GEETA DEVI @ GEETA RANI vs KETKI GARG

THIS appeal is by Geeta Devi @ Geeta Rani. She has approached the District Forum, Bathinda with the grievance that Dr. Ketki Garg, opposite party No. 1 and Dr. Surinder Pal Kaur Gill, opposite party No. 2 had shown negligence in rendering medical service to her. District Forum dismissed the complaint with the direction to the complainant to pay Rs. 2,000/- as compensation to both the doctors. Dissatisfied with the order, she has come up in appeal.

THE case of the appellant in brief is as under : As she was pregnant and suffering bleeding and signs of threatened abortion, on 30.3.1995 she went to the clinic of Dr. Ketki Garg. Lady Doctor checked and got her tested for pregnancy. THE result of pregnancy was positive. Dr. Ketki Garg told the appellant that at that time foetus was of seven weeks but without any cardiac activity. THE respondent No. 1 instead of advising her immediate abortion kept her as an indoor patient for 7 days and after that advised two days outdoor treatment. THE appellant spent Rs. 10,000/- on her treatment. THE negligent act attributed is in delaying the advice for abortion and the delay could have caused her death. Dissatisfied with the treatment given by respondent No. 1, she consulted another doctor, Dr. Surinder Pal Kaur Gill, respondent No. 2. She also kept the appellant for 10 days as indoor patient from 28.4.1995 onwards. Respondent No. 2 diagnosed the appellant as a case of threatened abortion but no treatment was being given for that purpose. On 14.5.1995, the appellant herself went to get the ultra-sound scan done wherein it was reported that the foetus maturity was of 7 weeks and three days. No foetal cardiac activity was detected. When the respondent No. 2. Dr. Gill came to know about the ultra- sonography report, she fabricated a prescription slip on 15.5.1995 showing diagnosis as "Threatened abortion advised ultra sound scan" and another prescription fabricated as "Missed abortion, advised D&C". Thus respondent No. 2 also acted negligently. The main grouse of the appellant is that when the doctors had come to know that the appellant was suffering from threatened abortion and the foetus was without cardiac activity, they should have advised for ultra-sound scan immediately so that she would have been treated immediately. The appellant has prayed for the compensation of Rs. 2 lacs on above mentioned ground.

The opposite parties contested the complaint Dr. Ketki Garg (respondent No. 1) rebutted the allegation that the appellant was treated as an indoor patient. She submitted that the appellant had come to her as outdoor patient. She submitted that the appellant had come to her clinic and was checked up. She had complained Nausea, Vomitting and discomfort in abdomen. On examination as per vagina, it was found that the size of uterus was of six weeks pregnancy. The uterus was soft and bulky but there was no bleeding at the time of examination. She advised the appellant treatment for complaint of Nausea and Vomitting i.e. Anti-Vomitting. Urine test for pregnancy was also done. She was charged and she paid Rs. 20/- only as consultation fee. Again on 23.4.1995, she visited as outdoor patient with spotting per vagina for a few days and with the report dated 20.4.1993 of urine pregnancy test being ''positive''. It has been mentioned in the books that the doctors should not do examination per vagina in the case of spotting. In such cases rest and medicine is the only cure. It was conveyed to the father of the appellant that when there is bleeding in the first trimester of pregnancy, there are every chance of missed abortion and the doctors have to do D&C operation if the bleeding continues and on this advice, both father and daughter left the clinic after paying her Rs. 20/- only. Thereafter, they never turned up.

RESPONDENT No. 2-S.P. Gill filed the reply to the effect that on 28.4.1995, the appellant came to her hospital and complained of pain in abdomen and was bleeding per vagina, for the last six days. She was diagnosed as a case of threatened abortion and was treated as an outdoor patient only. She was advised medicines for seven days with complete bed rest and was advised for blood test for "Toxoplasma" considering her case of bad obstetric history. On 30.4.1995, the appellant again came to her with "Toxoplasma Report''. She was prescribed medicines for 15 days. The appellant came again either on 14.5.1995 or 15.5.1995 and was referred to undergo ''ultra-sound scan test''. She gave her a reference slip containing detailed history. On 14.5.1995 or 15.5.1995, the appellant brought her report of ultra-sound scan. Examining the report, respondent No. 2 declared it as a case of "Missed abortion" and advised the complainant to go for D&C. The confusion of dates of 14.5.1995 or 15.5.1995 may be due to inadvertance either on her part or on the part of "Ramana Scan Centre'' where ultra sound test was done. The appellant never remained admitted as an indoor patient. She had paid Rs. 20/- only as consultation fee on 28.4.1995 and thereafter no money was paid. She did not come to her after D&C was advised. We have heard both sides and perused the available record. The point for determination is as to whether there was any deficiency of service or negligence in the management and treatment to the complainant Geeta Devi as alleged by her.

AS far as the case of appellant against respondent No. 1 is concerned, there is no substantial material on record to prove that the appellant remained admitted as an indoor patient in the clinic of the respondent No. 1 for seven days. Respondent No. 1 has placed on record her affidavit (Ex. R-1), prescription slip dated 30.3.1995 (Ex. R-2), Urine Test Report (Ex. R-3), Prescription Slip of 28.4.1995 (Ex. R-4) of the respondent No. 2 and Urine Test Report dated 28.4.1995 (Ex. R-5). The Prescription Slip dated 30.3.1995 (Ex. R-2) clearly shows that the appellant was treated not as an indoor patient as the medicines were prescribed for 15 days. There is no necessity to prescribe medicine for 15 days if the patient is admitted in the hospital. No Bed- Head Ticket is produced. No discharge slip is on the record. These allegations of the appellant that she remained "admitted as indoor patient" is false and fabricated. It has been noted that there is a false belief in the mind of the public that their complaints against the medical practitioners will be compensated. So lured by the compensation amount so many false and frivolous complaints are being filed. 9.As far as the compensation is concerned it has to be awarded if the negligent act in rendering medical service is established. The burden of proving negligent act on the part of opposite party is very heavy on the shoulders of the complainants. So far as the allegation of negligence on the part of the respondent No. 1 in treating, diagnosing and managing the complications is concerned, that remained unproved from documents on the file. The prescription slip issued on 30.3.1995 does not show at all that the patient was bleeding when she visited the clinic of respondent No. 1. She was given treatment for Nausea and Vomitting and was advised bed rest and intake of prescribed medicines. Ex. R-2 is the prescription slip wherein in four medicines have been prescribed. These medicines show that it was a case of Nausea and Vomitting which a woman generally suffers in the first semester of pregnancy. This treatment was appropriate and plausible so there was no negligence on the part of the doctor in rendering service. During her second visit on 23.4.1995, the doctor did not examine her as she complained of spotting per vagina for few days. Subsequently she was advised treatment for bleeding and pain so that pregnancy could continue. These medicines were rightly prescribed for the continuation of the pregnancy. The appellant has failed to prove that foetus in her uterus was without cardiac activity either on 30.3.1995 or on 23.4.1995 whereas the ''urine test'' report being positive clearly indicates that the foetus was alive so the allegation that the doctor (respondent No. 1) should have advised D&C on 23.4.1995 is baseless. The medical ethics lays down the rules that the doctors are to save the life and not to kill the foetus. As far as possible, all efforts should be made for the survival of the foetus. It was rather an early stage to suggest D&C when it could be saved.

Regarding the allegation against respondent No. 2, Dr. Mrs. Surinder Pal Kaur Gill, the appellant stated that she diagnosed her case as "Threatened abortion'' and instead of removing the foetus, gave routine treatment resulting in huge expenses as indoor patient. The appellant could not prove her case. Mere allegation on bald statement cannot put a noose around anybody''s neck. The appellant complained of pain in abdomen and bleeding per vagina for six days. It was diagnosed as a case of ''Threatened abortion'' which means a type of abortion with a possibility of continuance of pregnancy. The treatment given was bed rest and medicines to retain pregnancy. The main principle in management of threatened abortion is to try to conserve pregnancy by bed rest. This is the most important part of the treatment as bed rest improves interine blood flow and removes mechanical stimuli. The treatment prescribed by the respondent No. 2 was directed mostly to conserve pregnancy and not termination of it at any stage. The treatment was given for fifteen days. Somehow when the patient did not respond to the treatment, she was advised ultra sound scan test which revealed that there was no foetus cardiac activity. Then the D&C was advised. The appellant has concocted the case that she was not advised ultra sound scan test. She got it done on her own. This allegation is devoid of merit because the film (Ex. C-l) clearly shows the name of the doctor who referred the case. Dr. Mrs. Surinder Pal Kaur Gill''s name is printed on the left side top of the film. Thus, the case made against respondent No. 2 also meets the same fate.

Once the doctor has rendered the medical service by adopting the traditional and known procedure and process of treatment based on his professional experience and skill, the mere fact that the ultra sound scan was not suggested at the primary stage of the pregnancy cannot be attributed anyway to the deficiency in rendering service. 12. In view of the above discussion, we are of the considered view that both the doctors had performed their duty efficiently, honestly and to the best of their knowledge and ability. It has been established on record from the evidence produced that the treatment given by both the doctors to the appellant was the best one which is generally given in such like cases. We dismiss the appeal with additional cost of Rs. 2,000/- to be divided by both the doctors equally. It is further directed that if the doctors so desire, they can get the order published in the same newspaper where their defamation article had been published so that the general public becomes aware of the fate of false and frivolous complaints. We find no infirmity in the order of the District Forum, Bathinda, same is upheld.

The appeal is dismissed with costs as above. Appeal dismissed.