Doctor can’t be held negligent for missing an anomaly caused due to genetical and environmental factors

August 24, 2023

Medical science, despite its constant innovations, is not perfect. The most modern of medicines may not cure, the best of diagnostic tests could miss anomalies. Law accepts this fact and it simply mandates that doctors keep patients well-informed about such shortcomings that may depend from one case to another. 

Irrefutable Facts

The patient conceived after four months of an abortion. She consulted an obstetrician. The doctor confirmed pregnancy.

USG conducted at regular intervals reported the foetus to be normal. The doctor noticed development of placenta previa from Grade-II (posterior and to right) to Grade –III (posterior and to left) from earlier stages from the fifth scan. The said scan was conducted during the 2nd day of the 30th week of pregnancy.

The doctor predicted complications and risks to the baby and mother.

Accordingly, the patient was referred to another hospital for further management. The patient admittedly reported to the other hospital after twenty days, where a repeat obstetric ultrasound scan was conducted. The report revealed absence of placenta previa; the foetus was found to be normal.

Eventually, the patient gave birth to a baby with an absent left forearm.

The patient sued the obstetrician. It was alleged that despite conducting several scans, the doctor intentionally concealed the fact about foetus’ congenital anomaly. She also alleged that the doctor referred her to another hospital for false reason of placenta previa since the same was absent in the USG scan conducted at second hospital.

Doctors’ Plea

Citing medical records, the doctor pointed out that she noted ‘High Risk Pregnancy’ after USG scan performed during 14th week revealed Grade-II placenta previa. The patient was accordingly informed and treatment was advised. Thereafter all reports, including physical examinations, were normal.

The doctor further pointed out that USG performed during 30th week of pregnancy revealed Grade-III placenta previa and accordingly the patient was immediately referred to another hospital for further management to avoid any risk to her or the baby. However, she got admitted after a delay of 20 days and during that period the placenta previa may have disappeared.

Court’s Observations

After careful perusal of medical literature and medical records, the State Consumer Commission accepted obstetrician’s defence.  

The Court observed that USG scan may not reveal anomalies unless they are predominant anomalies and accordingly concluded that “giving birth with anomaly will not amount to medical negligence because the said anomaly was caused only due to genetical and environmental factors.”

The Court further observed that placenta previa may go up at later stages of the pregnancy and hence, rejected patient’s allegation that she was referred to second hospital for false reasons.

Prevention Is Better Than Cure

  1. Courts are aware of the sensitivity and specificity of different investigations and diagnostic procedures. This aspect is taken into account in deciding cases of medical negligence. This case is an excellent example of the aforesaid.  
  2. Take requisite precautions for complications that are anticipated. It is equally important to keep the patient well-informed and well-prepared for the same. This is a textbook case where the correct protocol was followed.

Source : 15MLCD (j58) Beena Rajesh v/s Vivius Hospital Pvt. Ltd. & Ors.

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