 The complainant is of a school teacher, Smt. Varinderjeet Kaur, delivered her second child by caesarean operation (LSCS) on 18.01.2009 in the BJS Bal Memorial Hospital (OP-2) i.e. the hospital of Dr. Ravinit Kaur (OP-1). Thereafter, on 5th day she suffered for Vesico-Vaginal Fistula (VVF). Hence, the patient suffered leakage of urine, she could neither sit nor travel. Her life became miserable, she was unable to attend the school. She approached various hospitals like Omni Hospital, Chandigarh, National Kidney Hospital, Jalandhar Vasudev Maternity Hospital, Jalandhar, Fortis Escorts Hospital, Amritsar, AMS Bassi Hospital, Ludhiana, etc. The complainant almost spent Rs. 8 lacs. The complainant filed the complaint before the District Consumer Disputes Redressal Forum, Gurdaspur (hereinafter referred to as ‘District Forum’) alleging that the VVF was developed due to wrong LSCS performed by the OP 1.
The District Forum allowed the complaint and awarded compensation of Rs. 2 lacs, subsequently it was confirmed by the State Consumer Disputes Redressal Commission, Chandigarh (hereinafter referred to as ‘State Commission’) by dismissing the First Appeal No. 553 of 2012, filed by the OP. Aggrieved by the order of the State Commission, the OP filed this revision petition.
Counsel for petitioner vehemently argued that the patient was in labour for more than 10 hours, therefore, the OP took the decision to perform LSCS. There was exertion of contracting uterus therefore; the baby’s head pressure may cause injury to the bladder. There was no injury due to LSCS. Hence, it was not a fault of OP doctor. He further submitted that the patient developed VVF after five days in the hospital i.e. the OP noted the soaking of clothes by urine after removal of Foley’s bladder catheter.
Whereas, the learned counsel for complainant Ms. Mithla Sharma argued that, the observations made by the District Forum and the State Commission are correct. She submitted that intentionally OP performed LSCS. The doctor was not careful while performing the LSCS. It was clear cut case of VVF developing after LSCS.
The court had also requisitioned the record from the District Forum. Perused medical record of various hospitals. As per the treatment notes, on 17.01.2009 at 02:00 pm the patient was admitted in OP-2 for labour pains, OP-1 followed her labour till 04:25 am on 18.01.2009. As the foetus was not progressing, OP-1 took the decision to perform LSCS.
In the instant case, it is very difficult for us to understand who has performed the LSCS operation. The qualification of OP-1 mentioned on the letterhead is confusing one ‘M.B.B.S., Gynaecologist and Sonologist’. Counsel for petitioner stated that, LSCS was performed by husband of OP1, who is a Surgeon. But, neither medical record nor the operative note had any mention about the name of operating surgeon. Even the OP-1 did not file any affidavit of her husband to prove it. Therefore, due to lack of cogent evidence, we are of view that, Dr. Ravnit Kaur (OP-1) had performed the operation, who was not qualified to do so. Hence, it was a medical negligence. Medical records from other hospitals where the patient took treatment clearly reveal, that after LSCS the patient developed VVF.
The labour (delivery) notes maintained by OP-1 clearly show that, the Cervix was 3 to 4 cm dilated, head was at “0” station. There was no full dilatation of cervix, head was not tightly fixed, no caput seen. Therefore, it was not a case of obstructed labour. Hence, there was no pressure necrosis.
It is pertinent to note that, usually, after LSCS the urinary catheter will be removed after 24 hours. Need for keeping catheter for long duration shall be only in case of any bladder injury or some reasons for incontinence of urine. In this instant case, medical record revealed that, the bladder catheter was removed on 5th day after LSCS. It has created a suspicion in our mind. The OP-1 bladder injury might have noticed during LSCS and repaired. For the free flow of urine the catheter was kept for 5 days
The Bolam Test is a familiar concept to most doctors –it is the measure of whether one has discharged his or her standard of care in the management of the patient. This test was developed through a series of English cases culminating in Bolam v Friern Hospital Management Committee (1957) 1 WLR 582. The test is the standard of the ordinary skilled man exercising and professing to have that special skill – he does not have to be the best doctor.
Therefore, on the basis of forgoing discussion the court held OP-1 liable for medical negligence, on two counts 1st the qualification of OP-1 because nothing is on record whether she was qualified to do the LSCS and 2nd failure to diagnose or concealment of bladder injury. The facts are sufficient to show that the doctor fraudulently concealed material fact. Hence, we dismiss this revision petition with cost of Rs.10000/- . OP-1 and 2 shall comply with the order within 90 days from the receipt of this order; otherwise it will carry further interest of 12% per annum till its realisation.
(National Consumer Disputes Redressal Commission, New Delhi, Revision Petition 4216 of 2014, Dr. Ravnit Kaur vs. Varinderjeet Kaur, decided on 3rd August 2015)
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