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Friday, December 3, 2021

Doctrine of Res Ipsa Loquitur and Medical Negligence

 



INTRODUCTION

 

Today, I will talk about the case of Bombay Hospital & Medical Research Centre v. Asha Jaiswal and Others, 2021 SCC OnLine SC 1149, wherein the Hon’ble Supreme Court discussed the Doctrine of Res Ipsa Loquitur, that literally means that ‘the thing speaks for itself’, in the context of Medical Negligence.

 

MEANING

 

Black’s Law Dictionary, Eighth Edition, explains Res Ipsa Loquitur as “the doctrine providing that, in some circumstances, the mere fact of an accident’s occurrence raises an inference of negligence so as to establish a prima facie case.”

 

Thus, whenever an accident or an injury occurs, the doctrine of Res Ipsa Loquitur may come into play to demonstrate that the nature or the manner of the injury or the accident raises a presumption of negligence against the wrongdoer. In cases of medical negligence, this doctrine is particularly helpful as the Court may apply the same to ascertain prima facie guilt of an accused person or a medical professional or a medical professional or a medical establishment, in relation to performance of any surgery or administration of a particular treatment. In order to understand this in a better manner, let us go through the pertinent observations by the Court.

 

 

OBSERVATIONS BY THE COURT

 

Firstly, the Court noted that “simply because a patient has not favourably responded to a treatment given by a doctor or a surgery has failed, the doctor cannot be held straightaway liable for medical negligence by applying the doctrine of res ipsa loquitur. No sensible professional would intentionally commit an act or omission which would result in harm or injury to the patient since the professional reputation of the professional would be at stake. A single failure may cost him dear in his lapse.”

 

Secondly, the Court discussed the two important lines of approach in regard to the application and effect of the maxim res ipsa loquitur: -

 

a. The maxim operates as an exception to the general rule of evidence that the burden of proof of the alleged negligence is on the plaintiff or the one who alleges it.

b. The maxim res ipsa loquitur is only an aid in the evaluation of evidence and does not lead to a mandatory presumption against the defendant or the wrongdoer. It is merely a permissive inference that is a means of estimating logical probability from the circumstances of the accident.

 

Thirdly, the Court also stated that “when a patient dies or suffers some mishap, there is a tendency to blame the doctor for this. Things have gone wrong and, therefore, somebody must be punished for it. However, it is well known that even the best professionals, what to say of the average professional, sometimes have failures. A lawyer cannot win every case in his professional career but surely he cannot be penalised for losing a case provided he appeared in it and made his submissions.”

 

And lastly, the Court opined that “Res ipsa loquitur is only a rule of evidence and operates in the domain of civil law, specially in cases of torts and helps in determining the onus of proof in actions relating to negligence. It cannot be pressed in service for determining per se the liability for negligence within the domain of criminal law. Res ipsa loquitur has, if at all, a limited application in trial on a charge of criminal negligence.”

 

Thus, upon cumulative consideration of the afore-stated legal juxtaposition, it was held that “in every case where the treatment is not successful or the patient dies during surgery, it cannot be automatically assumed that the medical professional was negligent. To indicate negligence there should be material available on record or else appropriate medical evidence should be tendered. The negligence alleged should be so glaring, in which event the principle of res ipsa loquitur could be made applicable and not based on perception.”

 

CONCLUSION

 

In conclusion, it could be said that res ipsa loquitur has limited applicability in medical jurisprudence and it is only in miniscule number of cases where the level of negligence is so apparent that no other inference except guilt of the accused could be drawn, can the doctrine be pressed into service. In all other cases, the allegations against a medical professional must be supported by concordant evidence failing which no case could be made out on the basis of res ipsa loquitur alone.

 

Therefore, I hope that the meaning and the nature of the doctrine of Res Ipsa Loquitur is clear by now.  

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