Doctor left for a drink: Court awards RM5.9m in maternal death case

Summary

• The High Court in Klang finds Dr Ravi Akambaram, Dr Shanmugam Muniandi, and their staff liable for negligence in the death of Punitha Mohan, a 36-year-old mother.

• Ravi left the clinic for a drink during a medical emergency, leaving the patient with unregistered nurses, while Shan Clinic lacked essential equipment and medication.

• The judge highlights significant breaches, including failing to transfer the patient to a hospital in time, not informing her family, and failing to adhere to the ministry’s SOPs for managing postpartum haemorrhage.

The High Court in Klang ruled that Dr Ravi Akambaram, a doctor at Shan Clinic, left his critically ill patient, Punitha Mohan, waiting under the care of unqualified staff to go out for a drink.

This alongside numerous other failures, led to the tragic death of the 36-year-old mother following childbirth complications.

Judge Norliza Othman, presiding over the case, found Ravi, clinic director Dr Shanmugam Muniandi, and three other staff at Shan Clinic liable for negligence.

The judgment was made on Dec 18, 2024, and uploaded onto the judiciary department website yesterday.

Punitha was admitted to Shan Clinic on Jan 8, 2019, to deliver her second child. While the delivery itself the next day was successful, she suffered from postpartum haemorrhage (PPH).

Instead of providing immediate medical intervention, Ravi left the clinic for a drink. Shanmugam was also seen leaving the delivery room, leaving Punitha’s care in the hands of unregistered nurses.

The clinic lacked essential equipment and medications, the court found.

“At approximately 12.35pm, a nurse from the delivery room suddenly stepped out and called Hospital Tengku Ampuan Rahimah (HTAR) to enquire about the specialist doctor on duty, as one of their patients was in critical condition.

“Upon overhearing this conversation, the mother of the deceased immediately rushed back into the delivery room and saw that the deceased was experiencing heavy bleeding.

“She observed the nurses attempting to control the bleeding using gauze, but the blood continued to flow. She assessed the condition of the deceased and found that her body had become cold, and she was struggling to breathe,” the judgment read.

By the time Punitha was transferred to HTAR, she lost a significant amount of blood. Despite the hospital’s efforts, her condition had deteriorated beyond recovery and she passed away the same day.

“All of this could have been avoided if both doctors had acted promptly by transferring the mother to HTAR and closely monitoring her condition, instead of leaving her with the nurses while Ravi went out for a drink,” the judge noted.

Negligence by doctors

The court highlighted key areas of negligence:

i. Leaving the deceased without a doctor’s supervision despite her experiencing severe bleeding;

ii. Failing to transfer the deceased to HTAR when her bleeding worsened;

iii. Failing to provide adequate facilities and essential medications;

iv. Failing to inform the deceased’s family about what was actually happening to her;

v. Failing to comply with the standard operating procedures (SOPs) issued by the Health Ministry in handling obstetrics and gynaecology (O&G) complications such as postpartum haemorrhage;

vi. Leaving the deceased in the care of nurses alone after performing a manual placenta removal procedure.

The court awarded the family of the deceased with RM5,993,936 in damages, including RM1.5 million in aggravated damages against Ravi, RM1 million each for the deceased’s two children, and RM700,000 in aggravated damages against Shanmugam and his clinic, among others.

Lawyer K Renuka represented the family while the law firm Messrs R V Lingam & Co represented the defendants.

Cops detain nursery operator following baby's death

Stateless teen mum in loan shark debt after traumatic childbirth

Suhakam: Lahad Datu Hospital under pressure, doing its best

Doctor arrested for allegedly molesting child patient

'Son vomiting, listless': Pasir Mas Hospital probed after mum's viral post