Supreme Court on Medical Negligence and Liability of Medical Professionals in India

Introduction

Recently, the Supreme Court of India in the case of Nand Kishore Prasad v. Dr. Mohib Hamidi & Others discussed the law relating to the liability of medical professionals in India.

Facts in Brief

The son of the Appellant (patient) was suffering from abdominal pain, fever and haemorrhage in both eyes. He went to a Doctor on 08.11.1995 who later on referred the patient to a Hospital. A surgery was conducted upon the son of the Appellant on 11.11.1995 in the Hospital when his platelet count was reportedly 35,000 per cubic millimetre. However, despite the surgery, the patient was bleeding and in spite of packing of leakages, the relatives of the patient discharged him on 13.11.1995 and took him to another Hospital wherein he died on 16.11.1995.

Before the Courts below, an Affidavit of another Doctor was produced in which it was opined that to operate the patient with excessive low platelet counts was the greatest blunder and a clear case of extreme negligence of doctors.

This fact was acknowledged by the State Consumer Commission and it found the Hospital as also the Operating Surgeon to be guilty of negligence and appropriate compensation was awarded against the Hospital as well as the Operating Surgeon. However, the amount of compensation awarded against the Operating Surgeon was set aside by the National Consumer Disputes Redressal Commission (NCDRC) though it held that the Operating Surgeon was also negligent.

Arguments Advanced

On the one hand, it was argued by the Appellant that performing surgery on his son was sheer negligence as his platelet count was extremely low whereas on the other hand, the Respondents argued that due care, diagnosis and tests were performed on the patient before taking him to surgery. It was further argued that the patient was already in a difficult and critical medical condition and the Surgeon was trying to save his life by removing the roundworms from the abdomen and transfusing blood to facilitate recovery. Thus, the decision of the Surgeon was bona fide.

Held

The Supreme Court held that there is nothing on record to suggest that performing a surgery was an absolute necessity to cure the patient. The Supreme Court decided to rely upon the test of reasonableness as was held in Arun Kumar Manglik v. Chirayu Medicine Health and Medicare Private Ltd., 2019 SCC Online SC 197, wherein it was observed as under: -

“53. In the practice of medicine, there could be varying approaches to treatment. There can be a genuine difference of opinion. However, while adopting a course of treatment, the medical professional must ensure that it is not unreasonable. The threshold to prove unreasonableness is set with due regard to the risks associated with medical treatment and the conditions under which medical professionals’ function. This is to avoid a situation where doctors resort to ‘defensive medicine’ to avoid claims of negligence, often to the detriment of the patient. Hence, in a specific case where unreasonableness in professional conduct has been proven with regard to the circumstances of that case, a professional cannot escape liability for medical evidence merely by relying on a body of professional opinion.”

Thus, the Court found out the decision of the Operating Surgeon to conduct surgery to be an unreasonable decision amounting to medical negligence. Further, with respect to the quantum of compensation, the Court relied on the principle of restitutio in integrum according to which a person entitled to damages should, as nearly as possible, get that sum of money which would put him in the same position as he would been if he had not sustained the wrong [See Livingstone v. Rawyards Coal Co., (1880) LR 5 AC (HL)].

The Supreme Court held that the NCDRC should not have interfered with the amount of compensation and it could have apportioned the amount of compensation payable by the Operating Surgeon to the Hospital as the Hospital had vicarious liability as well due the fact that the death of the son of the Appellant occurred during the course of employment of Operating Surgeon with the said Hospital.

Opinion

I concur with the reasoning adopted by the Supreme Court in this case. However, while discussing the concept of restitutio in integrum and Just Compensation, the Court could have enhanced the compensation. The boy who died was just 15 years old and had a whole life ahead of him. The Court agreed that the compensation has to be calculated on the basis of age and income but in absence of evidence relating income of the son of the father or family, the Court refrained itself from enhancing the compensation. I think such pedantic approach is unnecessary especially in cases of medical negligence where the standard of care required from a professional is higher and different than the standard of care in other services. The level of trust of the public with the medical fraternity is quite high and it should be rightly so because a medical professional performs upon the body of its patient. Without a certain degree of trust, a patient would be horrified by the medical procedures and practices. It is in this light that in my humble opinion, the compensation ought to have been enhanced by the Hon’ble Supreme Court.