- (1.) THE complainant s wife Mrs. Amudha was admitted in the hospital of the 2nd opposite party on the advice of the 1st opposite party on 28.5.1998. Though the general condition of Amudha was good, she did not develop any labour pain. Therefore, the 1st opposite party prescribed certain medicine at about 2.15 p.m. Around 2.30 p.m., she was transferred and admitted in the labour ward. The 1st complainant after leaving his children with his mother -in -law, came back to the hospital around 6 p.m. He was informed that the 1st opposite party had left the hospital at 5 p.m. and she was not available at the hospital and only duty nurses were present. They were informed by the nurses that the patient was in good condition and delivery was expected any time. Around 7.15 p.m. the complainant s wife developed fits. It was conveyed to the duty nurses around 8 p.m. The nurses said they were able to control the fits. The duty nurses requested the complainant to bring some other doctors as the condition of the patient was critical. Therefore, the complainant rushed to A.G. Hospital which is nearby and requested the doctor there to come and attend. Dr. Meenakshi of A.G. Hospital came and attended the patient. Dr. Meenakshi advised a Surgeon from Madambakkam to be brought immediately since an emergency operation had to be performed. Accordingly, he rushed to Madambakkam to bring the Surgeon but the surgeon at Madambakkam told him that he has received a phone call from the hospital stating that the delivery was over and that his presence was not required. The complainant rushed back to the hospital. Though Dr. Meenakshi promised that she will be shifted to A.G. Hospital, the patient was not shifted to A.G. Hospital. The complainant was informed that his wife had delivered a still born female child. The complainant was shocked. But the staff there did not disclose about the health condition of his wife. The complainant again rushed to A.G. Hospital and found only duty doctors and brought two of them to check the complainant s wife. They came out of the labour room in a confused state and rushed to A.G. Hospital. At the same time, the 1st opposite party arrived at the hospital. She came around 9.30 p.m. After rushing to the labour ward, she came back and informed the complainant that the condition of the wife is precarious and she tried to arrange for blood and that she was not successful and asked the complainant to arrange for blood. Though the complainant told her that his friend Udayakumar was having A positive blood, but, for the reasons best known to the 1st opposite party, she did not accept the same. She insisted upon the complainant being taken to Egmore Maternity Hospital. The complainant requested the 1st opposite party to provide Ambulance facility but that was also not done. Left with no other option, the complainant himself took his wife in his car to Military Hospital. Upon admitting in the Military Hospital, he was shocked to hear from the doctor that the patient was already dead. Thus, the opposite parties have failed to take proper care of the patient from the time she was admitted in the hospital. They have failed to exercise ordinary skill and care. They did not attend upon the patient for more than four hours. On account of their negligence and deficiency in service, two lives were lost. Therefore, the complaint is laid praying for a compensation of Rs. 18,00,000/ -.
(2.) THE written version filed by the opposite party runs as follows: The Hospital records have been taken away by the 1st complainant on the pretext of making insurance claim. The delivery pain did not develop despite administration of drips. Therefore, it was decided to stop the drip at 5 p.m. she left the hospital at 5.30 p.m. to attend her hospital anaesthetist s daughter s marriage reception. Before leaving, she had instructed the duty staff to take proper care of the patient and she expected to return within two hours namely around 7.30 p.m. Further she directed the hospital staff to seek the help of doctors in A.G. Hospital in case of emergency. She understood from the hospital source that the patient developed a sudden convulsion. Immediately Dr. Meenakshi from A.G. Hospital attended the patient and she decided to perform a caesarean since there was foetal distress due to convulsion. Before that proper medicine was administered by Dr. Meenakshi to subside the convulsion. The convulsion subsided. Dr. Meenakshi wanted to bring a senior obstetrician Dr. E.C. Srivatsan to perform surgery. In the meantime, the patient had labour pain and delivered a still born baby. Since the patient delivered normally, the help of senior obstetrician was not felt necessary. Originally, they decided to shift the patient to the adjacent A.G. Hospital, but as the patient delivered a still born baby, it was not found necessary. The death of the baby is due to convulsions prior to delivery. Half an hour later, suddenly, the patient had profuse bleeding. Again the staff summoned the doctors from A.G. Hospital and necessary treatment was given to arrest bleeding. In the mean time, there was a total black out throughout Tamil Nadu especially in Madras city as a result of which there was heavy traffic jam. It took considerable time for the 1st opposite party to return. She arrived at the hospital at about 9.15 p.m. but by that time, treatment for Post Partem Haemorrhage (PPH) has been started and the opposite party tried to arrange blood from the blood Bank but A1 positive was not available. There is no facility available in and around Tambaram to bleed the donor. Only an authorized Blood Bank can perform the aforesaid activity. Despite best efforts, A1 positive blood was not available. Hence, it was decided to shift the patient to Maternity Hospital, Egmore. Since there is no facility of ambulance in the hospital of the opposite party, they tried their best to arrange an ambulance from other hospitals. But, in the mean while, the 1st complainant took the patient in his own car and the opposite party deputed one of the hospital staff to accompany the patient. The condition of the patient and the treatment required was well explained to the 1st complainant and necessary letter was given to him to take the patient to Egmore Maternity Hospital. The patient had spontaneous delivery. After few minutes, the uterus started relaxing and she had profuse bleeding. The doctors from A.G. Hospital had treated the patient with utmost care. Alternate arrangements were made to look after the patient. The blood was not immediately available for transfusion. The normal contraction of the uterus failed in the case as a result of which there was excessive bleeding. Syntocinon, Methergin and Prostodin were given to the patient to arrest bleeding. All effective measures were taken. They did not loose any time. Proper care of the patient was taken. The absence of the 1st opposite party was not the cause for PPH. The amount claimed is excessive.
(3.) THE points for determination are: (1) Whether there is deficiency in service as alleged? (2) If so, whether the opposite parties are liable to compensate the complainant? Points : Since most of the facts are admitted, the matter or, decision is narrowed down considerably. The 1st complainant s wife Amudha was admitted in the hospital of the opposite party for delivery. She was admitted on 28.5.1998 at 10 a.m. with mild labour pain. From the case sheet which is marked as Ex. A1 issued by the 1st opposite party we find that the expected date of delivery was on 21.5.1998. In the version, it is stated that since the delivery got delayed, the opposite party decided to induce pain by giving drips and, therefore, they shifted the patient from general ward to labour ward. It is also stated that since the delivery pain did not develop despite administration of drips, it was decided to stop the drips at 5 p.m. From the very record, it is clear that the patient had her last menstrual period on 14.8.1997. The expected date of delivery was 21.5.1998. But she had been admitted on 28.5.1998 with mild labour pain which means that she was admitted past the due date of delivery. She was admitted at 10 a.m. and at that time she had mild labour pain. The general condition was good. Uterus was term, acting mildly. Head in lower Pole FHS + . From 10 a.m., we find it is only nothing was done. But, it was only at 3 p.m. dextrose drip was started. It runs counter to the pleadings in the version. It is not explained as to why immediately after admission or after an hour or two, dextrose drip was not statred. Though in the version, it is stated that the drip was stopped at 5 p.m. because there was no development of pain, it is not stated so in the case sheet. On the other hand, it is clear that the doctor had to attend a reception, therefore, she left the hospital at 5 p.m. and because she had to leave the hospital at 5 p.m. the drip was stopped. That is how the version would read. There is nothing to show that the doctor who left had made any arrangements to tackle the situation if any emergency arises. It is not the version that there was any other doctor in the hospital in whose care the patient was left. On the other hand, from the records, it is clear that when the doctor left, there were only nurses to take care of the patient and that no arrangement had been made to take care of the patient. Assuming there were nurses and they were instructed to take care of the patient, still that will not amount to discharge of duties by a doctor. When a doctor accepts a patient for treatment especially in a case of delivery and when the patient was admitted at 10 a.m. with mild labour pain and was over due for delivery, the doctor cannot leave the patient high and dry. That would amount to a gross deficiency in service. That apart leaving such a patient in the care of nurses without making suitable arrangements for a doctor to be present to look after the parties, is yet another deficiency in service. More so, in this case, the patient was admitted at 10 a.m. and she had only mild labour pain, according to her, even after administration of dextrose drip, there was no increase in labour pain. In such a context, the act of her leaving the patient amounts to deficiency. The act of the doctor in leaving the patient without making an alternative arrangements amounts to gross deficiency in service. She ought to have taken steps to see that a competent doctor is present on the bedside of the patient to take care of the patient in the event of emergency, especially in this case on hand, there was every possibility of a complication setting in because the patient had not developed proper delivery pain and the administration of dextrose was also not helpful. It is to be pointed out a prolonged labour always brings about complications in its wake, especially in the nature of PPH (Post Partem Haemorrhage) when a patient goes for PPH, definitely that is a serious condition, the doctor has to be ready to tackel and meet such a situation. The chances of patients going for PPH where there is prolonged labour is on the high side. Therefore, in that context, the 1st opposite party ought to have taken suitable steps. Thus, the standard of care that is expected of the opposite party is not there and it falls too low.;