SAUD ABBASI Vs. GARGI HOSPITAL

JUDGEMENT

(1.) In the recent days Cerebral Palsy (CP) is one which justifiably haunts modern obstetric practice which is apparently the fear of medico-legal litigation. However, with the advancement in medical science, the fact that fetal hypoxia is not the causative factor in the great majority of Cerebral Palsy cases.

(2.) It was alleged that though the patient was crying and suffering from severe labour pain, the OP-2 kept assuring that the Dr. Kiran Garg (OP-3) is on her way and will be reaching the hospital soon. The time was progressing with the labour pain and on repeated inquiry with the hospital staff, the complainant learnt that the OP-2 called one Dr. Rishi Arya (OP-4), a consultant gynecologist to visit and see the patient. Three hours after admission were elapsed, but the OP-3 was not available; therefore the complainant asked OP-2 to shift his wife to another hospital, but OP-2 again assured of no reason to panic, the OP-3 will be reaching shortly at around 7.30 pm. Thereafter, the patient was shifted to labour room on the instruction of OP-2, though gynecologist / obstetrician was not available in the hospital. The OP-2 who was a pediatrician, he was instructing the nurses in labour room to give injections and apply more fundal pressure in order to induce delivery. In the meantime at about 9.30 pm, Dr. Rishi Arya (OP-4) came to the hospital and examined the patient. She informed the OP-2 that the head of child was visible but, it stuck in the mother's pelvic bones. It was further alleged that, at about 10.15 pm, the complainant discussed with the OP-4 about possible remedy in such situation and told the OP-4 to perform delivery by the lower segment caesarian section (LSCS) to avoid complications to the mother and child. However, the OP-4 telephonically discussed with Dr. Kiran Garg (OP-3), but OP-3 instructed to wait for her arrival because it was her patient. Therefore, OP-4 did not perform LSCS. The complainant became helpless and waited till the arrival of OP-3. The necessary formalities of signing the consent form etc. were done. Till 11 PM, there was no correct information about the arrival of OP-3 , finally the complainant lost his patience and he told the OP-2 that he cannot wait further for OP-3 and LSCS should be done immediately in the interest of child and mother. Therefore, a call was sent to the Anesthetist Dr. Naresh Batra, and till his arrival the labour room staff was giving fundal pressure repeatedly in order to hasten the delivery.

(3.) At about 11.45 pm, Dr. Kiran Garg, OP-3 arrived and for the first time she disclosed that she had gone to Chandigarh for her daughter's P.G. medical entrance exam and returned late due to train journey. On knowing the truth, the complainant got angry and told the OP-3 that if he would have been informed earlier that she was in Chandigarh, then he would not have waited in the OP-1 hospital for delivery. Since, the OP-3 arrived; complainant requested OP-3 to perform LSCS expeditiously. Then, the OP- 4 Dr. Rishi Arya told that after arrival of OP-3 now it was not her headache anymore and Dr. Rishi Arya left the hospital. The OP-2 and 3 went inside the operation theatre (OT) and told the nurses to apply extra fundal pressure and gave injections to increase the labour pain. It was alleged that, both the doctors were not attentive to the patient, they were talking about the P.G. entrance test. The Anesthetist was still not available. The Anesthetist arrived at about 1 am, and finally the LSCS was performed after long waiting for five hours after admission of patient. At 1.45 AM one attendant came out from the OT and in a mere dismal manner informed that a male child was born. The complainant was shocked and rushed to nursery to see the new born child but, to his surprise, he noticed the OP-2 and nursing staff were giving oxygen to the new born baby with the help of ambu-bag. The display panel showed reading 74. The mother (patient) was shifted to the ICU. The complainant requested the OP-2 to shift the new born immediately to the ventilator support as child was showing abnormal O2 saturation level. The pediatrician (OP-2) told the complainant that the hospital (OP-1) does not have facility for ventilator support and the new born baby suffered some insult during the delivery process; need to shift at higher center having Neonatal Intensive Care Unit (NICU). After signing the consent form, the new born was shifted at 2.20 AM (22.01.2010) to the NICU in Yashoda Super Specialty Hospital. The OP-2 accompanied while shifting to Yashoda Hospital. Dr.Arun Kumar examined the new born, done re-intubation and baby was put on ventilator support. The baby suffered few seizures and its condition was deteriorating. Therefore, Dr. Arun Kumar advised the complainant to take the child to Apollo Hospital for further management.