BEFORE THE A.P.STATE CONSUMER DISPUTES REDRESSAL COMMISSION :HYDERABAD
F.A.No.717/2007 against C.C.No.14/2007, Dist. Forum-II,Krishna at Vijayawada.
Between:
Dr.M.Syam Sundar ,S/o.M.Hanumantha Rao,
Age:52 years, Occ:Doctor,
Sri Venkateswara Hospital,
Opp.R.T.C. Bus Stand, Nandigama,
Krishna District. Appellant/
Opp.party
And
1.Ch.Ravi Kumar, S/o.Srinivas Rao,
R/o.Government Hospital Road, Nandigama,
Krishna District .
2. Ch.Padmavathi, W/o.Ravi Kumar,
R/o. Government Hospital Road,
Nandigama,
Krishna District. …Respondents/
Complainants
Counsel for the Appellant : M/s. V.Shankara Rao
Counsel for the Respondents : M/s. V.Gowrisankar Rao
CORAM: THE HON’BLE JUSTICE SRI D.APPA RAO , PRESIDENT,
AND
SMT.M.SHREESHA, HON’BLE MEMBER,
FRIDAY, THE EIGHTH DAY OF OCTOBER
TWO THOUSAND TEN.
Oral Order : (Per Smt.M.Shreesha, Hon’ble Member)
****
Aggrieved by the order in C.C.No.14/2007 on the file of District Forum-II, Vijayawada , Krishna Dist. , opposite party preferred this appeal.
The brief facts as set out in the complaint are that the opposite party is the complainants’ family doctor and on 3.5.2006 the complainants approached the opposite party for checkup of the second complainant and the opposite party examined her and advised her to give her urine samples for laboratory tests. On the next day when the complainants consulted the opposite party they were informed that the second complainant was pregnant. On 22.11.2006 the second complainant approached the opposite party for abdominal pain and opposite party gave her an injection and prescribed some medicines and informed her that the delivery would take place after 21 days. Once again on 23.11.2006 when the second complainant approached the opposite party he gave her two more tablets assuring her that her condition is normal. When the pains were not controlled the second complainant approached opposite party again on the next day and she was admitted in his hospital for which he collected an amount of Rs.2000/- and opp.party conducted caesarean operation on 24.11.2006 and found that the Foetus dead two days ago. The Foetus weighed 2.5 kgs. and only because of the negligent treatment rendered by the opposite party right from the conception of the pregnancy till the delivery that the second complainant had to give birth to a still borne child. The complainant got issued a legal notice on 2.12.2006 to the opposite party seeking compensation of Rs.2 lakhs but there was no response from the opposite party. Hence the complaint seeking direction to the opposite party to pay compensation of Rs.2,50,000/- together with interest and costs.
Opposite party filed his written version stating that the second complainant never complained about diminished foetal movements or any abnormality and he advised the patient to go for Ultra Sound examination. On 22.11.2006 the patient came to the opposite party with a complaint of discomfort in the abdomen and as the complainant did not reach the expected date of delivery, the opposite party prescribed Uterine Sedative to prevent any preterm labour and advised to admit in the hospital, which the patient refused. The next day she came back again with abdominal pain and the opposite party examined her and found lower segment of the uterus is in threatened rupture and immediately performed caesarean operation to save the life of the mother and the patient did not pay any charges to the opposite party. The opposite party submits that there is no negligence on his behalf and he performed the caesarean only to save the life of the patient and prayed for dismissal of the complaint with costs.
The District Forum based on the evidence adduced i.e. Exs.A1 to A5 and pleadings put forward allowed the complaint directing the opposite party to pay Rs.2 lakhs with interest at 9% from the date of filing of the complaint till realization and to pay Rs.2000/- towards costs.
Aggrieved by the said order, the opposite party preferred this appeal.
The appellant/opposite party filed written arguments and also got Ex.B1 marked. This Ex.B1 is the case sheet of the opposite party.
The facts not in dispute are that the second complainant was treated by the opposite party doctor for her second pregnancy. The opposite party submits that the patient was also treated and blessed with one child and she started visiting his hospital w.e.f. from 4.5.2006 and was taking medical advise from him since more than 6 months. It is the case of the complainants that when the patient was suffering from abdominal pain on 23.11.2006 and the opposite party doctor gave her an injection and she was admitted in the hospital on 24.11.2006. Thereafter under the constrained circumstances when the patient condition became serious, opposite party conducted caesarean and dead foetus was born. It is the case of the complainant that the appellant doctor did not check the foetus movements or advised any Ultra Sound scan to check the condition of the foetus even when the patient complained of abdominal pain. It is the case of the appellant/opposite party that the patient came to him only on 22.11.2006 complaining of abdominal pain and he advised her to be admitted the hospital which she refused. The District Forum observed that the weight of the patient gained steadily from 5.7.2006 onwards from 58 kgs. to 64 kgs. as on 23.10.2006, but suddenly dropped to 60 kgs. i.e. almost a fall of 4 kgs. by 22.11.2006 and that the opposite party did not specify that on which date he noticed any abnormality or advised Ultra Sound Scan.
The learned counsel for the appellant/opp.party contended that the patient did not have any bad Obstetric History or Congenital Anomalies or Anemia or Hypertension or Diabetes and referring the patient always to Ultrasound Scanning depends upon the circumstances but not mandatory. He drew our attention to Text Book of Obstertrics including Perinatology and Contraception. He also stated that foetal complications arise because of the following reasons as specified in page 4 and 5 of written arguments:
“Fetal Complications :
· Fetal Chromosomal abnormalities and malformations- Constitute nearly 23-35% of all stillbirths(see P.492) .
· Fetal infections – with rubella, cytomegalovirus, parvovius- B19 (see P.399) and chorioamnionitis are important.
· Rh-incompatibility – Excessive haemolysis of fetal blood by antibody formed in the mother produces fetal anaemia, anoxia and heart failure, Nonommune hydrops (see 0.497) are also important.
· Introgenic:
· External version- it may result a true knot of the cord or entanglement of the cord round the neck or limbs of the fetus.
· Others - Post term pregnancy (see p. 318) , drugs (Quinine beyond therapeutic level) placental infection (malaria) are important causes.
· Idiopathic: In about 25-35% of cases, the cause remains undetermined even with thorough clinical investigations.
Sometimes the mishap tends to recur in subsequent pregnancies (0-8%) then the following conditions should be kept in mind – diabetes, Rh-incompatibility, syphilis, antiphospholipid syndrome, chronic nephritis hereditary thrombophilia and aneuploidy”
Counsel for the appellant submits that the appellant doctor did not charge any fees and to only save the life of the patient he performed caesarean operation and relied on the judgement of the Apex Court in Civil Appeal No.1386 of 2001 dt. 24.3.2009 between Ms.Ins.Malhotra vs. Dr.A.Kriplani and ors. to establish that he did not render any negligent treatment.
We have perused Ex.B1 which is the case sheet filed before this Commission by way of additional evidence. The date of admission of the patient is 24.11.2006 in which her complaint was diagnosed as ‘threatened rupture of uterus’ and that there was tenderness in the lower uterine and cervix is dialated to 2 cms. and that the foetal movements are not clearly heard. In the history of the patient it is stated that this is her second pregnancy and she has delivered a male child through caesarean earlier and that she had suffered from Chickengunya during her earlier pregnancy. The entire record of the treatment given from 24.11.2006 to 30.11.2006 is part of the record of Ex.B1. We also went through the deposition of the appellant doctor before this Commission in which he stated that the patient came to see him as an out patient on 22.11.2006 complaining some discomfort in the abdomen and on 23.11.2006 she left the clinic even before he completed the examination and admitted that he did not ask the patient to undergo Ultra Sound test and admitted that the age of dead foetus may be one or two days old. He denied that the lab reports dt.5.7.2007 and 24.11.2007 were to misguide. When the doctor has admitted that he has seen the patient on 22.11.2006 and the patient complained of abdominal pain it is an admitted fact that he did not check her for foetal heart beat or advised for Ultra Sound Scan. It is only on 24.11.2006 when the patient was admitted in the hospital and he conducted caesarean operation a dead foetus admittedly two days old was removed. While we are of the considered view that the caesarean operation was performed by the appellant doctor to save the life of the patient on 24.11.2006, we are also of the considered view that when the patient visited him on 22.11.2006 as deposed by him, he should have checked the foetal heart rate and advised Ultra Sound Scan, specially when the patient was complaining of severe abdominal pain. Had the doctor checked the foetal heart rate on 22.11.2006 itself, the condition of the patient would not have been that serious and there is a possibility that the life of the child could have been saved. At the same time, the reasons for foetal complications cannot be entirely blamed on the doctor. It is not the case of the complainant that the foetal complications arose because of the negligence of the appellant doctor. It is his case that the appellant doctor was negligent in rendering treatment two days prior to the caesarean operation i.e. on 22.11.2006. Keeping in view that ultimately the doctor did perform the caesarean operation on 24.11.2006 to save the mother’s life, we are of the considered view that the compensation of Rs.2 lakhs awarded by the District Forum is on the higher side. Even in case of death of a person with no fault liability, maximum compensation of Rs.50,000/- could be awarded under the Motor Vehicles Act and being a dead foetus we are of the opinion that it would meet the ends of justice if we award an amount of Rs.50,000/- towards compensation while we confirm the rest of the order of the District Forum .
In the result this appeal is allowed in part reducing the compensation awarded by the District Forum from Rs.2 lakhs to Rs.50,000/- while confirming the rest of the order of the District Forum. Time for compliance four weeks.
Sd./-PRESIDENT
Sd./-MEMBER
Dt.8.10.2010
