B DASH Vs. GHANASHYAM SETH

JUDGEMENT

(1.) -THE Sundargarh-II District Forum by order dated 15. 11. 1996 in CD Case No. 53 of 1994 has directed the authorities of Steel Authority of India to employ the husband of the patient and not to deduct the medical expenses from the retirement benefit of the complainant who is the father-in-law of the patient. Being aggrieved by the said order, the Steel Authority of India and the concerned doctors of the Ispat General Hospital, Rourkela have filed CD Appeal No. 855 of 1996. Contending that the District Forum should have awarded compensation due to medical negligence, the complainant has filed CD Appeal No. 205 of 1997. Both the appeals being analogous they were heard together and are disposed of by this common order.

(2.) THERE is no dispute that the complainant's daughter-in-law-Laxmi Seth was admitted in the Ispat General Hospital, Rourkela for delivery on 23. 7. 1991. The allegation of the complainant was that the patient fell down while she was in the ICU but the doctors did not attend her and because of medical negligence she had to remain in the hospital after delivery for more than the period required for the purpose.

(3.) THE attending doctors who are parties in the case filed written version denying the allegation. Dr. Dharani Patnaik who was working in the Gynaecology Department of the hospital has filed affidavit denying any medical negligence or deficiency in medical service. From her affidavit, it is evident that the patient was admitted in the hospital on 23. 7. 1991 for delivery. As she had high blood pressure induction of labour was done with Syntocinon drip. On 24. 7. 1991 she gave birth to a male child through cesarean section. She was normal till midnight on 24. 7. 1991 and her condition was satisfactory. After midnight she complained of chest pain. She was immediately attended by two Gynaecology Specialists, two Physicians, Anaesthetist and Surgeons. All necessary resuscitative measures were given to combat her shock condition. The clinical picture suggested "amniotic Fluid Embolism". When her condition slightly improved she was shifted to ICU at 4. 00 a. m. of 25. 7. 1991. In the ICU a team of doctors of different specialities attended her. She recovered from shock and became conscious. Subsequently, she developed Septicaemia and DIC (Disseminated Intravascular Coagulation ). This was evident from low platelet count and patechael haemorrhages on skin. She was given broad spectrum antibiotics. In the evening on 25. 7. 1991 she developed respiratory distress and cyanosis. She was put on ventilation till 29. 7. 1991. When she had good breathing the ventilatory system was disconnected. The endotracheal tube was removed on 30. 7. 1991. On 31. 7. 1991 stiches were removed and it was found that the union was good. At about 6. 20 p. m. of that day she again developed "dyspnoea". Later at about 9. 20 p. m. she developed generalised convulsions and became semiconscious followed by cardiac arrest. At 10 p. m. she was reintubated with endotracheal tube and connected to the ventilator. After that she went to coma. On 1. 8. 1991 she was examined by Neurosurgeon. As per the advice, CT scan was done and it was found that there is no cerebral haemorrhage. Tracheostomy was done on 11. 50 a. m. in O. T.-11 on 1. 8. 1991 and connected to ventilator. On 2. 8. 1991 patient developed early signs of decortication. Patient was in coma and was treated by both the Physician and Neuro-surgeon and they came to conclusion that the condition was due to Amniotic Fluid Embolism, followed by Disseminated Intravascular Coagulation, Acute Respiratory Distress Syndrome and Acute Renal Failure. The cerebral events following status epilepticus (Continuous convulsion) caused by septicaemic DIC with hyper pyrexia could be attributed to severe hypodia. Patient was treated for septicaemia and hypoxia brain condition. She gradually showed signs of improvement and was shifted to O. G. Ward on 9. 9. 1991. As it was a long time treatment and physiotherapy was needed for her, the husband was advised to take her home and to continue the treatment and physiotherapy at home, but he refused. The Catheter was removed on 4. 3. 1991 and she was able to pass urine by herself. Several attempts were made by the ENT Specialist to close the tracheaostomy wound and dilatation was done under G. A. in several sittings and finally the wound was strapped. Gradually the wound healed spontaneously and patient established normal respiration.