#LegallySpeaking: Case Of Newborn Delivered With Down Syndro
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• Tip:

~Medical opinion may differ regarding the course of action taken by a doctor to treat a patient.

• Background of the case:

~ A married couple failed to conceive for about 15 years and they approached a specialist in Assisted Reproductive Technique in the hospital.

~ The patient was advised IUI (Intra-Uterine Insemination) after failed In-Vitro Fertilization and in their 2nd cycle twin gestation pregnancy was confirmed.

~ At the 5th week of pregnancy, one embryo got destroyed internally and the surviving embryo was monitored as a singleton pregnancy.

~ When the baby was born, she was diagnosed with Down's syndrome.

• Complainant's allegation:

~ The doctors did not follow the standard procedures to manage such high-risk pregnancy.

~ The treating doctor failed to provide genetic counselling as it was elderly pregnancy with a previous history of missed abortion.

~ Certain diagnostic tests like Amniocentesis or Cordocentesis for detection of Down's syndrome were not advised.

~ The doctor didn't inquire about the past family history wherein the first cousin of the patient had a 15 years daughter with Down syndrome.

• Doctor's Defense:

~ The doctor submitted that after the couple conceived she had advised genetic screening/ invasive techniques to confirm karyotyping.

~ She further informed the couple that there were 1 in 100 chances of Down's syndrome and in the event of invasive procedures, the chance of losing the pregnancy was 1 in 100.

~ The final call was of the couple, they were happy with the long-awaited pregnancy after 15 years and they decided to continue the pregnancy without invasive procedures.

~ The option for the Triple test was there but it was not the correct screening because the patient has conceived after ART which involved the use of gonadotropins.

• The Commission held that:

~ The treating doctor suggested triple screening which the patient did not do.

~ She tried her best to attempt the diagnosis of Down's syndrome.

~ The medical record that mentioned that counseling of couple was done and advised for the invasive tests for prenatal diagnosis of Down's syndrome.

~ Giving the doctor relief the Commission noted that "She had a history of previous abortion and after genetic counselling, she did not opt for the invasive investigations to avoid miscarriage or losing the existing pregnancy."

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