The patient was due to deliver, but her blood pressure was fluctuating. The doctors decided to perform emergency LSCS, a healthy girl was delivered.
Although the mother’s condition remained unstable, she was discharged after about two days. Unfortunately, she was readmitted with complains of breathlessness. Strangely, she was discharged within half an hour.
The patient was taken to another hospital where she succumbed to complications. The cause of her death was congestive cardiac failure.
Her family sued the hospital and its doctors. They submitted in defence that patient showed signs of mild pre-eclampsia, and not severe pre-eclampsia. Her BP was varying, shot up on the first post-operative day, and she was stabilized with anti-hypertensive drugs. The patient was discharged as she was conducting all activities normally, she was discharged in a good condition.
The patient’s husband argued that the doctors wrongly described his wife’s case as mild pre-eclampsia, despite the fact that she was suffering from severe pre-eclampsia. They did not perform investigations to ascertain whether or not patient suffered pre-eclampsia.
He further argued that, as per ACOG guidelines, a pre-eclampsia patient has to be kept hospitalised under observation for seventy-two hours, whereas, the doctors discharged the patient after fifty hours. The patient was rushed to the hospital after discharge with complain of breathlessness. The doctors wrongly diagnosed it as asthma. They failed to diagnose pulmonary edema or congestive cardiac failure.
The Commission perused medical records, and agreed with patient’s husband.
“Medical records clearly establishes that there was high blood pressure prior to delivery as the feature of pre-eclampsia. The termination of pregnancy should have been done at thirty-seven weeks, but in the instant case, though the patient was under regular ANC follow-up of doctors the delivery was delayed beyond thirty-eight weeks despite uncontrolled hypertension. It is pertinent to note that despite two anti-hypertensive medicines, the patient had hypertension which was indication of severe pre-eclampsia.”
“On further perusal of records, it is revealed that before C-section, the treating doctors failed to conduct necessary investigations to diagnose pre-eclampsia. It is pertinent to note that the patient was discharged within short time of fifty hours after C-section. As per current norms, the hospital stay is required for up to forty-eight hours following uncomplicated vaginal delivery, and up to ninety-six hours for uncomplicated caesarean delivery. Thus, in my view, it was wrong decision to discharge the patient within such short time. As per the latest ACOG guidelines, for woman in whom gestational hypertension, pre-eclampsia or super imposed pre-eclampsia is suspected, the BP should be monitored in the hospital or in the OPD at least seventy-two hours post-partum”.
The doctors and hospital were held negligent for not following the established guidelines.
Source : Order pronounced by National Consumer Disputes Redressal Commission on 16th June, 2023.