Over the years, I have had this conversation with my girl friends, my sister, my mother and my aunt's. We have debated at length the benefits of a Cesarean versus a normal delivery concluding that most of the time a Cesarean is more of a commercial call than a health related call. This is so, because hospitals make more money in a surgery as opposed to a normal delivery. The post-birth care of the mother after a surgery adds to the revenue of the hospital. There have been times of course, where surgery was the only way forward - that's in cases where the baby's position has changed completely or is reversed (that is head down). But, honestly - these discussions have never ended with a firm answer of how to decide the best way forward? Another, more critical question is - Who's call should it be? Is the parents, the father, the mother, family member or all of them collectively OR only the gynaecologists? Yet again, can the gynaecologist tell with certainty? Will opinions not vary? If they do, should the gynacologists be involved at all in the decision making.
The recent decision of the Bombay Consumer Dispute Redressal Forum has probably attempted to resolve the issue, but to my understanding only complicated things. The court in my opinion, while granting the appropriate remedy pinned the causation to be the use of normal delivery over a cesarean, which is grossly incorrect. The Consumer Disputes Redressal Forum has fined two gynaecologists to pay Rs 10 lakh towards compensation and Rs 1.25 lakh towards medical expenses and Rs 1.90 lakh towards mental agony and harassment to a couple whose baby was rendered disabled due to the negligence caused by the doctors before and after the baby was born.
The facts are as follows:- The said case involved a lady who visited the first gynaecologists during the 7th month of her pregnancy. She was informed that the head of the baby is on the upper side, which would require the nurses to use a vacuum to extract forcibly the baby out forcibly. The new born was unable to cry and the doctor decided to keep her in a ventilator. It was found that the oxygen cylinder supplied to the baby in the incubator was empty. The cylinder was replaced after 30 minutes, until then the baby was gasping for breath and landed in a dangerous condition. It is this process, it was established that the brain of the baby got damaged. The couple then shifted her to another nursing home in the evening. The baby got serious during the nights on two occasions. The oxygen was supplied for 10 days and on 11th day the baby started breathing naturally. Thereafter, the baby was put through several tests and it was concluded that the brain of the child was heavily damaged. As time passed, there was no significant growth of the baby, she was unable to take milk, water and medicines and was not gaining body weight. After having put the baby to additional tests it was declared that she was having Delayed Milestone and Cerebral Palsy rendering her as a disabled child. She was suffering from physical as well as mental retardation and her vision was impaired. The couple believed that if a cesarean operation was done for the delivery, the baby would have been delivered on time and all the complications would not have arisen.
The president, M Y Mankar, of the The Consumer Disputes Redressal Forum called upon to determine the liability of both the doctors under whose observation the baby was kept. The forum directed the doctors to pay the said amount for the vegetative life of the baby girl.
In the given events, I believe that it was not the vacuum that caused the damage to the baby but was the lack of oxygen that led to the vegetative state. Like we know, this area of law is the most grey among others, I fail to pin in black and white - the right and wrong in the foregoing events.
