Pune based Hospital and Doctors absolved from the allegations of causing death of a Lawyer-Gravida due to Injection Tramadol. Adv. ROHiT ERANDE ©

Pune based Hospital and Doctors absolved from the allegations of causing death of a Lawyer-Gravida due to Injection Tramadol. 

The Court held doctors are faced with dilemma and they have to choose lesser Evil from the options available 

Adv. ROHiT ERANDE ©

REVISION PETITION NO. 2200 OF 2019

 (Against the Order dated 11/06/2019 in Appeal No. 439/2016 of the State Commission Maharashtra)

 PANDHARINATH WAGHOLE V/s. SANJEEVANI HOSPITAL & 3 ORS, PUNE

BEFORE:  

  HON'BLE DR. S.M. KANTIKAR,PRESIDING MEMBER

  HON'BLE MR. BINOY KUMAR,MEMBER                 

Judgment Link :

http://cms.nic.in/ncdrcusersWeb/GetJudgement.do?method=GetJudgement&caseidin=0%2F0%2FRP%2F2200%2F2019&dtofhearing=2023-03-22

 Pronounced on:  22nd March  2023

Facts in short :

 1.       The instant Revision Petition was filed by the Petitioner/ Original Complainant against the Order dated 11.06.2019 passed by the Maharashtra State Consumer Dispute Redressal Commission (Circuit Bench at Pune)   whereby the State Commission allowed the Appeal preferred by the Respondents/Opposite Parties against the order dated 15.03.2016 passed by the Pune District Consumer Disputes Redressal Forum  wherein the present Petitioner was granted Rs.10,00,000/- as a compensation from the Respondents -Hospital /Doctors.

2.       The wife of Complainant, Mrs. Indira Waghole  was an Advocate by profession, was taking treatment from the Opposite Parties for pregnancy and consulted the Respondent No. 2 for abdominal pain in the hospital on 24.08.2009. On the next day, she was admitted in the hospital and received treatment .  At about 11.15 p.m., the patient received Injection Tramadol, after which she was serious.  Since later she became critical and shifted to OP-4.  She didn’t respond to the treatment given by the OPs-1 & 4 and died during treatment. 

3. Aggrieved by the death of wife, the Complainant filed Complaint before the District Forum, Pune and the District Forum while allowing the Complaint awarded compensation of Rs. 10 lakh to the Complainant.

4.       Being aggrieved, the OP-1 to 4 filed the Appeal before the State Commission.  The State Commission allowed the Appeal and set aside the Order of the District Forum with the following observations:

“We have gone through medical records, literature and citations. Deceased Mrs. Indira, was apparently well till 11.30 pm and after injection tramadol, she became restless and unresponsive later. As per the literature on Tramadol, this kind of reaction does not occur after Injection Tramadol.  For the whole day 25**^August 2009, she was in the process of labour with mouth of cervix-uterus open. In this case the patient was immediately attended by qualified Gynaecologist, emergency management started by giving CPR (Cardio Pulmonary Resuscitation) after finding that the heart sounds were audible, patient was transported to higher centre at about 12.30am ( on 26 August 2009) in cardiac ambulance. 

In such situation, even though qualified, the doctors are faced with dilemma and they have to choose lesser Evil from the options available. In the instant case, the doctors in good faith decided to shift the patient to higher centre-in proper manner by cardiac ambulance, utilised the chance to save patients life that was priority. We find that in small window of time period available (around one hour), the team decided to shift the patient. The citation considered by district forum, is not applicable to the present case as doctors in good faith shifted this patient to Jehangir Hospital. Hence we find that the District Forum has not considered the emergency situation as well as efforts taken by qualified doctors to save patient's life. The answer to POINT no. 2 is NEGATIVE.”

Held : 

1. The NCDRC observed that from the record it is pertinent to note that on 24.08.2009, the patient received antibiotics and injection tramadol at 11pm. Again, on the next day, around 11pm, injection tramadol was given for controlling her labour pains. After 10-15 minutes of the injection, the patient became restless and felt suffocating. She was immediately attended and emergency treatment was given with oxygen. 

2. It was further observed that it is pertinent to note that the injection tramadol taken a day prior (24th) did not show any reaction. The Committee of experts Medical Board at Sassoon Hospital also held that there was no medical negligence. The PM report revealed torrent’s larynx and the cause of death   as “suggestive of traumatic intubation”, however the PM findings are devoid of the trauma or damage to larynx or trachea. The cause of death was due to pulmonary embolism or severe drug reaction, but not due to the treatment given at OP hospital.

3. The record showed that after the injection of Tramadol at 11.30 pm, suddenly the patient showed erythematous rashes over the body, red froth coming from mouth with locked jaw. Immediately the patient was intubated, CPR was started and for tertiary ICU management the patient was immediately shifted to Jahangir Hospital by ambulance with doctors. On arrival to Jahangir Hospital, CPR was continued and at 1.00 am. 

4. In the instant case the prime concern was to save the mother and already the intrauterine death of fetus was confirmed by USG. The patient was declared dead at 1.20am at Jahangir Hospital.    

5. Based on the discussion above, it was observed that we do not find the Opponent Doctors and hospital liable for the medical negligence. There was neither breach in duty of care nor any negligence during the delivery of the patient. Administration of injection Tramadol is not contraindicated for labour pains. The doctors have made their efforts to save the patient, but failed. The unfortunate incident shall not consider being medical negligence.

This judgment gives important relief to Medicos by holding that when Doctors do their job properly, they cannot be held responsible for the failed result and in emergency situation, Doctors have to make a choice between the Devil and the Deep Blue Sea. No doubt, the loss of companion is beyond any monetary compensation and it is irreparable loss. But there are certain things which are beyond control of Medical Science and at times Doctors inspite of their all out efforts, just have to watch !!

Thanks and Regards

Adv. ROHiT ERANDE ©