No Negligence During Delivery Via Episiotomy: Consumer Forum Exonerates Gynaecologist, Nursing Home

Also Read: Mens rea as intent not necessary in Medical negligence cases, Following Established procedure is: Supreme Court

The case goes back to 2007, when the wife of the complainant was pregnant and remained under the treatment of a gynaecologist. However, when the patient went into labour pain the doctor was out of town and so her husband took her to the treating nursing home.

It has been submitted by the complainant that the treating doctor in the case, a gynaecologist conducted episiotomy method of delivery on the patient and a female baby was born. However, after the delivery, the attendant noticed bleeding in the patient's vagina.

As per the allegations of the complainant, after calling an anesthetist, the episiotomy wound was stitched. However, as the bleeding didn't stop the patient was referred to S.C.B.Medical College and Hospital, Cuttack, where despite giving her the medical aid immediately the patient couldn't be saved.

The complainant alleged that his wife died due to the wrong method of episiotomy which was not prevalent at that time. In fact, he also lodged an FIR against the treating doctor and also approached the District Forum alleging negligence.

On the other hand, the episiotomy and nursing home- both denied any negligence on their part and the doctor informed the Consumer Court that he had conducted the delivery of the patient as per the usual process of episiotomy and also submitted that all the necessary steps were taken from the beginning till the end of the smooth delivery.

The doctor also submitted that the bleeding was from the stitched episiotomy wound but from the other wall of the vagina, nostril and pricking point and the pregnant woman had never collapsed. It was stated that the bleeding from the vagina and uterus after delivery of the placenta followed by bleeding from the nostrils and from the needle prickling point suggest the symptoms of DIC i.e., Disseminated intravascular coagulation.

The Commission noted that the District forum after listening to both the parties had dismissed the complaint by majority order of two members.

Meanwhile, the counsel for the complainant contended before the State Commission that the earlier order of the District Forum was faulty as the Forum had erred in law by not going through the evidence adduced by the complainant. He also submitted that learned District Forum has committed error in law by not understanding the concept of episiotomy. Apart from this, he submitted that the order had been passed without considering the request of the Complainant for cross-examining the Prof of Gynaecology of SCB Medical College and Hospital, who had provided expert opinion regarding the matter.

He also stressed the fact that there was a significant delay in transferring the woman to a better facility after the bleeding continued. Every minute delay caused by the doctor and clinic has resulted in the patient to collapse, the counsel for the Complainant had submitted.

On the other hand, the counsel for the treating doctor argued that the opinion of the Professor of Gynaecology and Obstetrics was clear to show that episiotomy is the usual method of delivery of patient and in the the instant case, the concerned Professor had given clean chit to the treating doctor.

After perusing the details of the order of the District Forum, the State Commission noted that the evidence of all the three witnesses is "not positive, clear and consistent" to prove the negligence on the part of the treating gynaecologist.

The Commission also perused the expert opinion rendered by Professor of Gynaecology and Obstetrics, SCB Medical College and Hospital, Cuttack. It had mentioned, that the treating doctor had "adopted usual required procedures during a normal vaginal delivery and thereafter has taken all preventive measures to arrest primary post-partum haemorrhage."

It further mentioned that not only the treating doctor was devoid of any lapse or negligence but he also took care of the patient by accompanying her from the place of delivery to SCB Medical College & Hospital.

At this outset, the Commission observed,

"OP No.1 (gynaecologist) has adopted usual required procedure during the normal vaginal delivery. Not only this but also the concerned Professor has maintained that OP No.1 has taken maximum care to arrest bleeding and at the same time has accompanied the patient to the SCB Medical College and Hospital, Cuttack. The method episiotomy was a regular feature at that time may be occasional feature at the present time to cause delivery."

It was further noted by the State Commission that the report of the Medical Board constituted under leadership of CDMO also clarified that the treating doctor had got a valid licence and also revealed that the Nursing Home had all the facilities for conducting normal delivery patient and of Obstetrics and Gynecology operation.

Noting that there was no other evidence placed by the Complainant to prove medical negligence against the treating doctor, the State Commission dismissed the Complaint and observed,

"This Commission is of the view that complainant having failed to prove the deficiency of service or negligence on the part of OP Nos. 1 and 2, there is nothing to interfere with the impugned order passed by majority Members. The minority view needs no discussion. Therefore the appeal stands dismissed by confirming the impugned majority order passed by the learned District Forum."

To read the order of the State Commission, click on the link below.