Rs 36 lakh awarded as compensation for medical negligence

March 22, 2019
Dr KK Aggarwal & Advocate Ira Gupta,
healthysoch
New Delhi, March 22,  2019 :
Is it always negligent to miss a significant fetal anomaly on a routine ultrasound scan at 20 weeks?

Consumer Commission Order

Judges: Retired Justice Sunil Hali and retired District and Sessions Judge DK Kapoor

Complainants: Seema Kumari and her husband Atish Kumar

Allegations

Dr KC Sharma and his wife Dr Uma Sharma were running an ultrasound scanning centre and nursing home at Udhampur “without adequate qualification, expertise and recognition from Medical Council of India”.

Missed

Hydrocephalous; it could have been detected earlier, if the sonographers/sonologists were experienced and suitably qualified.

Expert’s opinion

Dr Manisha Langer, a qualified radiologist, told the commission that myelomeningocele can be detected by ultrasound within 15 to 16 weeks of pregnancy. The detection rate improves after 24 to 25 weeks.

Result of missed diagnosis

The pregnancy could not be terminated

Compensation awarded

Rs 20 lakh compensation to the couple for medical treatment; out of this, Rs 15 lakh to be kept in a fixed deposit for the child.  Rs 15 lakh was awarded as compensation on account of pain and suffering undergone by the parents, and Rs 1 lakh as litigation charges.

Discussion

Sonographic diagnosis of open spina bifida typically occurs during the second trimester of the pregnancy.

Modern ultrasound equipment is undoubtedly capable of producing images that allow diagnosis of anomalies such as open lumbosacral spina bifida or atrioventricular septal defect. However, such diagnoses can only be made if considerable operator skill is combined with knowledge and experience.

In most cases the diagnosis of clinically significant fetal anomalies is quite straightforward, but evidence suggests that false-negative results occur regularly.

For example, European Surveillance of Congenital Anomalies (EUROCAT) (Ultrasound Obstet Gynecol. 2005;25:6-11) quotes a prenatal detection rate for spina bifida of only 68%, whilst a recent systematic review (Health Technol Assess. 2000;4:1-193) reports a detection rate for AV septal defect of just 42%. So, 32% doctors can miss the diagnosis at 20 weeks.

Was missing the diagnosis negligence?

Is it always negligent to miss a small open lumbosacral spina bifida (below L3) at a routine 20-week scan without extenuating circumstances (obesity, oligohydramnios)?

  • About 62% of experts state that it is not negligent to miss such a lesion.
  • 24% say it is not negligent to miss a small spina bifida provided there is documented evidence of normal intracranial anatomy (absence of head signs).
  • Only 4/29 experts will say that such an anomaly should always be detected.

www.healthysoch.com

Was termination the choice if the diagnosis would have been done before 20 weeks?

No. Spina bifida is a manageable condition. It is not an indication of termination by itself. Higher lesion level, larger segment span and an inter-pediculate distance greater than 10 mm are associated with poor recovery.

What was the cause?

Probably folic acid not taken by the mother before the conception

Legal points

  • Doctors should take informed consent from the patient that ultrasound can miss the diagnosis.
  • Was she and if not, why was she not given folic acid?
  • If she was not on folic acid, then why was the ultrasonologist not alerted to specifically look for spina bifida?
  • One expert cannot be relied upon, if other experts or opinion say it otherwise.

 Answer: This judgment should be challenged

The author of this article is Dr KK Aggarwal :

Padma Shri Awardee, President Heart Care Foundation of India , Past National President IMA

healthy soch

Stay informed with the latest news from HealthySoch. Sign up today for exclusive insights and updates!

We promise we never spam!

Leave a Reply

Your email address will not be published.

Health Tips

Dr. T S Kler Padma Bhushan Awardee
MD, DM, MRCP, FRCP(U.K), FACC, D.Sc
Chairman – Fortis Heart Institute Gurugram

Precautions to avoid Corona Virus:

  1. Stay home as far as possible.
  2. Wash hands with soap and water frequently.
  3. Keep distance from people even your home members.
  4. Keep atleast 1-2 metres away from anybody coughing.
  5. Don’t touch your face, nose and mouth.

 

Dr. K.K Says

Archives

MonTueWedThuFriSatSun
    123
45678910
18192021222324
25262728293031
       
   1234
567891011
12131415161718
26272829   
       
891011121314
293031    
       
    123
45678910
11121314151617
25262728293031
       
  12345
6789101112
13141516171819
27282930   
       
      1
2345678
9101112131415
16171819202122
3031     
     12
17181920212223
24252627282930
31      
   1234
567891011
12131415161718
2627282930  
       
1234567
891011121314
22232425262728
293031    
       
     12
3456789
17181920212223
24252627282930
       
  12345
6789101112
       
  12345
13141516171819
2728     
       
      1
9101112131415
3031     
   1234
567891011
       
282930    
       
    123
45678910
       
  12345
27282930   
       
      1
3031     
    123
11121314151617
       
28      
       
2930     
       
    123
       
       
       
      1
9101112131415
3031     
     12
3456789
10111213141516
17181920212223
242526272829 
       
  12345
13141516171819
2728293031  
       
      1
23242526272829
3031     
    123
       
    123
25262728   
       
78910111213
28293031   
       
293031    
       
14151617181920
28293031   
       
   1234
567891011
       
   1234
567891011
262728    
       
891011121314
293031    
       
    123
18192021222324
25262728293031
       
  12345
27282930   
       
      1
2345678
16171819202122
3031     
    123
45678910
18192021222324
       
28293031   
       
     12
31      
   1234
       
  12345
6789101112
       
HealthySoch

Don't Miss

Kerala youth donates his blood stem cells to save life of a blood cancer patient

Bengaluru-based DKMSBMST Foundation India helped find the match from its

Precautions to observe while going back to work amidst lockdown 4.0

Dr MS Kanwar, Senior Consultant, Department of Pulmonary, Critical Care