Ms Punitha Mohan died from postpartum hemorrhage, hours after giving birth to her second child at Shan Clinic and Birth Centre in Klang, Selangor. PHOTO: GOOGLE MAPS via The Straits Times/Asia News Network
SINGAPORE – Two experienced doctors who have delivered thousands of babies were ordered to pay a Malaysian family nearly RM6 million ($1.3 million) in medical negligence claims after a mother in their care bled to death following childbirth.
On Jan 9, 2019, Ms Punitha Mohan died from postpartum hemorrhage hours after giving birth to her second child at Shan Clinic and Birth Centre in Klang, Selangor. She had been admitted the night before.
The 36-year-old delivered her baby at around 10:30 am under the care of Dr Ravi Akambaram, who had also delivered her first child in 2016.
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Dr Ravi had an agreement to use the premises of Shan Clinic, owned by Dr Shanmugam Muniandi, who assisted with the 2019 delivery.
The two physicians have a combined medical experience of around 60 years and have overseen more than 8,500 births.
They were defendants in the civil case brought by Ms Punitha’s family, with her parents, sister and two children named as plaintiffs in the judge’s ruling published on Jan 9.
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Bleeding profusely
About an hour after the birth, nurses showed the baby to Ms Punitha’s waiting family, including her husband and brother, while she remained in the delivery room.
Ms Punitha was then heard shouting. Her mother entered the delivery room and saw her daughter bleeding profusely.
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According to the written judgment, Dr Ravi told the family he had to insert his hand into Ms Punitha to extract her placenta, adding that her uterus was swollen and causing heavy bleeding.
He told them not to worry and left the clinic, later admitting in court that he went for a drink. When asked why he left the woman in that state, he said he had planned to be gone for a little while and return immediately.
The family also told the court that they saw Dr Shanmugam exiting the delivery room, leaving Ms Punitha in the care of three nurses, who were later revealed not to be registered with Malaysia’s Health Ministry.
About two hours after the birth, at around 12:35 pm, the nurses called a nearby hospital to ask if an expert was available to treat a patient in critical condition.
Tragedy
According to the written judgment, Ms Punitha’s mother observed that her daughter was having difficulty breathing, and her body had become cold while the nurses tried to stop the bleeding.
The two doctors were not present at the time. Dr Ravi returned to the clinic at 12:57 pm, and the patient was taken to hospital more than 20 minutes later.
Ms Punitha underwent surgery but died at around 5:25 pm after resuscitation efforts failed.
Judge Norliza Othman found that the two physicians, despite their vast experience, had failed to ensure their patient was free of complications before leaving her in the care of the nurses.
Postpartum haemorrhage, a condition described simply as excessive blood loss, can occur in any woman after childbirth, but patients can be saved if given immediate treatment, the judge said.
The tragedy could have been avoided if the doctors had acted promptly to have Ms Punitha taken to hospital, instead of leaving her in the care of nurses while Dr Ravi went out for a drink, she added.
The family was awarded more than RM5.9 million in damages, including RM1 million for each of Ms Punitha’s two children, as well as RM1.5 million and RM700,000 in aggravated damages against Dr Ravi and Dr Shanmugam, respectively.
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