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--------------- Print Magazine --------------
  May 2016
  April 2016
CASE STUDY - by Anoop K. Kaushal

Expert Opinion of Medical Boards

Anand Parkash v. Dr. Satya Sawant

First Appeal No. 369 of 2009, pronounced on 31 st January, 2013 by the National Consumer Disputes Redressal Commission, New Delhi.

Facts: In his complaint before the State Commission, Appellant had stated that his late wife Smt. Usha Rani on conceiving her second child in March 1996 was under the medical supervision and care of Respondent No.1, who apart from working in Respondent No.2- Hospital was also doing private practice. On 22-12-1996, the patient approached Respondent No.1 with mild labour pains and was admitted on advice in Respondent No.2-Hospital, where she was put on a drip to induce labour for a normal delivery. Respondent No.1 was fully aware that patient's first child had been delivered through cesarean section and that she was also suffering from anaemia with a very low haemoglobin count but no arrangements for blood transfusion in anticipation of any emergency was made. She was kept in the labour room, where after 40 hours of labour she delivered a male child, developed complications immediately after delivery and blood transfusion became necessary. Appellant and his family donated seven units of blood on the spot, which was infused without any cross checking. Soon after, the patient went into an irreversible shock and was declared dead at 5.40 P.M. Appellant lodged an FIR at the Police Station and also a complaint with the Commissioner, Hisar Division, after which an enquiry was conducted by doctors from the Medical College & Hospital, Rohtak but nothing came out of it because of Respondent No.1's political clout.

Defence Version: Respondent No.1 while admitting that the basic cause leading to the death of the patient was Post Partum Haemorrhage (PPH) contended that following patient's death independent enquiries were conducted by a Medical Board of PGIMER, Chandigarh, which confirmed that there was no negligence or deficiency in service in the medical treatment and care to the patient. Further, an enquiry conducted by another Board of experts from Medical College & Hospital, Rohtak also concluded on the basis of evidence before it, including the medical records, that there was no medical negligence in this case. It was specifically concluded that at the time of her delivery, the patient was not anaemic as contended by the Appellant and it was only after careful assessment of her condition that she was cleared for a normal delivery. The fact that she had previously undergone a cesarean section by itself was not contraindicated in this case since the first cesarean section was necessitated because of pre-oclasptia and not because of any cephalo pelvic disproportion. The process of her labour was carefully monitored and the labour period in fact was less than 24 hours during which period all care and precautions were taken. The Appellant was also asked to arrange blood well in advance. After the PPH occurred, standard emergency treatment was given, including seven units of blood, but unfortunately patient went into irreversible shock and she could not be saved. It was also contended that the police had investigated the matter and found no medical negligence on the part of Respondents. Respondent No.1 also stated that she had not taken any monetary consideration from the patient. She treated her not in her capacity as a private practitioner but in the Respondent-Hospital which is run as a Trust.

Order of State Commission: The Haryana State Consumer Disputes Redressal Commission, after hearing the parties and on the basis of evidence produced before it, including the reports of the Medical Boards of PGIMER, Chandigarh and Medical College & Hospital, Rohtak, dismissed the complaint, following which the Appellant filed an appeal before the National Commission, who vide its order dated 28-4-2008 remanded the matter to the U.T. Chandigarh State Consumer Disputes Redressal Commission on the grounds that despite a specific request by the Appellant seeking permission of the State Commission to appoint any of the two doctors, namely, Dr. Vijay Luxmi Lal or Dr. G.I. Dhall, to give their expert opinion, the application was not disposed of by the State Commission either by accepting or rejecting it and it, thus, remained pending. On remand, the U.T. Chandigarh State Consumer Disputes Redressal Commission permitted Appellant's request to replace the earlier two experts, who were not in a position to give expert evidence, by either of two other experts, namely, Dr. Vijay Kumar Kadam and Dr. M.C. Gupta. The State Commission after hearing the parties and considering the entire evidence, including the evidence filed before the Haryana State Consumer Disputes Redressal Commission, concluded that there was no medical negligence in the treatment of the patient.

Held: Patient's admission in Respondent's Nursing Home and her death from PPH following a normal delivery are admitted facts. Detailed enquiries were conducted, including by two Medical Boards as also by a Chief Medical Officer who concluded that there was no medical negligence or deficiency in service in the case and the PPH was an unfortunate and unforeseen incident, for which also emergency treatment was given. From the evidence on record, we are unable to conclude that the patient was a high risk case. Admittedly, her haemoglobin count was low, three months prior to her delivery as per the medical records but at the time of her admission (as per the bed chart) because of medication, including iron supplementation it had increased to 10 gms., which is not indicative of anaemia. There has been no evidence to controvert that there was any error in the bed chart prepared at the time of her admission. Appellant's contention that the patient had hypertension is also not borne out by the medical records, which clearly indicated that it was very much within normal limits. It is also a fact that though the first delivery was conducted by cesarean section, this was undertaken not because of any cephalo pelvic disproportion but because of her temporary medical condition (pre-oclasptia) at that time, which necessitated a cesarean section. It is also on record that the progression of the patient's labour and delivery was carefully monitored and even when the PPH occurred, standard emergency treatment was given, including blood transfusion. These were clear findings of the Medical Boards consisting of highly eminent doctors from PGIMER, Chandigarh, a premier referral institution of excellence, and also from the Medical College & Hospital, Rohtak. Appellant's contention that these reports were biased appears to be both unreasonable and not acceptable since there can be no plausible reason for the medical boards of PGIMER, Chandigarh and Medical College & Hospital, Rohtak to be biased in this case. The evidence of the medical expert Dr. M.C. Gupta, who had neither examined the patient nor was a Gynaecologist, has little evidentiary value in this case. In fact, this witness had admitted during his cross-examination that his evidence was based on advice obtained by him from a Gynaecologist, neither he nor other medical expert Dr. Vijay Kumar Kadam, have been able to point out any deficiency, shortcoming or bias in the reports of the two Medical Boards.

The first appeal having no merit is hereby dismissed.

(Print Version)
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