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NATIONAL CONSUMER DISPUTES REDRESSAL COMMISSION, NEW DELHI
Dr. B.C. Gupta, Presiding Member and Dr. S.M. Kantikar, Member
Katra Satyanarayana and Ors. —Petitioners
versus
Lakshmi Nursing Home and Ors. —Respondents
Revision Petition No.2859 of 2006
(Against the Order dated 28/06/2006 in Appeal No. 200/1998 of the State Commission Andhra Pradesh)
Decided on 11.9.2017
For the Petitioners:Ms. A. Subhashini, Advocate
For the Respondents:Mr. G. Ramakrishna Prasad and Mr. Byrapaneni Suyodhan, Advocates
IMPORTANT POINT
Choosing different method of treatment is not a medical negligence.
Headnote:Consumer Protection Act, 1986—Sections 15, 17, 19 and 21—Medical services—Medical negligence—Maternity—Death of lady after delivery—Complaint dismissed by Fora below—Previous history of Cesarean section does not appreciately alter course of labour—Doctor can conduct normal delivery under such circumstances—Choosing different method of treatment is not a medical negligence—Patient was efficiently managed throughout delivery—Post-delivery bleeding was also managed—OP/doctors have acted in accordance with accepted, standard medical practice—Revision petition dismissed.
Held: Thus, it is clear from the medical literature that, the previous history of Cesarean section does not appreciately alter the course of labour. It means the doctor can conduct normal delivery under such circumstances. In the instant case, the patient underwent first delivery in 1990 i.e. almost 5 years back, thereafter the second delivery was in 1995 in the OP 1/hospital. OP 3/doctor after examination of patient, decided to conduct normal delivery instead of LSCS. Therefore, choosing the different method of treatment is not a medical negligence. In this regard, we rely upon the judgment of Hon’ble Supreme Court in Achutrao Haribhau Khodwa v. State of Maharashtra (1962) 2 SCC 634, which laid down the law as follows:
“The skill of medical practitioners differs from doctor to doctor. The very nature of the profession is such that there may be more than one course of treatment which may be advisable for treating a patient. Courts would indeed be slow in attributing negligence on the part of a doctor if he has performed his duties to the best of his ability and with due care and caution. Medical opinion may differ with regard to the course of manner which is acceptable to the medical profession and the court finds that he has attended on the patient, but as long as a doctor acts in a manner which is acceptable to the medical profession and the Court finds that he has attended on the patient with due care, skill and diligence and if the patient still does not survive or suffers a permanent ailment, it would be difficult to hold the doctor to be guilty of negligence.”
OP 3 is a qualified Gynecologist and OP/her husband was a surgeon, who had conducted the delivery. The medical record also proves that the Syntocinon was not given in controlled excess but it was administered in controlled manner. The patient was efficiently managed throughout the delivery. The post delivery bleeding was also managed by giving Haemaccel and 8 units of blood transfusion. Therefore, in our view, there was no failure of duty of care by OP 3. Though it has been noticed that the OP had not confirmed the blood group of the patient before delivery, certainly it has created panic and the patient was in need of blood. As the patient’s blood group was ‘A’ negative, which itself is a rare blood group, certainly, it has created panic and also mental agony to the patient’s relatives to arrange the rare blood group but immediately with the prudence of OP/doctors, they have administered Haemaccel and ‘A’ Positive blood, which was an accepted method of treatment to save the life of patient. The medical record did not show that there was uterine rupture as alleged by the complainant. The death of patient was due to Post Partem Hemorrhage (PPH) and Disseminated intravascular coagulation (DIC). On the basis of available medical literature, the cause of death was due to Post Partem Hemorrhage (PPH) and Disseminated intravascular coagulation (DIC).
12. In Jacob Mathews Case, (2005)6 SCC 1, the Hon’ble Supreme Court observed that:-
“When a patient dies or suffers some mishap, there is a tendency to blame the doctor for this. Things have gone wrong and, therefore, somebody must be punished for it. However, it is well known that even the best professionals, what to say of the average professional, sometimes have failures. A lawyer cannot win every case in his professional career but surely he cannot be penalized for losing a case provided he appeared in it and made his submissions.”
Considering the entirety of the facts, in our view, the OP/doctors have acted in accordance with accepted, ‘standard medical practice. In our view, the impugned order, therefore, does not suffer from any illegality, irregularity or jurisdictional error, which may call for interference in the exercise of revisional jurisdiction. We do not find any merit in the instant revision petition. Hence, it is dismissed. There shall be no order as to costs. (Paras 10 to 13)
Result: Revision Petition dismissed.
Dr. B.C. Gupta, Presiding Member—This revision petition is filed under Section 21(b) of the Consumer Protection Act, 1986 against the order dated 28.6.2006, passed in First Appeal No. 200 of 1998 by the A. P. State Consumer Disputes Redressal Commission, Hyderabad (in short, ‘ the State Commission’) whereby the State Commission upheld the order of the District Forum and dismissed the appeal filed by the complainants.
2. The relevant facts for the disposal of the revision petition are that Smt. Rajani Kumari, since deceased, (hereinafter referred as ‘the patient’) underwent first Cesarean delivery (LSCS) in the year 1990. During second pregnancy, she was under the care of Dr. K. Vara Prasad/OP 2 and Dr. K. Padmaja/OP 3 at Lakshmi Nursing Home (OP 1) since March 1995. On 20.11.1995, she developed labour pains and got admitted in OP 1/Nursing Home. It was alleged that OP failed to conduct blood tests including Blood Sugar, Urine Tests, Blood Grouping, Cross matching etc. The nursing home does not have proper facility for cesarean section and blood was not kept ready before operation. The doctors without performing any investigation, conducted the vaginal delivery, which resulted into death of the patient. It was further alleged that infusion of Inj. Syntocinon was given at the higher rate of 40 drops per minute, but in the case-sheet, it was recorded as 20 drop per minute. Because of high rate of Syntocinon drip led to rupture of the uterus through previous surgical scar which caused profused blood loss. The baby was delivered at 3.30 p.m. but the bleeding did not stop inspite of injection Methergine. OPs 2 and 3 did not attempt to investigate the cause of bleeding. Thereafter, at 4.40 p.m., the blood was sent for grouping and cross matching, the relatives were kept in the dark that the patient was in need of ‘A’ Negative blood. Due to non-availability of ‘A’ Negative blood, ‘A’ Positive blood was transfused to the patient without consulting any specialist, which further caused renal failure. The OP has not mentioned record of urine output, subsequently, patient developed shock and then she never recovered. Due to alleged deficiency in service and medical negligence, the complainant filed a complaint before the District Consumer Disputes Redressal Forum, Guntur.
3. The OP filed the written version and denied about the negligence on their part. The OP submitted that the patient did not approach OP at initial stage. There was no negligence while conducting delivery. The blood was needed because there was bleeding after delivery and due to paucity of ‘A’ Negative blood, the patient was transfused ‘A’ Positive blood. It was necessary to save the life of the patient. Throughout the delivery, the doctor and staff had monitored the entire process.
4. The District Forum on the basis of pleadings and evidence dismissed the complaint. The same order was challenged by the complainant before the State Commission by filing first appeal, which was also dismissed. Being aggrieved by the order of State Commission, the complainant filed the instant revision petition.
5. We have heard the learned counsel for both the parties. Learned counsel for the petitioner argued that the OP was well aware that the patient had first delivery by LSCS, therefore, OP should have been careful while conducting second delivery by vaginal route. The OP neither performed ultrasound nor done any blood test during ante-natal period. Thus, it was a breach in the duty of care from the OP /doctors. During delivery, OP had administered Syntocinon drip at higher rate (40 drips/minute), which further caused more uterine contractions and rupture of the uterus. Also, the counsel submitted that the medical record did not mention about details of trial of labour, which was mandatory in the patient’s undergoing trial of labour after previous LSCS. OP should have advised emergency cesarean but he proceeded with normal delivery. In this regard, counsel for the complainant produce
