Sakina Tashrifwala
Published on: November 04, 2022 at 20:29 IST
In a significant judgment, the Orissa High Court ordered the State Government to form a board of medical experts to advise it on creating a “Comprehensive Action Plan” to address the problem of maternal deaths.
Additionally, it has mandated that the government develop a plan or policy to address the need for reparations, including the payment of damages for each preventable maternal death and the assignment of blame in a time-bound manner.
When ruling on the matter involving the death of a tribal woman who passed away in 2015 during delivery, a division bench composed of Chief Justice Dr. S. Muralidhar and Justice Murahari Sri Raman issued the aforementioned instructions.
“As the EC noted, there has been a grave failure on the part of the whole teams of doctors at every level of the Odisha healthcare system to give the deceased with prompt and appropriate care and treatment.”
“The fact that a poor tribal woman had been carrying a dead foetus for a week previous to dying and that not a single member in the medical community was able to give her the care and attention she required—neglect that inevitably led to her death—shocks the judicial conscience.”
“The deceased’s fundamental right to health, which is a crucial component of the right to life protected by Article 21 of the Indian Constitution, has been flagrantly violated,” the Bench noted this.
Father-in-law of the wife, who on March 25, 2015, not only lost her kid due to intrauterine death, but also passed away while undergoing treatment, filed a petition.
According to the petitioner, both the woman’s and the baby’s deaths were preventable and attributable to medical malpractice.
The pleadings in the petition revealed disputed factual issues, with the opposing parties arguing that there was no medical negligence, according to a Division Bench composed of Chief Justice Dr. S. Muralidhar and Justice Radha Krishna Pattanaik, which made this observation in May 2022.
Additionally, it appeared that the opposing parties looked into the mother in question’s maternal death.
Therefore, the Court asked the Odisha State Commission for Women (‘OSCW’) to help it with the work and had issued a number of directives in order to acquire an unbiased appraisal of the materials on record.
As a result, on July 8, 2022, the OSCW’s Enquiry Committee (the “EC”) delivered its report to the Court.
Notes from the Court:
The Bench took note of the EC’s conclusions, which included, among other things, the discovery of extreme carelessness on the part of medical professionals and workers at various levels.
“The Enquiry Team is of the considered opinion that the deceased Martha Sabar died as a result of combined negligence by doctors on duty from the DHH, Paralakhemundi in the district of Gajapati, and Garabandha PHC (New), as well as ASHA, ANM, and AWW…”
“The Highest Hon’ble Court should make an effort to punish negligent doctors and DHH who broke the trust of a tribal illiterate poor woman and to give directives to guarantee that all programmes are promptly made available to the needy in the real sense of the word and not just through paperwork.”
The Court ruled that the level of carelessness is evident in the EC’s determination that the death in bed-head ticket was caused by “severe sepsis” with a “pulmonary embolism” but that no oxygen was given.
The court further noted that the dead was not only denied assistance under several programmes, but also had to pay for blood tests and ultrasounds at the hospital through a Private Radiological Centre.
The Court said with resentment,
“The victim was an underprivileged tribal woman for whom the public health system fell short. She was the beneficiary of numerous written plans that were supposed to assist her, but she died as a result of the state’s authorities, physicians, paramedics, and staff’s blatant callousness.”
“The deceased in this situation did not receive even the most fundamental first-level care and treatment at the level of the ASHA and ANM under the NHM. Despite having a high-risk pregnancy, she never received guidance. It is truly very bad that the various programmes aimed to help the underprivileged and vulnerable, like the dead in this case, do not get to them in a timely manner.”
Speaking on behalf of the bench, Chief Justice Muralidhar expressed some grave concerns about the state apparatus’s failure to ensure the implementation of numerous initiatives designed to help the underprivileged and impoverished. He noticed,
“This Court is compelled to point out that, in terms of Odisha, Martha Sabar’s death is not an isolated incident. It is extremely concerning how many women in tribal belts, rural, and semi-urban areas have died during pregnancy or as a result of hazardous deliveries.”
“The rise in maternal mortality in Odisha suggests a systemic problem with the health care system, which appears to have failed the most vulnerable and underprivileged people just when they most need it.”
After reading the reports, the Court strongly cited the decisions of the Delhi High Court in Laxmi Mandal vs. Harinagar Hospital (authored by CJ Muralidhar as a Judge of Delhi High Court) and the Apex Court in People’s Union for Civil Liberties vs. Union of India to emphasise the responsibility of the State to provide pregnant women with the benefits of numerous programmes and to ensure that all necessary precautions are taken to prevent maternal deaths.
The Errants’ Reactions:
The Court took harsh action against the careless medical professionals whose negligence led to Martha Sabar’s tragic death.
As a result, it instructed the State Government to take the necessary disciplinary action against any doctors, health professionals, or staff members whose behaviour had been negatively criticised by the EC of the OSCW in its report after receiving show cause notices and replies.
Payback to the Family:
Within six weeks of the date of the judgement, the Court ordered the Government of Odisha to pay the family members an amount of Rs. 10 lakhs. The settlement money was told to be stored in FDs in her husband’s and her in-laws’ names.
It was ordered to make FDs worth Rs. 3,50,000 apiece for the deceased’s mother-in-law and father-in-law, as well as one worth Rs. 3,000,000 for her spouse Ganpati Sabar.
Instructions for Forming the Advisory Body and the Scheme:
The Court noted that proper orientation, training, and sensitization are urgently needed for support workers, including ASHAs, ANMs, and Anganwadi Workers, whose roles are crucial for the proper delivery of the range of health measures in the various schemes floated by the state and federal governments.
The Court also agreed with the OSCW’s recommendations for improving the system for delivering the many welfare-oriented health-related programmes for women, children, and pregnant women in general.
As a result, it gave the State Government of Odisha the order to immediately appoint a body of advisory health professionals to develop a Comprehensive Action Plan that will include both preventive and remedial action points in the short and medium term to address the problem of maternal fatalities.
A distinct scheme or policy to handle the necessity for delivering reparation, including the award of compensation for every needless maternal death and the imposition of duty on negligent physicians, paramedics, and employees in a timely way, was also mandated for the State Government.
It was mandated that the task of creating a Comprehensive Action Plan and a Scheme/Policy for compensating those affected as stated above be finished within four months of the order date.