The medical practitioners failed to meet the standard of care expected, resulting in negligence and damages owed to the Plaintiff.

[1] This is the decision of the Court in respect of the Plaintiff's claim for medical negligence.

Chronological Background

[2] The Plaintiff is a Rohingya refugee who has been in Malaysia since 2011. Being a United Nation High Commissioner for Refugees ("UNHCR") cardholder, she is entitled to subsidised health care at the Klang Hospital ("the Hospital"). This meant that she had to pay charges imposed by the Hospital.

[3] On 9 August 2014, the Plaintiff was admitted to the labour ward of the Hospital. Due to the slow progress of her labour, the doctors decided to hasten the same by augmenting it with oxytocin.

[4] Shortly thereafter, the Plaintiff successfully delivered a baby boy weighing 3.25 kg at 2.10 pm on 11 August 2014. Based on the hospital records, it was recorded that an episiotomy incision was made to facilitate delivery. Post delivery, the episiotomy wound was sutured. Following re-suturing, Staff Nurse Miharlia (the 3rd Defendant: DW-1) discovered that there were pockets in the anus. This prompted DW-1 to consult a senior doctor, obstetrician and gynecologist, Dr Uma Mariappen (the 4th Defendant: DW7). DW-7 examined the Plaintiff at 4.10 pm.

[5] DW-7 found no 3rd or 4th degree tear on the Plaintiff, but nonetheless decided to refer her for examination under anaesthesia. For this purpose, the Plaintiff was then sent to the operation theatre at about 6.00 pm. At 7.00pm, Dr Nor Azhana Mohamed (the 5th Defendant: DW8) attended to the Plaintiff. Upon removing the sutures, DW-8 found perineal injuries of a serious nature (oasis of her anal sphincter).

[6] DW8 then requested for assistance of a general surgeon, Dr Mohammad Azhar bin Anis Ahmad (the 6th Defendant: DW-3). Both DW-8 and DW-3 found the Plaintiff's perineal area contaminated, inflamed and the perineal tissues friable. A decision was made to undertake an open repair of the perineal injuries and for a colostomy to be done. Under the colostomy procedure, the bowel is disconnected from the rectum and brought out to the abdominal wall.

[7] Post surgery, the Plaintiff regained consciousness and found a colostomy opening in her abdomen into which faces were to be drained. She was shocked, upset and demanded an explanation. The Plaintiff was also concerned on the cost of the surgical procedures and the time it will take for her to recover. Based on hospital records, both the Plaintiff and her husband were duly given the explanation sought and also counselling.

[8] Subsequently, the Plaintiff was successfully discharged on 20 August 2014. However, a few days later, the Plaintiff found her perineal injuries to be extremely painful and with discharge of pus. Due to this, the Plaintiff sought treatment at a general practitioner clinic in Meru, Klang where she was attended to by Dr Ghanti Karuppiah (PW3).

[9] PW-3 found the perineal wound to be infected prompting him to remove the sutures, cleaned the wound and gave the Plaintiff antibiotics. A few days later the Plaintiff's perineal wound was re-sutured.

[10] The Plaintiff thereafter, continued to attend follow up consultations at both the obstetrics and gynecology clinic and the surgical clinic respectively at the Hospital wherein the surgical clinic managed the colostomy and the rectal injuries whereas the obstetrics and gynecological clinic managed her perineal injuries.

[11] As the obstetric and gynecological clinic doctors were concerned about a subsequent pregnancy before the wound could heal properly,