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2016 MarsdenLR 2259
SESSION COURT (BUTTERWORTH)
JULIE LACK, J
Mohd Fadli bin Bakar – Plaintiff
Versus
Pengarah Hospital Hospital Seberang Jaya & Ors – Defendant
CIVIL SUIT NO 52–2391–10 OF 2011
The court found no negligence by medical practitioners as they met the applicable standard of care during the treatment of a high-risk patient, dismissing the plaintiff's claim.
Headnote:(A) Civil Law Act 1956 - Section 7(3B) - Claim for negligence - Plaintiff alleged negligence in medical treatment during childbirth - Court found that the standard of care was met - The deceased was a high-risk patient, but proper procedures were followed in her treatment and delivery. (Paras 12-15, 57-65)
(B) Medical Negligence - The standard of care expected of medical practitioners is to be evaluated based on recognized practices in the field - It was determined that the medical team acted in accordance with medical standards and protocols relevant at the time. (Paras 26-30, 56)
(C) Informed Consent - The issue of informed consent was raised but not specifically pleaded in the statement of claim - The court held that the plaintiff could not rely on unpleaded issues during trial. (Paras 70-72)
(D) Burden of Proof - The burden rests on the plaintiff to establish negligence - Court found insufficient evidence of negligence or breach of duty by the defendants. (Paras 43-46) (E) Conclusion - Claim dismissed as the plaintiff failed to prove negligence by the defendants. (Paras 106-107)
The Plaintiff’s cause of action against the 1st, 2nd and 3rd Defendants is founded upon the tort of negligence pursuant to Section 7 (3B) Civil Law Act 1057
Factual Background
The factual background of this case as adumbrated by me hereafter has been plucked from the medical records produced in court in the various bundles of documents filed in this case
The plaintiff was at all material times the husband of Nora bt Hussain (the deceased).
In the year 2008 the deceased was a vibrant 37 year old lady pregnant in her third trimester. She had two older children and this was her third pregnancy.
On 13.10.2008 the deceased came to Hospital Seberang Jaya for a routine medical check up. Since her blood platelet count was low the O & G specialist (Dr Samuel Mathew) decided to ward her for further review and treatment. A Doppler test was carried out on her on 14.10.2008. The outcome of the test was good in that the foetus was well and the amniotic fluid index was normal. The deceased was experiencing high blood pressure in pregnancy so the treatment plan was towards induction of labour in her 38th week or sooner to avoid foetal compromise. The deceased was discharged on 15.10.2008 when her blood platelet count increased and her blood pressure stabilized.
The next day her blood pressure again spiked thus requiring her to be readmitted into Hospital Seberang Jaya. An increased dosage of medication was prescribed. The Doppler test conducted on her on 20.10.2008 was normal and she was allowed to be discharged from the ward. The clinical notes indicate that she was to be readmitted to the maternity ward on 26.10.2008 which is her 37th week with a view for the induction of labour process to commence.
The deceased and her husband turned up at the hospital as required on 26.10.2008 and she was duly warded and she was monitored closely by the medical team handling her case. Her blood pressure was recorded at 130/90. At 8.40pm her blood pressure increased to 170/100 and came down to 151/84 about an hour later. She was administered with Nifidipine 10mg. Blood samples were taken and sent to the laboratory. The clinical notes record a low platelet count between 12 to 24 x 10 per ml in the afternoon. An ultrasound examination by the doctor on duty noted there was oligohydramnios. The platelet count was low and a provisional diagnosis showed she had idiopathic thrombocytopenia (ITP) and she was prescribed with medicines.
On 28.10.2008 at 8.50am the O & G specialist examined her and ordered for the induction of labour to commence after a CTG test was conducted. Her platelet count was 20 x 103/ml. The doctor directed 4 units of platelets to be on standby but only 2 units were ready. At 9.25am a prostinpessary was inserted in the vagina. She was wheeled to the maternity ward at 5.50pm and was under the care of the 3rd defendant who was a qualified birthing nurse. An examination of her cervix at 5.50pm showed 3 cm dilation. She was fully dilated at 7.50pm and she was ready to deliver. Her baby was delivered at 8pm. Soon after delivery of the baby but before delivery of the placenta the deceased complained of breathing difficulties. A doctor was called to her bedside. She was able to respond to the doctors questions. She was given oxygen and her vital signs and cardiac monitoring were taken. She collapsed suddenly and went into cardio pulmonary shock and a red alert was activated. Specialists from the O & G and anaesthetic team responded immediately. She was intubated, given CPR and medication and her vital statistics were stabilized. She was transferred to the ICU and monitored closely. An early impression by the medical team was of pulmonary embolism, amniotic fluid embolism (AFE) or acute pulmonary oedema (APO) – to rule out underlying heart disease. CTPA tests conducted on 29.10.2008 showed no evidence of pulmonary embolism suggestive of pulmonary oedema. After reviewing the CTPA, SD 5, Dr.Yuzainov Ahmad, the O & G specialist recorded the following impressio
