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5. Following the delivery, Kavitha's condition rapidly deteriorated due to continuous bleeding as a result of a medical condition termed PPH (post partem haemorrhage). Postpartum haemorrhage (PPH) is severe or excessive bleeding after childbirth. It is a serious, potentially life-threatening condition, because of 4 of 53 https://www.mhc.tn.gov.in/judis ( Uploaded on: 23/05/2025 03:55:20 pm ) which, one can lose large amounts of blood very quickly. It causes a sharp drop in the blood pressure, which can restrict blood flow to the heart, brain and other organs. Even at this stage, the doctor was not called upon to attend on Kavitha. The nurse attempted to address the situation. At 2.29 am, she called the ambulance service and shifted Kavitha to the District Government Hospital at Tirunelveli. The ambulance arrived at the hospital at around 3.45 am. Despite the attempts of the doctors at Tirunelveli to resuscitate Kavitha, she passed away at 4:30 a.m. No post-mortem examination was conducted. The final rites were carried out at Soolamangalam, Thanjavur District.

27 of 53 https://www.mhc.tn.gov.in/judis ( Uploaded on: 23/05/2025 03:55:20 pm ) d.Insufficient exercise of care to manage PPH

48. It should also be noted that the ambulance arrived at the scene at 2.50 a.m., after the birth of the child, when the petitioner’s daughter was undergoing PPH. The ambulance was not alerted to handle the situation of PPH but was called upon to transfer Kavitha from the PHC, Kadambur to Tirunelveli Medical College Hospital, Tirunelveli to manage the difficult labour. This shows that the haemorrhage, a consequence of the delivery, that was known to be beyond the managing capacity of the nurse- yet was attempted to be addressed by her, without the assistance of a Doctor.

49. Though the Respondents have contended, while answering the queries posed to them, that the reason for PPH could have been uterine atonicity and have maintained that the reasons for 2/3 rd of PPH remain unknown, the difficult labour and the consequential PPH could have been effectively handled if the duty doctor and assistant surgeon available on-call were present at the time of delivery. The non-communication of the completion of dilation and the on-set of difficult delivery by the nurse to the duty doctor has worsened the entire process, thereby evidencing her negligence and failure of her duty to take care of the deceased Kavitha .

52. Further, in the 7th respondent’s affidavit, it is detailed that the 29 of 53 https://www.mhc.tn.gov.in/judis ( Uploaded on: 23/05/2025 03:55:20 pm ) concerned nurse underwent various training programs, with specific information provided regarding the name, date, duration, and location of each training since 2020. It is mentioned that the nurse took PPH training on 20.04.2022. However, the tragic event in question occurred on 13.02.2022, which was nearly two months prior to this training. This shows that the nurse, who had not yet received specific training to treat PPH at the time of the incident, was expected to manage a critical condition such as postpartum hemorrhage. This further strengthens the petitioner’s assertions of gross medical negligence.