IMPORTANT POINT
Baby girl removed surgically from uterus, there should not be a chance of retention of bits of placenta, doctor failed to clear or inspect uterine cavity after delivery of baby, it was negligence.

Dr. S.M. Kantikar, Member—Smt. Neena Rani, (patient) the complainant, on 11.8.2013 underwent caesarian operation (LSCS), delivered a baby girl at Swami Premanand Hospital, G.T. Road, Mukerian. It was performed by Dr. Pardeep Kaur Dhillon, the medical officer/OP. She was discharged on 15.8.2013. The stitches were removed on 19.8.2013. At that time, she complained of bleeding per vaginum. The OP assured “nothing to worry”. It will be cured shortly. Thereafter, on 7.10.2013, she got scanning USG done from Sukhmani colour Scanning Centre, Dasuya, which revealed a large haterogenous enchogenic mass of 40 x 34 mm. Her problem increased during same night, the OP/doctor was contacted, but she was shifted to Life Care Hospital, Talwara, Mukerian. The scanning was repeated by OP on 10.10.2013 from Crystal Diagnostic Centre. The report revealed echo rich area anterior to the endometrial cavity-uterine hematoma. The OP continued medical treatment. Thereafter, patient herself approached Dhami Nursing Home, Hoshiarpur and as per the medical officer, she got MRI done on 20.10.2013. It was diagnosed as “degradation products, possibility of sub-acute haematoma with retained products of conception (Placental Tissue”. Therefore, she was referred to PGI or DMC, Ludhiana, on 25.10.2013, for further treatment. There, it was found that retained products of conception and she underwent treatment of VISE “Virtually Inspected Suction Evacuation”.

2. Therefore, the complainant alleged that due to negligence on the part of OP, she suffered a lot and spent almost Rs.2 lakhs, without any results. Hence, she filed a complaint before the District Forum, Hoshiarpur.

3. The District Forum partly allowed the complaint and directed the OP to pay a sum of Rs.2 lakhs as compensation, Rs.27,287 towards medical expenses and Rs.20,000 as litigation charges.

4. Aggrieved by the order of District Forum, the petitioner/OP filed first appeal before the State Commission, Punjab on 25.11.2014. The State Commission dismissed the appeal. Hence, this revision petition.

5. We have heard the learned counsel for the petitioner at the admission stage. He vehemently argued that the OP performed LSCS properly. The placenta was adherent. Therefore, it was not extracted completely. He further stated that complaint was bad for non-joinder of parties. The OP was the employee of Swami Premanand Charitable Hospital. Therefore, as such, the complainant had not hired any services from OP. The OP is a qualified a Gynecologist and fully competent. Even, DMC Hospital, Ludhiana had provided the same treatment.

6. We have perused USG report, the MRI report available on file and the other medical records. We have perused the relevant medical literature from the “Williams Obstetrics and Shaw’s Book”. It describes about the chances of retained products, as below:

7. There are abnormal variations of the placenta in which trophoblastic tissue invade the myometrium to varying depths. These conditions are placenta accrete, increta and Percreta. In such cases, these may result in perforation or Torrential Hemorrhage as a frequent complication.

About Succenturiate Lobe:

“The accessory lobe may sometimes be retained in uterus after delivery and may cause serious hemorrhage. In some cases, an accompanying vasa previa may cause dangerous fetal hemorrhage at delivery.

Usually, the retained piece undergoes necrosis with deposition of fibrin and may eventually form the so-called placental polyp.

8. We are quite surprised to find the way the OP performed LSCS. Baby girl was removed surgically from uterus, and therefore, there should not be a chance of retention of bits of placenta. It is thus clear that, OP doctor failed to clear or inspect the uterine cavity after delivery of baby. Therefore, it was negligence. It is pertinent to note that, the patient approached the OP with complaints of bleeding, but she was given only medication, not investigated properly. She was subsequently treated at DMC, Ludhiana by