The detection of foetal anomalies is an essential aspect of prenatal care to ensure the health and well-being of both the mother and baby.
In a case of severe medical negligence, the Kerala State Consumer Disputes Redressal Commission has mandated St. Luke Hospital in Pathanamthitta, along with two gynaecologists, to provide Rs 50 lakh in compensation to a child and their parents. (Creative Commons)
The detection of foetal anomalies — structural, genetic, or functional abnormalities that can affect a developing foetus during pregnancy — is an essential aspect of prenatal care to ensure the health and well-being of both the mother and baby.
This is usually done by the doctors before 20 weeks of gestation so that if there is any abnormality, the foetus can be terminated.
However, what happens when doctors fails in their duties?
In a case of severe medical negligence, the Kerala State Consumer Disputes Redressal Commission has mandated St Luke Hospital in Pathanamthitta, the district headquarters, along with two gynaecologists, to provide ₹50 lakh in compensation to a child and their parents. This negligence led to the child being born without lower limbs.
The commission has further ruled that the compensation was valid from the date of filing the complaint, March 2015, with an 8 percent interest rate applied, resulting in a total compensation of ₹82 lakh to be paid by the hospital.
Reshmi Das, who had been living abroad, relocated to Thiruvananthapuram during her pregnancy. Later, she shifted to her parental home in Pathanamthitta and sought medical care at the St Luke Hospital.
Throughout her pregnancy, she underwent multiple ultrasound scans, particularly after the fourth month of gestation.
During these scans, medical professionals from the hospital assured her that she was carrying a healthy baby, with the expected due date set for January 2015.
However, two weeks before the anticipated delivery date, Reshmi was admitted to the hospital and delivered a male child via a caesarean section.
To her dismay, the baby was born without lower limbs and hips. The birth of a child with such severe physical anomalies had a profound and distressing impact on Reshmi Das and her family.
“Dr Kenny A Thomas had conducted the ultrasound scan, but no hint of such a disaster was brought out through the scanning. Anomaly scan, which ought to have been done during the fourth/fifth months, was not done properly,” said Reshmi Das and her husband in their complaint.
“If a proper anomaly scan was done as stipulated, any abnormality, including congenital diseases to the foetus, could have been detected and if the scanning at the 4th month was properly carried out I could have taken precautionary measures,” their complaint added.
They further emphasised that the doctors’ negligence had led them to become parents to a child with severe disabilities, rendering the child incapable of movement, and significantly diminishing their quality of life, causing immense misery.
The child is currently receiving treatment, and it has become necessary to attach artificial limbs to the baby’s body.
In their defence, the hospital and the doctors argued that while ultrasound scans are valuable diagnostic tools, they are not infallible, and the detection of anomalies may be hindered by various factors.
They contended that the gynaecologist had conducted ultrasound scans diligently and without negligence, asserting that the limitations of ultrasound technology must be taken into account.
They explained that ultrasound generates a two-dimensional image of a three-dimensional foetus, and as such, it could not provide a 100 percent accurate depiction of the foetus during prenatal testing. The accuracy of ultrasound results depends on factors such as the foetal position and the volume of amniotic fluid.
If amniotic fluid is insufficient or foetal movement is restricted, the sensitivity of ultrasound diagnosis for foetal anomalies may be compromised. In this case, the hospital did not notice any indications of abnormalities during the scanning process.
The hospital and doctors maintained that the non-detection of congenital anomalies, specifically bilateral lower limb deficiency, during the scanning process was not due to any fault or failure on their part, as ultrasound imaging was not a foolproof method and could not be relied upon as conclusively accurate.
They further argued that the scans were conducted in line with standard protocols, and detailed anomaly scanning was typically recommended when there were indications or suspicions of abnormalities.
The gynaecologist was noted to possess qualifications in MD and DGO with 32 years of experience in gynaecology and ultrasound scanning since 1992, while Dr Preetha Biju, held MBBS and DGO qualifications with 10 years of experience as a consultant gynaecologist.
The hospital itself was recognised for its specialist doctors, experienced medical staff, modern facilities, and reputation for infertility treatment.
The commission determined that the standard anomaly scan, critical for identifying foetal abnormalities, was not performed as required and raised two potential scenarios, one suggesting that the reports were issued without actual examination, and the other pointing to carelessness on the part of the second opposite party (the gynaecologist).
The commission relied on the expert opinion of the Head of the Department of Radio Diagnosis at Thiruvananthapuram Government Medical College Hospital, emphasising that anomalies could effectively be assessed during the 18th-week anomaly scan.
The expert clarified that disabilities, if present, could be ascertained at this stage, and the doctor performing the scan should report any anomalies, enabling parents to make decisions regarding the pregnancy.
“While fixing the quantum of compensation the commission has to consider various aspects since a duty is cast upon us to compensate the victim through a monetary award. Compensation is a must for non-economic damages such as pain and suffering and also loss of enjoyment of life. If the abnormality that occurred to the foetus was brought to the notice of the complainants before 20 weeks of gestation they could have terminated the pregnancy and saved themselves and their baby from the misery,” said the commission in its judgement.
“The intensity of the trauma now being faced by the complainants cannot be assessed at this stage as the child has now reached only a tender age. As the child grows up so many complications would arise. Survival of a child without both lower limbs and hip might be very difficult and he may need artificial legs. It is not possible at this stage to assess the actual compensation to meet his requirements,” it added.
The commission has ruled that the hospital and its two doctors are jointly and severally liable to pay compensation totalling ₹50 lakh.
According to the commission, this amount is to be divided as follows: ₹30 lakh for the minor child and ₹20 lakh for the parents. The hospital is instructed to pay this sum along with an 8 percent annual interest rate, calculated from the date of filing the complaint, which is 17 March, 2015.
Furthermore, the hospital and doctors were directed to deposit the sum of ₹30 lakh in a nationalised bank in the name of the minor child, to be held until the child reaches the age of majority. The complainants are permitted to access the interest accrued on this amount for the daily needs of the minor.
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