The fact of the case as enumerated in the complaint is that the OP 1 is a director of Sonoscan Hospital, OP no 2 is director of Malda Nursing Home, OP no 3 is the director of Fertility Clinic, OP 4 is the founder and Chief Consultant of Fertility Clinic namely Dr. A.K Pradhan. The victim since deceased was the wife of this complainant. Wife of the complainant went to the chamber of OP no 4 i.e. Dr. A.K Pradhan for the purpose of creating pregnancy on 07.05.2015. OP 4 advised her to take admission on 14.05.2015 for hystero laproscopy which was done on 15.05.2015. Thereafter on being pregnant she with full maturity of baby in the womb went to him on 10.02.2016 to know the condition of the baby. Doctor on examination fixed the date of delivery on 23.02.2016. But in the meantime wife of the complainant felt uneasy and this complainant immediately took her to Dr. Pradhan on 17.02.2016. On examination doctor got her admitted at Malda Nursing Home. She took admission at that day at about 6.10 PM in bed no 111. At the time of admission at that nursing home patient was fully checked up by Dr. A Acharjee consecutively on 17.02.2016, 18.02.2016, 19.02.2016, 20.02.2016, 21.02.2016 and issued prescription. Thereafter patient was operated at Nursing Home on 21.02.2016 at about 8.15 AM to 9.15 Am. Dr A.K. Pradhan, Dr. T Chakraborty Dr. S.K. Barman, Dr. Z. Haque, Rajib Giri were present at the operation theatre. She gave birth a female child. After that patient was shifted to bed no 111 and was examined by Nursing Home authority i.e. Blood Pressure, Pulse etc. at 9.30 am, 10 am and 11.30 am, then at 6 pm. But since 11.30 am to 6 pm nursing home management or doctors did not check the patient. Hence this gap of checking is nothing but negligent act on the part of the doctors or Nursing Home Management. During this time patient became serious and under severe belly pain. She shouted at pain when complainant requested the nurse to call doctor immediately but they did not do it. Subsequently on seeing the condition of the patient, in the belated stage nursing home authority held a medical board by Dr. Pradhan, Dr A. Acharjee. Dr. S.k Barman, Dr. T P Roy and took decision of re-operate to see the reason of pain. Reoperation held at 9.15 pm to 10.20 pm by Dr AK Pradhan, Dr. A Acharjee, Dr T Chakraborty, Dr SK Barman, Dr A Gupta and Situ Saha. Patient was given blood at 9.30, 9.50, and 10.10 pm at that time. Unfortunately after second time operation condition of the patient deteriorated and she was taken to ICCU. But patient did not recover. Practically at the time of admission on 17.02.16 the patient was in good condition i.e. sound body, mind and disease less. According to the advice of the doctors the admitted pregnant patient was fully checked up and taken into operation in well condition. Operation held between 8.15 am to 9.15 am on 21.02.16. The baby was in good condition but after caesarean the patient was not in sense and after first caesarean operation patient remained unchecked since 11.30 am to 6 pm. Nursing Home authority did not check up the patient which was very negligent performance on the part of the Nursing Home. Practically due to their bad handling and utilization of bad instruments and lack of skill in operation the patient died. The negligent treatment would be shown at their treatment sheet. So due to premature death of the wife and loss of the mother of the new born baby caused a great shock an irreparable loss to this complainant. Nursing Home authority and doctors are the responsible for the death of the victim. First time operation was a negligence operation and doctors were also negligent in checking the patient after operation. Complainant hence approached before this commission for compensation of rupees twenty lakhs.
All the Ops contested this complaint contending inter-alia all the materials allegation and submitted that the case had been filed with ulterior motive. They tried to give best treatment to the patient. They treated with their best skill and sincerity. Fact remains this victim since deceased had no fertility, hence came to the Dr A Pradhan who treated and made her fit to conceive. Subsequently for the delivery they had to do caesarean operation and had done it with great precaution. All medical papers and bed head tickets will show it. They applied modern sophisticated test and applied modern devices so doctors were not responsible for the death of the mother. It is the act of almighty and transcendental. The medical papers never say any negligence on the part of the doctors. Moreover patient died in transit when she was shifted for higher medical treatment. Hence this complaint petition has no merit.
Now the complainant in order to prove the content of the petition examined himself where the statement under the petition was repeated and he also faced the cross examination where admitting that it was not possible for him to say or prove that the line of treatment was correct because he having no specific knowledge about the medical science and nothing shown to him.
List of documents what he filed those are prescriptions and advice note of fertility clinic, document of admission at Malda Nursing Home and Prescription and advice note of there, documents of Sonoscan, all treatment sheet of Malda Nursing Home, Marriage certificate of them and death certificate which are kept in the record.
On the other from the part of Ops, OP no 4 i.e. A K Pradhan examined himself. He said patient came to him with history of infertility. Subsequently through treatment she was fit to conceive through some trifling type of surgical interventions. It was necessary for caesarean operation for delivery and he did it with full precaution. Bed head ticket would show it. Medical paper would never show that they were negligent or there any deficiency of service on their part. Actually the disease for which the patient was suffering is rare and ratio is said to be 3 in 10,000 and its mortality rate is very very high. Practically initial treatment by him was successful and the patient was able to give birth child but later stage is tragic. Victim died out of disseminated intravascular coagulation.
On behalf of Ops no documents/C.Ds were produced.
ARGUMENT BY THE PARTIES
Complainant pointed out aspects of negligence as follows:
Firstly through report dated 22.02.2016 of SONOSCAN diagnostic centre it is noticed that the function of the kidney of the patient was normal but from the post operative treatment sheet of the doctor it is noticed patient was attacked with Septicemia and acute kidney injury, unconscious, no pulse, low blood pressure etc. So it is evident that due to the wrong operation during Caesar her kidney was injured and only for that reason septicemia accrued and patient shouted at severe pain but no doctor attended.
Secondly it is admitted position that after the Caesar patient was not at all duly cared. No doctor attended. From the bed head ticket it will be cleared that after taking her to the bed she was checked by the nurse at first at 9.30am, then 11.30 am and afterwards at lastly at 6 pm. But since 11.30 to 6 pm no check up was made. Lastly when hospital authority found no sense is gained and patient was in intense pain in abdomen they informed doctors. Afterwards doctor came and took decision of second time operation. But did not inform the man of the patient family that why second time operation is needed. Patient party was only asked to arrange blood and it may be that blood was transfused when it creates no result. So why after first operation the blood was not given? And if so given and continuously supervised by the doctor patient may gain sense or blood pressure may arise but nothing was done on behalf of the doctors or nursing home authorities at the first operative measure of the patient. And it is most possible that actually the Caesar was done by the junior instead of any senior which is nothing but a negligent, careless and nonchalant attitude of the doctors.
Thirdly the doctors not at all informed why the second time operation was needed. It may be some instruments or gauze or anything else was abandoned in the abdomen at the time of Caesar, that’s why operation needed which is a vital negligence on the part of the doctors. Accordingly all such things are significant to the negligence of the doctors at their treatment.
On the other dogma learned counsel of the Ops with elaborate WNA (which is kept in record) submitted that all along patient was under the observation of doctors though practically there no note in this regard under the bed head ticket. Moreover injury on the kidney which was opined by the physician as pointed out by the Complainant-counsel that was actually about the stoppage of the urine or none functioning of the kidney but not any substantial injury to the kidney. There no scope of injury on the kidney at the time of Caesar because both organs remain at distance in the human body. Practically this patient died out of DIC which is a disease and may occur after delivery. Factually the lady was kept in care. There no lacuna in the treatments or any negligent action of the doctors. Apart from that this Ops adduced an evidence of impartial doctor as expert who also deposed that there no latches in the treatment. But on the other, complainant did not adduce any impartial doctor as an expert to show the lacuna in the treatment. Eventually there is no merit in this case on behalf of the complainant.
:DECISION:
Issues arose for decision
- Is the complaint filed within statutory period?
- Is there pecuniary jurisdiction of this commission?
- Is there any negligent part on behalf of the nursing homes or doctors whose authorities were Ops in this case?
- Is the complainant entitled to get the compensation?
Firstly to observe about issue no 1 and 2 that the complaint is well within territorial and pecuniary jurisdiction of this commission and also not time barred one.
Issue no 4 and 5 are taken unitedly for discussion.
Admitted position young victim since deceased with her all hopes of getting motherhood left this world though tolerated entire pain, agony of being mother. It is also admitted position on completion of cesarean she never got her sense since 21.02.16 to 22.02.16 i.e before her premature death, may it be at nursing home or in transit to other hospital.
Now the first question from this commission that why this pregnant woman was decided of getting Caesar on her when her date of maturity of delivery /discharging womb was on 23.02.16. Medical papers nowhere shows any clearance at that point that why she needed Caesar and not appropriate/ worthy to be normal delivery. Patient may not able to tolerate labour-pain but that would never be any reason or cause for any doctor to do caesarean operation irrespective of giving consent by the patient party. It is the doctor who would select whether caesarean operation would be operated or not on the patient considering risk of cesarean.
Now we (commission) find it has been a trend on the part of the doctors to perform Caesar-operation to the pregnant-patient irrespective of any complication. However it was the orbit of the doctor why he made Caesar or why Caesar was necessary and the process of normal delivery could not be adopted.
But fact to say in this instant case there no history of discharging any fluid or any bleeding on the patient at the date when patient felt uneasy and came to the doctor i.e. 17.02.16 and admitted there. Even no such history we noticed in the complaint petition save and except uneasiness of the patient at that day or no such version even either in W.V or in the evidence of the doctor that this victim needed urgently caesarean operation. So why the doctor took such decision? No reasonable cause was shown before this adjudicating authority from the part of the OP/ Doctor that why method of Caesar was adopted. However if the decision of the caesarean operation was taken by the doctor why after that operation instantly the patient was not shifted to the ICU? if delivery was imminent or the delivery through cesarean was urgently necessary instead of normal. We hold this patient was ought to be taken much more care by the nursing home authority and by the principal doctor to whom she was created fertile in place of infertility. We find instead of shifting to ICU after delivery she was shifted to bed no. 111 probably general bed.
That apart most unfortunate factor since first operation to second time operation, there we find no history of in bed head ticket or in treatment sheet that there any doctor attended the patient rather it was chronologically mentioned in the sheet that patient was unconscious and blood pressure was not normal /low and urine was not discharged and she was in acute pain at her belly. If so why the nursing home authority did not inform the principal doctors who were in the operation theatre?
Within the medical paper as produced before this commission there mentioned no point or reason that why the patient was taken further to second time operation or why it needed. We (commission) hold there must have some defect in the first operation due to the latches of the doctors and any fluid had gone to the vessel of the body for that reason blood clotting raised and the doctors were bound to open the abdomen/ belly further. But not any factors or reasons were cleared about the second time operation either in WV or even in evidence of the OP-Doctor that why second time operation was needed. Rather OPW gave statement as their self defense that patient died out of DIC (disseminated intravascular coagulation) and there no negligence on their part. We the commission hold, it should be the incumbent duty on the part of the doctors that they should prepare and produce a video cassette/C.D before the court to show their modus-operandi of operation and to show their skillfulness in operation on the part of the body of any human, when negligence is attributed at their action by the complainant. It is the incumbent duty of the doctors to exonerate them from this type of complaint through cogent document/evidence because patient parties are not allowed to visualize the operation and they are lay men. Here we find no such video cassette/ C.D or anything else from where we can hold that there no iota of deficiency on the part of the treatment/ operation/ taking of any care to the patient. Rather we find there latches of observation by the nursing home authority to the patient since 11.30 to 06.30 when patient was in acute stage. Medical papers are not at all clear why caesarean operation was necessary? Why within 12 hours of cesarean patient did not regain sense and why she was taken for second time operation.
Regarding the disease of DIC we know DIC is caused due to inflammation, infection or cancer and risk factor of DIC includes pregnancy complications such as placenta that is left behind after delivery. It also may be caused due to recent surgery or anesthesia or it may be caused due to severe tissue injury.
We find in Para 11,12,13,14, 15, 16, 18 this complainant specifically stated about severe negligence and lacuna in operation but those statements under complaint were not specifically denied by the Ops and we (Commission) reiterate there no proof in the hands of the OPs through any video cassette/C.D or anything else that they had no latches behind causing of the disease DIC. They did not disclose either in evidence or in WV that why second time operation required for the victim.
So all these circumstances do not wither-away the deficiency on the part of the doctors and suppression of the real fact by the nursing home authority.
We (Commission) hold in the case of medical negligence, doctors and medical institutions like nursing home etc. would be more responsible to prove their flawless innocence or blamelessness or faultlessness or correctness specially in the case of surgery. In this instant case OP should prove that due to their fault or surgical operation this DIC or septicemia did not arise, when commission find that Victim was of full health and energy before the operative measure.
In fine we (Commission) hold in this instant case on the dearth of showing lacuna less surgical operation with proper care by the medical institution (Nursing Home) this complainant is entitled to get compensation as asked-for for his innumerable loss.
Hence Order
As per aforesaid observation in the judgement this complainant is entitled to be compensated at the tune of Rs.20,00,000/- (Rupees twenty lakh) only and also do get further of Rs.10,00,000/- (Rupees ten lakh) only for the maintenance of new born baby of the complainant and the deceased by all the OPs jointly or severally within three months from this order. In default complainant is entitled to realize the aforesaid amount of Rs.30,00,000/- (Rupees thirty lakh) only availing the execution process either U/S 71 or 72 of CP Act 2019.
