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Missed Diagnosis of Ectopic Pregnancy in early gestation: Not a case of Medical Negligence, hence no deficiency in service under COPRA

Missed Diagnosis of Ectopic Pregnancy in early gestation: Not a case of Medical Negligence, hence no deficiency in service under COPRA

By: Prof. (Dr.) Mukesh Yadav Published Date: 31-03-2019 DOI : 2803201912345 Issue Date: 28-03-2019

Abstract

An ectopic pregnancy occurs when a fertilized egg implants and grows outside the main cavity of the uterus. Ectopic pregnancy occurs in the fallopian tube in over 95% of cases is called Tubal pregnancy, most of them to occur in the ampulla (70.0%), then isthmus and then fimbria. Other locations for ectopic pregnancies are rare: abdominal, ovarian or cervical.

Detection by USG for ectopic pregnancy in early weeks (before 6 weeks) is very difficult. In some cases, the diagnosis of ectopic pregnancy can be made after a single measurement of HCG in combination with transvaginal ultrasound, if the HCG is above the discriminatory zone and transvaginal ultrasound shows no evidence of an intrauterine pregnancy and the presence of findings that suggest an ectopic pregnancy.

This research paper deals with an interesting case of misdiagnosis in early weeks of gestation due to limitation of technology as reported in medical literature. Based on presentation of symptoms and clinical findings attending doctor made diagnosis of incomplete abortion and performed D& C as standard reasonable practice in such case.

Questions for consideration before NCDRC:

  1. Whether there was deficiency in service from the OP to diagnose the ectopic pregnancy?
  2. Whether it was a misdiagnosis?

On allegations of medical negligence before DCDRC, which find doctor negligent and awarded compensation for deficiency in service, in appeal decision was affirmed by SCDRC and dismissed the appeal. NCDRC while deciding Revision Petition ruled out medical negligence.    

There is need for creating awareness among doctors to rule out ectopic pregnancy and among public to understand the limitations of medical professionals in to diagnose ectopic pregnancy.

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