Newborn death, hysterectomy after vacuum delivery: Gynaecologist, hospital get relief from medical negligence charges
No Medical Negligence
Thiruvananthapuram: The State Consumer Disputes Redressal Commission, Kerala recently exonerated a Kasargode-based hospital and doctor from allegations of medical negligence leading to the death of a newborn and consequent hysterectomy of the patient.
The history of the case goes back to 2009, when the patient was admitted to the treating hospital. After the delivery, she fell unconscious. However, she regained consciousness soon and was allegedly informed that the baby was alright. However, the next day, the complainant was informed by her husband that the child had passed away.
It was alleged that even though the treating doctor told her that the delivery was normal and both the child and mother had no problem, the demise of the child was intimated only on the next day. Allegedly, one hour after the delivery, the patient's husband was informed that the child was serious, but only when requests were made to see the child.
They further alleged that even though suggestions were made to take the complainant to another hospital, the treating hospital insisted that the patient did not need to be discharged. However, she could not prevent frequent urination, and ultimately, she was referred to another doctor at Kasaragod, where the patient continued her treatment.
Later, the patient was referred to Father Muller’s Hospital at Mangalore, where the doctor had recommended the removal of the uterus; otherwise, the life of the patient would have been in danger, and ultimately, a hysterectomy was done.
The complainant alleged that when enquiries were made to the doctors at Father Muller's Hospital, the complainant came to know that a hysterectomy was necessitated due to medical negligence, with respect to the doctor who provided the initial treatment.
Since the complainant remained absent and did not file any Chief Affidavit, the consumer court adjudicated the complaint based on the evidence filed by the complainant.
Taking note of the discharge card from the treating hospital, the consumer court observed that the complainant was admitted to the treating hospital on 07.12.2019 and was discharged on 09.12.2019. She was diagnosed with "cephalic presentation with term pregnancy in labour G2 P1 L2". Clinical notes mentioned that as "term female baby with severe birth asphyxia. Baby could not be revived (face presentation)."
From the records, the Commission noted that the doctor had referred the complainant to a higher medical centre and while referring, the doctor had reported that the complainant had "delivered (vacuum delivery) on 07.12.2019 due to severe birth asphyxia. Today complaints of incontinence of urine and pain in left iliac fossa."
The records also showed that the subsequent treatment given to the complainant was by the treating doctor. It could also be seen "complainant was admitted on 07.12.2019 with labour pain at 11.30 a.m. She had good contractions. Around 6p.m. ARM was done. Clear liquor was drained. Patient had good contraction and progress vacuum was applied due to second stage bradycardia. Despite continuous CPR baby could not be revived. Patient was stable on 08.12.2019 (D2). On day 3 complained of incontinence of urine. Patient was cathetrised (? Bladder rupture). On examination patient was referred to higher centre for further treatment".
Subsequent treatment was carried out at the United Medical Centre and the scanning report done at the hospital noted as "suspicious rupture of anterior cervix, large amount fluid in peritoneum." Consequently, the patient was sent to Father Muller Medical College Hospital for further treatment.
At Father Muller Medical College Hospital, the patient was diagnosed with "bladder rupture with uterine rupture." She had undergone an exploratory laparotomy with bladder wall repair and hysterectomy.
From the medical records, the Commission noted that there was no medical negligence on the part of treating hospital and doctor. It observed,
"The medical records do not show any medical negligence on the part of the opposite parties. No expert evidence is available to assess as to whether there was any negligence on the part of the opposite parties in providing the treatment to the complainant with respect to her delivery. When medical negligence is alleged, the onus is on the complainant to plead and prove that there was negligence on the part of the opposite parties in rendering the treatment. It is also the burden of the complainant to establish that the opposite parties had failed to provide due care and caution during the course of treatment. Merely because of the reason that the patient did not respond in a positive manner one cannot jump into a conclusion that there was medical negligence on the part of the doctors. Mere marking of the medical records is not sufficient for the complainant to establish a case of medical negligence."
"On consideration of medical records produced in support of the complaint, one cannot attribute any act of negligence on the part of the opposite parties with regard to the treatment given to the complainant in connection with her delivery. Therefore, it is found that the complainant had miserably failed to establish her case so as to entitle her to get any relief. Points are found against the complainant," it further noted, while dismissing the complaint.
To view the order, click on the link below:
https://medicaldialogues.in/pdf_upload/kerala-scdrc-no-medical-negligence-319823.pdf
