S Sujatha vs General Manager, Southern Railway

THIS revision petition has been filed by Mrs. S. Sujatha (hereinafter referred to as the ''Petitioner'') being aggrieved by the order of the State Consumer Disputes Redressal Commission, Tamil Nadu (hereinafter referred to as the ''State Commission'') in Appeal No. 25/2002 decided in favour of Dr. Lalitha and three others (hereinafter referred to as Respondent Nos. 1, 2, 3 and 4 respectively), who were the Respondents.

THE facts of the case are that the Petitioner who was the original complainant before the District Forum was a paying out-patient in the Railway hospital from 27.3.2000. She was examined on 15.11.2000 and told that she was likely to deliver her baby by 22.11.2000 by Respondent No. l Petitioner developed labour pains on 20.11.2000 and came for admission to the Respondent/hospital at about 10.45 p.m. According to her, there was no doctor and she was admitted in the hospital by the duty nurses who locked her in the labour room and went to sleep. Although, Petitioner was shouting because of the labour pain, no one came to her assistance till 7.40 a.m. the next day i.e. on 21.11.2000 when Respondent No. 1 examined her and without giving any further information conducted a caesarean operation by which a still-born baby was removed from the Petitioner''s uterus. According to the Petitioner, if she had been given proper medical treatment by the doctor from the time of admission, she would have not lost her child. Petitioner, therefore, sent a letter followed by a lawyer''s notice to the Respondents on ground of medical negligence and deficiency in service and claimed Rs. 5 lakh towards compensation. However, she received no reply because of which she filed a complaint before the District Forum requesting that the Respondents be directed to pay Rs. 4,90,000 towards compensation and Rs. 5,000 as litigation cost.

RESPONDENTS denied the above contentions and stated that one Dr. Mallika was very much present at the time of the patient''s admission on 20.11.2000 at which time she was in mild labour pain and her blood pressure, pulse rate was also normal and, therefore, in preparation for delivery the duty staff placed the patient in the labour room since she did not require immediate presence of a gynaecologist/doctor. However, progress of labour pain, foetal heartbeat, etc. was regularly monitored throughout the night and the foetal heartbeat was normal upto 6.30 a.m. and it was only at about 7.00 a.m. that the foetal tieartbeat was found absent and a scan was immediately done confirming inter-uterine death of the foetus. Thereafter, all efforts were made by the Respondent/Doctor and her assistant for a normal delivery by doing an artificial rupture of membrane and a co-duty doctor was asked to stay with the patient to watch over her. Only when the vaginal delivery was not possible and after obtaining the consent of Petitioner''s relatives, lower caesarean section (emergency) was conducted and the dead foetus was removed. The cause of death was because of the umbilical cord around the neck of the foetus which was also confirmed by cord lilubrin (jaundice). Thus, there was no negligence at all since all care and precaution were taken during the labour and later to save the life of the Petitioner.

THE District Forum after hearing both parties allowed the complaint on the grounds that no documents were a to show that there was duty doctor present at the time of admission and only a duty nurse appeared to have been present and that had a gynaecologist being present at the time of admission, the child could have been born alive and taken out by way of normal delivery. Since, this was not done the Petitioner suffered throughout the night without any medical attention and without due steps being taken for performing a normal delivery before the foetus died in the Petitioner''s womb. This clearly points to deficiency in service and medical negligence. The District Forum, therefore, directed the Respondents to pay the Petitioner Rs. 50,000 as compensation and Rs. 1,000 as litigation cost.

AGGRIEVED by this order, Respondents filed an appeal before the State Commission which allowed the appeal by observing that the District Forum had erred in holding that there was any deficiency in service on the part of Respondents because timely action was not taken to deliver the child and that the baby was stillborn because of the lack of medical attention by the Respondent/doctor. In fact, even the District Forum has acknowledged that the foetal heartbeat was regularly monitored throughout the night which clearly indicated that the Petitioner was being attended to and thereafter the standardized and approved procedure was adopted and surgery was done to save the Petitioner''s life. Unfortunately, because the umbilical cord had bound itself around the neck of the foetus while it was in the uterus, he could not be saved. This was not because of any medical negligence.

AGGRIEVED by this order, the present revision petition has been filed.

COUNSEL for Petitioner was present. None was present on behalf of the Respondents. Since the service was complete, the case was heard ex parte.

COUNSEL for Petitioner reiterated before us that no doctors were present on duty when the Petitioner came to the Respondent/hospital and the Petitioner was admitted by a duty nurse. In fact a gynecologist (Respondent No. l) only attended to her at 7.40 a.m. when the foetal heartbeat had stopped. If a qualified gynecologist/doctor had been present and personally checked the patient, then either through a caesarean or by inducing a normal delivery the child could have been saved. The District Forum as a court of fact on the basis of evidence produced before it had, therefore, rightly concluded that there was medical negligence and deficiency in service. The State Commission erred in not appreciating these facts deciding in favour of the Respondents.

WE have heard learned Counsel for Petitioner and have carefully gone through the evidence on record.

THE facts of the Petitioner being an out-patient in the Respondent/hospital and her admission/delivery on 20/21.11.2000 is not in dispute. There is also documentary evidence to the effect that at the time of admission, Petitioner was examined, her blood pressure was normal (120/70) and her general condition was observed as being good. There is also documentary evidence that the foetal heartbeat was monitored throughout the night right from 11.00 p.m. i.e. at the time of Petitioner''s admission till 6.45 a.m. and it was recorded that this was between 140/138 which is normal. This indicates that the Petitioner was given due medical attention as required at the time of her admission and throughout the night. Thereafter, it is on record that following the absence of foetal heartbeats, all efforts were made as per the standard procedure to get foetus expelled through normal delivery failing which a caesarean section was done in the interest of Petitioner''s health and after obtaining the written consent of her relatives. It was found following the caesarean section that the death of the foetus had occurred because of suffocation due to the umbilical cord being bound around the neck. The death of the foetus in utero was thus an unfortunate event but we agree with the State Commission that it cannot be attributed to lack of medical attention since right from the time admission of the patient, her medical condition as well as of her unborn foetus was being regularly monitored. Since, the Petitioner''s condition was normal at the time of her admission with only mild labour pain and her blood pressure and pulse rate being normal, it was not required that a doctor should be present throughout her stay. Her condition was monitored by staff competent to do so and when required a qualified doctor was immediately summoned. Thus, we do not find that this is a case where the death of the foetus occurred because of any medical negligence and deficiency in service and agree in toto with the order of the State Commission in this respect. The revision petition is dismissed with no order as to costs. R.P. dismissed.