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       This Complaint has been filed under Section 21 of the Consumer Protection Act, 1986 (for short 'the Act') by Punit Goyal (the Complainant) against Dr. Mridula Vohra, and Bhagirathi Neotia Woman and Child Care Center (the Opposite Parties) seeking compensation of          Rs. 20 Crore for the alleged death of his wife Jyoti Goyal due to the gross medical negligence during second delivery.  

2.       The Complainant's wife Jyoti Goyal, during 2nd pregnancy, was under care of Dr. Mridula Vohra (OP-1). Her expected date of delivery (EDD) was in September, 2014. She was diagnosed as 'Placenta Previa /Accreta', but it was allegedly never disclosed by OP-1. On 14.07.2014, due to acute lower abdomen pain, the patient was admitted in the OP-2 Hospital. The patient was in stable condition, no bleeding and no scar tenderness. The OP-1 did not perform USG and the Duvadilan (R) Test prior to delivery on previous night. It was alleged that the OP-1 never disclosed about the high risk of PPH, blood transfusions and possible need for emergency Hysterectomy. The OP did not take 'High Risk Consent' for Hysterectomy.  

10:45AM: once the patient party arrived OT started. After opening the abdomen, when lower segment was incised there was profuse bleeding. Baby was extracted after cutting through the placenta. Baby was handed over to the pediatrician. Placenta and membranes expelled, placental bed was repaired and uterus closed in layers. Uterus was well contracted and there was no bleeding.
11:40AM. Abdomen was closed in layers after proper haemostasls. During the surgery the BP dropped for which supportive treatment was administered. BP rose to 130/60 mm of Hg and patient again started bleeding profusely. Bimanual compression did not help and Consultant took the decision for Hysterectomy. The same OT followed into Hysterectomy. Party was informed about PPH (Post-Partum Hemorrhage). Complainant's consent for Hysterectomy was taken. As per operative doctor's advice blood was arranged by the hospital with minimal timing from the institute Mission of Mercy Hospital which is situated opposite to OP no 2 hospital with the minimum time taken for sample cross matching. Per operative 4 units (2 units of whole blood and 2 units of PRBC) were received and was transfused to the patient starting from 12 Noon, 2nd bottle at 12:30 PM, 3rd bottle at 12:45PM and 4th bottle at 1:05PM. Blood was arranged within 15 to 30 minutes post order of the Consultant from Mission of Mercy Hospital and transfusion was started immediately. There was no delay in arrangement and Transfusion of blood. FFP (Fresh Frozen Plasma) was also arranged as per Consultant's advice in case of requirement for eventuality, 1:10 PM: Patient received by ICU. Manual ventilation, pupil mid dilated, put on ventilation CMV mode, 2 PM: Blood Transfusion continued till 2PM. 2:15 PM Cardiac Arrest occurred. CPR started. Pulse and BP not palpable and recordable. CPR was given continuously. Adrenaline and Atropine administered followed by Cardiac shock with short recovery period with Pulse 30/min. Atropine given. Pulse 60 / min. BP not recordable.

9.       I have heard the arguments from the learned Counsel for both the sides. Perused the material on record, inter alia, the Medical Record. The learned Counsel on both the sides reiterated their evidence.  

10.     The learned Counsel for the Complainant argued the OP-1 failed to take proper care during pregnancy with Placenta Previa.   He submitted that the OPs forced the Complainant to give their consent for hysterectomy. 

11.     The learned Counsel for OPs reiterated their evidence. The OPs filed medical literature on PPH and few citations. 

13.     To know about the PPH and Postpartum Hysterectomy, I have gone through few medical articles, WHO recommendation and the William's Obstetrics (14th Ed.) textbook and the Johns Hopkins Manual of Gynecology and Obstetrics (5th Ed.).

13.1  The Postpartum haemorrhage (PPH) is known as an Obstetric haemorrhage is associated with increased risk of serious maternal morbidity and mortality. 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. PPH may result from failure of the uterus to contract adequately (atony), genital tract trauma (i.e. vaginal or cervical lacerations), uterine rupture, retained placental tissue, or maternal bleeding disorders. Uterine atony is the most common cause and consequently the leading cause of maternal mortality worldwide.