Medical negligence cannot be inferred merely due to later cancer diagnosis: NCDRC exonerates Delhi hospital, doctor, orders Rs 5 lakh ex gratia

New Delhi: Setting aside the State Consumer Court's order, the National Consumer Disputes Redressal Commission (NCDRC) recently exonerated a Delhi-based private hospital and its doctor of allegations of medical negligence in the death of a 54-year-old cancer patient.

Although the Apex Consumer Court cleared the hospital and the doctor, it directed them to pay the Rs 5 lakh already deposited to the complainants as an ex gratia payment to cover treatment costs.

The complainants had alleged that the hospital and the doctor failed to act on the biopsy report, resulting in the delayed diagnosis. Earlier, holding them liable, the State Consumer Commission, Delhi, on February 16, 2018, had directed them to deposit Rs 20 lakh, with Rs 5 lakh to be deposited to the complainants. The doctor was separately directed to pay Rs 2 lakh.

During a recent hearing, the NCDRC bench overturned the state commission's order and observed 

"Medical negligence cannot be inferred merely because a later diagnosis of cancer was made. There must be evidence to establish that the treatment given was not in accordance with accepted medical practice or that the doctor failed to exercise reasonable care and skill expected in the circumstances."

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Case Background: 

The case history dates back to 2005 when the patient was undergoing treatment for back pain and underwent an MRI at a private hospital on September 9, 2005. Later, he consulted the treating doctor and was diagnosed with tuberculosis involving the L2-L3 region, a left psoas abscess, and diabetes.

When he was admitted on September 11, 2005, he underwent debridement the next day and was discharged on September 16. However, his condition worsened. On December 27, when the treating doctor was unavailable, he was examined by another doctor from the same hospital. When the doctor sought the histopathology report, it was revealed that the report recorded an undifferentiated malignant tumour, including possibilities of malignant fibrous histiocytoma, liposarcoma and lymphoma.

Consequently, the patient was referred to an oncologist. Subsequently, he was examined at AIIMS on January 3, 2006 and died on June 23, 2006.

According to a Lawtrend report, it was argued by the patient's family that the hospital and the treating physician had failed to review the biopsy findings promptly, and this resulted in fatal delays in cancer therapy. 

On the other hand, the hospital and the doctor submitted that the report, processed by an external diagnostic facility, was never submitted to them during intermediate consultations.

Observations by NCDRC: 

Indian Express has reported that NCDRC found no evidence establishing when the report was collected or to prove that the report had been shown to the doctor earlier. The report came to light on December 27, when the second doctor examined the patient and referred him to an oncologist.

The Apex Consumer Court observed that the diagnosis of tuberculosis and treatment was consistent with accepted medical practice. It noted that the MRI indicated tuberculosis, while tissue was sent for biopsy to confirm the diagnosis.

NCDRC also took note of the Delhi Medical Council's finding that the tumour was highly malignant and the earlier cancer treatment was not shown to have changed the outcome.

The Commission flagged coordination gaps due to which the biopsy report did not reach the patient earlier. However, it also observed that these did not establish medical negligence.

Accordingly, setting aside the SCDRC order, the top consumer court ordered Rs 5 lakh already deposited by the hospital to be released to the complainants with interest as an ex-gratia payment towards treatment costs. It ordered that Rs 2 lakh imposed on the doctor be returned to him after 30 days.

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