- i l ft T--;- ',.. Dated *#.,.. I -:.r. ;'-' 1 '\ P .1i-.i . - _-\'_ ! 5 i A l a ' \ I i ' :iSiON,IiARYANA, ,,:.DIS} i-i'lEsREDRESSALCGi',1,r l:'ANCHI(ULA -1.l.. ComplainiN o,17 i,.i'.,u:r7 '.;,", Dateof Institutior,r .:'1.'200'l ' Dateof Decision -i :.1 :':il12 ajesh )lr,:nan,residentoi Viitag' &mL.r ,i$ar(Haryanal .lr;:P1.,,.;ianl rtn6 .r,.+** ,*,#'iit( Dep:.,r-,: tft;5'''+'' of i-Iealth, civil --.,. ,,ia at i-.i,'ndigarh. !,,:- -:r.a,: ",: 'L l,c-',l)ii"r,:,i , r-',-,,-,l.ih, Stateof Hari'an3at i S',:i'-iioes, .rL-JLrrr. 'l';"',' ili,.i'l ' 'q:.',i, Disirict Yamuna ) i-,i ii , . il j-. Ci:lil F{ospital,Jagadhi., j-,'i:;; ;ct YamunaNagar. T';i* rieii,i;r' ii'ri:,i:;ai Oii- .:r,:r, trii JagadhrD i istrict r r' ^iospiial, Jagadhri, OppcsiteFarties District Yatntma lirg-irr' :ltrougi-rits Medical G t i b l F l o s ; - 1 , , r '':Att*tagar, ,. rrt Supr:iinienuir Pu:';i Cral ,:1,,-'-' fiistitut,.-of Medical Education a:rc i+-,;iearch.Chandisarh , l, i'. , : .h i t s i , i r l c t o r ,S e c t o 1 i',iir.;i i r 2 ,C h a n d i g ai r ii't-, i),:;.i,i;l'a OpitositeParties ^),r,"y:_, i5 S;lFOftE: ii,-i,r'r;;e Mr. .iListice R.S.Madan,Piesidr:iil. \,,r li.M. Belli, .iudicialMember. 313 ,, I t l iroi the Partie:;: +/vh r' Advocatelbr Comp;;.,irr,ri. 5lii'; irlin SeiiLe,i,vat, ,,...iay .:qli:r: Advocatefbr Cppo:;itrP:irtieslrio.1to 6. Chiiurihary, .;i'i:o;itePariiesNo.7 & 8 exparte. {i,t;i,r''.rlte Par-l;')ro.9PerformaOpposite,';"ri" ORDE]R -) rhe inrrial Complainantwas gi..'elr Primary by iLt"' .il(itt,,'e11' il!.':.,jll aS iiecessalyvaccinations 'l ll.; fut',.liernecessaryvaccinatton i2.)t.\iii;;,.j .lii' on Health Cen.i';. K^aiarvnr givenon01.02'200(,i.lreexpectedc]at',:oi-rj..lii\.]j.'wasg-tveilaSonorbeforewithin. ,rviiicrrwas dr-rein the month of May,2r)t')('' es 02.0$.?005 rssessect date the frorn weeks i''' ieferred the comp1ai1411 iiiinalr ;r,c:-iil',ceirti.';, ot cio'ior:; ihe For fuither treatmen.i. t'i as on 02.09.2005and date -uvhLele: \,va5i;}:i:i*Ssed l,.lvi^ir. Civil }Iospital, Jagarliiri offi,:er on duty. The complainaill ils 09.0i;'200:ii;i.ii-re |,.1.:j;r.:;rl aSSeSSi:,-l was delivery as i)'ii 1.' ir$'JQsi-ior further treatment i-[.:;t'4.a: c;r'ii was called to the u-rr..r.d L.M'P' i'r 0:109':ltl05' ;'r:':r'eafi:ei c t.iec;k-up' 21.06.2006for medicai on23.06.20ilt,biccrlini<starior'ttctheLrlil;]]iainailtalrdduetoconstantandLl.-'i by the Mediclil \\l:i'"; ll;:llritted ;br delivery compiztini:nt rhe stoppage of bleedrlig. AuthoritiesatciviiLios:pital.Jagaiil,ri.she-,r'r'tsrLdmittccatll:00P'M''tltrt""u card "Dr. Manishu11;ri:J :iiip/Trez:tment ries,crigtr.,:u tht," 'rr ;:,oiins lhr; oflicer on duty put 0:30.\'M L ' Y PGIMER' / * ' u u " r v w v t the n 2'+'06'2006' on i.e. 'e' o day ay 1 ssame ame d ccmplainantascase wiy blrn malechiio o1' Chandigarhto on the wa,vftoltr PfjllviER' furnutuNagar' ii -.' exercisedrr:c'dical that fhe opirosittr'-'a'f iLi'esof Civil Hospital' y the MedicalAr;ti-.r':; in servlce rfricii'tcf,rciency inedicalnegiigence ;;; i ,.'r' iilale cnuu uevqruv "^-; alleged that LlLt- dueto the faurtof ,rr. ultimatelv opposiicp 'ii'ries,which LegalNoticedated corn''xe'ir''aii""' the *^of cnila vrru\r male ';,e :r .i,,eqaililust mail iire rle. *''i'. 11c -ilist :.esuLtccin.;o the AD and UPC with regisii;r"eil ugh parttes ';.rasgi..{e':tc.,rhe opposite 20.03.200,1 'i;;:-Litir:s to compiy with ":_'_ a . ^.^l,a*tlo -'J "er'r,rent-{}l:I a5-:***.-*r****" opposite iailed rs etrtitled for r:lrecoi"rtplainant that *'{prayer *ift : iriis conrpf";nt :r.a,csforthedeathofhgrfirstrnaiechiit-i;Rs'Slacsforphysica ..\ r ,- +-^.- +Lc cVneflSgS i''s'2 lacs tbr the expenses qufferincs and an . pain --^:- .-,1 sufferings andl i-rarassmont, we* as nreiiial tof.*rr,.. rrt' rlr;urrv*^-^I- aL;:rr: spent forr riieclical [r.. Upo* vy"^' the - \r^ 1 tn 6 tt.''p*ot* atlrcal'eci anct contested to " No'1 parties ,to,ftr,*. ihe oppcsite , . I *L^ ^ranqrinns iirey denied the allegattons lirit wrifien 'tf"*t"t whereii'r Last Mensli":ai It is statedthqrtthe is Period of the patient Lorigivenuy4nepatientirerscji.ilrrcli|tlreMedicaloffi verify tht s';'.lr": :est done to uiiiir get to pa-tientis advised on 20'06'2006 ant 'Trr3'i'dhri Hospi"zri' Civil rlaiuantcametO of pregnancy.The ct)iilD rinani got i;er ttlha:;*i::t"'ti ltestdone and producedthe rep'rii .,vi s witii singi.:iive icrtr.r'i.,ir]re mailagementfoetuswas givenol.r which revealed37+_1 The cor:iPlairult !\,'asttlii iilcr \i!rr ljrrlqld cotrreto the hospital,if she h:r''! 21.06.2007. labour pains or any irt'cbl rns. 'fhe dli1 irf delivery is assessedon the basisof e.xp;ected 1 ci;:rJ the dateof last mensu'L'alrtrrio,i and or,li, lon <;i ti:,-:patier::s ieliver onthe expected is givetr corr+cili i,rythe patient. It is also stated that lhc of delivery given if rrrlo LrLticrri expecteddateof dell''":t.Y period and there m.i1/ i of ti": radiologistor the assess'i'; ir r:irc.r'':rrti''L riisu:'epan,,:-, clinician. On 23.06.200t- 10.3CP.M. ihe cornpiiiin{nthad come to the Civil Hospiraiby inc cioclol+rr ball duty at 11'00 P'M' and proper Jagadhri and she wr$ r zr:iniiiecl rel*i':urt iin1c. ilr:rp was nc Gynecologistavaiiable i;r managementwas givtn A^tILL:LI ii:c ' Civil Hospital,Jagaciliri lfro could clc ilaesalciuis.:e]tionand so in caseof emergency ri l:,fsarear, sectiondelivery' it is furih':r i:f be i,i';'.ilcc', seivicesof Dr. Mani;i;a ri::red 'rvas rieith,rr posteci;ts iif]edical Officer in General Hospiiai. stated that Dr. Mailislla Jagadhri nor a Harf iuia caesareancasesonlY. # the doctor on call 'lLi Manisha,proper man$g labour pains,the Paiicr:t for further managejile managementand w,-rerr as per the informatlan Therefore,Dr. Divf a r' ji furthermanagement. Hospital, Jagadhri r:il'r GeneralHospital, Yam itted at Gaba i;ii i:hli ications,tfue- f$ advice and the child was declaredas child left the pGIMER Chandigar:hagainstmedical ,LAMA, (Left Against Medical Advice). Thus, there is no medical negligenceor parties and the death of child occuned deficiency in service on the part of the opposite of the child who had left the PGIMER due to own negligenceon the part of the attenclants merited dismirisal' Chandigarhas "LAMA". It is pra;iedthat the complaint respective claims' complainant Both the parties led eviderncein support of their and affidavit of her husband Rajesh heLsrendered her own affidavit as Ex.CW-1/A DhimanasEx.CW-2/Aiilongwit}rdocumentsEx'C-ltoC.29. of Dr' Surinder Kumar Rathi Opposite parties in their ervidencetenderedaffidavit R2' ar;Ex"RW-1 alongwith clocumentsas Ex'RW and perusedthe casefile' we have heard l,:arnedcc,unselfor the parties and date of delivery given by The grievance of the cornplainant is that the expected pfoper and also that she remained the Doctors at Civil l{ospital, Jagadhri was not the caseof the complainant that as per unattendedat civil Hospital, Jag,adhri.It is further shehad given birth the Doctors of Gaba Hospital, Jagadhriwhere it was a to her first male child' ,over period clelil,ery' due to which there was complicationto the newly born had referred ch'd and for that reas.n the Doctors at Gaba Hospitar the newly born baby topGlMER,Chandigarhasthechildwashavingsomerespiratoryproblembutchild died. Takingintocorrsideratic,nthefactsandcircumstancesofthecase'wehardlyfind and deficient any ground to hold the opposite parties negligent in service' It has come on as per the information period of'the patientis assessed the recordthat the Last Menstruar any discrepancyby the Medical Officer' given by the patientherself.Ho,wever,in caseof test done to verity the facts' Admittedly' the the patient is advised to get u.ltra sound complainanthadcom,;tocivilHospital,Jagadhriot20'06'2006andshehaddisclose Thus' expected date of delivery of the her Last Menstrual Period as 02,09,2005. 32-34wee]<s as 09.06.2006'Her per abdomenfindings showed complainantwas asserssed" gef:'lheu examination,the complainantwas advisedto nd test done''in order fo . " J J!+ae-'.,-- lt assessthe period of pregnan,oy.A.fter getting her ultrasoundtest, the complainanthad prorlucedthe report which revealecl37+3 vys.ks with single live foetus,due management 'lil're foetus was given on 2I.0r5.20t06. complainantwas told that she should come to the hospital, if she had labour pains or any problems. The expected date of delivery is assessed on the basis of the date of last menstrualperiod. It has also come on the record that only 4Voof the patien,tsdeliverron the expecteddate of delivery given if information is given correctly by the patient. On 23.06.2006the complainant had come to Civil Hospital Jagadhriat 10.30P.ltl. and shewas examinedby the doctor on call duty at 11,00 P.M. and proper managemerLtwas given. As Gynecologistwas not available in Civil Hor;pital,Jagadhriwho could do Caesareansection and therefore in oaseof emergency the servicesof Dr. Manisha used t,obe availedfor Caesareansectiondelivery. However, Dr. Manisha was neither posted ai; Medical Officer in GeneralHospital, Jagadhrinor a HaryanaGovernmentErnployeearLdsheusedto be called for emergencycaesarean cases Di. tr,{anishawas not avaiiabie. Fiowever,the ciocior on duty onl'i. Bu; or,23.C.5.2C05 after consultationtelephonicallywith Dr. Manisha,had given proper managementto the complainant.Due to norl-progression of labour pains,the patient was referredby opposite party No.5 to oppositeparty -Dr. t)ivya for further management.Accordingly, Dr. Divya attendedthe patient for further marlagementand when there was non clescentof head she contracted Dr. Manisha, who as per the information given by on duty staff nurse Parimjeet, was not avail'able.Therefore,Dr, Divya referred the cornplainantto Civil Horipital,Yamuna Nagar for rther management.Thus, it is not establishedthat the the complainantremained unattendedat Civil Hospital, Jagadhri.It has also come on the recordthat the complainart was relerredto Generalllospital, YamurraNagar but shewas got admitted by her attenclantrs at (iaba Hospital, Jagadhri where a male child bom alive. the child was referred to PGIMER Chandigarh,As per But due to some complic'atio:ns, the record gf PGIMER Charrdigarhthe attendantsof the child had left the PGIMER, ). Thds, in 'view of the facts and circumstancesof the casewe do not findl,bvenan ioth of evidenceon the recordto establishit a caseof any kind of medical r.{ in sen'ice.There is no evidenceon be.halfof the complainant negligenceand deficiLenc,v in the shapeof affidavit of the attendingDoctors at Gaba Hospital, to say againstthe oppositeparties.In fact the grievanceof the compiainantis on accountof deathof her neu'lv born male chilld and as per evidenceavailableon the record,the newly born child died due to own ner3ligr:lceon the part of the attendantswho had left the PGIMER, Chandigarhagainstthe naedicaladvice.AnnexureC-9 'OUT PAIIIENT TICKET' issued clearly showsthat the patient (minor child) was declaredas a from PGIMER, CharLdigarh case of 'LAMA'. T'hus, uncler the facts and circumstancesof the case, no medical negligenceand deficiency in serviceagainstthe oppositepartieshas been establishedon the record in view olf the observationmade in casecited as Kusum Strarma and others versus Batra Hospital & Mledical ResearctrCentre and otlhers,2010 ACJ 1444, whereintheir Lordship of the Hon'ble SupremeCor:rt have discussedthe basicprinciples with respectto the medicalnegligenceas under:- .6/1 \ Ilcgligenr;e isthe breacirof a duty exercisedby ornissionto do something whictr a reasonableman, guided by those considerationswhich ordinarily regulate the conduct of human affairs, would clo, or doing something whictLa prudentand reasonableman would not do. (r) Negligen,;eis an essentialingredientof the offence.The negligenceto be establishedby' the'prosecution must be culpable or gloss and not the neglligencemerely basedupon an error ofjudgment. (IID The rnedjcalprofessionalis expectedto bring a reasonabledegreeof skill and knowledgeand must exercisea reasonabledegreeof care.Neither the very lhiglLestnor a very low degreeof care and competencejudged in the of eachcaseis what the law requires. light,rf the particularcircumstances (iV) A medical practitionerwould be liable only where his conductfell below of a reasonablycompetentpractitionerin his field. that of th,gstarLdards (V) In the realm of diagnosis and treatment there is scope for genuine differenceof opinion and one professionaldoctor is clearly not negligent mereJ,ybecalrsehis conciusion differs from that of other professional doctor. (VD The rnedicalprofessionalis often called upon to adopt a procedurewhich invglves higher element of risk, but which he honestly believes as pro'vidin15greater chances of success for the patient rather than a procedureinv,rlving lesserrisk but higher chancesot-'failure.Just because lookingto the gravityof illness a professional the patientout of his/hersu risk to re,deern to negligen"f'"/' resultmaynot amounl. desirrrd +jii: . (VID camot be attributed th reasonableskill and Onecourseof action in l - r - r : 2 h r , . i. r + ' \voulil i tl ii ,i':' ) iv i'I, dr:ctirr i' i:: il il.r.:':.li the; +: ". petence. Merely becausethe doctor to the other one available,he -!rrq:,il!i b.i J:in: w:* xi=::tah!* rl] l,i' ;iSSi,' , . i : 1 1 1 - Ir i - i i i : i r r, I r,: , ar.l :. ..:,, a doctor so long as he performshis .', ;.i-l |-jir' J t c t ; ' r e . , i- . 1 , , - . . , r , i r i . ' . aj t - , r if : n i i g . t , , i . : , 1 : - ] .r i j . : , i r l i l :,'l"r', I ir-'ir l.ir-,i E:-il r-'r" ll'"rtinnn rr, : - r t_i ..,: l (VD Negligence cannot be attributed to a doctor so long as he p*f6#, ili, duties with reasonableskill and competence.Merely becapsethe doctor choosesone courseof action in preferenceto the other oni available,he would n,ctbe liable if the courseof action chosenby him was acceptable to the medicalprofession. (VIII) It would not be coirduciveto the efficiency of the medical Orot rrror rrno doctor c<luldaCministermedicinewithout a halter rou.ndhii neck. (IX) trtis our boundenduty and ob.tigationof the civil societyto ensurethat tfie rnedical prollessionalsare not.unnecessaryharassedor humiliated so that they can perform their professionalduties without fear and apprehension. (X) The medical pracrtitioners at times also have to be savedfrom.such a class of complainants'ruhouse criminal processas a tool for pressurizingthe medicai prof'essionals/hospitals particularly private hospitalsor clinics for ensation.Suchmalicious proceedingsdeserve edicalpractitioners. re entitled to get protection so long as they easonableskili and competenceand in the nterest and welfare of the patients have to be ofbssionals." ,; , In Eatra Hosp,ital A n'f)dieqff,.esearchCentre and others, case ts.rpruj it has . 4 . \ beenobservedthat the negligenceto Ueeihl>lish{l by the prosecuti.on must be ,utpiUte - t a or gross and not the nerglip;ence merely basedupon an\error of judgment. Merely, the doctor failed to cure the disease,cannotbe a caseof medical negligenceor deficiency in se:rvice.None of the above mentionedingredientshave beenproved.by the complainant in this case. In casecited as Molnd. A.brar versus Dr. Ashok Desai and others, 2011 CTJ 613 (cP) (NCDRC) Ho.n'bleNational commission has observedas under:- . "The meclicalpractitionerscannot be treatedas magir;iansor demi-Gods. They are fallible human beings. The liability to pay compensationmay arise only' when the complainantproves that the causationwas result of negiigence committed by the medical practitioner and there was clear materialavailableto foreseethe injury." Hon'ble NationalCommissionin casecitedas Smt. Sajini, Major Versus Chaya Nursing Home & Ors, ,1012(1)CPR 111 (NC) hasobservedthat medicalcomplications cannotalways lead to iirfbrerrceof medicalnegligence. a recentjudgrrLentcited as Smt. Narangiben SubodhchandraShah through versus Gujarrat Research and Medical Institute popularly known as .:Yr -. [i _\.'l RajasthanHospital & Ors, 2012Q)CPR I 2 (NC), Hon'ble National Commissionhas observedthat every medical failure is nol As a seqtuelto our aforesaid negligenceor deficiency in serviceon the ild ocburreddue to own negligenceon ical negligence. ion, we find that there is no medical of"the opposite parties and the death ol part of the attendantsof the child who had PGIMER Chandigarhas "LAMA" sdl- J u s t i c eR . S -M a d a n ' Fresicient. Arurounced: 23.11,.2012 Certifiel true caPy { Suneri Slatr C 'L-- Rf,lresl;. 'l tta{./ afl a r' :'r--lrc,itki** t\\ sdlB' [Jl'Bedi JudicialMember
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