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3. The O.P. No.1 filed his written statement and denied the allegations made by the complainants against him. The O.P. No.1 did not commit any medical negligence. During pregnancy of Smt. Nameshwari Sahu, on 08.11.2016, 10.01.2017, 06.03.2017 and 24.03.2017, for examination of the child in womb, the Sonography and Sonography Color Doppler, was done by the O.P. No.1. When the complainant came to the O.P. No.1 for Sonography of the complainant No.2, at that time they brought slip of Dr. V.N. Sahu, who advised the complainant No.2 for Sonography on the basis of which the O.P. No.1 conducted Sonography of the complainant no.2 and provided the report to the complainants and informed them regarding the report, which is mentioned in para 2(a) to 2(d) of the written statement. From the perusal of the Sonography Report dated 19.04.2017 filed by the complainant, which was prepared by Dr. M. Graham of Christian Hospital, Dhamtari, it is clear that in the Sonography report dated 19.04.2017 of Smt. Nameshwari Sahu, Dr. M. Graham reported that the development of child was not proper in womb, no defect was found and the heart-beat of the child in womb, was normal. From the Sonography report it is clear that in the report which was provided by the O.P. No.1 to the complainants after conducting Sonography, there was no error in the report. From the averments of the complainants it is clear that when the child was shown to Dr. Kinjal Bakshi, Cardiology Department of M.I. Narayana Hospital and echo of newly born child was done, then it came to know that he was suffering from serious heart disease. The information regarding heart defect since birth can be obtained by the Cordiologist when the Foetal Echo is conducted, which is done during 18 to 22 weeks of the pregnancy in the developed child. In the instant case, in 18 to 22 weeks, no foetal echo of the // 7 // child in womb was done and from general Sonography or colour Doppler Sonography, the heart defect to the child in womb, cannot be ascertained. If in the Sonography it is found that in the womb, there is abnormal changes in the heart beat of the child or there was past history of congenital heart disease in the mother - father of the child or in foetal hydrops womb, in the body of the child there is swelling or water is logging or there is excessiveness of Amniotic Fluid in the womb of the mother or complaint of polyhydraminio is found, then in such circumstances on the basis of Sonography, the advice is given for conducting foetal echo. In the instant case, the O.P. No.1 did not find any fact during the Sonography due to which concerned doctor also gave advise to the complainants for conducting foetal echo.Foetal echo cardiography is nly done by the Cardiologist. As the O.P.No.1 only a Radiologist, therefore, the foetal echo would not have been done by the .O.P. No.1. It was informed that the child in womb was having heart disease since birth, which cannot be ascertained by general Sonography or colour Doppler. The above fact is examined by the Cardiologist through foetal echo. The O.P. No.1 is a radiologist and he only conducted Sonography of the complainant No.2 by which the disease of the child in womb cannot be ascertained. The O.P. No.1 did not comit any act, which comes in the category of medical negligence. This Commission has no pecuniary jurisdiction to hear the complaint. The complainants are not entitled to get any relief and the complaint is liable to be dismissed with cost. The O.P. No.1 had obtained Professinal Indemnity Doctors Policy No.192500/48/2017/616 from The Oriental Insurance Company Limited, Divisional Office, Durg (C.G.) which was valid for the period from 26.07.2016 to 25.07.2017 and Insurance Polic No.192500/48/2018/632 for the // 8 // period from 26.07.2017 to 25.07.2018. In the instant case, the O.P. No.1 has not done any act, which comes in the category of medical negligence, even then if this Commission come to the conclusion that the O.P. No.1 committed medical negligence, then in such circumstances, the Oriental Insurance Co. Ltd. is responsible to pay the compensation. The O.P. No.1 is not liable to pay compensation to the complinant. The complaint is liable to be dismissed.

 A single loop of cord seen posterior to fetal neck at the time of examination.
// 24 // Conclusion : 
                     .......


                     ........


                     FEtal Echo S.O.S."
28. The O.P. No.1 has filed Literature on Dignostic Ultrasound Volume Two marked as Annexure 3, in which under Chapter 38 under the Head The Fatal Heart, it is mentioned thus :-
"Sonographic evaluation of the fetal heart can identify fetal cardiac abnormalities that impact obstetric cre in a variety of ways, including mode of delivery, place of delivery, opportunity for termination, intrauterine therapy and parental reassurance. Congenital heart disease (CHD) is a significant problem with an incidence of between 2 to 6.5 cases cases per 1000 live births.....
Indications for fetal echocardiography are detailed in the box on p. 1126. Although the most common indications for formal fetal echocardiography are family history of CHD and fetal arrhythmia, the majority of these foetuses will have normal hearts.
The higest incidence of CHD occurs in patients referred for an abnormal four chamber view on screening obstetric ultrasound, fetal hydrops, or polyhydramnios respectively. The fact that most foetuses with congenital heart disease have no known risk factors..................

// 31 // Clinical Implications Congenital malformations occurred in 2-4% of all births. Despite their relatively low prevalence, fetal malformations are responsible for approximately 30% of perinatal deaths in addition to considerable infant morbidity in developed countries. Prenatal diagnosis of congenital disease provides information for decisions during pregnancy and appropriate treatment perinatally (timed delivery in tertiary czre centers) and it is assured to improve perinatal and log term outcome. However, this assumption has been demonstrated only for few specific subsets of malformations, and with conflicting results. Bonnet et al showed that prenatal diagnosis reduced to nihil pre and post-operative mortality in foetuses affected by complete transposition. In another study preoperative conditions were improved in cases with complete transposition and hyproplastic left heart, without no improvement in perinatal mortality. Survival at 2 years was the same in diagnosed as in undiagnosed foetuses with pulmonary atresia with intact ventricular septum. No improvement was seen in cases of hyproplastic left heart diagnosed antenatally. A major impact of antenatal diagnosis of malformations is related to the severity of the malformations detected. Most severe defects are reportedly detected earlier than minor ones, which is especially relevant in many countries where only before viability is termination of pregnancy authorized by law. The gestational age at which a severe malformation is diagnosed is therefore crucial to further management of the pregnancy. A recent metaanalysis assessing the use of routine ultrasound compared to selective ultrasound before 24 weeks gestation has shown that where detection of clinically unsuspected fetal malformation occurred. As a result, an increased rate of pregnancy termination was recorded in study group undergoing unltrasound screening (odds ratio 3.19; CI 1.54-6.6). The impact of the high pregnancy // 32 // termination rate is a decrease in prevalence of livebirths affected with severe malformations of the order of 20%-30%."