Localized Fluid Collection at Surgical site after C-section: Hospital told to pay compensation

Jalandhar: Stating that the doctor and the hospital are liable to be punished for the medical negligence committed during caesarean operation of a patient; the District Consumer Forum has directed them to pay compensation to the patient. The patient had undergone another surgery due to the alleged negligence in the delivery procedure.

The case concerns the patient who was admitted to a maternity home for delivery. The doctor had advised for caesarean operation and accordingly, it was conducted. Post-surgery, the patient; who is also the complainant in the case; had started experiencing some internal pain and severe stiffness on the operated part.

After consulting the doctor about the same, she was prescribed oral medicines. However, even after her discharge and taking medicines as advised, instead of subsiding, the pain became aggravated. After checkup, she was again advised to take medicines and told that there was nothing serious or unusual and that it was normal after-effects of caesarean operation. A few days later, blood started oozing out from the operated area and there was continuous profuse bleeding from the operated area following which the patient was rushed to the hospital for treatment. Due to heavy blood loss, the patient was administered two units of blood.

The patient was later taken to another hospital for treatment where an ultrasound scan was done which showed that the operated area was not properly stitched and there was an internal wound which did not get treated. The doctor’s impression on the report was—“localized fluid collection in the anterior abdominal wall at the scar site in the suprapubic region having an approximate volume of 120-130 CC.”

After seeing the report, Dr Sharma of the other Hospital observed on the summary slip - “25 years Postpartum lady, underwent caesarian section on 28.08.2017 at a private nursing home. Postoperatively she had bleeding and discharge from the suture linen which was being managed conservatively with dressings and oral antibiotics. Patient had to be transfused blood and suffering from fever and in physical examination, it was found that an open wound in lower abdomen over the transverse scar line. Large clots visible in the wound cavity with foul-smelling discharge.”

The patient then underwent surgery at this hospital.

Thereafter, alleging medical negligence and deficiency in service, the patient filed a complaint with the District Forum. She stated that when she need medical attention, the doctor left for Mumbai in the evening itself and neither made any alternative arrangement of any gynaecologist or other competent doctor nor gave any information about her leaving for Mumbai leaving her to fend for herself at the mercy of the paramedical staff only.

The counsel for the patient submitted in the petition that she was looked after by inexperienced and incompetent paramedical staff who just did dressings on the operated area. She alleged that before leaving, she had only done dressing of stitched area from outside wherefrom blood was oozing profusely, but no procedure was done for stopping the internal bleeding. It was alleged that the hospital and the doctor offered very casual treatment to her, which led to complications after faulty caesarian operation.

The hospital authorities and the doctor denied all allegations against them citing that the complaint is not maintainable as the medical opinion was not taken by the Forum from a competent doctor or committee of doctors specialized in the field.

After analyzing the treatment given by the hospital and the doctor, the forum bench of Karnail Singh as President and Jyotsna as Member noted that there was some glaring negligence on the part of the doctor and both are liable to be punished for that.

“Moreover, whenever any serious patient is admitted or under treatment with the doctor, then it is primary duty of the doctor to save the life of the human being instead of doing his household work or personal work if any very important work is required to be done by the doctor by himself/herself, then he has to make an alternative arrangement of expert doctor so that the patient will not suffer, but in this case, the negligence of the OP No.1, though not relating to conducting caesarean operation, but the same is post operated, but she did not make any arrangement for any expert doctor in her absence when she admittedly had gone not to Mumbai rather to Dubai as admitted by her in the written reply. What was the requirement to immediately shift on 11.09.2017 to Patel Hospital, from the hospital of the OPs No.1 and 2, that act and requirement of the complainant itself established that she was not provided appropriate services by the hospital of OPs No.1 and 2 and further, OPs No.1 and 2 by committing such like negligence is playing with the valuable life of the human beings and therefore, the OPs No.1 and 2 are liable to be punished for that negligence.”

On the issue raised by the doctor that consumer complaint is not maintainable because the Forum did not take medical opinion of competent doctor or committee of doctors; the bench observed:

there is no requirement to take such like opinion from the doctor in every case if Forum required or feel its necessity, then can take it suo-moto, but in this case, the said requirement is not necessary.

The forum further directed the hospital and the doctor to pay medical expenses i.e. Rs.32,000/- to the complainant with interest @ 12% per annum from the date of filing complaint till realization and further for causing mental tension and harassment to the complainant, Rs 20,000/- and litigation expenses of Rs 10,000/-.