16 years on, doctors to pay mom 17.5 lakh for not detecting foetal defect

MUMBAI: Holding that doctors are duty-bound to detect any anomaly in a foetus early on, the state consumer disputes redressal commission recently ordered a nursing clinic and its two doctors to pay Rs 17.5 lakh as damages to a woman who gave birth 17 years ago, in 1999, to a baby girl with severe spinal defects. The child, “though of good intelligence, is paralyzed waist down,” thecommission said. Wheelchair-bound, she completed her Class X last year.

The mother had approached the commission in 2000 alleging negligence by her doctors in not detecting the defects, despite conducting over half a dozen sonography tests. The commission, in a judgment delivered 16 years later, set out to compensate her.

“The complainant, Nalini Sule (name changed), was subjected to seven-eight sonographies and yet not diagnosed with any malformation of the foetus. This amounts to gross negligence by doctors… She was constrained to give birth to a crippled child. Certainly, the doctors and clinic are liable to compensate her,” it said .

The nursing home and clinic based in Nashik and a doctor couple attached to it, Drs Pradip Pawar and Suwarna Pawar, were guilty of deficiency in service, held presiding judicial member Usha Thakare and member Dhanraj Khamatkar of the commission.

Dr Pradip Pawar, who had conducted the tests, denied any negligence on his part or of his wife who owns the clinic. He was confident about the accuracy of test reports which showed the foetus as “normal”.

Sule was referred to Dr Pawar in 1998 after five years of marriage and failure to conceive. The baby, she said, was “precious” to her. But “dissatisfied” with the way the doctors handled her case and asked her to get admitted to the hospital twice, she changed her gynaecologist and consulted another doctor, also in Nashik, who advised sonography and neonatal tests in March 1999. “The results of the sonography came as a shock to everyone, including the doctor,” the commission said. It showed the foetus had “meningomyelocoele—a severe congenital malformation.” This was in the 37th week of pregnancy.

On March 16, 1999, a girl child with congenital and incurable defects in both lower limbs was delivered. “Paediatric surgeons operated on the child twice, but except for some relief, major problems of movement, bladder and bowel function persist,” observed the commission after hearing Sule’s authorized representative Dr M S Kamath and the doctors’ advocate S B Prabhavalkar.

Sule’s case was that “sonography is meant to detect and treat foetal malformations at the earliest stages, but this was defeated by negligent attitude.” She sought Rs 17.5 lakh compensation to look after the child.

Dr Kamath cited medical literature to argue that sonography even in the early stages would have 100% accurately detected the defects. The judgment stated though it is incumbent on doctors to give sonography pictures to the patient, they did not.The doctors accused Sule of making “wild allegations” to extract “a handsome ransom”‘ and denied any negligence or lack of skill. “Ultra sonography has its own limitations…,” said Dr Pawar who relied on expert evidence of three doctors. The doctors argued the commission was not the correct forum to hear this complex case of facts and law, in a summary trial. The commission, relying on Supreme Court rulings, held otherwise. It said “the case of the complainant cannot be thrown out only because she has not filed any expert opinion”.

It relied on a verdict to state the court is not bound by expert evidence which to a large extent is advisory in nature. “Dr Pawar faulted in diagnosing the spinal defect of the foetus,” said the commission, which began to hear the case only in 2014.

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