Decided on February 26,2003



MAMATA LAKSHMANNA,MEMBER - (1.) THIS appeal has been filed by the unsuccessful complainants in O.P. No. 293/1996 on the file of District Forum, Guntur.
(2.) THE first complainant is the husband of late Rajani Kumari and complainants 2 and 3 are his minor children. When Rajani Kumari was expecting her second baby, she approached opposite party No. 1 and consulted third opposite party, who is the Gynaecologist. She was a patient of third opposite party from 26.9.1995 to 21.11.1995 when she died in the first opposite party nursing home. Her first delivery was by caesarean section in another hospital in 1990. When she approached the third opposite party, she showed all the reports of her first delivery. She was admitted in the opposite party nursing home when pains started on 20.1 1.1995. However, no tests were conducted like blood, sugar, urine etc. nor RH typing was done. When she was admitted at 12.00 noon on 20.11.1995, as per the case sheet, her B.P. was 140/90 which came down on 130/90 and there was mild meconium stained liquor and the opposite parties did not make any preparation for caesarean section in case of emergency, such as, blood grouping, cross matching, RH typing etc., and keeping the necessary blood ready. It is alleged that at that stage Syntocinon was given with 40 drops per minute and not 20 drops as mentioned in the case sheet. This high rate of Syntocinon led to rupture of the uterus and previously operated scar also got damaged which led to profuse blood loss. This all happened due to the negligence of third opposite party. At 3.30 p.m. the baby was delivered but bleeding was not controlled inspite of methergine injections, but no attempt was made to investigate the bleeding and clotting time. Only at 4.40 p.m. the blood was sent for grouping, typing and cross -matching. By 4.45 p.m. B.P. was not recoverable. Though her condition was bad, till 5.00 p.m. relatives were not informed only then they informed the relatives that A negative blood was required. Since it was not available A positive blood was given to the patient. In spite of repeated requests by the family to consult some other doctor, it was not done, nor was the patient investigated for renal failure. No record of urine output was maintained. Ryles tube was passed and 200 ml. of coffee coloured fluid noticed and ultimately she went into shock from which she never recovered.
(3.) THE opposite parties filed a joint version and denied all the allegations. Their contention was that Rajani Kumari came as out -patient for the first time on 26.9.1995 and after that she never turned up for check up. She finally came on 20.11.1995 when labour pains started. All the necessary tests like urine -albumin, blood grouping typing etc. were done when she visited the first time. She had undergone caesarean operation for her previous delivery 5 years ago. On admission on 20.11.1995 she was given routine treatment with antibiotics, 5% dextrose with 2.5 units of syntocynon with 20 drops per minute which is half the usual dose. Opposite parties 2 and 3 were constantly monitoring the pulse rate, B.P., fetal heart rate and progress of labour. A healthy baby was born at 3.30 p.m. by normal delivery. Presence of mild meconium stained liquor was not a very serious thing and it would never affect the mother in any case. Placenta expelled automatically within 10 minutes after delivery and methergine injection was given at 3.15 p.m. Suddenly profuse bleeding started and even another dose of methergine followed by Prostadin injection at 4.00 p.m. could not control it. By 4.30 p.m. the patient went into shock, the pulse became thready and B.P. fell. At that stage all required drugs were given and measures taken to control the bleeding and a second time, blood grouping was done as a measure of abundant care. As A negative blood was not available and seeing that the condition of the patient was deteriorating one bottle of A positive blood from her maternal uncle was given which shows the care taken by the doctors. Subsequently 6 units of A negative blood was also transfused. Inspite of all this, the patient could not be revived. The complainants complained huge amounts which is not justified since there was no negligence and also because complainant No. 1 has married a second time. The District Forum on a consideration of the material and evidence on record came to the conclusion that there was no deficiency in service since the opposite parties acted in the manner generally acceptable to medical profession and thus dismissed the complaint. Hence the appeal.;

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