Madras High Court Orders 5 Lac Compensation To Man Who Lost Wife Due To Non-Availability Of Ambulance At Health Centre

A Single Bench of Justice N. Anand Venkatesh held that while there was no negligence in treatment given to the Petitioner's wife at the PHC, but the delay in shifting her to the Medical College concerned, proved to be fatal, resulting in her death.

"There was a delay in shifting the deceased from the Primary Health Centre to the Medical College, Asaripallam. When it comes to saving a life, every second count and delay by even a few minutes can cause the death of a person. Therefore, when it comes to medical emergencies, delay can never be condoned like how leniently we condone in Courts" the Court observed.

It added,

"Every Primary Health Centre is supposed to have an ambulance readily available to shift patients in case of emergency. It is an admitted case that the Primary Health Centre was regularly dealing with delivery cases and they have to expect an emergency at any time, and they cannot afford to run a Centre without an ambulance."

Background

The petitioner's wife was admitted for delivery in the Primary Health Center (PHC). After she gave birth to a female child, she suffered from excessive bleeding. The PHC, while treating her, found the need for blood transfusion and recommended shifting her to Medical College, Asaripallam. As there was no ambulance available at the PHC, the nurse had to call a 108 ambulance which took 30 minutes to reach the PHC, and the deceased wife could finally reach the Medical College after 1hour 15minutes, where she was declared as dead. As per the medical records, the cause of death was 'postpartum hemorrhage.'

The petitioner's case was that he lost his life due to the non-availability of an ambulance and delay in reaching the Medical College.

The District Medical Officer, Medical and Rural Health Service, Kanyakumari, and the duty surgeon denied the allegations of not providing medical help. Their submission was that the duty Doctor and Nurse jointly referred the patient to the Medical College and called for a 108 ambulance, which arrived immediately.

Concerning the availability of an ambulance at PHC, the counter-affidavits stated that a 108 ambulance is not available in Primary Health Centre. It only has a Hospital on Wheels Vehicle Van, which functions only in the daytime to cater to the medical needs of people living in remote areas.

Findings

The Court highlighted the respondents' submissions that 4 to 6% of the cases can encounter postpartum hemorrhage during delivery and that it is a common cause for maternal deaths after delivery in India.

"It is clear from the above that the condition that was suffered by the petitioner's wife is not uncommon and unfortunately the wife of the petitioner falls under the category of 4 to 6 percent cases, who undergo such Complications", the Court held.

However, it clarified that the woman's death could not be attributed to negligence on the part of the doctor attending her, as he administered necessary drugs as a first aid and attempts were made to bring the situation under control.

The Court proceeded to hold that there was definitely a delay in shifting the petitioner's wife from the Primary Health Centre to the Medical College, which ultimately proved to be fatal resulting in her death. Here, the Court revisited the concept of the golden hour as given by R. Adams Cowley, meaning the time between life and death.

To emphasize the need for an ambulance at a PHC, the Court also relied on the case of PB Khet Mazdoor Samity v. State of West Bengal AIR 1996 SC 2426, where the Supreme Court gave 7-point recommendations regarding proper medical facilities for dealing with emergency cases. It included adequate facilities at PHC, upgrading hospitals at district and sub-district level to treat serious cases and specialist treatment, centralized communication system to track the availability of beds, proper arrangement of the adequately equipped ambulance.

Finally, it ordered the State Government to compensate the Petitioner to the tune of Rs. 5,00,000/, from a Corpus Fund created vide GO dated 04.09.2018 for the said purpose.

Case Title: T. Rajagopala v. State of Tamil Nadu & Ors.

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