PRESENT: Sh. Navin Kapur, Adv. for the Complainants.

Sh. P.K. Kukreja, Adv. proxy for OP-1.

Sh. P.K. Kukreja, Adv. for OP-2.

Ms. Ritu Jain, GP for OP-3.

PER ASHOK RAJ BHANDARI, MEMBER 

     The case of the complainants is that the Complainant No.1 & 2 got married in the year 2001 but for the first time Complainant No.1 conceived in the year 2007 and was under the treatment and care of ESIC Model Hospital, Ram Darbar, Chandigarh during the pregnancy with LMP dated 22.3.2007 and EDD dated 29.12.2007. Unfortunately, the Complainant No.1, while going on foot, was hit by a Motorcycle on 06.12.2007 at Ram Darbar and she started bleeding profusely and was immediately rushed to ESIC Model Hospital, Ram Darbar, Chandigarh, under whose care she was from the inception of pregnancy and reached there at about 11.00 A.M. Because her husband was out of station and due to emergency, the Employee Identity Card was not being carried by her and she was also unable to contact her husband or communicate with him in this regard at that point of time. Accordingly, the Complainant No.1 was unable to produce the ESIC Card at that time. The child in the womb of Complainant No.1 was alive at the time she was taken to ESIC Hospital. OPD card as well as Antenatal Card were produced before the attending doctor, but it was insisted by the doctors present there that for getting treatment over there, she will have to first produce the ESIC Identity Card and only then the treatment will be administrated and the doctors did not even give first aid. After initial probing, refused to administer any treatment and that too after she was made to cry over there for more than three hours i.e. uptill about 2.00 PM. Even when everybody started coercing the doctors to give treatment to her, the Lady Doctor showed her inability to attend to the Complainant No.1 despite having seen the OPD and Antenatal Cards and the Complainant No.1 was instead directed to Govt. Medical College and Hospital, Sector–32, Chandigarh at about 2.00 PM. The Complainant No.1 was immediately rushed by her uncle-in-law to GMCH, Sector –32, Chandigarh. It is further submitted that when the Complainant No.1 was taken to ESIC Hospital, at that time, it was told by the doctors that the Complainant No.1 will have to be operated for delivery of the child and it was told by them that the child is alive. At last, after 2.00 P.M. when the Complainant No.1 reached GMCH, Chandigarh, it was declared that the child in her womb has been brought dead. That is thus the case of gross negligence on the part of the doctors at ESIC Hospital and due to their improper care and by not administering required and proper treatment, which was obligatory upon them by virtue of having charged ESI premium from Complainant No.2, the husband of the Complainant No.1, the death of child of the Complainants has been caused who was yet to see this world and before his coming, his eyes have been permanently closed. The Complainant No.2 sent a written complaint to the OPs, for taking legal action against the erring doctors, but no action has been taken by the Authority (OPs 1 & 2). 

     Alleging this as deficiency in service on the part of Ops 1 & 2, complainants have approached this Forum with the prayer that Ops 1 & 2 may be directed to have rendered deficient services to the Complainants and may now be directed to pay the claimed amount of Rs.4,50,000/- (Rs.4,00,000/- or causing death of her child due to gross negligent and deficient services rendered by OPs and Rs.50,000/- as compensation for the pain and suffering caused to the Complainants), alongwith interest @18% per annum with effect from 06.12.2007 i.e. the date of admission in OPs Hospital, till payment as well as litigation cost of Rs.11,000/- to them.

2.        In its reply, OPs took some preliminary objections regarding the maintainability of the complaint etc. Further pleaded that the Complainant was covered under the provisions of ESI Act with effect from 13.12.2002. It is denied for want of knowledge that OP No. 1 got married in the year 2001 and had met with the said accident dated 06.12.2007. But it is admitted that the Complainant reached the OP No.2 at around 11.00 a.m. on 6.12.2007. The Complainant No.1 gave history of being hit by a motorcycle followed by a fall, resulting in some injuries, PV bleeding and pain abdomen. The Complainant was a booked ANC patient and was carrying the ANC card with her. Doctors on duty referred the patient from Casual Ward to Labour Room. A complete physical and gynecological examination of the Complainant No.1 was done and dressing of her bruises was done. The vitals of the Complainant were stable, her gynae and Obs examination was normal and as per speculum examination, Os was closed and there was no apparent PV bleeding. The FHS was also normal. After the initial examination, the Complainant No.1 was sent to Radiology Department, accompanied by the N/o for an urgent USG. After sonography, she was brought back to the Labour Room. The USG report of the Complainant was normal with no signs of abruptca placenta or foetal compromise and as a result, a conservative management of the patient was planned and she was kept in Labour Room itself. It is admitted that OP No. 2 was out of station on that day. Without the production of ESI identity card, which was not even required to be produced at that time, the Complainant No.1 was treated and IV fluids and analgesic injections were administrated to the Complainant No.1 and her vitals and FHS were monitored.  At about 1.00 PM, the Complainant No. 1 suddenly developed PV bleeding and her speculum examination revealed profuse vaginal bleeding. The Complainant No. 1 was immediately catheterized and efforts were made to contact her husband to explain the condition, but the husband of the Complainant, as already stated, was out of station, so the condition was explained to the attendant that due to lack of operation facility, the patient needed to be urgently referred to the near by hospital i.e. OP No.3. A proper reference slip, with all the reports and ANC card was given to the attendant and ambulance was arranged from the Labour Room.  Complainant No. 1 was sent to Casualty with N/o from where she was transported to the OP No. 3 in the ambulance of the OP No. 2. As soon as profuse PV bleeding developed and abruptca placenta was suspected, the Complainant NO. 1 was immediately referred to the OP No. 2 in the hospital ambulance, as in such kind of patients, treatment may require FFP, BTs and even ICU care, which was not possible with OP No. 2, as such like facilities were not available with OP No. 2. The alleged delivery of dead child at OP No. 3 is denied for want of knowledge. It is correct that the complaint (Annexure C-8) was received from Complainant No. 2 and its reply was given (Annexure C-10).  To probe into the allegations of the Complainants, OP No. 1 & 2 even appointed a Committee to ascertain the truth in the allegations of the Complainant No. 2. The Inquiry Committee submitted its report, which is available along with annexures (Annexure C-10), which clearly reveals that the allegations of the Complainants were wrong because the best possible treatment was provided to Complainant No. 1. Thus, the OP No. 1 & 2 prayed that the complaint of the Complainant may be dismissed with costs against OP No. 1 & 2.    

3.        In its reply, OP-3 pleaded that as per history sheet, OP No. 1 was bleeding since 11.00 P.M. on 06.12.2007 when she had met with a road accident. Necessary medical examination of the patient was done by the qualified doctors and radiologist. Thereafter at around 9.20 p.m. on the same day, the patient delivered a dead baby boy weighting 3 kg. The delivery of the child was Vaginal. The body of the child was also shown to the father and he acknowledged the same. Thereafter, Post Mortem Report dated 07.12.2007 was issued by answering respondent hospital and the patient was discharged in healthy condition at 11.30 p.m on 08.12.2007. Thus, the answering OP prayed that the present complaint may be dismissed.

4.        We have carefully gone through the entire case thoroughly, including the complaint and the relevant documents tendered by the complainant / OPs. We also heard the arguments put forth by the learned counsel for the parties. As a result of the detailed analysis of the entire case, the following points / issues have clearly emerged and certain conclusions / arrived at, accordingly:-

i)   The basic facts of the case in respect of the Complainant No.1 having taken the treatment in the Hospital of OP No. 2 during antenatal period and also on 06.12.2007, when she had met with an accident and suffered injuries, including bleeding and having reached the Hospital at 11.00 AM on the same day, have all been established.

ii)  The basic grievance of the Complainants, especially Complainant No. 1 against OPs, especially against OP No. 2, has been that whereas, she had reached the Hospital on 06.12.2007 at 11.00 AM, she was not attended to by the doctors on duty at the Hospital of OP No. 2 on account of the fact that due to her rushing to the Hospital on account of accident, she could not carry the ESI Employee Identity Card with her and also she was not able to contact her husband, as he was out of station.  As per the Complainants, she remained in the Hospital of OP No. 2 till 2.00 PM i.e. for about 3 hours, but no treatment was given to her, not even the first aid and finally, instead of treating her in the Hospital, she was shifted to Govt. Medical College and Hospital, Sector 32, Chandigarh (OP No. 3), although she was carrying with her, the OPD, as well as Antenatal Cards. At the Hospital of the OP No. 2, as well as OP No. 3, she was told by the doctors that she will have to be operated for delivery of the child. While she was in the Hospital of OP No. 2, she was told that the child in her womb was alive; whereas, when the actual delivery took place in the Hospital of OP No. 3, she had delivered a dead baby boy on the same day i.e. 6.12.2007 at 9.20 PM. She also made a written complaint to the Hospital Authorities of OP No. 2, alleging gross negligence, improper care and lack of proper treatment on the part of the doctors, but no action was taken by the OP and as such, she could not see the face of her son, who had a still birth on that day.

iii) All the allegations of the Complainants have been denied stoutly by OP No. 1 and 2, which are the main parties in the present case, as OP No. 3 is only a proforma party. As per the OPs, they had never insisted upon the Complainant to produce the ESI Employee Identity Card and as a matter of fact, it was not even required, as the Complainant was already having the OPD and Antenatal Cards with her. The doctors on duty referred the patient from Casualty Ward to Labour Room. A complete physical and gynaecological examination of the Complainant was done, her bruises were dressed and it was found that the vitals of the Complainant were stable and her Gynae/Obs examination was normal, as per Speculum Examination, OS was closed and there was no apparent PV bleeding. The FHS was also normal. As per the OPs, after the initial examination, the Complainant No. 1 was sent to Radiology Department, accompanied by the N/o for an urgent USG and after Sonography, she was brought back to Labour Room. The USG report of the Complainant was normal with no signs of abruptca placenta or foetal compromise and as a result, a conservative management of the patient was planned and she was kept in the Labour Room itself. She was also given IV Fluids and analgesic injections and her vitals and FHS were continuously monitored. It was only at about 1.00 PM on 06.12.2007 i.e. 2 hours after her reaching the Hospital, that the Complainant suddenly developed PV bleeding and her speculum examination revealed profuse vaginal bleeding and, therefore, she was, immediately, catheterized and efforts were made to contact the husband of the Complainant (Complainant No.2). Since the husband of the Complainant was out of station, the entire position was explained to the attendant accompanying the Complainant, stating that due to lack of proper operation facilities at the Hospital of OP No. 2, the patient needed to be urgently referred to some nearby Hospital i.e. OP No. 3. A proper reference slip with all the reports and ANC card was given to the attendant and ambulance was also arranged from the Labour Room of OP No. 2.  The Complainant was sent to casualty with N/o, from where she was transported to OP No. 3 in the ambulance provided by OP No. 2. As soon as profuse PV bleeding developed and abruptca placenta was suspected, the Complainant No. 1 was, immediately, referred to OP No. 3 on account of the reason that in such kind of patients, treatment may require FFP, BTs and even ICU Care, which were not available with OP No. 2. As per OP No. 2, the alleged delivery of dead child at OP No. 3 is denied for want of knowledge. OP No. 2 further says that since the Complainants had also made a written complaint in respect of certain allegations against the doctors, an Inquiry Committee was appointed, which submitted its report, which is available at Annexure C-10. As per the inquiry report, the allegations made by the Complainants were found to be wrong and it has been stated that the best possible treatment was provided to Complainant No. 1 by OP No.2.  

iv)  On the similar lines, OP No. 3 have also pleaded not guilty saying that the patient was already bleeding when she was brought to the Hospital of OP No. 3. She was examined by the qualified doctors, as also a Radiologist. At about 9.20 PM on the same day, the patient delivered a dead baby boy through a normal delivery, for which a Post Mortem Report was also issued and the patient was discharged in a healthy condition at 11.30 PM on 8.12.2007. OP No. 3 has denied any deficiency of service on its part.  

v)   After closely examining and scrutinizing all the documents produced by the respective parties, we find that the main allegation of the Complainants, especially Complainant No. 1, against the OPs, especially OP No. 1 & 2 (OP No. 3 being a Proforma Party) is that whereas on 06.12.2007, she had gone to the Hospital of OP No. 2 and remained there for about 3 hours, without getting any treatment and not even the first aid and further, because of the improper treatment given by the OP No.2, she lost her child, which was delivered at the Hospital of OP No.3 as a dead baby boy. As per the Complainant, while she came to OP No. 2 after meeting with an accident, she was told that the child in her womb was alive and not dead; whereas, when the actual delivery took place at the Hospital of OP No. 3, it was found to be a dead child. The complete case file, both at the Hospital of OP No. 2 and OP No. 3, reveals that the plea taken by the Complainant is not substantiated by any evidence or document; whereas, the OPs have submitted the complete set of documents stating that she was never refused the treatment on account of her not carrying the Employee Identity Card. She was put to ultrasound examination, her bruises were dressed and a Speculum Examination for Gynae/Obs was done and at that time, OS was closed and there was no apparent PV bleeding. The FHS was also found to be normal and after this procedure, she was sent to Radiology Department for USG/Sonography. There were no complications with the patient (Complainant No.1) and there were no signs of abruptca placenta or foetal compromise and, therefore, OP No. 2 planned a conservative management in the Labour Room. Not only that she was also given IV fluids and analgesic injections and FHS were continuously monitored. All this treatment continued till 1.00 PM, when the Complainant suddenly developed PV bleeding, as also profuse vaginal bleeding and, therefore, she was catheterized and efforts were made to contact her husband, who was out of station on that day. Since the team of doctors felt that the patient had to undergo an operation and proper facilities were not available with OP No. 2, she was referred to OP No. 3 for further treatment. OP No.2 itself provided the ambulance for the transportation of the patient. This was done on account of the reason that in such kind of patients, treatment may require FFP, BTs and even ICU Care, which were not available with OP No. 2. Therefore, it is quite clear that the allegations of the Complainants against OP No. 2 are patently false and unwarranted, as what to say of first aid, OP No. 2 has attended to the patient with all kind of treatments, including Sonography, physical examination and medicinal treatment, which has been properly documented as well. The only option with OP No. 2 after 1.00 O’clock was to shift the patient to a better and well equipped hospital, as she was to undergo surgical operation for delivery of her child. It is quite obvious that the ESI Hospital is not a full fledged hospital, which has not got all the facilities, which other bigger and better hospital like PGIMER, GMCH Sector 32 have and the best option with any good doctor or team of doctors in such a case always is to shift the patient to a better hospital and this has precisely been done by OP No. 2 by shifting the patient from OP No. 2 to OP No. 3 and we do not find anything wrong or amiss in the procedure.

vi)  Not only OP No. 1 & 2, which are the main parties in this case, have treated the patient in the best possible manner, they had also instituted an inquiry on receiving a written complaint from the Complainants with regard to the alleged improper treatment of the Complainant at the Hospital of OP No 2. The detailed inquiry report is available on record. The inquiry was conducted by a team of three doctors. The Inquiry Committee have completely rejected the allegations made by the Complainants against OP No. 2, giving concrete reasons and grounds for such rejection and we have no reasons to disbelieve the findings of the Expert Committee.        

vii)   So far as OP No. 3 is concerned, as already stated, it is only a Proforma Party and has not much to do with the present complaint. In the affidavit filed by Prof. Raj Bahadur, Director Principal, Govt. Medical College & Hospital, Sector 32, Chandigarh (OP No.3), it has been stated that on arrival of the patient at GMCH, the foetus in the uterus did not show any sign of life and it was communicated to the patient’s relative. As per OP No. 3, the patient was examined by qualified doctors of Obstt. & Gynae Department; an ultrasound was done by a qualified Radiologist. She (Complainant No.1) was having pulse rate of 96/minue and her BP was 120/90. But it was noted that Foetal Heart Sound was ‘Nil’. Ultrasound report also confirmed that the foetus/child was not alive. The ultrasound report (Annexure R-2) had the following observation: -

“No feotal cardiac activity noted.”

After necessary confirmation on receipt of Ultrasound report, the child was declared dead and the patient and the attendants were accordingly intimated and the consent of husband was taken for further management of patient. Consequently, on the same day i.e. 06.12.2007, at 9.20 PM, the patient delivered a dead baby boy weighing 3 Kg and the delivery of the child was vaginal. The cause of foetal death, as mentioned in the report, was Placental Abruption (Medical Term for Traumatic Placental Separation). Thereafter, the Post Mortem Report (PMR) dated 7.12.2007 was issued by OP No. 3 and the patient was discharged in a healthy condition on 8.12.2007 at 11.30 PM.  

5.        From the above detailed analysis of the entire case, it is our considered view that the allegations made by the Complainants are devoid of any merit, carry no substance and weight. As such, the present complaint deserves rejection. We, therefore, dismiss the complaint. However, the respective parties shall bear their own costs.

6.             Certified copy of this order be communicated to the parties, free of charge. After compliance file be consigned to record room.

Announced

04.12.2009

‘Dutt’

C.C.No. 202 of   2008

PRESENT:     None

          As per separate detailed order of even date, this complaint is dismissed.. After due compliance, file be consigned.

Announced.

04.12.2009 President   Member