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DMC/DC/F.14/Comp.2806/2/2019/ 27th January, 2020

O R D E R

The Delhi Medical Council through its Executive Committee examined a complaint of Shri Pramod Kumar, r/o- C-121, Hanuman Road, New Delhi-110001, alleging medical negligence on the part of Dr. L. Shyam Singh, GHS Maternity & Gynae Hospital, New Delhi, R.K Puram, Sector-V, New Delhi, in the treatment administered to complainant’s wife Smt. Priyanka Kumari.

The Order of the Executive Committee dated 07th January, 2020 is reproduced herein below:-

“The Executive Committee of the Delhi Medical Council examined a complaint of Shri Pramod Kumar, r/o- C-121, Hanuman Road, New Delhi-110001, alleging medical negligence on the part of Dr. L. Shyam Singh, GHS Maternity & Gynae Hospital, New Delhi, R.K Puram, Sector-V, New Delhi, in the treatment administered to complainant’s wife Smt. Priyanka Kumari.

The Executive Committee perused the complaint, written statement of Dr. Shyam Singh Leimapokpam, Consultant Gynae & Obstetric, CGHS, Maternity and Gynae Hospital, copy of medical records of CGHS, Maternity and Gynae Hospital and other documents on record.

It is noted that as per the complaint the complainant’s wife Smt. Priyanka Kumari was in the family way. After confirmation, she reported to CGHS Maternity & Gynae Hospital on 9.5.2019, there Dr. L. Shyam Singh checked her and prescribed some medicines and tests and called her for follow up. For this, she underwent ultrasound in Goyal MRI & Diagnostic Centre on 13.5.2019. In the report it was clearly mentioned that Fetal cardiac activity is not seen and in impression was mentioned that “Single intrauterine gestation of 6w1d (by CRL) duration. Differential diagnosis includes missed abortion and wrong dates”. She again visited Dr. L. Shyam Singh on 16.5.2019 for checking the report, Dr. L. Shyam Singh told her that her baby was well and in development process, there was no tension to worry and advised her to go home town with the medicine as prescribed before and come back after returning with a blood test. On 17.5.2019 she felt some pain in stomach and bleeding but ignored. On 19.5.2019 she left Delhi for home town. In the meanwhile, on 20.5.2019 she began to feel stomach pain and started a lot of bleeding. So she visited a local doctor for check-up; there she was informed that baby was no more after seeing the report of Goyal MRI and suggested her to do get another ultrasound. In the meanwhile, in midnight she felt much pain and a lot of bleeding and visited the doctor. The doctor advised her to visit any clinic for immediately admission and abortion otherwise poison will spread throughout the body which may lead to patient’s death. She was admitted there and aborted. In this regard he had to state there that due to the negligence of Dr. L. Shyam Singh his wife run the risk of death. He requests that stern action be taken against Dr. L. Shyam Singh for negligent behavior.

Dr. L. Shyam Singh in his written statement averred that Smt. Priyanka Kumari 30yrs female w/o Shri Pramod Kumar was examined by Dr. Anupama Prasad on 9.5.2019 at ANC OPD and not by him as stated by her husband. She was advised to get ultrasound done for fetal cardiac activity and other routine blood and urine investigations for antenatal patient. She was advised to attend ANC OPD after 2 weeks/SOS. Her obstetric history: - patient has one live child by LSCS 3 years ago and one MTP done one year ago. She came to ANC on 16.5.2019 to show her investigation reports. On 16.5.2019 when he enquired for any pregnancy related problem, patient said that she did not have any problem. She came to show the investigation reports only which were duly recorded by him in the ANC card along with her reports. Her routine blood and urine investigations were within normal limits. However, TSH & HPLC reports as advised on 9.5.2019 were not available with the patient on 16.5.2019. Her ultrasound report dated 13.5.2019 for cardiac activity showed single fetus of 6 week 1 day (10 weeks period of gestation by her LMP) with CRL 5.1mm. Gestational Sac was regular with fetal pole and yolk sac seen. No gross collection seen. Fetal heart pulsation was not seen at the time of scan (possible diagnosis of missed abortion/wrong date). This ultrasound scan was the first scan in this pregnancy. As the gestational sac was regular with visible fetal node and yolk sac, patient had to be followed up as there was a possibility of wrong dates/delayed conception. On that day patient did not have any complaint, so he told her to take/ continue the same medicine prescribed on 9.5.2019 and follow up in the next ANC OPD/SOS as advised on 09.5.2019. Further, as the patient had pain abdomen and bleeding on 17.5.2019 (as per the statement given by her husband in his complaint) patient should have been brought to the hospital for examination and management in emergency as advised on the prescription dated 9.5.2019 (review after 2 weeks/SOS). CGHS, MGH is functional 24x7 for emergency services. As per the hospital policy for ANC OPD patients, all the treatment papers (prescription/investigation reports) were with the patients. Only antenatal card is kept in this hospital which is re returned to the counter by the staff after the OPD. As per the photocopy of ANC card submitted by patient’s husband, patient’s ANC card was taken out from the counter on 23.5.2019. But the patient has not been examined by any doctor on 23.5.2019. As per her records of treatment in Patna, she was in Patna from 20.5.2019 to 02.6.2019. Since the patient was not in Delhi on 23.5.2019, what was the need to take out the ANC card by her relative/husband on 23.5.2019 (since ANC card is our hospital record)?. Original ANC card is not available in their registration counter at present, so most likely the patient’s relative/husband took the ANC card away on 23.5.2019.

In view of the above, the Executive Committee notes that Smt. Priyanka Kumari G3P1L1A1 reported to CGHS Maternity & Gynae Hospital on 9.5.2019, with early pregnancy. All her routine antenatal investigations were within normal limits. She was advised ultrasound for fetal cardiac activity. Ultrasound dated 13.5.2019 showed single fetus of 6 weeks 1 day, regular fetal pole, yolk sac, and no cardiac activity. The Executive Committee is of the opinion that when patient’s dates do not match with USG findings, it is advisable to wait for one to two weeks specially when gestational sac is regular and yolk sac is present. In this event patient is advised to report to hospital in case of bleeding per veginum or pain abdomen. Management in this patient has been done as per the standard protocol.

In light of the observations made herein-above, it is, therefore, the decision of the Executive Committee that prima-facie no case of medical negligence is made out on the part of Dr. L. Shyam Singh, GHS Maternity & Gynae Hospital, New Delhi, R.K Puram, Sector-V, New Delhi, in the treatment administered to complainant’s wife Smt. Priyanka Kumari.

Complaint stand disposed.”

Sd/: Sd/: Sd/:

(Dr. Arun Kumar Gupta) (Dr. Vinay Aggarwal) (Dr. Ajay Gambhir)

Chairman, Member, Member,

Executive Committee Executive Committee Executive Committee

Sd/: Sd/: (Dr. Satendra Singh) (Dr. Vijay Zutshi) Member Expert Member Executive Committee Executive Committee

The Order of the Executive Committee dated 07th January, 2020 was confirmed by the Delhi Medical Council in its meeting held on 09th January, 2020.

By the Order & in the name of Delhi Medical Council

(Dr. Girish Tyagi)

Secretary

Copy to:-

1) Shri Pramod Kumar, r/o- C-121, Hanuman Road, New Delhi-110001.

2) Dr. L.Shyam Singh through Medical Superintendent, GHS Maternity & Gynae Hospital, New Delhi, R.K. Puram, Sector-V, New Delhi.

3) Dr. Hans Raj Baweja, Consultant, Medical Council of India, Pocket-14, Secctor-08, Dwarka, Phase-1, New Delhi-110077.(w.r.t. No. MCI-211(2) (Gen.)/2019-Ethics./143774 dated 02.09.2019)-for information.

(Dr. Girish Tyagi)

Secretary

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