Consumer Protection Act, 1986: Medical negligence – Claim for compensation – The wife of the claimant-appellant who was suffering from various diseases was admitted on 15.10.2011 in respondent no.1-Hospital and was treated by respondent no.2Doctor on account of fever and chills and dislodgement of nasal feed tube – Nasal feed tube was reinserted and various tests were done which showed infection and her medical treatment commenced with intravenous administration of injection – As per the medical reports, the cannula used for treatment stopped working and as the patient displayed normal vitals, respondent no.2 prescribed a further antibiotic tablet to be orally administered through the nasal tube – On 18.10.2011, she was discharged from hospital and was prescribed to continue antibiotic tablet for 5 days post discharge, which was administered to her as per the appellant – On 23.10.2011, she was again admitted in another hospital where she was put on life support ventilation system and as her condition deteriorated she was shifted to Fortis Hospital – On 31.10.2011, she died – Claim petition filed by appellant against respondents before State Commission which directed respondents to pay to the appellant compensation of Rs.15 lakhs and cost of Rs.51000/- – National Commission exonerated the respondents of any medical negligence opining that at the highest it could be termed as a case of wrong diagnosis and certainly not one of medical negligence – Held: The approach adopted by the National Commission cannot be said to be faulty, while dealing with the role of the State Commission, which granted damages on a premise that respondent No.2-Doctor could have pursued an alternative mode of treatment – Such a course of action, as a super-appellate medical authority, could not have been performed by the State Commission – There was no evidence to show any unexplained deviation from standard protocol – The deceased was medically compromised by the reason of her past illnesses and was admitted to two other hospitals, post her discharge from respondent No.1-Hospital – The medical certificate issued for the cause of death by the Fortis Hospital cited septic shock due to multiple organ failure as the immediate cause of death, with her diabetic condition being an antecedent cause, as also the multiple malignancies, post chemotherapy and radiotherapy all contributing to her passing away – There was no fault in the reasoning of the National Commission – Negligence. Consumer Protection Act, 1986: Medical negligence – A doctor cannot be said to be negligent if he is acting in accordance with a practice accepted as proper by a reasonable body of medical men skilled in that particular art, merely because there is a body of such opinion that takes a contrary view – A liability would only come, if (a) either the person (doctor) did not possess the requisite skills, which he professed to have possessed; or (b) he did not exercise, with reasonable competence in a given case, the skill which he did possess – It is not necessary for every professional to possess the highest level of expertise in that branch in which he practices – Negligence.
Words and Phrases: Negligence – Meaning of.
Dismissing the appeal, the Court
HELD: 1.1 A doctor cannot be said to be negligent if he is acting in accordance with a practice accepted as proper by a reasonable body of medical men skilled in that particular art, merely because there is a body of such opinion that takes a contrary view. A physician would not assure a full recovery in every case, and the only assurance given, by implication, is that he possesses the requisite skills in the branch of the profession, and while undertaking the performance of his task, he would exercise his skills with reasonable competence. [Paras 9, 10] [849-B-C, F-G]
Jacob Mathew v. State of Punjab (2005) 6 SCC 1 : [2005] 2 Suppl.SCR 307 – relied on.
Bolam v. Friern Hospital Management Committee (1957) 1 WLR 582 : (1957) 2 All ER 118; Hucks v. Cole (1968) 118 New LJ 469 – referred to
1.2 Respondent No.1-Hospital promptly attended to the wife of the appellant. Respondent No.2, physician, once again, attended to her promptly, and started her on antibiotic treatment. The nasal feed tube was re-inserted promptly. However, next day, the cannula stopped functioning and instead of re-cannulating the patient, oral administration of the antibiotic Polypod was found justified. It was this aspect, which according to the appellant, amounted to medical negligence. The explanation offered by respondent No.2-Doctor was that he found that the drip had been disconnected, on account of all peripheral veins being blocked due to past chemotherapies, and that the drip had been stopped, the night before itself, at the instance of the appellant. Taking into consideration the fact that the patient was normal, a febrile, well-hydrated and displayed normal vitals, the oral administration of the tablet was prescribed. This, according to the NCDRC was the professional and medical assessment by respondent No.2-Doctor, arrived at on the basis of a medical condition of the patient, and could not constitute medical negligence. [Para 13] [852-C-F]
1.3 The appellant has also sought to make out a case that the blood culture report required his wife to be kept in the hospital. This was again a judgment best arrived at by respondent No.2-Doctor, based on her other stable conditions, with only the WBC count being higher, which, as per the views of the respondent No.2-Doctor, could be treated by administration of the antibiotic drug orally, which was prescribed for 5 days, and as per the appellant, was so administered. In the perception of the doctor, the increase in lymphocytes in the blood count was the result of the patient displaying an improved immune response to the infection. It was in this context that the NCDRC opined that at best, it could be categorised as a possible case of wrong diagnosis. The approach adopted by the NCDRC cannot be said to be faulty, while dealing with the role of the State Commission, which granted damages on a premise that respondent No.2Doctor could have pursued an alternative mode of treatment. Such a course of action, as a super-appellate medical authority, could not have been performed by the State Commission. There was no evidence to show any unexplained deviation from standard protocol. The deceased was medically compromised by the reason of her past illnesses. The deceased was admitted to two other hospitals, post her discharge from respondent No.1Hospital. The moot point was whether her admittance and discharge from respondent No.1-Hospital was the sole, or even the most likely cause of her death. The death had been caused by multiplicity of factors. There is no fault in the reasoning of the NCDRC. [Paras 14-16, 18] [853-A-E, G]
Kusum Sharma & Ors. v. Batra Hospital & Medical Research Centre & Ors.(2010) 3 SCC 480 : [2010] 2 SCR 685 – relied on.
As published in the Supreme Court Reports, Supreme Court of India. Text from the Indian Supreme Court Judgments open data set (Dattam Labs), CC BY 4.0.
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