Delhi HC upholds Rs 23 lakh compensation to patient who lost arm due to medical negligence

New Delhi: Dismissing the plea by the city government, the Delhi High Court recently upheld the order of the single judge bench directing the government to pay Rs 23 lakh compensation to a patient, who is a vegetable vendor by profession, for loss of arm due to medical negligence.

The man had lost his arm because of the medical negligence by the staff at the State-run Jagjivan Ram Hospital. While the State challenged the previous order, the division bench of Chief Justice Satish Chandra Sharma and Justice Subramonium Prasad opined that "the computation of compensation cannot be found fault with."

"The Appellants have not disputed the computation of the monthly income of the Respondent i.e., Rs.12,000/- per month. The multiplier of 14 which has been used in the calculation of compensation relying upon the Judgment of Apex Court passed in Syed Sadiq (Supra) and Raj Kumar (Supra) also cannot be faulted with," the HC division bench further noted.

In its order dated 25.01.2021, the Single Judge had directed the Government authorities for paying a sum of Rs 23,47,680 to the vegetable vendor as compensation along with the interest at the rate of 9% per annum from the date of filing the petition.

The history of the case goes back to 2010, when a vegetable vendor, the patient had approached Baby Jagjivan Ram Hospital complaining of lower abdominal pain, diarrhoea and vomiting. 

After being administered injections, the patient developed complications and came back to the hospital where he got diagnosed with Thrombophlebitis. Consequently, the patient was referred to Hindu Rao Hospital where he was denied emergency treatment and was advised to approach a specialist doctor at LNJP Hospital, New Delhi.

Later the patient was diagnosed with Compartment Syndrome and later admitted for a Fasciotomy procedure. After being under observation at LNJP Hospital for 27 days, the patient was advised to get his affected arm amputated.

Following this, the patient filed the plea seeking directions to the Hospital to provide necessary medical assistance for treatment of his damaged forearm and also sought compensation for the loss suffered by him because of the negligent treatment by the hospital.

The HC single judge bench had directed the Superintendent of RML Hospital, Delhi to arrange for a thorough medical examination of the patient and to advise appropriate medical treatment. Consequently, a Medical Board of RML Hospital was constituted and the report mentioned, "Post volkmann ischemic contracture, exposed and non- viableulnar bone with infected wound with stiff hand and elbow with gangrene thumb hypo-anesthetic and nonfunctional hand."

Regarding the treatment of the patient, the Medical Board had opined, "Amputation of thumb at MP joint level and coverage of exposed bone with flap cover. However, in view of severe stiffness of wrist and small joints and sensory impairment limb will have negligible function. Amputation of right forearm and hand at elbow Joint may be considered in the long run.”

After this, the Court had passed orders for setting up an Enquiry Committee to find out if there was any medical negligence. In its report dated 09.09.2013, the Enquiry Committee attributed the cause of injury to an error of judgment on the part of Junior Resident and the Senior Residents on duty in identifying the complications arising out of the patient’s case.

On the basis of the Enquiry Committee's report, the Court held it to be a case of medical negligence and opined that the patient was entitled to compensation. Apart from this, the Govt was directed to quantify the compensation by applying the principles applicable to Motor Accident Claim cases and submit the same through an affidavit.

While computing the amount of compensation, the Single Judge issued the order dated 25.01.2021 and assessed the monthly income of the patient to be Rs 12,000. In this context, the HC bench referred to the Supreme Court judgment in the case of Syed Sadiq &Ors. vs. Divisional Manager, United India Insurance Company Ltd, which had also dealt with a case of vegetable vendor and the top court had assessed the disability of the Respondent at 85% to determine the loss of income.

 Therefore, the Single Judge had allotted a non-pecuniary claim of Rs 90,000 towards pain and suffering and Rs 30,000 for cost of litigation. So, the govt had been directed to pay a sum of Rs 23, 47, 680 as compensation along with the interest at the rate of Rs 9% per annum.

However, challenging the order of the Single judge bench, the counsel for the Govt, ASC Mr. Satyakam submitted that the disability of the patient could not be assessed more than 30%. Further, it was submitted that the Single Judge bench had failed to consider that there was contributory negligence on part of the Respondent in getting himself treated by a quack against medical advice.

On the other hand, the counsel for the patient submitted that the functional disability of the patient had been assessed at 90% as per the disability certificate dated 29.07.2011 issued by Dr. Baba Saheb Ambedkar Hospital, Delhi. Reliance was placed upon the report dated 22.03.2011 prepared by the RML Hospital, which noted that "amputation of the right forearm and hand at elbow joint may be considered in the long run".

Apart from this, the patient's counsel also referred to the report by the Enquiry Committee, which had stated that there had been an error of judgment on the part of the Junior Resident and Senior Resident on duty as injections had been mixed and injected in the veins which developed into further complications.

After taking note of the submissions, the HC division bench perused the disability certificate issued by Dr Baba Saheb Ambedkar Hospital. The HC bench also noted the fact that an inquiry was ordered by the Principal Secretary of Health for examining the complaint of the patient regarding negligence.

The Committee, so constituted for enquiry, consisted of three members i.e., HOD, Medicine (Chairman), Sr. Specialist, Ortho(Member) of Dr. BSA Hospital and HOD (Anestheisia) (Member) of DDU Hospital. The statements of the Respondent, staff nurses, junior resident and various CMOs, who had attended the Respondent, were taken.

Consequently, the Committee concluded in the report, "There has been error of judgment on part of JR on duty (Dr. Sandeep) in identifying the complication of this case. Even the Senior Resident of Surgery Dr. Milan who examined the patient twice failed to recognize the complication and manage the case appropriately and Hence it appears that there is error of judgment on part of SR surgery also."

Further noting that the Single Judge had relied upon the Supreme Court order in the case of Syed Sadiq (Supra), the division bench opined, "In Syed Sadiq (Supra) an argument was also taken in respect of contributory negligence on the part of the victim therein which was rejected by the Apex Court."

At this outset, the HC division bench referred to the contention of the ASC regarding contributory negligence and noted, "The contention of Mr, Satyakam, learned ASC appearing for the Appellants, that the Respondent had left the hospital against the medical advice of the hospital and got treatment by a quack is of no avail in view of the findings of the Enquiry Committee which categorically states that there was a mistake in administering injections to the Respondent and both the Junior Resident, and the Senior Resident failed to recognize the complication and manage the case of the Respondent appropriately."

"The poor vegetable vendor who got discharged himself from the hospital cannot be said contributed to the negligence of the doctors on duty," further noted the bench.

Observing that the government authorities assessed the disability of the patient at 30%, and Dr. Baba Saheb Ambedkar Hospital, Delhi determined the permanent disability to be 90%, the HC division bench noted, "The learned Single Judge vide impugned judgment has assessed the disability of the Respondent at 85% which does not require any interference."

Disagreeing with the contention of the ASC that the compensation must be assessed in accordance with the Workmen Compensation Act, the division bench further noted,

"The right upper limb of the Respondent has been affected from elbow downwards. The upper two third of ulnar bone is exposed, grossly infected and non-viable. There is stiffness of elbow joint. The supination and pronation movement is restricted. There is stiffness of wrist joint, MP Joints, PIP joints and DIP joints of all the fingers. The thumb is gangrenous line of demarcation at distal to MP Joint. There is partial sensation in the forearm. It has been opined by the Dr. RML Hospital that in view of severe stiffness of wrist and small joints and sensory impairment limb will have negligible Junction and amputation of right forearm and hand at elbow Joint may be considered in the long run. This means that Respondent herein has virtually lost his right arm."

"The Appellants have not disputed the computation of the monthly income of the Respondent i.e., Rs.12,000/- per month. The multiplier of 14 which has been used in the calculation of compensation relying upon the Judgment of Apex Court passed in Syed Sadiq (Supra) and Raj Kumar (Supra) also cannot be faulted with," further opined the bench.

Upholding the order of the single judge bench, the division bench mentioned in the order,

"In view of the above, the computation of compensation cannot be found fault with. The Respondent has also not challenged the Order seeking enhancement of the compensation as directed by the learned Single Judge. Therefore, the Judgment passed by the learned Single Judge does not require any interference and the instant appeal preferred by the Appellants cannot succeed."

To read the order, click on the link below:

https://medicaldialogues.in/pdf_upload/delhi-hc-vegetable-vendor-203655.pdf

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