₹10 lakh penalty on nursing home for not reporting unborn child’s disability

BHUBANESWAR: A district consumer court in Odisha’s Jagatsinghpur district has asked a nursing home to pay ₹10 lakh as compensation to a couple for failing to give a correct picture of their child’s physical deformities during pregnancy despite three ultrasonography tests on the woman in different trimesters.

The Jagatsinghpur district consumer disputes redressal forum, in its order on Wednesday, asked the nursing home owned by radiologist Pratap Keshari Das and her wife Lipsa Das to make a fixed deposit of ₹10 lakh in the name of the child – born without a left leg and a right hand– in a bank account till he attains the age of 26. The nursing home owners were also asked to pay ₹50,000 to the woman for her mental agony and ₹4,000 towards the cost of litigation.

“Had the woman been informed about the disability of foetus then she could have aborted the foetus. It is because of good faith of the woman on the nursing home and their reports that she did not terminate the pregnancy and gave birth to a physical handicapped male child. The radiologist who conducted the ultrasound and issued reports without pointing out the deformity in the foetus not once but thrice could have pointed out. Giving wrong reports amounts to gross deficiency,” the consumer court said in its order, noting that “deformity cannot be compensated in shape of money”.

The radiologist was asked to deposit the amount within 45 days from the date of receipt of the order, failing which they would be slapped with an interest of 8% per annum on ₹10 lakh.

The Medical Termination of Pregnancy Act, 1971, permits termination of pregnancy up to 24 weeks if there is a substantial risk that, if the child were born, it would suffer from serious physi- cal or mental abnormality. A woman can also abort the child if the continuance of the pregnancy involves a risk to the life of the pregnant woman or of grave injury to her physical or mental health. The termination of pregnancy up to 24 weeks requires the opinion of at least two registered medical practitioners.

The 24-year-old woman and her husband were overjoyed after she conceived their first child in December 2020. Following the advice of a gynaecologist at a community health centre in Patakura area of Jagatsinghpur, she went for the routine ultrasound tests.

Between December 2020 and September 2021, when she delivered the child, the woman underwent three ultrasound tests at the L&P nursing home in Rahama area of Jagatsinghpur on the seventh week of her pregnancy (first trimester), 19th week (second trimester) and 33rd week (third trimester). But the test reports did not reveal anything out of the ordinary.

“Real time obstetric sonography reveals - single life intrauterine pregnancy. Adequate amount of amniotic fluid present, Foetal body and limb movements appear normal. Normal cardiac activity is seen. Placenta is fundopost in location-with grade 1 maturity. A single live foetus with vertex Presentation is seen,” said the second ultrasound report

A woman is allowed to terminate her pregnancy under the Medical Termination of Pregnancy Act, 1971

If there is a substantial risk that, if the child were born, it would suffer from serious physical or mental abnormality

If the continuance of the pregnancy involves a risk to the life of the pregnant woman or of grave injury to her physical or mental health

The termination of pregnancy up to 24 weeks requires the opinion

of at least two registered medical practitioners.

issued in April 2021.

However, to the couple’s dismay, their child was born with physical abnormalities. “After speaking to the gynaecologist who advised us to go for ultrasound tests, we went to the chief district medical officer of Jagstsinghpur and aired our grievance. The CDMO told us that had the disability been detected at an early stage, the placenta could have been removed,” the husband said.

Aggrieved over the ultrasound report, the child’s father met the radiologist, who allegedly threatened him with dire consequences. The husband is unemployed, and lives with his three brothers at his parental home.

In October last year, the woman moved the Jagatsinghpur district consumer disputes redressal forum, seeking ₹20 lakh as compensation from the nursing home owner, alleging faulty ultrasound tests. Though the nursing home owners were summoned by the consumer forum, they did not appear even once.

Dr Mrutyunjay Mohapatra, a

leading gynaecologist in Odisha based out of Bhubaneswar, said between 18-20 weeks of a woman’s pregnancy, deformity in limbs or any organs such as the kidney can be detected if a specific scan called anomaly scan is done. “As per the MTP Act, foetus can be aborted upto 24 weeks, and so in this case, the woman should have been asked to abort,” said Dr Mohapatra.

The radiologist, who had conducted the ultrasound tests, said he had not done any anomaly scan on her during the second trimester as there was no such prescription. The woman, however, said that she had given the radiologist the prescription she was given by the gynaecologist. “It is for the doctors to decide. All I know is that I have been a victim of medical negligence,” she said.

According to several radiologists HT spoke to for perspective, a level 1 scan done during the first trimester of pregnancy is normally meant to check for foetus viability; even if there is a gross deformity, it can be picked up. A level 2 scan, or the anomaly scan, that is done closer to 20 weeks is a more detailed scan done precisely to pick up congenital defects. It is a detailed test where all kinds of anomalies are scanned for, and where,if gross physical defects are missed, there is possible liability. It can take up to 30 minutes to perform the scan. The scan in the third trimester should also pick up severe defects.

A radiologist at AIIMS Bhubaneswar said that as the health systems are not codified in India, and since each pregnant woman does not have to undergo such tests regardless of the advice, such issues are often seen. “It depends on the quality of the machine, the expertise of the radiologist and the rigour that they follow. If one is not observant, the deformities can be missed, ” said the radiologist.

Pramil Swain, activist and general secretary of the National Alliance of Women, said that such abnormalities going undetected can often have dangerous consequences. “Deformed babies have always been more vulnerable to infanticide,” Swain said.

Kirtirekha Mohapatra, head of the department of gynaecology and obstetrics at the SCB Medical College and Hospital in Cuttack, one of Odisha’s biggest government hospitals, also said that cases like these were not uncommon, particularly in semi-urban and rural areas

“An anomaly scan costs at least ₹3,000 and the radiologist will need at least an hour to conduct the scan on just one person. There are many who cannot afford this much and may not think it’s important. Also, in more remote areas, it does not always happen that a radiologist spend that much time on a single patient. They also need special training to detect such anomalies,” said Mohapatra.