Delhi HC relief to Cardiologist on Allegations of Medical Negligence, Upholds Medical Council Order

New Delhi: Granting relief, the Delhi High Court bench on Monday exonerated a cardiologist from charges of medical negligence while treating a patient with a history of Coronary Artery Bypass Graft (CABG).

After the death of the patient, his son alleged that the cardiologist Dr. Chanana treated his father very casually despite being told that the patient had undergone bypass surgery in the past.

Previously, the Delhi Medical Council had also held that there was no medical negligence in the treatment administered by the cardiologist. However, challenging this order, the patient's son approached the Delhi High Court.

The Delhi HC bench comprising Justice Subramonium Prasad upheld the order of the Delhi Medical Council and pointed out that "It is well settled that High Courts cannot enter into the thicket of facts while considering the allegations of medical negligence."

"The Committee has looked into the facts and has found that the treatment given by Dr. Chanana to the late father of the Petitioner herein was in accordance with the established medical practice. It is well settled that so long as a Doctor follows a practice acceptable under the Medical Practice on that day, he cannot be held liable for negligence merely because some other alternative course or method of treatment could have been resorted to save the life of the patient instead of the practice that was followed by the concerned Doctor. A professional can be held liable for negligence only when he is not possessed with requisite skill which he has professed to have possess," the bench further observed.

The matter goes back to 2020 when the petitioner approached the doctor for the treatment of his 78-year-old father, who had a history of Cardiac Disease. His father was suffering from breathlessness, uneasiness, headache and vomiting on July 26, 2023. 

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When the petitioner took his father to Dr. Chanana's clinic, allegedly the doctor did not conduct any tests on the patient and only prescribed certain medicines. The petitioner alleged that the doctor treated his father in a very casual manner and assured him that he was not suffering from any heart-related issues.

It was alleged by the complainant that on the evening of the same day when the petitioner's father once again experienced breathlessness, the petitioner contacted the doctor and was advised to continue the same medication. 

However, a few days later, the symptoms of breathlessness continued and the patient was once again taken to Dr. Chanana. This time, after conducting the tests, the doctor informed the petitioner that his father's condition was very serious and he was required to be taken to a hospital with requisite facilities. As per the petitioner, even though he took his father to Saroj Hospital, Rohini, he could not be saved.

Thereafter, the petitioner approached the Delhi Medical Council alleging that when the patient was taken to Dr. Chanana's clinic for the first time, the doctor should have conducted the necessary tests to diagnose the exact cause behind the symptoms. Allegedly, the doctor treated his father very casually despite being told that the patient had undergone bypass surgery in the past. The petitioner contended that had requisite tests been done the first time itself, the patient could have been saved.

On the other hand, the doctor in his defense informed DMC that when the patient came to his clinic with certain symptoms he prescribed medicines as per the symptoms exhibited by the patient at the time of examination.

He further informed the Council that during the first visit, the patient was in stable condition and his BP, pulse, ejection fraction, etc. were normal for his age. However, when the patient was taken the second time, he was detected to have features of a complete heart block which required urgent medical intervention, and therefore, he was advised to visit the nearest health facility equipped with emergency cardiac care. With this submission, the doctor claimed that there was no medical negligence on his part.

The matter was examined by the Disciplinary Committee of DMC, which found that the prescription dated 26.07.2020 did not mention the complaint/symptoms of the patient nor any diagnosis. The panel also found that the clinical findings regarding the blood pressure and chest of the patient were illegible and the duration for which medicines were prescribed by the doctor was also not mentioned which reflected the casual approach of the doctor.

"It is noted that the patient had presented to Dr. *** Chanana for the first time on 26th July, 2020 with complaints of breathlessness, nausea, and headache and vomiting sensation, for which, the treatment(as mentioned hereinbefore) advised as per the prescription, was appropriate and since ejection fraction was 50% in a patient with history of CABG, there was under the prevailing condition, no pressing requirement for further cardiac evaluation. Having said that the prescription dated 26th July, 2020 of Dr. *** Chanana suffered from certain shortcomings viz :-it did not mention the complaint/symptoms of the patient nor any diagnosis; the clinical findings regarding the blood pressure and chest, were illegible. The duration for which medicines were prescribed is also not mentioned. The prescription reflects the casual approach of Dr. *** Chanana, which is not expected of an ordinary reasonable prudent doctor," noted the Disciplinary Committee.

Therefore, the complaint was disposed of by DMC with advice to the doctor to be more mindful of his responsibilities in the future and noted, "It is incumbent on a medical practitioner, in his own and his patient's interest, to record a prescription mentioning the patient's history of complaints, current symptoms, his vital parameters and other clinical observations and a provisional diagnosis (and/or recommendations for further diagnostic tests). Dr. *** Chanana is, therefore, advised to be mindful of this responsibility, for future."

However, the panel held that no medical negligence could be attributed to the doctor in the treatment administered to him to the patient. The order of the medical council was challenged by the petitioner, who approached the National Medical Commission in this regard. However, the said appeal was not entertained by the NMC because under the NMC Act, 2019 an appeal filed by a non-Medical Practitioner or Professional cannot be entertained.

Thereafter, the petitioner approached the Delhi HC bench and filed a plea in this regard. Before the HC bench, the petitioner reiterated the contentions raised before the Delhi Medical Council.

On the other hand, the counsel for the NMC informed the bench that the complaint was dealt with in accordance with the provisions of the Indian Medical Council (Professional Conduct, Etiquette and Ethics) Regulations, 2002.

While considering the matter, the HC bench perused the observations made by the Disciplinary Committee of DMC and noted,

"The Disciplinary Committee of the Delhi Medical Council consisted of four doctors who are experts in their field. It is well settled that High Courts cannot enter into the thicket of facts while considering the allegations of medical negligence. The Committee has looked into the facts and has found that the treatment given by Dr. Chanana to the late father of the Petitioner herein was in accordance with the established medical practice."

The HC bench further reiterated that so long as a doctor follows a practice acceptable under the Medical Practice on that day, he cannot be held liable for negligence just because some other alternative course or method of treatment could have been resorted to in order to save the patient's life instead of the practice that was followed by the concerned doctor.

"A professional can be held liable for negligence only when he is not possessed with requisite skill which he has professed to have possess. In the present case, Dr.*** Chanana is a Cardiologist with experience of over 30 years. There is nothing on record to show that Dr. Chanana was involved in the earlier by-pass surgery of the late father of the Petitioner. There is also no record to show that Dr. *** Chanana had interacted with the patient prior to 26.07.2020. When Petitioner’s father visited Dr. Chanana on 26.07.2020, looking at his age and the symptoms medicine was prescribed by Dr. Chanana, which, according to the Committee, was appropriate and since ejection fraction was 50% in a patient with history of coronary artery bypass grafting, there was no pressing requirement for further cardiac evaluation. On 31.07.2020 when the patient presented himself with a more serious condition, Dr. Chanana advised him to be admitted to the nearest health facility equipped with emergency cardiac care. Since the prescription of Dr. Chanana suffered from certain shortcomings he has been asked to be more careful in future," the bench noted.

Therefore, refusing to interfere with the Delhi Medical Council's decision, the bench further observed,

"This Court, under Article 226 of the Constitution of India, cannot substitute its own conclusions to the one arrived at by the experts unless the decision taken by the experts is perverse and unconscionable and has the effect of shaking the consciousness of this Court."

To view the order, click on the link below:

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