BEFORE THE A.P.STATE CONSUMER DISPUTES REDRESSAL COMMISSION: AT HYDERABAD.
OF 2007 AGAINST C.C.NO.35 OF 2006 DISTRICT CONSUMER FORUM W.GODAVARI AT ELURU
Between
Addala Veera Venkata Satyanarayana
@ Yedukondalu S/o Venkataratnam
@ Manidhat, Hindu Male, aged 35 yrs
Employee working at Secunderabad
permanent resident of Varigedu Village
Attilll Mandal, West Godavari Dist.
Appellant/complainant
A N D
Dr.Smt V.Sarojini, MBBS, DGO.,
Gynecologist and Obstetrician
Sri Satya Hospital, Old Post Office St.
Tanuku, West Godavari District
Respondent/opposite party
Counsel for the Appellant Sri K.Raghavacharyulu
Counsel for the Respondent Sri V.Sankara Rao
QUORUM: SRI SYED ABDULLAH, HON’BLE MEMBER
&
SRI R.LAKSHMINARSIMHA RAO, HON’BLE MEMBER
WEDNESDAY THE SIXTH DAY OF OCTOBER
TWO THOUSAND TEN
Oral Order ( As per R.Lakshminarsimha Rao, Member)
***
The facts of the case as set out in the complaint are that the complainant is blessed with two children and his wife was on the family way and as such consulted the opposite party on 27.5.2005 as also prior to that date in the month of April 2005. On medical checkup of the patient, the opposite party informed the complainant that his wife would be able to have a free delivery as there was no complaints of BP and other ailments. The complainant’s wife was admitted as inpatient in the hospital of the opposite party on 27.5.2005, with the complaint of severe pain in her abdomen. The opposite party assured her of normal delivery and on the same day at about 1 p.m. the complainant, his parents complained of pains of the patient to the opposite party and the nurse on duty. The opposite party assured them everything would be normal. Suddenly, the blood pressure of the patient rose alarmingly high, the patient turned black and ultimately died of oozing out of blood from her mouth, nose, ears due to hemorrhage of brain. An unqualified nurse attended to the patient. The opposite party has not even rescued the baby. There was negligence and lack of care on the part of the opposite party from the time the patient was admitted to the hospital till the patient died.
The complainant has got issued notice to the opposite party for which the opposite party gave reply stating that amniotic fluid embolism was the cause of the death of the complainant’s wife. On 22.4.2005 the complainant had paid `100/- towards consultation fees and he incurred `300/- towards expenses for tests and scanning of his wife. The opposite party collected an amount of `10,000/- from the complainant for the treatment of complainant’s wife. The opposite party left the patient while the patient was suffering from labour pains to the care of an unqualified nurse. Therefore, the complainant claim `10 lakhs towards compensation and `5 lakhs towards loss of consortium and `10,000/- towards costs of the proceedings.
The opposite party resisted the claim admitting that she assured the complainant that his wife would be able to have free delivery as there was no complaint of blood pressure and other ailments and contended that the patient’s previous two deliveries were normal vaginal deliveries. The patient consulted the opposite party, for the first time in the 4th week of April, 2009 and later in the month of May 2005 for routine check-up, as a outpatient. The patient died due to amniotic fluid embolism which is a rare obstetric emergency that occurs in one case in all 8000-30,000 pregnancies and it occurs during labour. Amniotic fluid embolism is unpredictable, unavoidable, unpreventable and it is caused all of a sudden, without any warning.
The signs of AFE are hyperpnoea or trachypnea, cyanosis and a shock progressing into profound coma. The opposite party had taken all possible care and caution and attended the patient personally and did everything to the best of her ability. On 27.5.2005, when the patient was admitted to the hospital, her cervical dilation was 5cms, she was prepared, enema was given and she was brought to the labour room. The opposite party again examined her in the labour room, the patient’s condition was normal with full dilation of cervix and she was experiencing labour pains. Suddenly, she complained of breathlessness and dizziness and immediately had a tonic spasm like movement she was gasping and developed cyanosis, her pulse became feeble and BP decreased. The anesthetist attended to the patient. The opposite party had taken the resuscitative measures to revive the patient. The patient could not be revived and she died due to Amniotic Fluid Embolism.
Mrs D.S.N.Kumari, the opposite party’s staff nurse attended the patient on 27.5.2005, she is a qualified, multi purpose health worker and possessed 30 years of experience as staff nurse. There are four other trained and qualified nurses working in the hospital of the opposite party. The opposite party charged only `30/- towards consultation (ordinary), `50/- (special) and `60/- (by appointment) which is valid for one month. Since no investigations were done at the hospital of the opposite party, the question of collecting `3,000/- towards various tests and scanning does not arise. Due to pulmonary oedmea as a sequel for amniotic fluid embolism blood was seen oozing from the mouth, nose and ears of the deceased but not on account of hemorrhage. Hence, prayed for the dismissal of the complaint.
The complainant has filed his affidavit and got marked Exs.A1 to A7. The opposite party filed her affidavit and got marked Exs.B1 to B5 on her side.
The District forum has dismissed the complaint opining that the complainant failed to prove negligence on the part of the opposite party and there was no deficiency in service rendered by the opposite party in view of the opinion of the doctor and the relevant decisions relied upon.
Feeling dissatisfied with the order of the District forum, the complainant filed the appeal contending that the opposite party was not present at the bed of the patient when the patient condition was critical and left the patient to the care of untrained nurse. Further it is contended that the opposite party failed to prove that the patient died due to amniotic fluid embolism as also that the symptoms of AFE were not present in the patient at the time of her death.
The points for consideration are:
1) Whether the opposite party rendered deficient service while treating the complainant’s wife?
2) Whether the complainant entitled to the relief sought for?
3) To what relief?
POINTS NO.1 AND 2 The facts not in dispute are that the complainant’s wife was on the family way consulted the opposite party in the month of April 2005 and on 27.05.2005 she was admitted to the hospital of the opposite party. Prior to the delivery in question, the complainant’s wife was blessed with two female children and she had the two previous normal vaginal deliveries. On 27.5.2005 the complainant’s wife was admitted to the hospital with a complaint of pain in her abdomen. The opposite party examined the patient and after preparing the patient and administering enema to her, shifted the patient to the labour room where the opposite party again examined the patient. On both the occasions prior to the shifting of the patient to the labour room and thereafter at the labour room, the blood pressure of the patient was normal. Her cervical dilation was 5 cm. At 12 p.m, the patient suddenly complained of breathlessness and dizziness as also of tonic spasms like movement. She was gasping and developed cyanosis.
The case sheet shows that the past history of the patient was significantly nil and her blood pressure on 27.5.2005 at the time of admission was 110/70 and pulse 86. The values were noted at 9.45 a.m., 11.a.m. 11.50 a.m. and 12.10 p.m. At 12.15 p.m. it is noted that the patient suddenly fell dizziness and breathlessness. She was not responding to deep stimuli. Her pulse rate was 180 per minute 60/54. The patient was given dopamine drip and dextrose was administered to her. At 12.20 p.m. it was noted that cyanosis did not improve and pulse was not palpable. At 12.30 p.m. the case was seen by Dr.G.R.K.Bhaskar Rao and at that stage also the pulse of the patient was not palpable and heart sounds were absent. The pupil of the patient was dilated, sluggish and no respiration was observed. Immediately cardiac massage was started and the patient was intubated. There was no response to IPVV oxygen and cardiac massage. Intra cardiac adreline was administered, cardiac massage and IPPV continued. At 12.40 p.m. no improvement in the condition of the patient was reported and the pulse was not palpable as also that there was no heart beat. At 12.45 p.m. the patient was declared dead as no heart beat was felt and pulse was absent as also that there was no response to the treatment.
Dr.G.L.Shobita, Civil Surgeon at Dist. Hospital Machilipatnam had rendered her opinion marked as Ex.B2 that the opposite party followed as also the anesthetist followed the treatment protocol in accordance with the standard protocol. She has opined that the patient died due to Amniotic Fluid Embolism which is considered as unpredictable, unpreventable and its cause is not known. According to her, the opposite party had attended the patient to her lever best and the death of the patient was not due to any professional negligence of the attending doctors and the staff.
The contention of the complainant that the opposite party left the patient when the patient was in critical condition to the care of untrained nurse is refuted by the opposite party stating that she was attending the patient all through. The opposite party had cited the instance of her examining the patient prior to shifting of the patient to the labour room and thereafter in the labour room as also that the labour room was situated adjacent to the consultation room facilitating her to attend the patient. The various measures she had taken since the time the patient was shifted to the labour room has been noted in the case sheet in detail. We have considered the particulars of treatment mentioned in the case sheet.
The opposite party had submitted that the nurse Smt D.S.N.Kumari who attended the patient was a qualified nurse endowed with 30 years of experience and apart from Smt D.S.N.Kumari there are other trained nurses working in the hospital of the opposite party. The complainant has not chosen to deny the statement of the opposite party in regard to the treatment administered in the labour room by her and the anesthetist as also the assistance taken by them during the course of treatment.
The learned counsel for the complainant has submitted that the District Forum had not considered the evidence adduced by the complainant except extracting the articles from medical books. The complainant has produced a copy of legal notice and reply thereto besides extract of Amniotic Fluid Embolism downloaded from internet. The contents of the notice have been reiterated in the complaint. We had considered the averments of the complaint as also those of the written version. The complainant claimed a sum of `10 lakhs towards damages on the premise that the opposite party had not properly attended the patient and left the patient to the care of unqualified nurse. The presence of the opposite party at the labour room was established as the contents of the case sheet would prove the treatment administered and the measures taken by her.
The extract downloaded from internet on Amniotic Fluid Embolism by the complainant shows that it is more likely a male fetus is the cause and the condition is considered an unpredictable and unpreventable event, and the cause is reported as unknown. It is mentioned in “cause for Perpnea Maternal Death” that Amniotic Fluid Embolism is a rare but fatal complication of labour in which Amniotic Fluid Embolism factors the maternal vascular system becomes lodged in the pulmonary vascular bed. The signs and symptoms of Amniotic Fluid Embolism are followed with respiratory distress followed by cyanosis followed by cardiac vascular collapse followed by hemorrhage. The oppose party has attended to Amniotic Fluid Embolism as most of the symptoms referred to by the complainant were present in the patient, she had administered cardiac massage, dopamine drip, adreline injection and dextrose. Therefore, all possible measures were taken by the opposite party to revive the patient which however could not save the life of the patient. The loss of life of the patient by itself will not be construed as negligence in treatment administered by the opposite party while the patient was attacked by Amniotic Fluid Embolism in the labour room in the hospital. Therefore, we do not see any merit in the appeal. The impugned order does not warrant any interference in the appeal.
In the result, the appeal is dismissed confirming the order of the District forum. No costs.
MEMBER
MEMBER
Dt.06.10.2010
KMK*
