Neeti Saluja vs K. Batra

SMT . Neeti Saluja, the Complainant, aged 25 years, an Executive in a Travel and Tourism Co. alleges that due to the negligence of Dr. Mrs. K. Batra the OP -1, she suffered various complications after her caesarean delivery. The Complainant got admitted in Batra Nursing Home for her first delivery, under treatment of Dr. Mrs. K. Batra (OP -1) on 15.11.2000. She was assured of safe and normal delivery. She developed labour pains on 19.11.2000; however, instead of normal delivery, the OPs performed the Caesarian Section (LSCS). It was also alleged that Mr. Tulsi, a Compounder/Technician had performed the operation under the guidance of OP -1 and the OP -1 herself has not operated upon the Complainant. The Complainant further stated that, not a single normal delivery took place in the said nursing home, but about 10 -11 caesarian operations were performed on 15.11.2000. Due to such carelessness and negligence in performing LSCS, the Complainant suffered a large scar on her stomach, the suture material used was of inferior quality and there was improper suturing also. Due to this, she developed "Obstructed Umbilical Hernia". After the delivery, the Complainant consulted OP -1, regularly for her abdominal pain, for which OP -1 assured that there was nothing to worry. Due to unbearable pain, she consulted Dr. R.K. Sippy, who diagnosed the patient with "Obstructed Umbilical Hernia" and opined that it was due to gap in the abdominal wall and the Complainant has to go for an emergency operation. Dr. Sippy advised the Complainant not to lift heavy weights and also not to conceive further. The affidavit of Dr. Sippy is placed as Annexure (H). Due to the scar on the stomach, the Complainant was unable to wear Saree. The Complainant issued a legal notice to the OPs and sought details of medical record, the list of the patients having normal and caesarian deliveries in the hospital. But, the OP did not produce. Hence, the complainant fled this complaint and prayed for compensation of Rs. 22,02,650 with interest @ 18% p.a. and Rs. 50,000 towards the costs. Defence:

In the defense, the OP admitted about the Caesar delivery of the patient/complainant. Further submitted that the patient/complainant had some cardiac problems and a family history of diabetes. She was also treated in Sir Ganga Ram Hospital, between 27.3.2000 and 31.3.2000, for pain in abdomen and breathlessness. She was a known case of hypo -thyroidism and was under treatment, since 1999. Thus, there was no question that OP assured the Complainant that she would be having a normal delivery. Despite this, the OP gave the best available medical care to her for delivering a healthy baby. The OP further stated that the Complainant was admitted on 15.11.2000, with signs of high Blood Pressure (BP), Intra Uterine Growth Retardation (IUGR) and Pre -eclamptic Toxemia (PET). Therefore, she was advised for caesarean delivery. The OPs also denied that anesthesia was given without any check -up and without any consent; but it was given by a qualified Anesthetist. The operation was performed by Dr. Mrs. K. Batra. The Pediatrician Dr. Jaswant Batra was also present for the purpose of examining the new born child. OP -1 further denied that the caesarian section performed by her was an unwanted, unauthorized or performed in a careless and negligent manner. It is further wrong and denied that poor quality suture material and improper suturing led to the development of obstructed umbilical hernia.

Arguments:

HEARD the Counsel for both the parties and perused the medical records. The Counsel for the OP vehemently argued that the Complainant was a known case of Hypothyroidism and was under treatment from August, 1999, with family history of diabetes. The Complainant and family members were satisfied by the treatment of OP. There is no link between LSCS performed on 19.11.2000 by the OPs and the operation for obstructed Umbilical Hernia performed by the other Dr. Sippy on 30.9.2001. Dr. Sippy who treated the Complainant for Umbilical Hernia, also, did not disclosed about the cause of Umbilical Hernia was developed due to caesarian section. There is no expert evidence in this case. The Counsel contended that the Complainant was satisfied with the care given by OP -1, she did not disclose about the sepsis in her stitches. Hence, the OP''s are not liable for medical negligence or any carelessness. Also, the complaint is not maintainable, because of delay in filing the present complaint. The Counsel for Complainant argued that there was negligence in conducting LSCS operation. The operation was performed with vertical incision and therefore the patient developed Umbilical Hernia, which was a medical negligence. Reasons:

On perusal of medical records and referring the several surgical books, text and literature, on the subject of LSCS and Umbilical Hernia. On perusal of Annexure -1, Sir Ganga Ram Hospital''s discharge summary, dated 31.3.2001, it is noted that the patient was diagnosed as hypo -thyroidism with early pregnancy and was put on proper treatment. Also, the medical record from Batra Nursing Home clearly goes to show, that the said patient was overweight and she was regularly followed -up during pregnancy. She was given trial labour during delivery and on 19.11.2000, the OP has performed LSCS, as there was an indication of IUGR and thick Meconium. As per medical texts, the suturing for the caesarian section is usually done on the lower abdomen, situated about 10 to 12 cms, below the navel. In case, if there is any improper suturing during LSCS, then, incisional hernia would develop at the site of caesarian section and not umbilical hernia. There is no reported case of Obstructed Umbilical Hernia, being caused due to caesarean section. The medical records show that the Complainant had High BP, IUGR, PET. The Complainant was admitted to the Nursing Home for controlling the BP to ensure normal delivery. Dr. Rajinder Kumar Sippy''s affidavit only states about the serious medical condition of the patient, developed due to improper suturing, after caesarian section which, left a gap and developed Obstructed Umbilical Hernia in the patient. This submission is not supported by the facts of the case or by any medical history, hence, it has no evidentiary value.

THUS , it is convinced that the OPs have conducted LSCS in good faith of the patient/complainant, there was a proper indication of LSCS, like the thick muconeum, IUGR and PET. LSCS was performed to save the life of the baby. There was no deviation from the medical practice followed by the OP; hence it is not a medical negligence. Similar view dovetails from several decisions of the Hon''ble Supreme Court and this Commission regarding medical negligence. In Jacob Mathew v. State of Punjab, : III (2005) CPJ 9 (SC) : III (2005) CCR 9 (SC) : VI (2005) SLT 1 (SC) : 122 (2005) DLT 83 (SC) : (2005) 6 SSC 1 and in Indian Medical Association v. V.P. Shantha, : (1995) 6 SC 651, the Hon''ble Apex Court had concluded that, "a professional may be held liable on one of two findings: either he was not possessed of requisite skill which he professed to have possessed, or, he did not exercise reasonable competence in given case, the skill which he did possess."

Also, the Bolam''s case, Bolam v. Frien Hospital Management Committee,, (1957) 1 WLR 582, discussed that, a doctor is not negligent if he is acting in accordance with standard practice merely because there is a body of opinion who would take a contrary view. Therefore, in the case on hand, the OP -1 exercised reasonable care and skills, during patient follow -up during pregnancy and also during delivery by LSCS. The patient suffered obstructed Umbilical Hernia. It was not an Incisional Hernia due to any defective suturing of LSCS incision. Also, it is unacceptable without any cogent evidence about, the vague allegation of the complainant that the compounder/assistant performed such major surgery of LSCS. The Complainant failed to prove her case. Hence, this complaint is dismissed. Parties are directed to bear their own costs.