The main legal point established is the application of the Bolam Test to determine medical negligence and the standard of care in the management of the patient.

ORDER

Dr. S.M. Kantikar, Member. - The complainant a school teacher, Smt. Varinderjeet Kaur, delivered her second child by caesarean operation (LSCS) on 18.01.2009 in the BJS Bal Memorial Hospital (OP-2) i.e. the hospital of Dr. Ravinit Kaur (OP-1). Thereafter, on 5th day she suffered for Vesico-Vaginal Fistula (VVF). Hence, the patient suffered leakage of urine, she could neither sit nor travel. Her life became miserable, she was unable to attend the school. She approached various hospitals like Omni Hospital, Chandigarh, National Kidney Hospital, Jalandhar Vasudev Maternity Hospital, Jalandhar, Fortis Escorts Hospital, Amritsar, AMS Bassi Hospital, Ludhiana, etc. The complainant almost spent Rs. 8 lacs. The complainant filed the complaint before the District Consumer Disputes Redressal Forum, Gurdaspur (hereinafter referred to as District Forum) alleging that the VVF was developed due to wrong LSCS performed by the OP 1. The District Forum allowed the complaint and awarded compensation of Rs. 2 lacs , subsequently it was confirmed by the State Consumer Disputes Redressal Commission, Chandigarh (hereinafter referred to as State Commission) by dismissing the First Appeal No. 553 of 2012, filed by the OP. Aggrieved by the order of the State Commission, the OP filed this revision petition.

2. We have heard the learned counsel for both the parties. Counsel for petitioner vehemently argued that the patient was in labour for more than 10 hours, therefore, the OP took the decision to perform LSCS. There was exertion of contracting uterus therefore; the babys head pressure may cause injury to the bladder. There was no injury due to LSCS. Hence, it was not a fault of OP doctor. He further submitted that the patient developed VVF after five days in the hospital i.e. the OP noted the soaking of clothes by urine after removal of Foleys bladder catheter.

3. Whereas, the learned counsel for complainant Ms. Mithla Sharma argued that, the observations made by the District Forum and the State Commission are correct. She submitted that intentionally OP performed LSCS. The doctor was not careful while performing the LSCS. It was clear cut case of VVF developing after LSCS.

4. We have also requisitioned the record from the District Forum. Perused medical record of various hospitals. As per the treatment notes, on 17.01.2009 at 02:00 pm the patient was admitted in OP-2 for labour pains, OP-1 followed her labour till 04:25 am on 18.01.2009. As the foetus was not progressing, OP-1 took the decision to perform LSCS.

5. In the instant case, it is very difficult for us to understand who has performed the LSCS operation. The qualification of OP-1 mentioned on the letterhead is confusing one M.B.B.S., Gynaecologist and Sonologist. Counsel for petitioner stated that, LSCS was performed by husband of OP1, who is a Surgeon. But, neither medical record nor the operative note had any mention about the name of operating surgeon. Even the OP-1 did not file any affidavit of her husband to prove it. Therefore, due to lack of cogent evidence, we are of view that, Dr. Ravnit Kaur (OP-1) had performed the operation, who was not qualified to do so. Hence, it was a medical negligence. Medical records from other hospitals where the patient took treatment clearly reveal, that after LSCS the patient developed VVF.

6. The labour (delivery) notes maintained by OP-1 clearly show that, the Cervix was 3 to 4 cm dilated, head was at "0" station. There was no full dilatation of cervix, head was not tightly fixed, no caput seen. Therefore, it was not a case of obstructed labour. Hence, there was no pressure necrosis.

7. It is pertinent to note that, usually, after LSCS the urinary catheter will be removed after 24 hours. Need for keeping catheter for long duration shall be only in case of any bladder injury or some reasons for incontinence of urine. In this instant case, medical record revealed that, the bladder catheter was removed on 5th day after LSCS. It has created a suspic