MANISHA AGRAWAL Vs. KAPIL BAJAJ

JUDGEMENT

(1.) The blame of tragic misfortune for unexpected, unavoidable, unpredictable, unpreventable Amniotic Fluid Embolism ( AFE), most of the times the obstetrician is a scapegoat. Unfortunately in some cases, despite the doctor's best intentions, patients suffer injury or die, and the clinicians involved often become the secondary victims.

(2.) Brief facts are that the complaint's wife Parul Bajaj (for short 'the patient') was pregnant and for 2-3 months before the due date she was under treatment of Dr. Manisha Agarwal (OP-1). On 04.11.2012, she developed labour pain and for delivery got admitted in Manisha Hospital (OP-3). She was in good health at the time of admission and the OP-1 assured delivery of baby will be normal. It was alleged that the OP-1 treated the patient casually and did not advise the required investigations as per standard norm. During the labour one injection was administered by OP-1, which stopped the pain for some time, and then OP-1 and 2 created situation such that the complainant was compelled to give consent for lower segment cesarean section (hereinafter referred as 'LSCS'). It was further alleged that without proper facilities and staff, the OP-1 negligently and carelessly performed the LSCS. The anesthetist (Dr. Neelam) was not present and she did not give anesthesia on the date of unfortunate incident (04.11.2012). The time of 4-5 hours was wasted in the operation theatre (OT) and the OP-1 without disclosing the condition of patient suggested for shifting the patient to any other super hospital. It was alleged that, till date the patient is under coma and unable to recognize anyone. Being aggrieved by the alleged negligence and deficiency in service from the OPs, the complainant filed a complaint before U.P. State Commission seeking compensation of Rs. 99 lakh from the OPs. The complainant also filed another complaint before the UP Medical Council.

(3.) The OPs filed their common written version and denied all the allegations. The OP-1 submitted that during labour no injection of any nature was given to the patient either by herself or any member of the team. The labour pains were increasing, but there was no visible progress in cervical dilatation. As the fetal distress was noticed, the OP-1 explained the patient and her husband about the risk to the baby and suggested LSCS delivery. However from the patient side, there was no response or consent for LSCS. The OP-1 was constrained due to non-cooperation from the patient side and emphatically warned the attendants including the patient either to consent for caesarean section or to take the patient to any other hospital. Thereafter, complainant gave the consent voluntarily informed consent. The consent was not at all obtained under coercion or pressure. The spinal anesthesia was given by an anesthetist Dr. Neelam. The LSCS was performed by OP-1 with experienced team of doctors. The OT was well equipped and LSCS was performed with utmost skills and reasonable standards. A female healthy baby was delivered at 1.20 PM. After delivery the patient suddenly developed cardiorespiratory arrest. Amniotic Fluid Embolism (AFE) was suspected and immediately Dr. Neelam started resuscitation. The patient was intubated and started positive pressure respiration. The patient showed signs of partial revival and the LSCS was completed by the OP-1 and the surgeon Dr. Anil Gupta. The relatives were informed about the sudden happenings and the serious condition of patient. It was denied by the OP-1 that the patient was unnecessarily detained in OP-3 hospital. Thereafter, the patient was shifted in ambulance to the nearest tertiary care centre at Yashoda Hospital with the positive pressure respiration. In the ambulance OP-1 accompanied the patient. The patient was put on ventilatory support in Yashodha Hospital. Thus there was no breach of duty of care or any compromise with professional ethics while treating the patient. The complaint was filed without any justification with ulterior motive to claim huge compensation.