Decision to perform emergency Caesarian was correct: Anaesthetist, Hospital absolved of medical negligence
New Delhi: Observing that the decision taken by the doctor was right of conducting an emergency Caesarian operation on the patient, who in the advanced stage of labour, the National Consumer Disputes Redressal Commission (NCDRC) has exonerated her and the hospital against the charges of medical negligence.
According to hospital records, the concerned doctor was an anaesthetist and she had not performed the Caesarian operation. On perusal of the Operation theatre (OT) register nd operative notes, the bench noted that a Surgeon who was regularly performing surgeries in the hospital performed the Caesarian operation under spinal anaesthesia and a baby was delivered.
The top consumer court noted that the main allegation of the Complainant was that the cause of death of his wife was either due to spinal shock because of excessive anaesthesia or mismanagement while applying anaesthesia or excessive bleeding at the time of delivery which the doctor had failed to control.
Although the Commission opined that the first nursing home could have directly referred the patient to PGIMS, rather than referring to the treating hospital, it further noted that the doctor dealt with the medical emergency with due medical care.
"It was an emergency managed by the OP-2 doctor (anaesthetist) as per the standard reasonable practice. The duty of treating doctor is to decide the method of treatment depending upon the condition of the patients and the circumstances of each case, thus it cannot be construed as medical negligence," noted the judgment by Dr S.M. Kantikar, presiding member of the NCDRC.
The case concerns the complainant's wife, who during her pregnancy, was under regular observation in Civil Hospital, Kalka. However, after the labour pain started she was referred to the hospital, and there, the surgeon performed a cesarean section upon her.
Post-operation, after giving birth to a female baby, the patient became critical and unconscious. So, the treating hospital in Pinjore referred the patient to PGI Chandigarh. On the way to the hospital, the patient died. The death certificate issued by the hospital had mentioned that the patient had died due to Septicemia with labour pains.
Alleging medical negligence against the doctor and hospital, the complainant approached the District Forum, Kalka and submitted that the patient was referred to PGI Chandigarh, without providing any medical attendant.
On the other hand, the doctor and hospital had denied negligence during delivery and submitted that when the patient was brought to the hospital, she had a 50% effaced cervix and with a fever of 1020F. Her pulse rate and respiratory rate were also high. The doctor diagnosed it as septicemia and the treatment was started immediately to save the patient as well as the baby.
They have further informed that after taking due consent, the Caesarian operation had started. However, during the closure of the operative wound, the patient suffered hypotension and convulsion. The Patient was revived, but again she developed hypotension, which did not improve further despite treatment. So, for further management, the patient was referred to PGI Chandigarh in the hospital ambulance along with nurse, Ambubag with O2 and IV lines.
Denying negligence on their part, the doctor and hospital had submitted before the Forum that despite resuscitative efforts, the patient couldn't be revived and was declared dead at 10.00 P.M.
After listening to both the parties, the District Forum had allowed the complaint and had ordered the doctor and the hospital to pay a lump sum compensation of Rs 5 lakh to the complainant. When the order of the District Forum was challenged before the State Commission, the Commission had upheld the previous order. So, the doctor and the hospital approached the NCDRC and filed a revision petition.
The Commission noted that at the time of admission the patient had a high grade fever and anemia. Further, looking at the medical records the Commission noted that the operation was not performed by the treating doctor, who was an anesthetist. In fact, another surgeon, regularly operating at the treating hospital had performed the Caesarian operation under spinal anesthesia. The medical records further revealed that the emergency was managed by the treating doctor as per standard reasonable practice.
Referring to the Supreme Court judgment in the case of Jacob Mathew v State of Punjab, the Commission mentioned that in this particular case, the Apex Court had stated that when faced with a medical emergency, the doctor always tries his best to redeem the patient out of his suffering. No sensible professional would intentionally commit an act or omission which would result in loss or injury to the patient, the Apex Court had held.
In that particular case, the Supreme Court had also held that "a mere deviation from normal professional practice is not necessarily evidence of negligence."
The decision of the treating doctor was "correct to perform emergency Caesarian operation to save the life of patient and the foetus. Therefore, not referring the patient to PGIMS was neither act of omission nor negligence," noted the Commission.
"It was an emergency managed by the OP-2 doctor (anaesthetist) as per the standard reasonable practice. The duty of treating doctor is to decide the method of treatment depending upon the condition of the patients and the circumstances of each case, thus it cannot be construed as medical negligence," stated the judgment by the Apex Consumer Court.
Further referring to the Supreme Court judgment in the case of Achutrao Haribhau Khodwa vs. State of Maharashtra & Ors, the Commission reminded that negligence cannot be attributed to a doctor so long as he is performing his duties to the best of his ability and with due care and caution.
The Commission further noted that both the District and State Commission didn't observe any negligence on the part of the treating doctor but held the treating doctor and hospital liable because the patient was not referred to PGIMS.
Thus, setting aside the orders of the District and State Commission, the NCDRC dismissed the complaint and exonerated the treating doctor and the hospital.
To view the original order of the Commission, click on the link below.
