Case nº First Appeal Nos. 217, 223 and 391 of 2007 of National Consumer Disputes Redressal Commission, April 24, 2014 (case Singhal Maternity and Medical Center Vs Master Nishant Verma)
| Judge | For Master Nishant Verma and Ors.: (Party-in-Person), For the Medical Centre and Ors.: Mr. R.M. Aggarwal, Advocate and For the Insurance Company : Mr. R.C. Mishra, Advocate and Dr. Meera Aggarwal |
| President | D.K. Jain, J. (President), Vineeta Rai and Vinay Kumar, Members |
| Resolution Date | April 24, 2014 |
| Issuing Organization | National Consumer Disputes Redressal Commission |
Order:
Vineeta Rai, Member
1. First Appeal Nos. 217 of 2007, 223 of 2007 and 391 of 2007 have been filed by M/s. Singhal Maternity and Medical Centre and others, Master Nishant Verma and others and National Insurance Co. Ltd. respectively against order dated 6th March, 2007 of the U.P. State Consumer Disputes Redressal Commission (for short "the State Commission") passed in Complaint No. 48 of 2004. The State Commission vide the impugned order had partly allowed the complaint of medical negligence and deficiency in service filed on behalf of Master Nishant Verma by his parents and awarded damages and compensation to the rune of Rs. 17,00,000 (i.e. Rs. 15,00,000 to be paid by National Insurance Co. Ltd. and Rs. 2,00,000 by M/s. Singhal Maternity and Medical Centre and Dr. Pratibha Singhal). Since the facts and the parties are common/similar in respect of all these first appeals arising out of the same consumer dispute, it is proposed to dispose them of through a single order by taking the facts from First Appeal No. 223 of 2007. The parties will be referred to in the manner in which they were referred to in the complaint i.e. Master Nishant Verma as Complainant No. 1, Mr. Bijendra Singh Verma as Complainant No. 2, Mrs. Renu Verma as Complainant No. 3, M/s. Singhal Maternity and Medical Centre as Opposite Party No. 1, Dr. Pratibha Singhal as Opposite Party No. 2, Dr. R.K. Singhal as Opposite Party No. 3 and National Insurance Company Ltd. as Opposite Party No. 4/Insurance Company.
Facts:
It was contended by Shri Bijendra Singh Verma (Complainant No. 2), father and guardian of Master Nishant Verma (minor), Complainant No. 1, that he had taken his pregnant wife Smt. Renu Verma (Complainant No. 3) to M/s. Singhal Maternity and Medical Centre (Opposite Party No. 1) for ante-natal care and delivery under Opposite Party No. 2/Dr. Pratibha Singhal (Gynecologist), who along with her husband Opposite Party Nos. 3/Dr. R.K. Singhal (an Anesthesiologist), who owned and ran the Medical Centre/Opposite Party No. 1. After tests, Complainants No. 2 and 3 were informed that a normal delivery was expected. On 16th August, 2002 Complainant No. 3 was admitted for delivery and consent of Complainant No. 2 was taken for any emergency surgery. After the delivery on 16th August, 2002, Opposite Party No. 2/Doctor informed Complainant No. 2 that she had faced extreme difficulty in conducting a normal delivery due to the excessive weight of the baby and also since the shoulder did not expel normally, it became necessary to use forceps to complete the delivery. In the process of extracting the baby with forceps, the nerves of his upper right limb appeared to have got damaged causing paralysis and his head had also been injured and heavily pulped on both sides. His neck and shoulder had also turned blue due to bleeding under the skin. Complainant No. 2 thereafter got Complainant No. 1 examined by various eminent Neurologists and specialists, including at the All India Institute of Medical Sciences, who confirmed that during the course of delivery all the five nerves of Complainant No. 1, namely C5, C6, C7, C8 and T1 had got totally damaged due to paralysis/rupture. Despite surgeries conducted in France and subsequently in the USA and other treatments, Complainant No. 1 continues to suffer from various disabilities. This occurred because of the medical negligence and deficiency in service on the part of Opposite Parties at all stages of the medical treatment starting from the ante natal checks to neo natal care. Complainants confined their claim of compensation to Rs. 1,00,00,000 with interest @ 24% per annum although the actual compensation justified would be over Rs. 2,00,00,000.
2. On being served, Opposite Party No. 2/Doctor filed a counter affidavit on behalf of all Opposite Parties No. 1 to 3 and denied any medical negligence or deficiency in service on their part. Being highly qualified professionals and running a well-equipped specialized medical centre providing gynecological and maternity services, Opposite Parties No. 2 and 3 denied that the necessary ante natal tests were not conducted. These as also the three ultrasonography tests confirmed that there were no complications or adverse findings pertaining to either the health of Complainant No. 3 or the progress in the growth of the fetus, including the possibility of its being macrocosmic i.e. over 4.5 kg. Progression of labour was also smooth to begin with until the 2nd stage when the heartbeat of the fetus dipped drastically, which is indicative of compression of the umbilical cord causing lack of supply of oxygen to the fetus' brain, Outlet forceps delivery was, therefore, performed with due care and professionalism to avoid possible death of the fetus. After delivery of the head, shoulder impaction occurred because of poor maternal effort on the part of Complainant No. 3 leading to shoulder dystopia and known complication, namely, brachial plexus injury. It is medically well established that both these are unpredictable events and can occur despite perfect obstetrical management, as in the instant case. On detecting this condition, Opposite Party No. 2 acted as per standard protocols by using McRoberts maneuver, widening of episiotomy and applying supra pubic pressure. Following delivery, both Complainant No. 1 and Complainant No. 3 received the best possible medical care and attention from a number of specialists, including a Pediatrician and a Neurologist. Under the circumstances, the complaint of medical negligence and deficiency in service is not maintainable and deserves to be dismissed.
3. The National Insurance Company Ltd., Opposite Party No. 4, while confirming that under the insurance cover taken by Opposite Party Nos. 1 to 3, the legal liability, which professionals may incur due to error or omission while rendering service, is covered and which Insurance Company would be liable to indemnify as per the terms and conditions of the policy, also stated that as per the evidence on record, there did not appear to be any medical negligence or deficiency in service.
4. The State Commission, after hearing the parties and on the basis of evidence produced before it, including the medical literature cited by both the parties, and after taking into account what constitutes medical negligence, as ruled by the Hon'ble Supreme Court in its celebrated decision in Jacob Mathew v. State of Punjab and Anr., III (2005) CCR 9 (SC): VI (2005) SLT 1 (SC): 122 (2005) DLT 83 (SC): III (2005) CPJ 9 (SC): (2005) 6 SCC 1, concluded that although Opposite Party No. 2/Doctor had reasonable competence and skill she did not exercise this skill and competence in the medical treatment of Complainant Nos. 1 and 3 starting from the ante natal checks. The relevant findings of the State Commission are reproduced:
...We conclude that the use of forceps with excessive force and excessive traction caused injury to the head, avulsion of head of humerus and blue scar on the chest. The pitiable condition of the child, who was on the verge of mutilation, suggests that the forceps were not used according to prescribed norms. The above discussion also concludes that the summary and recommendation of Acog practice bulletin and other studies mentioned above rebuts Henry Lerner's suggestions. We also conclude that the maneuver prescribed in literature, and the medical science was not used and applied by Dr. Pratibha Singhal. Not only this, she has not made proper documentation and the discharge card only mentions supra pubic pressure applied and episiotomy widened but no important and necessary maneuvers as has been repeatedly suggested in medical literature mentioned above were applied by the doctor nor there is any documentation. Dr. Singhal's mentioning is also untrue when she avers in the affidavit that McRoberts maneuvers were used. This does not find in discharge card nor any documentation. We are also concluding that the complainant's contention about the stature and physic of the mother is more near to the truth, which suggests that prescribed several investigations to ascertain pelvic condition, etc. of the mother were not carried out. The contention is also true that the baby...
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