Decided on October 30,2007

Dauda Khan Appellant
Ispat General Hospital Respondents


- (1.) MR . Justice R.K. Patra, President -Attributing medical negligence this complaint has been filed. The sum and substance of the allegation is that Saida Begum @ Khatoon, wife of the complainant No. 1 (hereinafter referred to as the patient) was admitted in the Ispat General Hospital, Rourkela for delivery and because of the negligence of the doctors -opposite parties 2 and 3, her uterus was ruptured ultimately leading to her death.
(2.) THE case as made out in the complaint is that the patient was admitted in the Ispat General Hospital, Rourkela on 12.10.1992 on payment of Rupees 600 as fees for delivery. The treating doctor prescribed for administration of saline which was done. The staff nurse administered half unused saline. When the patient complained of pain, her attending mother requested the opposite party No. 2 -doctor to attend to her but she did not pay any heed. She suffered severely for about 15 minutes as a result of which the uterus was ruptured. Ultimately, the doctor and nurse shifted the patient to the labour room but there also none attended to her. After some time opposite party No. 3 -doctor took charge of the operation of the deceased. She was operated upon and a stillborn baby was removed from the uterus. Removal of uterus was also done. Ultimately she could not survive. Rupture of the uterus and its removal were due to the negligence of the attending doctors.
(3.) OPPOSITE party No. 2 -Dr. S. Khare has filed affidavit asserting that there was no deficiency in service by the attending doctor in treating the patient. Opposite party Nos. 1, 3 and 4 filed a joint reply denying the allegation. Their common case is that the patient reported at the hospital for ante natal checkup on 12.10.1992. Although the expected date of delivery was 6.10.1992 there was no sign of labour. The doctor on duty after examination, recommended for admission in the hospital for further observation, checkup and treatment. It was her third conception, the first being a caesarean section at Cuttack and the second a normal delivery. After her admission on 12.10.1992 at about 5.50 p.m. the doctor examined her condition and observed as follows: "Pulse : 80 per minute and regular B.P. : 110/80 Paedal Oedema : Nil Uterus : term, size, relaxed Liquor : Adequate. Vertex : Just fixed F.H.S. (Foetal Heart Sound) : Good. Cervix : Effaced. Pelvis : Adequate." Blood Test (for Hb.D.C.TLC), Urine Test (for sugar albumin, cross matching) was conducted and the doctor on duty prescribed: "S.W. Onema Liquid diet Injection Syntocinon 2.5 units in 5% dextrose solution slow 9/V. Watch for progress of labour." At about 11.10 p.m. the doctor on duty examined her and observed as follows: "Pulse : 80/min. Uterus : mildly irritable Vertex : fixed, F.S.H. Positive. No scur tenderness No discharge from vagina." Accordingly the following treatment was recommended. "Omit : Synotocinen. Restart : at 6 a.m. on the next day." On 13.10.1992 opposite party No. 2 in routine checkup attended the patient in the ward and was satisfied about the treatment given to her. She recorded that her uterus was relaxed and F.H.S. was regular. She prescribed syntocinon. At about 10.45 a.m., the patient complained pain and she was immediately taken to the labour room. She was feeling restless. Her hands were cold. Pulses were 80/ min. but feeable, B.P. was 50 mm hg. In the labour room the doctor on duty recommended for cross matching and advised to omit Syntocinon. He suggested for urgent specialist review. At 11.00 a.m. her condition became critical. It was observed as follows: "Pallor +++, Sweating + and Cold extremities. Chest : Clear B.P. : 50 mm Hg. Systolic. Pulse : Feeble Abdomen : Tenderness + Contour of uterus not felt F.H.S. : ? No vaginal bleeding." Dr. (Mrs.) B. Acharya who was on duty then apprehended rupture of uterus and prescribed as follows: "D.I.L. (Dangerous ill list) Urgent cross matching 4 units of blood for transfusion. Raise foot and of bed. O.T. Informed Prepare for C.S. + Hysterectomy Consent. Inj. Ampicillin 500 mg. I/V 6 hrly. after skin test. Haemaccal start in other hand. Inj. Depamine 300 mgm. with dextrose start......." All treatments were recommended and pursued under the direct supervision of specialist doctor and the patient was kept under constant care. Blood transfusion was started immediately. Operation theatre was made ready for operation. At 12.30 p.m. after clinical operation rupture of uterus was confirmed. A team of doctors immediately discussed and decided to hold operation. Opposite party No. 2 performed operation under general anaesthesia. After operation a dead female child was taken out. A big clot in the abdominal cavity weighing about 1 kg. was removed. For post operation treatment, Dr. C.S. Padmavati prescribed for blood transfusion in two units along with dextrose. At about 1.30 p.m. the patient was shifted to I.C.U. for constant monitoring. Her blood pressure was 130/80 mm Hg. by 2.30 p.m. She was given 5th and 6th units of blood. Blood transfusion and dopamine drip were also continued. She was given four more units of blood. Her condition deteriorated. On 14.10.1992 she was declared dead at 8.10 a.m. of that day. Opposite parties assert that there was no negligence in treating the patient. Considering the nature of the case, we requested Professor and Head of the Department of Obstetrics and Gynaecology, SCB Medical College and Hospital, Cuttack to examine the papers and render his opinion. All the relevant papers were sent to him. On perusal he has submitted his report. Copies of the report were given to Counsel for both parties. The opposite parties have filed additional notes disputing the finding recorded by the expert.;

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