Punjab

StateCommission

A/11/1445

Frances Newton Mission Hospital - Complainant(s)

Versus

Mamta - Opp.Party(s)

Veena A. Talwar

09 Apr 2015

ORDER

STATE CONSUMER DISPUTES REDRESSAL COMMISSION, PUNJAB, DAKSHIN MARG, SECTOR 37-A, CHANDIGARH.

 

 

(1)                        First Appeal No. 1445 of 2011                                                   

                Date of institution  :    22.09.2011   

      Date of decision     :    09.04.2015

 

1. Frances Newton Mission Hospital, Railway Road, Ferozepur Cantt. Through Dr. Richard David, Director/Medical Superintendent.
2. Dr. E.J. Singh, Medical Officer and Surgeon, Frances Newton Mission Hospital, Railway Road, Ferozepur Cantt.
3. Dr. Deepti, Gyneacologist, Dispensary of Ram Sharnam Ashram, near CIA Staff, Ferozepur Cantt.
4. Dr. Simmi, Medical Officer, Frances Newton Mission Hospital, Railway Road, Ferozepur Cantt.
5. Oriental Insurance Company Limited, The Mall, Ferozepur City, having its Regional Office at SCO No. 109-11, Sector 17-A, Chandigarh through its authorized Signatory Ram Avtar, Deputy Manager.

…….Appellants/Opposite Parties

 

Versus

Mamta wife of Gulshan Kumar son of Ramesh Chander resident of Street No.17, House No. 10, Ferozepur Cantt.

                                                              ……Respondent/Complainant 

First Appeal against the order dated 27.07.2011 of the District Consumer Disputes Redressal Forum, Ferozepur.

 

Quorum:- 

 

          Hon’ble Mr. Justice Gurdev Singh, President

                        Mr. Baldev Singh Sekhon, Member

                        Mrs. Surinder Pal Kaur, Member

 

Present:-

 

          For the appellant no 1-4  : Sh. Sandeep Khunger, Advocate

          For the appellant no.5    : Sh. Rahul Sharma, Advocate

          For the respondent         : Sh. Nakul Sharma, Advocate

 

AND

 

(2)                        First Appeal No. 1540 of 2011

                                                                   Date of institution  :     19.10.2011   

                                                        Date of decision     :     09.04.2015

 

Mamta, aged 22 years, wife of Gulshan Kumar son of Ramesh Chander, resident of Street No. 17, House No.10, Ferozepur Cantt.

……Appellant/Complainant

Versus

1. Frances Newton Mission Hospital, Railway Road, Ferozepur Cantt. through its authorized signatory.
2. Dr. E.J. Singh, Medical Officer and Surgeon, Frances Newton Mission Hospital, Railway Road, Ferozepur Cantt.
3. Dr. Deepti, Gyneacologist, Dispensary of Ram Sharman Ashram, near CIA Staff, Ferozepur Cantt.
4. Dr. Simmi, Medical Officer, Frances Newton Mission Hospital, Railway Road, Ferozepur Cantt.
5. Oriental Insurance Company Limited, the Mall, Ferozepur City (Insurance Company of Respondent No.1).

…….Respondents/Opposite Parties

Quorum:- 

 

          Hon’ble Mr. Justice Gurdev Singh, President

                        Mr. Baldev Singh Sekhon, Member

                        Mrs. Surinder Pal Kaur, Member

 

Present:-

 

          For the appellant              : Sh. Nakul Sharma, Advocate

          For the respondent no1-4:Sh. Sandeep Khunger, Advocate

          For the respondent no.5 : Sh. Rahul Sharma, Advocate

 

MR. BALDEV SINGH SEKHON, MEMBER :-

 

                    This order will dispose of the two first appeals i.e. F.A. 1445 of 2011 and F.A. 1540 of 2011 as these are directed against the same impugned order dated 27.07.2011 passed by District Consumer Disputes Redressal Forum Ferozepur,(in short "District Forum"), vide which the complaint filed by the complainant, Mamta wife of Gulshan Kumar, was allowed and all the opposite parties (in short "OPs") were jointly and severally directed to pay to the complainant a sum of Rs. 1 Lac as compensation. The order was to be complied with in 60 days from the date of receipt of the copy of the order, failing which, the said compensation was ordered to carry interest @ 9 % per annum from the date of complaint i.e. 01.12.2010 till realization.

2. The facts have been taken from the F.A. No. 1445 of 2011 and parties are being referred to as per their status in that appeal.
3. Briefly stated, the facts of the care are that the complainant, being pregnant, was getting regular check up from doctors at Civil Hospital, Ferozepur and her pregnancy was progressing satisfactorily without any complication. After every check up, doctors of Civil Hospital assured her that there would be no need of caesarean operation. Thereafter, complainant approached OP No.1 hospital for further follow up/check up. On the onset of labour pains, she got herself admitted in OP No.1 hospital on 04.01.2010. At that time, its staff obtained signatures of her husband on some blank papers and on inquiry, it was told that same was a formality for admission in the hospital. It was pleaded that throughout her treatment the doctors and staff of OP No.1 were assuring her and her husband that the delivery would be normal and there would be no need of any caesarean section surgery. OP no. 2 and OP No.4 did not follow the established medical jurisprudence for the delivery of the child and performed the surgery in a hurried manner with malafide intention to claim exaggerated bill. No ultrasound/sonography was conducted before taking decision to perform surgery. Similarly foetal heart beat was also not monitored. In fact, doctors were required to monitor labour pains after every 15 minutes but they failed to follow the said procedure. The labour was quite in progress. The record OP hospital showed that after every per-vaginal examination, firstly amniotic membranes of the liquor was present and pelvic of patient was shown to be adequate/normal and not CPD (Cephalo Pelvic Disproportion). When the patient was progressing towards normal delivery, OPs suddenly posted her for lower segment caesarean section (LSCS) stat in view of alleged NPOL (Non-Progress of Labour) without showing or mentioning any other reason/cause for LSCS like Foetal Distress or Meconium Staining or CPD. It was pleaded that the descent of the baby was normal, vertex was low down and Cervix was also two finger loose. Foetal heart rate as well as Blood pressure of the complainant was normal. The fluid was adequate and utrine contractions were regular which were the signs of a normal delivery. However, without waiting for the normal delivery, OPs performed caesarean section in a hurried manner which caused not only mental agony, pain and harassment to the complainant but it resulted in deterioration of her health. She had to face physical complications of the surgery. She spent a total amount of Rs.25,000/-, including Rs.15,000/- for surgery, costs of medicines etc.
4. It was further pleaded that OPs did not supply her the hospital record of her medical treatment and for that purpose her husband had to approach the court of CJM Ferozepur and despite court directions, the hospital authorities did not provide the medical record. Thereafter, the contempt of court proceedings were initiated against the hospital them and it was only then that the medical record was made available to her. Pleading medical negligence, deficiency in service and unfair trade practice on the part of the OPs, the complainant filed the complaint before the District Forum seeking following directions to the OPs:-

1. to return the excess amount charged from the complainant;
2. to pay her compensation to the tune of Rs.2,50,00/- and along with interest besides litigation expenses of Rs.6,600/-;

5. Upon notice, OPs No.1 to 4 filed their joint written reply wherein it was pleaded that there was no deficiency in service on the part of OP No.4 at any point of time. Complainant was treated to the best of abilities and expertise by their doctors. She was admitted to the labour room of OP-1 hospital on 04.01.2010 at 11.00PM with a history of Amenorrhea and pregnancy of 37+6 weeks with complaint of pain in abdomen for three hours prior to admission. There was no history of leaking per vagina or bleeding per vagina. Her P/V examination was done and it was observed that uterus was 34 to 36 weeks in size. Contractions were felt for 25-30 seconds after every two and half minutes. It was a cephalic presentation and foetal heart rate was 140-144 per minute regular and good volume. Leaking P/V was +, Cervix was 2 finger loose, minimally effaced, membranes+, Vertex was down and pelvis was adequate. Soap and water enema was given to the complainant at the time of admission. Patient  went into spontaneous labour and continued to have contractions during the night and was constantly monitored. On 05.01.2010,  she was having contractions during night after every three minutes for 25 seconds. Foetal heart was regular and no leakage per vagina was seen.

          Repeat pelvic examination was done at 12 noon on 05.01.2010, which showed cervical dilatation of two fingers, 30% effaced, membranes present, vertex was down. Intensity of contractions increased to 45 seconds after interval of 3 and 3½ minutes. Foetal heart remained 140/minute. Pelvic examination was again done at 5.30 PM which revealed a cervical dilatation of two fingers, 40 to 50% effaced. Since there was no progress in labour, it was decided to post the patient for LSCS operation; which was done at 6.30 PM, on 05.01.2010. An alive female child was delivered, who gasped and cried immediately after its birth. Her post operative period remained uneventful and she was discharged in a satisfactory condition on 12.01.2010. Adequate trial of trying to get normal vaginal delivery was given and further delay could have caused an adverse effect on the child and eventually on the mother. Relatives were duly explained and written consent was taken from her husband before performing surgery. The total hospital bill was Rs. 13,600/-, which was quite reasonable. All other allegations were denied and dismissal of complaint was prayed.

6.      OP No.5 Insurance Company, in its written reply, pleaded there was no pivity of contract between it and the complainant. Any medical negligence or deficiency in service on the part doctors of OP No.1 hospital was denied. Any liability of paying compensation to the complainant by OP No.1 was also denied. Dismissal of the complaint was prayed.

7.      Parties led their evidence by way of an affidavits before the District Forum, which after going through the same, allowed the complaint in aforesaid terms.

8.      Aggrieved by this order, OPs have come up in joint appeal on the ground that the District Forum failed to appreciate that the fact that complainant was admitted in the hospital on 04.01.2010 at 11.00 PM and the doctors at the hospital waited till 6.30 PM on 05.01.2010 before caesarean delivery was done because there was no progress, in spite of making all efforts, for the normal delivery. Learned District Forum also failed to appreciate that well being of the child was of paramount consideration and caesarean delivery was done as per established medical practice. Learned District Forum substituted its own opinion by observing that complications are associated with every type of treatment, but because of fear of complications, doctor is not supposed to avoid prescribed procedure of treatment. It was submitted that even in the expert opinion, obtained by the District Forum, it was clearly mentioned that "Patient was in labour for 16.5 hours and there was no progress of labour which is valid indication for caesarean." Thus, as per expert evidence, after waiting for such a long period, the caesarean delivery was perfectly valid. It was further submitted that the impugned order is based on conjunctures and summarizes. The learned District Forum of its on mentioned that the caesarean delivery was performed because otherwise, the doctor would had to wait for another 4-5 hours during the night so it was decided to pre-pone the delivery through caesarean section. While making these observations, District Forum has failed to appreciate that for the indoor patients there is proper monitoring round-the-clock and there is proper duty roster for doctors even during the night hours. The learned District Forum has allowed the complaint in a very casual manner without considering the parameters laid down by Hon'ble Supreme Court in case of Malay Kumar Ganguly Vs. Suh Kumar (DR) other reported as 2009 (3) CPC 388. Acceptance of the appeal and setting aside of the impugned order was prayed.

9.      Complainant also filed F.A. 1440 of 2011 for the enhancement of the compensation awarded by District Forum on the ground the District Forum has failed to consider the fact that the complainant suffered mental agony and harassment at the hands of the OPs after surgery. She suffered a number of health problems and even faced difficulty in doing her routine work. The compensation awarded by the District Forum is on the lower side, which is liable to be enhanced. It was further submitted the District Forum has not awarded the cost of proceedings to the complainant and also overlooked the fact that the she not only suffered mental agony, pain and harassment but medical negligence on the part of OPs also resulted in deterioration of her health. 

10.    We have thoroughly gone through the pleadings of the parties and carefully perused the evidence on record and heard the learned counsel on their behalf.

11.    The admittedly the complainant was admitted in the hospital of OP No.1 on 04.01.2010 at 11.00 PM with the pregnancy of 36+6 weeks with a complaint of pain in abdomen for 3 hours prior to admission. The grievance of the complainant is that through out her treatment, the doctor and the staff of the OP No.1 assured that her pregnancy was going on satisfactorily and the delivery would be normal and there would be need to any caesarean section surgery, but the doctors at OP No.1 hospital, without any need, conducted caesarean delivery with malafide intention to claim exaggerated bill. OP No.2 and OP No.4 did not follow the established medical jurisprudence for the delivery of the child and performed the surgery in a hurried manner. No ultrasound/sonography was conducted before taking the decision to perform surgery and feotal heart beat was also not monitored, which was required to be done after every 15 minutes. The labour was quite in progress and even the record of the OP hospital showed that after every Per Vaginal examination, amniotic membranes of liquor was present, pelvic of the patient was adequate/normal and not CPD (Cephalo Pelvic Disproportion). The patient was progressing towards normal delivery but the OPs suddenly posted her for LSCS Stat in view of reported non-progress of labour (NPOL) without showing and mentioning any other reason like Fetal Distress or Meconium Staining or CPD for the same. The complainant has further contended that the OPs were not willing to supply her the copies of the hospital record and for which she had to file court case and even to initiate contempt of court proceedings against OPs and it was only thereafter, the medical record was supplied by OP No.1.

12.    On the other hand, the stand of the OPs is that since there was no progress in labour, it was decided to post the patient for LSCS, which was done at 6.30 PM on 05.01.2010. Adequate trial of trying to get normal vaginal delivery was given and further delay could have caused an adverse effect on the child and eventually on the mother and that relatives of the patient were duly explained and written consent was taken from the patient's husband before performing the surgery.

13.    Perusal of hospital record (Ex.C23) shows that the complainant was admitted in OP No.1 hospital at 11.00PM on 04.01.2010 with a pain in abdomen since 7.00 PM. During general examination on arrival, it was noted as under:-

P/A®

• ut-34 weeks-36 weeks;

• V x ¯ Contractions after 2-2½ minutes for 25-30 seconds;
• FHR- +, Regular, Good volume.

 

 

      L/E:-           FM + No LPV seen

 

 

      P/V:-          

• Cx-2 fingers loose, minimally effaced
• Membranes Å
• V x ¯
• Pelvis adequate

 

      Plan:-        

• Shave & prepare
• s/w enema
• wait & observe.

 

                         Sd/-

Angel

 

Subsequently, patient was examined at 10.00 AM, 12.00 AM and 5.30 PM on 05.01.2010 and following observations were made by the visiting doctors:-

 

10.00 AM

05.01.2010

 

 

                   P/A= 34 weeks

                   V x ¯, mild contractions after 3 minutes for 25 seconds

          FHR-Å, Regular, Good volume

    L/E             No LPV seen.

          Patient seen by Dr. E.J. Singh                        

         

Plan-          To let the patient go in spontaneous labour herself

                                                                                      Dr. Deepti

                                                                                                Sd/-

P/V

12.00 PM

 

 

          Cx-2 fingers loose

          30% effaced.

          Membranes Å

          Pelvis adequate.

          V x ¯

 

Dr. Simmi

                                                                                                Sd/-

 

5.30 PM

 

          38 weeks

          P/A-ut 34-36 weeks

          Contraction for 45 seconds after

          3-3½ minutes.

          V x ¯

          FHR-140 bpm good volume regular

 

          L/e- n.a.d

 

 

P/V-            Cx 2 fingers loose

          40-50% effacement

          Membranes Å

          Pelvis adequate

          V x ¯

 

 

Plan:-         Posted for LSCS Stat in view of NPOL.

 

Dr. Simmi

                                                                                                Sd/-

 

Careful perusal of these notes shows that on 05.01.2010 at 10.00 AM the patient was examined by Dr. E. J. Singh, and parameters of the patient were found to be normal and fetal heart was regular and having good volume and he advised that the patient be allowed to go in spontaneous labour herself. Thereafter the patient was examined by Dr. Deepti at 12.00PM and again cervix was two fingers loose and 30% effaced vertex was down and pelvic was adequate. Same was the position at 5.30 PM except that the cervix was 40-50% effaced. There was no indication to the effect that either the foetus was in distress or any other parameter was suggestive of any emergent situation warranting caesarean section surgery. But suddenly, Dr. Simmi made a note to the effect that 'the patient be posted for LSCS stat in view of NPOL' and the operation was conducted at 6.30 PM. Though the OPs have contended that since there was no progress in labour, it was decided to post the patient for LSCS, which was done at 6.30 PM, but there is no record to support the contentions that delay would have caused an adverse effect on the child or the mother, as alleged by OPs. Moreover there is no remark by any doctor at any stage up to 5.30PM which was indicative of any emergent situation. Rather per vaginal examination  at 5.30 PM showed that pelvis was adequate, vertex was and cervix was loose and 40-50% effaced, when suddenly Dr. Simmi planned to go for LSCS on alleged NPOL. She did not point out how waiting for normal delivery could have caused adverse effect on the foetus or the patient. The contention of the OPs that the written consent of the husband of the complainant was obtained before performing the surgery is not convincing because as per allegation of the complainant some printed forms were got signed from her husband at the time of the admission itself on the pretext of completion of formalities. Apparently the decision to post the patient for LSCS was taken on extra medical considerations.

14.    The case of the complainant was referred by learned District Forum to the Director, Guru Gobind Singh Medical College Hospital, Faridkot, for consideration by a committee of experts to study it there was medical negligence or deficiency in service on the part of OPs. The report of the medical board was proved as Ex.C24; in which it is mentioned that "during normal labour, every half an hour foetal heart is indicated but the record did not show any such evidence." Though it is also mentioned that the patient was in labour for 16.5 hours, which was a valid indication of caesarean, but, it is further pointed out by the Board of doctors that "record did not show that any attempt was made by the OPs at augmentation of labour by medical/surgical methods." The board of doctors clearly opined that there was deficiency on the part of the OPs in "foetal heart monitoring and labour augmentation." There was absolutely no change in parameters that warranted immediate intervention by way of surgery without argument of labour by medical or surgical methods. The OPs have not even pleaded that any attempt was made for labour augmentation. They have not given any justification for LSCS except that any delay would have caused an adverse effect on the child and eventually on the mother. Such a plea without any supportive evidence is not sustainable. The learned District Forum has dealt the case at length and has reached at correct conclusion that the OPs were found deficient in rendering service to the complainant and performed the surgery only for extract money.

We do not find any reason to interfere with well-reasoned order of the District Forum. Accordingly the appeal filed by the OPs is dismissed.

15.    So far as appeal of complainant for enhancement of compensation is concerned, the District Forum has awarded Rs.1,00,000/-. We do not find any reason to enhance the same. Accordingly, F.A. No. 1540 of 2011, filed by complainant, is also dismissed.

16.    The arguments in this case were heard on 05.03.2015 and the order was reserved.  Now, the order be communicated to the parties.

17.    The appeal could not be decided within the statutory period due to heavy pendency of court cases.

18.    Copy of this order be placed on file of F.A. No. 1540 of 2011.

 

                                                               (JUSTICE GURDEV SINGH)

                                                                           PRESIDENT

         

 

                                                                  (BALDEV SINGH SEKHON)                                            

                                                                                 MEMBER

                                                                                                    

                                                                          

 

                                                                 (SURINDER PAL KAUR)

April      09, 2015                                                MEMBER

RK2