No Negligence if LSCS preferred over complicated Normal Delivery ...

Much awaited relief for Drs in these days where Caesarian is often called as "Unwarranted"  .
A case  claiming  compensation Rs. 20 lakhs+ against Doctors got rejected. 

The National Commission in its judgment dated 17th July, 2017, rejected the Complaint of Rs.20,27,350/- in the case of  KUNDAN LAL JAYASWAL & ANR V/s.  DR. MALA PANDYA (THAKKAR) & ANR, Mumbai.

You may see the link :

http://cms.nic.in/ncdrcusersWeb/GetJudgement.do?method=GetJudgement&caseidin=0%2F0%2FFA%2F1654%2F2016&dtofhearing=2017-07-17

Facts in Short :

1. The primi-gravida - complainant no.2 was taking treatment from the Opponent Dr.. As per USG report  dated 16.3.2015, there was a double loop of cord encircling about 2/3^rd circumference around the neck of fetus.Her expected date of delivery was 23.04.2015. However  on 25.3.3015, as the water discharge from uterus increased,  the patient approached the Doctors and after other investigations, the Doctors decided to go for LSCS in the interest of patient. On the same day at 9.45 PM, a male baby was delivered by LSCS

2 It was alleged by the complainants that the bill was prepared fraudulently and complainants were cheated, in as much as, an amount of Rs.700/- was demanded towards HGT and only then the patient was discharged. The patient was charged for the doctors, who did not attend the patient. The relatives of the patient did 

3. Thereafter 3 days the baby fell sick and it was alleged that on account of pre-mature delivery, the patient and her baby were under continuous medical treatment and this was only because of Decision of LSCS. Thus the Complaint claiming a sum of Rs.20,27,350/- as compensation for harassment, medical expenditure and cost. The Complainant who fought in-person, also submitted news papers cutting which talked about the increasing trend of caesarean delivery in Mumbai and it had doubled in the last five years (2010 to 2015)

4. The Doctors refuted all the allegations. In the interest of mother and new born, the decision of LSCS was taken to avoid complications; LSCS was successfully performed  after due consent from the patient and her husband and therefore, there was no negligence on the part of the opponents. the State Commission dismissed the compliant and hence the appeal was filed.

Held :

1. The National Commission dismissed the appeal after perusing the record and hearing the parties and held that  as the double loop of cord was present around the neck of fetus, the emergency LSCS was performed by Dr. Mala Thakkar alongwith Dr. Kansariya, under spinal Aneasthesia, which was administered by Dr. Jyoti Thite. Strangely,  the husband and relatives were reluctant as they wanted to wait till evening for the Normal Delivery. The operation was performed under high risk consent and the consent form was signed by her husband, Mr. Arvind and the patient herself.

2. It  refuted the contention of the Complainant that the patient has to remain life-long on medication and she would not have normal delivery !

3. It also observed that the complaint was highly inflated  to confer jurisdiction on the State Commission. however it ordered to refund Rs.5000/- with interest , charged by the Doctors as fee for rounds.

The Normal delivery or LSCS delivery, this question has become the moot question now a days. There are two opinions amongst medical fraternities too.. Few days back I read a news that one of the state Govt. was also thinking of making some sort registry for recording the no. of deliveries by LSCS and Normal deliveries. There cannot be no 2 opinions that what is best in the interest of patient has to be done. A patient may have choice and as few of Medicos would agree that now a days since the pregnancy age is increasing and more ladies are opting for LSCS on their own. But in case of complications, Doctor's opinion should prevail. In any case Informed Consent is a must.. Really, what could be the solution ? Matching the cost of Normal or LSCS delivery ? Just a thought...

It reminds me the famous judgment of UK Supreme Court which held that "Giving birth in the "natural" and traditional way or giving birth by caesarean section (unless she lacks the legal capacity to decide) " is the choice of a Pregnant woman !!! Montgomery  V/s. Lanarkshire Health Board  (Scotland). It further held that  "Pregnant women should be offered evidence-based information and support to enable them to make informed decisions about their care and treatment. Gone are the days when it was thought that, on becoming pregnant, a woman lost, not only her capacity, but also her right to act as a genuinely autonomous human being" Her Ladyship observed while concluding her judgment !!!!

thanks and regards

Adv. Rohit Erande

Pune.  ©