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10.     While suturing the episiotomy wound the patient started bleeding, it was the post-partum haemorrhage (PPH). Therefore, immediately steps were initiated to stop the bleeding by uterine message and use of Oxytocic injections eg. Ergometrine, Prostaglandin. The Oxytocin drip was started, but the bleeding did not stop completely. On examination, the blood was coming from the uterus; there was neither laceration nor tear of cervix or in the genital passage. The condition of the patient was deteriorating, therefore it became mandatory to open the abdomen to control uterine bleeding. Patient's mother-in-law who was present outside the labour room was apprised of the situation and explained that even hysterectomy might be required. In the meanwhile another senior colleague  Dr. Alka Pandey a practicing senior Obstetrician and Gynaecologist who was already called by the Opposite Parties who also expressed the need for opening the abdomen of the patient. Dr. Alka Pande and O.P. No. 2 opened the abdomen and performed the Bilateral Internal Iliac artery ligation and the uterine Branch of Ovarian Arteries. However, the bleeding stopped only for 8-10minutes. Then B-lynch sutures were inserted but it also failed, the bleeding did not totally stop. The condition of patient gradually became very serious. She was on continuous cardiac monitoring. Her pulse rate was fluctuating (140-160/min) the systolic Blood Pressure dropped to 70 mm of Hg. Under such dire circumstances, main aim of the O.P. No. 2 was to save life of the patient Anuja at any cost. Therefore, the emergency hysterectomy was performed as an accepted practice. It was not a medical negligence.
Arguments on behalf of the Opposite Parties:
12.     The learned counsel for the opposite parties reiterated their affidavits of evidence. He further submitted that the delivery of child was uneventful, but the patient developed Atonic PPH, which was not controlled by conservative methods, therefore, emergency hysterectomy was performed. The O.P. No. 2 doctor gave various Oxytocic, like injection Ergometrine, Prostodin   and Oxytocin drip was administered besides other IV infusions. There was no evidence of laceration in the genital passage like cervical or vaginal tears or uterine perforation. The O.P. No. 2 performed 'B-Lynch suturing' but that too did not stop bleeding. The patient became very serious having low BP and high pulse rate. The patient was given few units of blood transfusions. The best line of treatment was adopted by the opposite parties and it is an accepted medical practice. It is further submitted that the patient's mother was informed about the serious condition and requirement of the removal of the uterus. After the Hysterectomy operation, the patient was continuously observed for the post-operative complications like, renal failure, coagulation failure, embolism, etc. Lastly, the learned counsel submitted that  the present complaint  was filed maliciously against the doctors, it is not maintainable as the complainants are not come within the definition of the 'consumers' as under section 2(1)(d) of the Act,1986.and the claim made by the complainants is totally arbitrary.

iii) Pt.Paramanand Katara vs Union of India & Ors. (1989) 4 SCC 286

iv) Dr.T.T.Thomas vs Smt Elisa & Ors   AIR 1987 Ker 52 We find the facts and legal proposition in those cases are not consistent with the instant case in hand.

Medical literature:

26.     On the subject of normal delivery, the PPH and the Management of Obstetric & Hysterectomy we have gone through the standard text books and few medical articles. [William's Obstetrics and Text book of Dr. D.C. Dutta] Postpartum haemorrhage (PPH):

Obstetric haemorrhage is associated with increased risk of serious maternal morbidity and mortality. Postpartum haemorrhage (PPH) is the commonest form of obstetric haemorrhage, and worldwide, a woman dies due to massive PPH approximately every 4 min. As per WHO the PPH is generally defined as blood loss greater than or equal to 500 ml within 24 hours after birth, while severe PPH is blood loss greater than or equal to 1000 ml within 24 hours. PPH is the most common cause of maternal death worldwide. Most cases of morbidity and mortality due to PPH occur in the first 24 hours following delivery and these are regarded as primary PPH whereas any abnormal or excessive bleeding from the birth canal occurring between 24 hours and 12 weeks postnatally is regarded as secondary PPH.