Medical Council report on Medical Negligence not above consumer court order, SC upholds Rs 9 lakh compensation on Ophthalmologist

New Delhi: The Supreme Court bench recently observed that in a case of medical negligence, a report by the Medical Council, while relevant, cannot be determinative to contradict the factual findings made by a consumer forum. 

This observation was made by the Apex Court bench while considering a plea alleging medical negligence by an ophthalmologist and an Eye Clinic, based in Bardhaman, West Bengal. It was alleged by the complainant that due to negligent cataract surgery by the doctor and the clinic, his 13-year-old boy lost complete vision in his right eye.

Although the District Consumer Court had allowed the plea for compensation, the order was set aside by the State Commission based on a report by the Medical Council. The order by the State Consumer Disputes Redressal Commission (SCDRC) was upheld by the National Consumer Disputes Redressal Commission (NCDRC) and following this, the complainant filed a plea before the Supreme Court.

While considering the matter, the Supreme Court bench comprising Justices Vikram Nath and Satish Chandra Sharma observed, "While the report of the Medical Council can be relevant for determining deficiency of service before a consumer forum, it cannot be determinative, especially when it contradicts the evidentiary findings made by a consumer forum. In these circumstances, the appellate forum is tasked with the duty of undertaking a more thorough examination of the evidence on record."

The matter goes back to 2006 when the patient sustained an injury in his right eye and thereafter he was taken to a Disha Eye Hospital. The examination report revealed that the patient was suffering from traumatic cataract and required a minor surgery. However, being unable to finance his son's treatment at Disha Eye Hospital, the appellant approached the treating doctor- Dr Banerjee and a partner at Megha Eye Centre.

Affirming the previous medical opinion, the doctor conducted the surgery. After the surgery, the patient started experiencing irritation, pain, and blood clotting and despite visiting the doctor multiple times, there was no improvement in his condition.

Eventually, the doctor referred them to the Regional Institute of Ophthalmology (RIO), which allegedly informed the appellant that it was a case of Retinal detachment leading to permanent loss of vision in the right eye, caused due to faulty operation conducted by the treating doctor.

While considering the matter, the District Consumer Court, in its order dated 16.05.2013, observed that there was a deficiency in medical services provided by the doctor and the clinic and directed them to pay Rs 9 lakh as compensation to the appellant. The DCDRC relied on the uncontroverted expert evidence provided by Dr. Anindya Gupta, RMO-cum-Clinical tutor from the Burdwan Medical College to hold that the patient lost his vision due to the negligent and careless attitude of the treating doctor manifesting through lapses in pre-operative and post-operative care and rehabilitation.

The order was challenged before the SCDRC, which set aside the order and held that the appellant had failed to establish deficiency of service/negligence on the part of the doctor and the clinic. For this, the SCDRC relied on the report of the West Bengal Medical Council dated 18.05.2015 which exonerated the doctor of all charges of misconduct/negligence and instead found contributory negligence on the part of the appellant as he visited RIO only after a delay of 1 month, contrary to the advice given by the treating doctor.

NCDRC also held that there was no medical negligence on the part of the doctor and the clinic and concluded that the Appellant’s delay of one month in approaching the RIO was fatal for his son.

Approaching the Supreme Court, the counsel for the appellant argued that the NCDRC bench failed to consider that the State Consumer Court undertook a selective appreciation of evidence, completely disregarding the uncontroverted expert evidence provided by Dr. Gupta regarding the lapses in pre-operative and post-operative care. 

On the other hand, the counsel for the doctor and clinic submitted that both the NCDRC and SCDRC correctly placed reliance on the Medical Council's decision to arrive at their conclusions regarding the absence of any medical negligence on the part of the doctor and the clinic.

While considering the matter, the Supreme Court bench referred to the findings made by the District Consumer Court and noted,

"It is evident that the DCDRC has made specific findings regarding lapses in duty of care by Respondent No.1 vis a vis both pre-operative and post-operative standards for conducting a traumatic cataract surgery. More pertinently, through the evidence of Dr. Gupta, a nexus was established between the lapses in post-operative care (the delay in review, the abnormal vision rating on 06.12.2006 which was left unchecked by Respondent No. 1, failure to undertake extra capsular method of surgery despite having the necessary equipment) and the development of loss of vision after the operation. It must be reemphasized that the expert evidence of Dr. Gupta went entirely uncontroverted due to the absence of cross-examination and the failure of the Respondents to bring on record any other contradictory expert evidence."

The Apex Court noted that despite the presence of evidence pointing towards negligence by the doctor and the clinic, both the SCDRC and NCDRC failed to consider it and relied only on the report of the Medical Council. 

Perusing the report of the Medical Council, the Supreme Court bench noted,

"...it appears that the Medical Council did not delve into the nuances of pre-operative and post-operative care. Further, the finding of contributory negligence attributed to the Appellant is entirely unsubstantiated by expert opinion."

The Court opined that both the State and National Consumer Court ought to have examined the evidence in especially since the plea was urged by the Counsel for the Appellant in both the forums. "Instead, both the forums have mechanically and exclusively relied upon the Medical Council report and reiterated its findings without any reference to the evidence of Dr. Gupta," it observed.

Holding that the Medical Council report cannot be determinative, especially when it contradicts the evidentiary findings made by a consumer forum, the Supreme Court bench observed, that the specific findings made by the DCDRC regarding lapses in post-operative care by the doctor and clinic and the resultant development of Retinal detachment remains unchallenged by the other evidence on record.

Therefore, affirming the District Commission's order, the Apex Court observed,

"In fact, the holding of the DCDRC is strengthened not only by the report of the Medical Council which states that development of Retinal Detachment is not uncommon in cases of blunt trauma as in the case of Irshad, but also by the admission of the Respondent No. 1 itself that management and rehabilitation of traumatic cataract for a child is very difficult, unpredictable, and prone to complications. That being the case, and in view of the established principle of law that in cases of deficiency of medical services, duty of care does not end with surgery, we have no hesitation in affirming the finding of the DCDRC that there was a deficiency in the medical services provided by the Respondents to the Appellant’s son."

It further ordered, "In view of the aforesaid, the present appeal succeeds and the order of the NCDRC and the SCDRC are set aside. Accordingly, the Respondents are directed to comply with the order of the DCDRC within one month from the date of this order."

To view the order, click on the link below:

https://medicaldialogues.in/pdf_upload/supreme-court-consumer-court-234080.pdf

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