Newborn suffers leg fracture during breech delivery: Consumer Forum relief to gynecologist, hospital
Tripura: The District Consumer Dispute Redressal Commission of Tripura has recently dismissed a case of medical negligence against a gynecologist and the hospital where the petitioner alleged that the right leg of the newborn surffered a fracture due to the negligence of the doctors while conducting a breech delivery.
The petitioners had moved the court claiming compensation of 5 lakh while submitting that they had to approach a number of medical facilities and doctors for the treatment of the newborn which caused them serious financial loss and mental agony.
However, the commission found that the petitioners did not mention the view of the doctor who himself conducted the cesarean and also found that there was a complication in the pregnancy of the women and the surgery was also a breech surgery. The commission observed that it is during the surgery that the baby received a fracture in the leg as he was in a left transverse lie (obstructed). After this the court dismissed the case.
The petitioner submitted that she underwent a cesarean delivery in the respondent hospital and a baby was born but soon after the delivery, it was observed that the newborn baby was continuously crying and whenever his right leg is touched his crying is loud.
After that, the petitioner was informed that during operation and delivery and due to accident the fracture happened of shaft of the right femur of the newborn baby during manipulation of EmLSCS, and the femur bone is in a broken condition of the baby and it is in a delicate position.
As no orthopedic specialist was available in the facility the baby was referred to a better facility. After that, the baby was admitted to two or more different hospitals and the doctors advised for the operation of the right femur. The petitioner alleged that the attending physicians never disclosed that during delivery the right femur leg of the baby has been fractured.
The baby had to be treated for one month but no improvement was detected after which the baby was admitted to a Kolkata based facility for proper and better treatment. After one month it was observed that the baby is moving his right leg quite joyfully, the petitioner submitted.
It was stated that due to the fracture of femur bone the complainant had to incur an expenditure of more than 4 lacs. Moreover, the complainant suffered serious financial loss and severe mental agony, harassment and also the baby suffered from physical discomfort, sufferings and pain due to the deficiency of service of the hospital and the doctor as well as the medical negligence. Hence, they filed the complaint seeking compensation of Rs.5 lacs.
The counsel for the hospital and the doctor denied the allegation of medical negligence and rather alleged that the petitioner had intentionally hidden the fact that the patient was a regular patient of another doctor who himself conducted the cesarean but he was not made a party.
Ultimately the hospital and the doctor in their written statement made prayers for rejection of the complaint and also for a direction to compensate them adequately for causing damage to their reputation and also causing mental pain by making false defamatory allegations against them.
It was also submitted that during the caesarian operation it was found that the baby is in left transversely lie(obstructed) and this complication needed proper management to safe the life of the child and mother and with great difficulty the baby was removed and during the removal of the baby from the womb there was fracture of femur in the right side of the baby.
The doctor in his defence clearly stated that the patient presented the case of 36 weeks of pregnancy that transverse lie (abnormal presentation and position) in labour with hand prolapsed. In that case, there was no mechanism for vaginal delivery and in such a case if it is delayed in management it can be led to fatal death due to cord prolapsed and increasing obstruction and some times maternal complication hence the extraction of the baby from uterus even by caesarian section was difficult as the baby is deeply impacted in an abnormal position and the liquor (water where baby moves) drained out completely, they added.
It was also mentioned by the gynecologist that the mechanism of extraction of the baby by internal manipulation and by pulling one leg at the ankle rotating the baby inside and delivery of the baby by breech(buttock) called breech extraction. Since the baby was deeply impacted due to the absence of liquor and abnormal presentation manipulation becomes inevitable inspite of taking all the care during extraction of the baby from the womb(uterus) after which the patient was referred to other facilities for better treatment.
After considering the submission of both the parties, the court questioned why the doctor who followed the case from the beginning was not made a party from the beginning and further added, "Dr. *** took all reasonable cares while doing operation as well as post operation. It is fact the accused doctor is not a pediatric surgeon. So, when he found that during the removal of the baby from the womb there was fracture of femur in the right side of the baby, he suggested the hospital authority to take the necessary measures in respect of the baby."
Mentioning the principles laid down by the Hon'ble Apex Court in respect of medical negligence, the commission further stated
We have considered the pleadings as well as evidences of both sides very carefully. We have also gone through Dr. D. C. Dutta's text book of Obstetrics which is relied upon by the counsel of the O.Ps. From the text book we find that ''Long bones – bones commonly involved in fractures - are the humerus, the clavicle and the femur. These occur in breech delivery. Fractures are usually of greenstick type but may be complete. Rapid union occurs with callus formation. Deformity is a rarity even where the bone ends are not in good alignment.'' So we find that medical science approves such nature of fracture which may occur in a breech delivery. we find that the event was accidental in nature and there was no negligence on the part of the Opposite parties.
Stating that the hospital authority took the necessary measures for the treatment of the newborn baby, the court also stated
It is unfortunate that the complainant had to incur huge amount for the treatment of the baby, but for which we can not say that the opposite parties are responsible and liable to compensate the expenditure. While we have appreciated the evidence of both sides, we kept the principles laid down by the Apex Court in respect of medical negligence which is mentioned above. On over all appreciation of evidences of both sides, we do not find that there is/was any negligence or any deficiency of service on the part of the opposite parties. Hence, we are in the opinion that the complaint is devoid of merit and liable to be dismissed. No costs. Supply free copy of the judgment to both the parties.
To view the judgment, click on the link given below:
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