Death of Pregnant Doctor Due to Delayed Medical Attention: HC sets aside WBCERC order, directs Re-adjudication of case
Kolkata: Setting aside the order of the West Bengal Clinical Establishment Regulatory Commission (WBCERC), the Calcutta High Court has directed the Commission to re-adjudicate the case concerning the death of a pregnant doctor, who passed away because of refusal of treatment and delayed medical attention by 3 hospitals.
The WBCERC held only Bhagirathi Neotia Woman & Child Care Centre (BNWCCC) responsible and asked it to pay Rs 20 lakh for negligence in the treatment of the deceased. However, while considering the plea by BNWCCC the Calcutta High Court bench expressed its surprise at the fact that no complaint was filed against Apollo Hospital, where the patient was taken at first and was denied treatment or Belle Vue hospital, which kept the patient waiting for 35 minutes before commencing treatment.
Asking the Commission to re-adjudicate the matter, the HC bench ordered, "Accordingly, WPA No.16381 of 2021 is allowed, thereby setting aside the impugned award passed the respondent no.1- Commission dated September 6, 2021 on the sad demise of Dr. ****** ******"
"The matter is remanded to the respondent no.1-Commission for a re-adjudication, upon giving opportunity to the parties to produce further evidence to substantiate their cases and for a fresh decision on the issue as to the compensation to be awarded against the BNWCCC and/or Belle Vue Clinic in the facts and circumstances of the case, in the light of the observations as made hereinabove. It is expected that the Commission shall complete such re-adjudication at the earliest, preferably within three months from the date of communication of this order to the Commission," it further noted.
The matter goes back to 2021 when the patient/doctor was pregnant. The date of delivery was scheduled on June 12, 2021. Meanwhile, the patient /doctor felt mild chest pain on April 24, 2021.
Consequently, the patient opted for a check-up by the treating doctor immediately, who advised the patient that everything was normal and there was no need to worry.
However, later that evening, the patient felt severe lower abdominal pain. Even though the family members called the treating doctor, he refused to prescribe medicine and denied to pay a house visit to check and examine the patient.
He further advised for hospital admission. Accordingly, the patient was taken to Apollo Hospital which denied to provide treatment to the patient on the ground that the Hospital was full of Covid patients and it would be risky to admit a pregnant patient.
When the patient was taken to BNWCCC, the hospital informed the patient's family that they all talked to the treating doctor, who instructed not to admit the patient at the concerned hospital.
Finally, after waiting for more than 45 minutes, the patient and her family went to Belle Vue Hospital. Finally, the hospital admitted the patient after being pressurised by the medial publicity and call from the police. However, despite all efforts by attending RMO, the patient was declared dead.
Challenging the WBCERC order directing BNWCCC to pay Rs 20 lakh, the counselor for the hospital argued that no complaint was lodged against the Apollo Hospital even though it shrinked its duty as clinical establishment as well.
Even Belle Vue was been given a clean-chit, although a considerable delay was occasioned by the Belle Vue and the patient met her unfortunate demise in Belle Vue after having had to wait for a considerable period of time, argued the hospital's counsel.
Further, the counsel for BNWCCC submitted that the hospital provided preliminary treatment to the patient, measured her blood pressure and also provided an ambulance, in which she was taken to the Belle Vue Hospital.
Regarding the denial of admission at the hospital, BNWCCC submitted that the staff of the hospital immediately contacted the treating doctor, who said the appropriate facilities were not available in BNWCCC, for which the patient could not be admitted to the said CE.
"Since it was the attending doctor who had so advised, the staff of BNWCCC was in no manner responsible for any sort of medical negligence whatsoever," submitted the counsel for the hospital.
The counsel for the petitioner further argued that even the Commission observed that a member of the Commission, on whose report the petitioners were indicted, was critical against Belle Vue as would appear from his opinion set out in the order of the Commission.
However, the Commission observed that the patient was attended at Belle Vue, as was seen in a video, although what treatment was actually given or not would be the exclusive domain of the West Bengal Medical Council.
Referring to this, the petitioner's counsel argued that the same logic ought to have been applied to BNWCCC as well, as it was beyond the purview of the Commission to enter into the treatment protocol meted out by the CEs. The only ambit of the Commission‟s enquiry was negligence, which was not found in case of the BNWCCC at all.
Meanwhile, the counsel for the Complainant in the main case referred to the order in the case of Pt. Paramanand Katara Vs. Union of India and others. In the said judgment, it is argued, it was observed that preservation of human life is of paramount importance and every doctor has the professional obligation to extend his services with due expertise for protecting life.
It was held that there is no legal impediment for a medical professional, when he is called upon or requested to attend to an injured person needing his medical assistance, to extend such service, since there is no doubt that the effort to save the person should be the top priority not only of the medical profession but even of the police or any other citizen connected with the matter or who happens to notice such an incident or situation, argued the counsel for the Complainant.
Further, it was argued by the authorities that due to the callous attitude of the BNWCCC in not admitting the patient at the crucial juncture and making her waiting for 45 minutes, turned out to be fatal and BNWCC committed that a flagrant violation of the duties of CEs. As such, the compensation awarded against the BNWCCC was justified.
After considering the arguments of all the parties, the HC bench observed,
"Upon hearing learned counsel for the parties, it transpires that the patient, even as per the report of an expert on which the Commission relied, was suffering from Eclampsia, which is a pregnancy-induced hyper-tensive disorder with super imposed seizures/convulsions, which is largely preventable. As per the report, there is a WHO (World Health Organisation)-designed effective „Anti-Convulsion Tranquilizer Therapy‟ in Eclampsia and other anti-convulsant regimes. It was further observed in the report that each transfer and transport had added to the seriousness and severity of Eclampsia."
Further, the bench observed that the treating doctor i.e. Dr. Khetan not only refused to prescribe medicine to the patient, but he also did not make any effort to see the patient and only advised her hospital admission.
"As per the advice of Dr. Khetan, the patient was taken to Apollo which did not admit the patient on the ground that the Hospital was full of Covid patients and it would be risky to admit a pregnant patient there," noted the bench.
Expressing its surprise that no complaints were made against Apollo Hospital, the HC bench observed,
"Surprisingly, no complaint has been lodged against Apollo, although it was the first CE which refused admission to the patient. There is nothing on record to indicate that, despite there being several Covid patients, there was no infrastructure at Apollo at the relevant juncture to admit a pregnant lady, having convulsions and serious neurological complications. The said aspect ought to have been looked into by the Commission."
"The cryptic version of Apollo was that as per their records, the patient never visited the CE on the fateful or any other day, and, hence, they were unable to apprise the Commission that what had actually happened on that day. The said issue was not explored any further. Surprisingly, the complainant/husband of the patient did not make any formal complaint against Apollo. Even at the time of hearing, he did not make any request to add Apollo as a respondent. Even the visit of the patient to Apollo was denied. The Commission held that in the absence of proper proof it would be difficult for it to blame Apollo. Since no complaint was lodged against it, there is no scope of ascertaining the role of Apollo in the sordid episode. Thus, the finding of Commission on such score cannot be faulted. The insinuation of the petitioners that Apollo was never indicted cannot be of much help to the petitioners, since no complaint has been lodged in the first place against Apollo," it further noted.
Addressing the role of Belle Vue clinic, the bench was of the opinion that it should not have been given the clean chit and noted,
"From the above circumstances, it is clear that Belle Vue kept the patient waiting for at least 35 minutes at a crucial juncture, immediately after which the patient met her demise. Such apathy on the part of the Belle Vue, keeping in mind that the admission there took place only upon social media inducement, ought not to have been pardoned by the Commission while assessing compensation."
Regarding BNWCCC, the bench noted,
"Insofar as the BNWCCC is concerned, it was required to be ascertained as to whether the BNWCCC actually has the infrastructure to treat Eclampsia. Although, prima facie, the BNWCCC is supposed to be a Multi-Specialty Hospital taking care of women and children and ought to have sufficient expertise and infrastructure regarding pregnancy complications, it cannot be ascertained without an examination on facts as to whether it had the infrastructure at the relevant point of time to give proper treatment to the patient. Apparently, the telephonic conversation between the BNWCCC staff and Dr. Khetan, annexed to the writ petition, indicates that Dr. Khetan was of the opinion that at Neotia „there isn‟t a proper ICU‟ and that the BNWCCC does not have proper facility. The said fact was not ascertained properly on the basis of materials by the Commission while passing the impugned award."
"One other aspect, apart from the facility at BNWCCC, is whether the BNWCCC provided proper medical care to the patient during her wait for 45 minutes. The BNWCCC claims that basic medical attention was given to the patient and her biological parameters were checked as far as possible. It is also alleged that an ambulance was provided by the BNWCCC, which has not been denied from any quarter. Hence, prima facie, it is arguable as to whether the BNWCCC was really the sole CE which was to take the entire blame for the sad demise of the patient," the bench further observed.
"In fact, the petitioners are justified in arguing that whereas the Commission observed that it could not go into the question of treatment protocol with regard to Belle Vue, double standards were applied in as much as BNWCCC is concerned, due to the observation of the Commission that the latter did not extend proper medical care to the patient," it added.
Opining that the Commission should have considered these factors and yardsticks while deciding the issue of compensation, the HC bench set aside the order of the Commission and directed it to re-adjudicate the matter.
To view the order, click on the link below:
https://medicaldialogues.in/pdf_upload/calcutta-hc-order-217990.pdf
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