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Not all anomalies can be detected by ultrasound-NCDRC while dismissing Rs 17 lakh complaint

“Not all anomalies can be detected by ultrasound study.”

A case claiming Rs.17 lakhs compensation was dismissed by the National Consumer Disputes Redressal Commission, that was seen alleging failure on part of Doctors to diagnose fetal anomalies

Case Details :
S. SARAVANAN V/s. M/S. RASI CLINIC & 3 ORS, TAMILNADU. Judgment Dated : 20 Mar 2017

Facts in Short :
1. The complainant along with his wife approached the Respondent on 20.9.2007and the Doctor confirmed the 2nd pregnancy. It was contended by the Couple that due to extraction of 4 teeth 2 days back, the wife consumed heavy doses of pain killer medicine and requested to advise for termination of pregnancy if the fetus would face any problem due to these medicine !. But this possibility was ruled out by the Doctors.
2. Then the patient was referred for regular scanning with the Respondent No.2 and all he 3 ultrasound scans were normal and heart activity was recorded.
3.On 16.6.2008 a female baby was born under C-Section. But as the baby had breathing problems, she was referred to another Hospital. The baby was diagnosed as as 15 days old female neonate with   downs phenotype and Tetralogy of Fallot with severely hypoplastic MPA & PA confluence

4. Thus a case of Medical Negligence was filed against all the Doctors for Rs.17 lakhs alleging that the Doctors did not give the correct advice at the first instance about the adverse effects of the pain killer medicines and that the Doctors failed to diagnose fetal anomalies. Both the lower forums dismissed the Complaint.
5. The Indian Medical Council (MCI) was impleaded as the party, but since no relief was claimed against it, its name was deleted.
1. The Doctors refuted all the allegations made against it.. It was contended that the lady did not come for the follow-up in time. While the Ultrasound on the 12-13 week recommended a repeat ultrasound at 18-20 week, but the patient did not come for the same.

The complainant in response to this then told the court that the while the report stated repeat ultrasound at 18-20 weeks, the gynecologist herself did not advice the same to the patient and hence there was negligence

Held :
1. The Commission observed from the Evidence that the Complainant never uttered a single word in the Complaint that the Doctor was deficient in not advising scan/ultrasound between 18-20 weeks of pregnancy and this was the total new case made up..
2.. Relieving the Doctors from the charges negligence it was observed that there is no proof much less of an expert witness that complications developed due to the effect of medicines taken for dental treatment and secondly, there was no occasion to advise any higher level scan as all the scans were found normal as per the report of the sonography expert and the lady failed to come for the second ultrasound/scan during the duration of 18-20 weeks of pregnancy.
3. The Commission pointed out the Footnote at the end of the report which started as “Not all anomalies can be detected by ultrasound study…” More over the court observed that since here was no occasion for the Gynecologist/clinic to advice any higher level scan/ultrasound. Thus, there has been no negligence on the part of gynecologist/clinic because first of all, there is no proof that complications developed due to the effect of medicines taken for dental treatment and secondly,  there was no occasion to advice any higher level scan as all the scans were found normal as per the report of the sonography expert, OP-2.
This is a very important judgment for both, Gynecologist and Sonologist. Anomaly scan is very important aspect in pregnancy and no Doctor would purposely give wrong report.
But the question remains, that if the anomaly would have been detected,the patient would have exercised her right of MTP. But what if it would have been detected after 20 Weeks ? Only ray of hope is Supreme Court. But recently we have seen the contradictory judgments of Apex Court on this topic.. One which allowed the MTP even after 20 weeks and the recent one disallowed in the case of down syndrome ! This judgment again emphasises the need to amend the MTP Act.

Thanks and Regards

Adv. Rohit Erande
Pune.©

You can read the full judgement by clicking on the following link

http://cms.nic.in/ncdrcusersWeb/GetJudgement.do?method=GetJudgement&caseidin=0%2F0%2FRP%2F2159%2F2014&dtofhearing=2017-03-20

Disclaimer: The views expressed in the above article are solely those of the author/agency in his/her private capacity and do not represent the views of Medical Dialogues.
Source: Self
5 comment(s) on Not all anomalies can be detected by ultrasound-NCDRC while dismissing Rs 17 lakh complaint

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  1. user
    Dr mamdade d n March 31, 2017, 4:43 pm

    Right decision of Court

  2. user
    DR SYAM SUNDER RAO March 31, 2017, 4:19 pm

    IT IS TRUE THAT ALL CONGENITAL ANOMALIES CAN NOT BE DETECTED ONLY BY ULTRASOUND. IT DEPENDS ON FETAL POSITION, AMNIOTIC FLUID VOLUME AND GESTATIONAL AGE OF THE FETUS.
    IT IS VERY IMPORTANT THAT WE HAVE TO DO NT SCAN AT 11-13 WEEKS AND ANOMALY SCAN AT 20 WEEKS AND FETAL ECHO AT 24- 28 WEEKS. SERIAL FOLLOW UPS ARE VERY ESSENTIAL. SOME CARDIAC ANOMALIES ARE SEEN ONLY IN THIRD TRIMESTER.
    THANK YOU ROHIT ERANDE FOR ENLIGHTENING AND SHARING THE CASE WITH US.

  3. user
    Adv. Rohit Erande April 2, 2017, 11:44 am

    Thanks a lot for your words of appreciation Dr. S S Rao.. My pleasure as always..

  4. user
    Dr Mohan Ranawade March 31, 2017, 9:36 am

    Nice case study Adv.Erande, you have been enlightening doctors on medicolegal aspects and this has made us less scared of the law, since we now have the Power and tool of documentation ,which makes it difficult for people to randomly file cases against doctors.

  5. user
    Adv. Rohit Erande April 2, 2017, 11:43 am

    Thanks Dr. Mohan Ranawade. It\’s my pleasure. Being a professional I have high regards for other professionals too and Doctors are more equal for me…