Can a baby born prematurely be called a foetus? Can a hospital rule out "medical negligence” when a premature baby showing “signs of life” is declared dead? Do doctors in India lack empathy in cases of premature deliveries?
The recent case of a premature baby being found alive after Safdarjung Hospital declared it dead raises some of these questions – and more.
On 12 June, Rohit Kumar Tandon took his six-month pregnant wife Shanti Devi to Safdarjung Hospital in New Delhi, after she complained of pain and bleeding. On examining Devi, the doctor on call said that she required two litres of blood, and admitted her to the hospital. What followed, according to the family, was the doctors in Safdarjung Hospital washing their hands off Devi’s ‘case’.
Five days later, Devi, still admitted, complained of “intense pain”. She thought she was going into labour, but the doctor allegedly dismissed her and told her “not to lie about pain that did not exist”.
On 18 June, Devi gave birth to a premature baby – a boy weighing 440 grams. While the hospital claims that the newborn was 20 weeks old, Tandon claims that his wife was pregnant for six months – or 26 weeks.
The newborn was declared dead on delivery by the hospital staff. The hospital personnel wrapped the baby in a polythene bag, labelled it, and handed it over to the father.
They rushed the baby to Apollo Hospital in south Delhi, where the doctors confirmed that the newborn was alive. The baby was then taken back to Safdarjung Hospital, as the parents, both daily wage labourers, could not afford private medical care.
Dr AK Rai, the medical superintendent at Safdarjung, constituted an inquiry committee, including heads of the gynaecology and the paediatrics departments, to probe into the incident.
On 21 June, the committee ruled out “medical negligence” in the case.
The child’s family has rejected the hospital’s stance.
“If we had not opened the sealed polythene cover, I would have never known that my son was alive and breathing,” says Rohit Tandon, the child’s father.
With the hospital authorities accepting that the premature baby showed signs of life when being admitted again, calling it an abortion and not a delivery raises a number of alarming legal and medical questions.
While Safdarjung Hospital’s inquiry committee insists that there isn’t medical negligence as per the MTP Act, it might not be relevant to the case, The Quint’s legal correspondent Vakasha Sachdev points out.
The duty of care for doctors is higher as professionals, and not adhering to standard medical practice would be negligence.
It the responsibility of the doctors to assess properly whether the child is alive or not, says Dr Satish Saluja, who has been practising neonatal care for 30 years.
According to the WHO’s definition of Preterm births, Tandon and Devi’s newborn is an ‘Extreme Preterm’ baby – born alive before 28 weeks of pregnancy are completed.
According to Born Too Soon: The Global Action Report on Preterm Birth, ‘Extreme Preterm’ babies require intensive care to have a chance at life.
Preterm birth is the second leading cause of deaths in infants in India, preceded only by pneumonia.
However, Dr Saluja says India has come a long way in reducing the number of these deaths. “In the 80s, babies that were born before 30 weeks of gestation in India always died. Now, there is a strong rate of survival of those newborns that are at least 26 weeks old. It is those delivers that are born with less than 26 weeks of gestation that have minimal chances of survival. India has come a long way but,” Dr Saluja says.
“While medically nothing might be possible, doctors should try and show empathy, and look at patients as people, beyond being a ‘case’,” says Dr Priya Shanker, a practising gynecologist at a leading private hospital in Delhi.
“Doctors need to be competent enough to judge whether there are any chances of saving a life,” says Dr Sumit Ray, specialist of internal medicine at Sir Ganga Ram Hospital.
Tandon, the child’s father, says that while he wants to take the hospital to court, he does not have the finances to do so. “Poor people like us cannot afford private medical care,” he says, as he raises two important questions:
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