Sri.D.Krishnappa,<br /> President<br /> <br /> 1. This complaint was filed initially by the mother and daughter duo alleging medical negligence against the opposite party. Later on, not only an advocate appeared for them but through an application the mother went off the record. Thus, only the daughter remains on record and she has been referred as the complainant.<br /> <br /> 2. The complainant who is a resident of Bangalore consequent to her marriage became pregnant and approached the opposite party, a gynecologist, for prenatal checkups. She approached the first opposite party for the first time on 20.12.2005 when an ultra sound scanning was done which revealed that she was pregnant and the fetus showed no obvious anomalies. Thereafter, she went to the opposite party for the check up on 21.4.2006 and the ultra sound scanning revealed that her pregnancy was proceeding well. However, sometime thereafter the complainant was feeling “heavy weight” and “discharge in the lower abdomen”. So she met the opposite party on 8.5.2006. The opposite party told the complainant that the baby was dead inside the womb and she could come the next day to get it removed.<br /> <br /> 3. The complainant came home and at around 10 p.m she experienced discharge and felt “weight dropping inside her” and rushed to the Holdsworth Memorial Hospital, Mysore by her mother. The duty doctor told the mother that “it was turning poison and she has to be admitted immediately”. The doctors induced pain and the complainant delivered a female baby, dead, massacred.<br /> <br /> 4. The complainant has stated that the dead baby had no head, skull or hair, though the opposite party had given the circumference of the skull in the scanning report. The dead baby, also, carried no sensory organs like the nose, ears and mouth. The upper and lower lips were cut and the limbs were not normal. She has alleged that the opposite party had assured that the baby had no major anomalies despite the fact that these anomalies are visible in the scanning. Thus, it is the contention of the complainant that had the opposite party informed her about these anomalies earlier, she could have exercised the choice of terminating the pregnancy. Further, she has alleged that though the opposite party came to know that the baby was dead, she did not advice her to get admitted thus exposing her life to risk. She says that she has become a psychic due to the trauma.<br /> <br /> 5. The complainant has made more allegations against the opposite party’s nursing home that there are no qualified nurses, radiologist and doctors to attend to emergencies.<br /> <br /> 6. She has claimed compensation of Rs.5 lakhs, transportation charges of Rs.5000/- on the ground that she used to travel from Bangalore by taxi for the checkups, Rs.5000/- towards mental agony, Rs.10,000/- towards cost of medicines and Rs.1500/- towards cost.<br /> <br /> 7. The opposite party has denied all the allegations made by the complainant about the efficiency and negligence but has admitted the three scanning done on 22.12.2005, 21.4.2006 and 8.5.2006. She has denied that she sent away the complainant on 8.5.2006 after the scan report revealed intra uterine demise of the baby. She has, also, denied the allegation that the baby died in the womb in the 4th month of pregnancy itself and she did not inform the complainant about it. The opposite party has stated that in such a situation, there would be spontaneous expulsion of the fetus and if it does not happen the patient will develop D.I.C complication. The opposite party has denied all the other allegations including the allegation that there were no doctors, nurses and radiologist.<br /> <br /> 8. From the above rival contentions, the following points arise for our consideration<br /> <br /> I. Whether the complainant proves that the opposite party has caused deficiency in service by misleading her that the baby in the womb was free from anomalies?<br /> II. Whether the complainant proves that the opposite party caused further deficiency in service by not doing the needful after it was known that the baby had died in the womb?<br /> III. Whether the complainant proves that the nursing home of the opposite party suffered from lack of doctors and nurses due to which she did not get prompt and timely service?<br /> IV. What relief or order?<br /> <br /> 9. After hearing both sides and perusing the documents, we have answered the above points as under:<br /> Point I : In the affirmative.<br /> <br /> Point II : In the negative.<br /> <br /> Point III : In the negative. <br /> <br /> Point IV : As per final order<br /> <br /> REASONS<br /> <br /> 10. Point No. I:- The case of the complainant is that she was visiting the Opposite Party for prenatal checkups. She has produced the ‘Antenatal Card’ issued by the Opposite Party and the same has been marked as Ex.C.4. From the said card it is evident that she visited the Opposite Party 4 times on three occasions ultra sound scan were done. The foetal age as on the date of scan have been recorded as 18 weeks, 31 weeks and 33 weeks. In the first two scans dated 20.12.2005 and 21.04.2006 it has been noted that there were no major anomalies. The complainant met the Opposite Party for the last time on 08.05.2006 when after physical examination the Opposite Party found the foetal heart rate good and noted the same in the “antenatal card”. However, during the course of cross examination she has stated that she did suspect something and advised an ultra sound scanning which revealed intra uterine demise of the baby. She has explained her note in the “Antenatal Card” that the foetal heart rate was good by saying that sometimes aortic pulsation mimics foetal heartbeat. The complainant’s allegations are that though the baby had anomalies like cleft palate and clubfeet they were not noted in the scan report and even after coming to know about intra uterine demise of the child she was sent away asking her to come back the next day.<br /> <br /> 11. The complainant has alleged that after she was sent away by the Opposite Party she had trouble by night on the same day and was rushed by her mother to Holdsworth Memorial Hospital where pain was induced and the baby was aborted the next day. The said Hospital has noted delivery of “a macerated still born female baby complete right sided cleft lips palate present back leg CT E/V present”.<br /> <br /> 12. In order to answer this point it is essential to know what deformities or abnormalities are termed as major anomalies and also what details are visible in an ultra sound scan. Ultra sound scan is an important tool which gives useful information about the health and development of the baby in the womb. What is an abnormality or deformity is difficult to define. Doctors may perceive a condition as an donormality or deformity if such condition is life threatening or is likely persist through out the life of the child. But for the parents an abnormality or deformity in the child is one which they will find it difficult to cope up. Here, the question is not how severe the abnormality is and whether it can be corrected by surgery or otherwise. Thus, there may be problems which may not be a major anomaly from the point of view of the Doctors, but the parents may find the difficult to cope up. It may be for economic reasons or it may be burdensome to the parents or to the child itself. Thus, the nature of relationship between the doctor and the patient demands that the doctor appraise the parents about any problems in the child so in the womb that they can take the decision about continuation or otherwise of the pregnancy.<br /> <br /> 13. In the light of above discussion if we look at the ultra sound scan reports of the complainant and compare them with the features of the baby as given in the case sheets of Holdsworth Memorial Hospital it becomes evident that conditions like cleft palate and clubfeet which were found in the baby were not recorded in the ultra sound scan report. Dr. Jyothi Umesh, the doctor who treated the complainant at Holdsworth Memorial Hospital has stated that cleft palate and clubfeet can be visualised in an ultra sound scan. In any case, the Opposite Party does not say that such anomalies cannot be visualised in an ultra sound scan. All that she says is that the Sonologist can comment on that. Thus, it is a case where the Sonologist has himself categorised anomalies into major and minor and has placed conditions like cleft palate and clubfeet under the minor anomalies category. It is also apparent that the complainant was not informed about these anomalies and given counseling. It was essential for the Sonologist to reveal in the report the existence of cleft palate and club feet. It was, also, essential for the opponent to counsel the complainant on this. After all these conditions become evident around the 13th week of pregnancy. It is therefore our firm opinion that not revealing these anomalies to the complainant is an act of deficient service. Therefore, we answer the point in the affirmative.<br /> <br /> 14. Point No.II:- The Opposite Party has no doubt noted in the “Antenatal Card” that on 08.05.2006 the foetal heart sound was good. She has stated in her cross-examination that even then she suspected something was wrong and asked for an ultra sound scan. The scan was done the same day which revealed intra uterine demise of the child. It is the allegation of the complainant that she was sent away asking her to come back the next day. The Opposite Party has categorically stated that she advised the complainant to get admitted immediately, but she went away against such advice. It is true that the complainant chose to go to Holdsworth Memorial Hospital for the expulsion of the dead fetus. This no doubt looks strange. She has gone to Holdsworth Memorial Hospital at 9.15 p.m. on 08.05.2006 though the ultra sound scan was done in the afternoon which revealed intra uterine demise of the child. The contention of the complainant, that the opponent after perusing the CT scan report on 08.05.2006 advised her to come on next day for removal of the dead baby from her womb do not appears to be true and acceptable. Because as could be seen from the records and the evidence of both the parties, the opponent doctor on 08.05.2006 though inadvertently made an entry in the Antenatal card, that foetal heart sound was good, but in her evidence and also in her action she has exhibited that she was not happy with her examination of the patient and therefore advised Ultrasound CT scanning and admittedly made the complainant to wait till the receipt of the report and after going through the report found that intrauterine demise of the child and stated to had advised the complainant to admit to the Hospital for expulsion of the dead baby and further stated that the complainant, against her advise went away by collecting her card. The complainant has not disputed referring her to Ultrasound CT scanning and she waited till the report of scanning. It emerges from these circumstances, that the complainant who was not happy with the treatment of the opponent did not chose to admit to the opponent’s Hospital for expulsion of the baby, but went away. It is further found from the admission of the complainant and the documents, she on 08.05.2006 at 9.15 pm goes to Holds Worth Memorial Hospital for expulsion of the dead baby. The complainant in her evidence has made certain exaggerative statements regarding the death of the baby by stating that baby had died. Even few weeks earlier to 08.05.2006 but has made a categorically statement in the cross-examination she was feeling the movement of the baby till 07.05.2006. Therefore, if the opponent was so negligent as contended by the complainant she would have immediately on examining the complainant found heart beating of the baby was good would have straight away told the complainant, that everything was alright and to come for checkup next time. But, she suspect something wrong and therefore advised Ultrasound scanning by making the complainant to wait till the receipt of the report which conduct of the opponent. In our view proves that the opponent was deligent in her further action. Further she being a doctor, it is highly unlikely that she would have asked the complainant to come the next day for removal of the dead fetus. We have also noted from the case sheets of Holdsworth Memorial Hospital that she had pain in the abdomen since morning. Hence, we inclined to believe that the Opposite Party did not send the complainant away asking her to come back the next day for removal of the fetus. We therefore answer the point in the negative.<br /> <br /> 15. Point No.III:- The complainant has not led any evidence about the paucity of doctors and nurses in the nursing home of the Opposite Party. She has also not stated anything about the problems she faced due to such paucity. Therefore, we answer the point in the negative.<br /> <br /> 16. The complainant has also alleged that though the baby was dead in the womb for a long time the Opposite Party failed to notice it. This allegation does not find the place in the complaint though questions have been put to the witnesses in this regard. Dr.Jyothi Umesh has stated that the baby must have died 24 to 48 hours before the complainant came to their Hospital (Holdsworth Memorial Hospital). She has also explained the consequences a dead baby in the womb for a long time. The scanning report reveals that the baby was alive at least till 21.04.2006. Further the complainant herself has stated in the cross-examination that she did not notice any change in her health till 07.05.2006 and was feeling the movement of the baby till 07.05.2006. Hence, the allegation that the baby was dead for a long time and the Opposite Party failed to notice it, is an allegation unsupported by pleadings and evidence.<br /> <br /> 17. While deciding on the question of quantum of compensation we intend to impose upon the Opposite Party we take into consideration the fact that the deficiency in service attributed to the Opposite Party did not result in the death of the baby. We cannot, also, speculate whether the complainant would have gone in for termination of pregnancy, if she was aware that the child in the womb had cleft palate and club feet. The deficiency is in not following the standard reporting procedure and not conducting in a professional manner rather than any negligence. If the complainant had given birth to the baby with the anomalies then the quantum of compensation would have been much higher as negligence would also have counted. Considering these facts, the compensation we intend to impose has to be seen as an eye opener to the Opposite Party and Radiologist so as to conduct themselves more professionally. With these observations, we proceed to pass the following order.<br /> ORDER<br /> <br /> A. Complaint is partly allowed.<br /> B. The Opposite party is directed to pay the Complainant Rs.5,000/- as compensation within one month from the date of this order, failing which such amount shall carry interest at the rate of 12% p.a. thereafter until the date of payment.<br /> C. The Opposite party shall pay the Complainant cost of Rs.1,000/-.<br /> D. Give a copy of this order to each party according to Rules.<br />