkk mldh jkf'k vizkFkhZx.k] ifjoknh ls izkIr djus ds vf/kdkjh ugha jgsaxs A vk ns 'k vr% ifjoknh dk ifjokn fo:) vizkFkhZ la[;k ,d ls rhu ,oa lkr ls vkB la;qDr :i ls ,oa i`Fkd&i`Fkd :i ls vkaf'kd :i ls Lohdkj fd;k tkdj vkns'k fn;k tkrk gS fd vizkFkhZ la[;k ,d ls rhu ,oa lkr ls vkB la;qDrr% ,oa i`Fkdr% ifjoknh dks Jherh lfjrk daoj dk ykijokgh iw.kZ bZykt djus ls gqbZ lfjrk daoj dh e`R;q ,oa mlds Hkwz.k dh e`R;q gksus ls gqbZ {kfr ds dkj.k gqq, ekufld larki] e`rdk lfjrk daoj ds lkfu/; ls oafpr jgus ,oa larku lq[k ls oafpr jgus dh ,ot esa ,d eq'r jkf'k 10]00]000@&:i;s ¼v{kjs nl yk[k :i;s½ e; ifjokn izLrqr djus dh fnukad 08-04-2009 ls 9 izfr'kr okf"kZd nj ls C;kt ds vnk djs ,oa ifjokn O;; ds 25]000@&:i;s ¼v{kjs iPphl gtkj :i;s½ vnk djs A mDr jkf'k dh vnk;xh gsrq vizkFkhZ la[;k ,d ls rhu ,oa lkr ls vkB dks 45 fnol dk le; iznku fd;k tkrk gS A mijksDr jkf'k 10]25]000@&:i;s ¼v{kjs nl yk[k iPphl gtkj :i;s½ r; vof/k 45 fnol esa vnk ugha fd;s tkus ij ifjoknh mDr jkf'k ij fu.kZ; dh fnukad ls okLrfod olwyh dh fnukad dh vof/k gsrq 12 izfr'kr okf"kZd nj ls C;kt Hkh izk Ir djus dk vf/kdkjh gksxk A vizkFkhZ la[;k pkj ls N% ds fo:) ifjoknh dk ifjokn vLohdkj dj [kkfjt fd;k tkrk gS A ekuuh; jktLFkku mPp U;k;ky; ds vkns'k fnukad 12-02-2008 dh ikyuk esa lfjrk daoj dks ubZ fnYyh ,El vFkok vU; fdlh l{ke vLirky esa bZykt djkus ds fy, tks 10]000@&:i;s dk pSd vFkok tks fVfdV cuokdj fn;k x;k Fkk mldh jkf'k vizkFkhZx.k] ifjoknh ls izkIr djus ds vf/kdkjh ugha gS A ¼lat; Vkd½ ¼fueZy flag esM+roky½ ¼nsosUnz dPNkokgk½ lnL; lnL; ¼U;kf;d½ v/;{k