Doctors, hospitals liable for medical negligence only when failing to meet competency standards: Consumer court relief to doctor

The District Commission's order had directed Garg Hospital and its doctor to compensate Rs 28,500 for alleged negligence, improper treatment and charging exorbitantly from newborns admitted to Garg Hospital on being referred by Rajiv Hospital without the consent of the newborn children's parents.

Through its order issued on August 31, 2023, by the State Commission's bench consisting of HPS Mahal, Presiding Judicial Member, and Kiran Sibal, Member, also dismissed the complaint against Garg Hospital and its doctor.

In 2017, a pregnant woman was admitted to Rajiv Hospital, Moga, for delivery. Due to the critical condition of her three newborns, they were referred to Garg Hospital, Moga. The complainant, the patient's husband, alleged that this referral was done without his consent, and he also claimed that Garg Hospital and its doctor provided improper treatment and diagnosis for the babies. Furthermore, he stated that he faced misbehavior from the doctor when he expressed dissatisfaction. The children's condition allegedly worsened due to negligence at Garg Hospital. Additionally, the complainant accused the hospital and the doctor of unlawfully charging him Rs 76,608 and violating regulations.

As a result, he transferred the children to Suresh Nursing Home, Akalsar Road, Moga, and filed a consumer complaint, seeking a refund of Rs.76,608 and Rs.2,00,000 in compensation for damages, mental anguish, and harassment.

Garg Hospital and the doctor contested these allegations, arguing that the babies were premature and critically ill due to oxygen deficiency, a result of lung immaturity. They asserted that they provided proper treatment following medical procedures, with no service deficiencies.

After both parties presented evidence and arguments, the District Commission partially granted the complainant's complaint, directing Garg Hospital and the doctor to pay Rs 28,500 as compensation.

Dissatisfied with this decision, Garg Hospital and the doctor appealed to the State Consumer Disputes Redressal Commission, Punjab, Chandigarh. They argued that the complaint lacked necessary parties, and the charges for hospital admission and treatment were not excessive.

Further asserting that during emergencies, no formal consent is required, but oral consent was obtained before transferring the babies to Garg Hospital, the counsel sought to overturn the impugned order, highlighting the points made in their written response to the District Commission.

Examining the case, the State Commission noted that the complainant's accusation of consent lacking during the infants' transfer to Garg Hospital was directed at Rajiv Hospital, yet Rajiv Hospital wasn't a party in the District Commission complaint. The appellants (OPs No.1 - Garg Hospital and No. 2 - the doctor) argued that the complaint was flawed due to this omission and the absence of medical records from Rajiv Hospital to demonstrate the infants' medical emergency severity.

The Commission acknowledged the infants' life-threatening situation due to oxygen deficiency from lung immaturity, highlighting that both Rajiv Hospital and Garg Hospital's medical professionals acted promptly. The doctor was summoned by Rajiv Hospital's gynecologist, resuscitated the infants, and accompanied them to Garg Hospital. The appellants (OPs No.1 & 2) clarified they played no role in the referral; Rajiv Hospital made the transfer with the complainant's oral consent.

The central question under the State Commission's consideration was whether the hospital and the doctor were negligent. To ascertain this, the Commission thoroughly examined the pleadings and presented evidence, and eventually asserted that the infants were admitted in critical condition, received individual surfactant treatment using the 'Insure Technique,' and non-invasive ventilator support supervised by the doctor, leading to significant morning improvements, aligning with medical protocols.

The Commission further examined the evidence, legal principles, and guidelines established by the Supreme Court in cases of medical negligence and service deficiencies. It relied on the Supreme Court's judgment in "Jacob Mathew Vs. State of Punjab and Anr., 2005 (6) SCC 1," which, in turn, considers the "Bolam Vs. Friern Hospital Management Committee" case.

It found that the complainant had not presented substantial evidence to establish negligence on the part of the hospital and the doctor, and concluded that there was no allegations of gross negligence or errors. The Commission observed;

"In the present case, it is proved on record vide Ex. C-2 to C-4 i.e. discharge cards, that the babies were diagnosed with ‘Respiratory Distress Syndrome(RDS)’ and they were given Surfactant by Insure Technique, which is a due medical procedure for treatment of said medical condition. The question of skill of the Doctor and even the procedure/treatment adopted by the Doctor in the said hospital is not under challenge. Therefore, negligence cannot be attributed to a Doctor as long as he has performed his duty with reasonable skill and competence and course of action chosen by him was acceptable to the medical profession. Negligence is an essential ingredient of the offence and if needs to be established, then it must be culpable or gross and not the negligence merely based upon an error of judgment."

Raising the complainant's main concern that was the medical bills, which he considered exorbitant, the Commission clarified that the charges were justifiable given the medical procedures employed. It observed;

"In the present case neither there is any error nor any allegations of gross negligence. The respondent/complainant has simply stated that the appellant/OP No.2 was rude with him and that the condition of the babies did not improve, which is contrary to the findings in the discharge cards of the Suresh Nursing Home. The main issue that the respondent/complainant has raised is qua the medical bills, which according to him were on exorbitant side, which has been duly justified by the appellants-Hospital that 3 separate vials had been administered to the 3 babies and the oxygen level was maintained through ‘Insure Technique’, which incurs a higher cost. Moreover, the respondent/complainant, after discharge of the babies under LAMA has taken the children to another hospital i.e. Suresh Nursing Home. From the perusal of discharge card of Suresh Nursing Home, Ex.C-19, we find that under heading “Diagnosis it is mentioned “Preterm/SGA/Mild resp dis/NNJ”, from which an inference can safely be drawn that the children were not in critical condition when they were brought to ‘Suresh Nursing Home’. The respondent/complainant has failed to lead any cogent evidence to show that the appellants were negligent in providing the treatment to the children. Even the bills raised by the Suresh Nursing Home i.e. for consultation, bed/room and nursing care etc. are almost at par with the Garg Hospital. Therefore, it cannot be said that the bills raised by the appellants were on exorbitant side."

Subsequently, the State Commission granted the appeal of the Hospital and the doctor and overturned the District Commission's impugned order. It further dismissed the complaint filed against them. It noted;

"In the light of the above discussion, we are of the opinion that a medical practitioner or hospital would be liable only where their conduct fell below the standards of a reasonably competent practitioner in their field. As such, we are of the considered opinion that no negligence can be attributed to the said doctor as well as the hospital as the appellant-Doctor has performed his duties with reasonable skill and knowledge and has also been present during the night when the children of the complainant were admitted in emergency care of Garg Hospital. Accordingly, we find force in the contentions raised by the appellants and the impugned order of the District Commission is liable to be set aside."

To view the original judgement, click on the link below: