Neerja Singh, Member:

1. The facts of the case, as portrayed by the appellants, are that appellant No. 1-Dr. B.R. Bansal, who himself is a doctor, and his wife (hereinafter referred to as the deceased), who was pregnant, consulted Respondent No. 2, Dr. Jayashree Sridhar, at Arihant Hospital & Research Centre. On 22.7.2003, the deceased suffered from bleeding per vagina and was admitted at the Arihant Hospital & Research Centre till 27.7.2003. She was discharged when her condition improved. However on 19.8.2003, when she was 33 weeks pregnant, she again suffered from bleeding. Dr. Bansal was not informed of the gravity of the situation. Dr Jayashree Sridhar admitted her in the hospital, and along with Dr. Manish Khasgiwala, M.S, and an anaesthetist, Dr. Prakash Dhudia, commenced surgery, even though the hospital did not have the latest technologies, nor was there any arrangement for blood. The brother-in-law of the deceased made arrangements for blood from Verma Union Hospital, 600 ml of blood had drained from the urinary bladder. Four other doctors were called at the fag end of the operation, which was performed negligently as a result of which she died the same night at 11.45 p.m. Dr. Bansal alleges that had he been informed of the seriousness of the situation he would have shifted the deceased to another well-equipped hospital and hired services of other specialists to save his wife's life. Due to the negligent operation, she died as a result of excessive bleeding for which respondents 1, 2, 3 and 7 are primarily responsible. He further states that the principle of res ipsa loquitur is applicable to the facts and circumstances of the case.

2. Respondents 1, 2 and 3 in that their joint reply state that the case of Dr. Bansal's wife was complicated. She had conceived 4 times previously and had the pregnancies terminated. Her uterus had become weak. She was kept at the hospital from 22.7.2003 to 27.7.2003 for bleeding per vagina, and was discharged with strict instructions to take complete bed rest and hospitalisation. Obviously, she did not heed this advice and had to be admitted again for bleeding on 19.8.2003, when she was 33 weeks pregnant. When she was brought to the hospital, she was bleeding, her haemoglobin had come down to 3.1% and her BP was 80/60. She was in a state of shock. She was diagnosed to be having bleeding due to placenta percreta, in which the placenta pierces the uterus wall and enters the urinary bladder, which was causing the loss of blood. It was explained to Dr. Bansal that she was a high risk patient and that to stop the blood flow a hysterectomy was necessary, for which Dr. Bansal gave permission. Being a doctor, he was also present in the operation theatre during the surgery. The operation was done by giving a vertical incision on the upper uterine segment, and the pre mature baby was handed over to the paediatrician. The uterus was also removed. As the condition of the deceased was very critical, a decision was taken to call 4 other specialists after consulting appellant No. 1. To save the life of the deceased, Ringer lactate and haemacael, 2 units, were administered and the blood bank was immediately informed of requirement and blood bottles were made available. There was sufficient blood arranged prior to the surgery. 8 pints of blood and 2 units of fresh plasma were given. As the bleeding did not still stop, the internal iliac artery was also ligated. Despite their best efforts, the bleeding did not stop and the patient went into DIC resulting in her death. The uterus with placenta was sent for histo-pathology and it was opined that the deceased had placenta percreta. The appellant No. 1 refused to have the post-mortem done.

3. The remaining respondents state that Dr. Bansal called them. As he is a doctor, they came to help out of courtesy and goodwill. No consideration was given to them. There was no negligence in the treatment. The excessive blood loss was due to placenta percreta.

4. We have heard the arguments of the learned Counsel for the parties and perused the documents filed on record.

5. The allegations made by Dr. Bansal are two-fold. First, he states that had he been informed of the seriousness of the situation, he would have obtained better medical care and facilities for the deceased. Secondly, he alleges that blood was not arranged by the hospital in time.

6. The medical papers, which have been filed on record, show that at the time of admission the deceased was having excessive bleeding and her haemoglobin, which was 10gm% on 27.7.2003 as per discharge card, had come down to 3.1gm%. She was in a state of shock. The diagnosis was `Placenta Praveia c ? Placenta Percreta c massive haemorrhage'. As she was bleeding profusely, she was taken for an emergency caesarean. That Dr. Bansal was not informed of the gravity is difficult to believe. Being a doctor himself he must have been aware that she was in a very serious condition. He had brought her to the hospital in a critical state. He was also aware of the facilities provided by the hospital as the deceased had earlier been admitted there for a week. He could have opted for another hospital, if he was not satisfied with the facilities or the competence of the doctors.

7. It is true that the hospital did not have a blood bank but they had an arrangement for supply of blood from the blood bank of Verma Union Hospital. The record of the Operation Theatre, Doctors order sheet and the blood bank report are all evidence of the fact that within two hours, 8 pints of blood and 2 units fresh plasma were administered to the deceased. Verma Union Hospital Blood Bank have also given a certificate stating that 12 units of blood were issued without any delay between 8 p.m. and 10.45 p.m. Dr. Bansal has also not filed any expert opinion to show that insufficient supply of blood resulted in the death of the deceased or that there was any delay in providing blood.

8. The deceased suffered from a problem of the placenta, which caused excessive bleeding. An emergency c

aesarean section was done. As the bleeding did not stop, the caesarean section was followed by a hysterectomy, as is the standard medical procedure. Pregnancy at Risk 3rd ed. Usha Krishna, D.K. Tank, S. Daftary Pg 7: "Obstetric hysterectomy-In cases of otherwise intractable obstetric haemorrhage emergency hysterectomy may be a life saving procedure." 9. The appellants have not been able to show that the method of treatment was not in accordance with the standard procedure or that there was any negligence on the part of the respondents. 10. In the result, the appeal fails and is dismissed. No order as to costs. Appeal dismissed.