NCDRC junks medical negligence complaint against Apollo Hospitals Andhra in CKD patient death case

New Delhi: Upholding the State Commission's order that found no medical negligence, the National Consumer Disputes Redressal Commission (NCDRC) dismissed an appeal filed against Apollo Hospitals in a case related to the death of a 53-year-old patient suffering from Chronic Kidney Disease.

The bench of Dr Inder Jit Singh (Presiding Member) and Dr Sudhir Kumar Jain (Member) said that the appellant has failed to discharge the burden of establishing negligence or deficiency in service on the part of the respondent. 

While dismissing the appeal, the Commission stated "the impugned order passed by the State Commission is upheld as there is no error apparent in it which warrant for interference of this Commission."

The incident dates back to 2012 when the complainant's wife was undergoing treatment at Seven Hills Hospital, Visakhapatnam, for Stage 5 Chronic Kidney Disease (CKD). She was discharged from there with advice to undergo haemodialysis three times a week. After following this advice, her creatinine levels were brought under control within two days. She had also been taking herbal medicines for the past one-and-a-half years due to high serum creatinine levels.

On the advice of doctor friends, she was taken to Apollo Hospitals for a second opinion. There too, her creatinine levels were controlled within two days, and she was advised to continue haemodialysis thrice a week. However, according to the complainant, the dialysis conducted at Apollo Hospital led to complications such as high blood pressure, body tremors, and unconsciousness. Her earlier dialysis routine at Seven Hills Hospital was discontinued, and she was admitted to Apollo Hospitals on July 19, 2012, in a critical condition.

It was further alleged that after admission, she was kept in a shared AC hall with other seriously ill patients, which negatively affected her health instead of helping her recover. She was discharged on August 20, 2012, against medical advice, but no discharge summary was provided at that time.

Later, she was shifted to an old-age home in MVP Colony and subsequently to Aditya Critical Care Centre near the KG Hospital gate, where she was declared brain dead. 

The complainant claimed that despite filing several RTI applications, he was not given the patient’s case sheet. The discharge summary was eventually provided in November 2012 through the RDO, Visakhapatnam. The hospital informed authorities that the case sheet and related records were not released due to non-payment of pending bills and because the patient had been discharged against medical advice.

Aggrieved, the plaintiff filed a Consumer Complaint before the Andhra Pradesh State Consumer Disputes Redressal Commission, Vijayawada, alleging deficiency in service on the part of Apollo Hospitals and seeking appropriate relief.

In its reply, the hospital stated that the patient was admitted with Stage 5 CKD and serious symptoms, including breathlessness, fever, swelling, hypertension, and hypothyroidism. She was diagnosed with acute kidney disease, sepsis, hypervolemia, and pulmonary edema, and was shifted to the MICU. She was treated with dialysis, antibiotics, blood transfusions, oxygen support, and other necessary care. It claimed she was discharged on August 21, 2012, against medical advice after her condition stabilised.

Denying negligence, the hospital said the discharge summary was ready but not collected. It also alleged that a Rs 1 lakh cheque given towards bills was dishonoured, and over Rs 3 lakh remained unpaid. The hospital argued that there was no medical evidence or expert opinion to prove negligence and sought dismissal of the complaint.

In its order dated August 30, 2022, the State Commission observed that the patient was already suffering from Stage 5 Chronic Kidney Disease at the time of admission to Apollo Hospitals and had been taking herbal treatment earlier.

The Commission noted that the complainant made only vague allegations and mentioned irrelevant facts. It also observed that the patient was discharged against medical advice and that the complainant, in his affidavit, failed to highlight any specific instance of negligence.

Accordingly, the State Commission concluded that no medical negligence could be established against the hospital.

The complainant then filed Review Application before the State Commission, but it was dismissed. The Commission observed that its earlier order had been passed after carefully examining all documents submitted by both parties and that the complaint had no merit. It also noted that under the Consumer Protection Act, 1986, it did not have the power to review its own order.

Thereafter, the complainant moved the National Consumer Disputes Redressal Commission. He argued that the State Commission’s order was incorrect, illegal, and should be set aside. He claimed that the hospital was negligent, which led to a rise in the patient’s blood pressure, body tremors, and unconsciousness and alleged that her condition worsened on July 28, 2012, due to negligent treatment, and that she later died on August 26, 2012, at a Critical Care Hospital due to brain death and a heart attack. He also complained that he was not provided with the case sheet and gave detailed facts in his appeal.

On October 3, 2025, no one appeared during the hearing, and the appeal was taken up for decision on merits based on the record and written arguments.

In his written submissions, the complainant alleged that the State Commission passed its earlier order without properly examining the record and without his participation. He also raised concerns about the functioning of the State Commission. He claimed that the hospital kept the patient on ventilation from July 28 to August 20, 2012, without proper medical support and dialysis. He further alleged that she was discharged in an ambulance without oxygen support and was shifted in an emergency condition to Aditya Multi Care Hospital. He maintained that no proper case sheet was provided and requested that the impugned order be set aside and his complaint be allowed.

While hearing the appeal, the Commission explained that negligence means failure to exercise reasonable care. To prove negligence, three elements must be established: (1) a legal duty to exercise due care, (2) breach of that duty, and (3) consequential damages. In medical cases, negligence arises when a doctor fails to exercise a reasonable degree of skill and care expected from a medical professional.

"The negligence can be normally explained as a breach of duty caused by omission to do something which a reasonable man guided by those considerations which ordinarily regulate the conduct of human affairs would do, or doing something which a prudent and reasonable man would not do. The actionable negligence consists in the neglect of the use of ordinary care or skill towards a person to whom the defendant owes the duty of observing ordinary care and skill, by which neglect the plaintiff has suffered injury to his person or property. The definition involves three constituents of negligence which are i) a legal duty to exercise due care, ii) breach of the duty and iii) consequential damages. The medical negligence may be explained as a want of reasonable degree of care or skill or willful negligence on the part of the medical practitioner in the treatment of a patient with whom a relationship of professional attendant is established, so as to lead to bodily injury or to loss of life. The absence or lack of care that a reasonable person should have taken in the circumstance of the case is held to be negligent. The three ingredients of negligence are i) the defendant owes a duty of care to the plaintiff, ii) the defendant has breached a duty of care and iii) the plaintiff has suffered an injury due to breach," observed the Commission.

The Commission referred to the principle laid down in Bolam v Friern Hospital Management Committee and also relied on several Supreme Court judgments, including Laxman Balakrishna Joshi v Trimbak Bapu Godbole, Jacob Mathew v State of Punjab, Kusum Sharma v Batra Hospital, and Martin F D'Souza v Mohd Ishfaq.

Emphasising that a medical professional can be held liable only if it is shown that he lacked the required skill or failed to use reasonable competence in treating the patient, the Commission said, 

"The Supreme Court in Martin F. D’Souza V Mohd. Ishfaq, (2009) 3 SCC 1 observed that simply because a patient has not favourably responded to a treatment given by a doctor or a surgery has failed, the doctor cannot be held straightway liable for medical negligence by applying the doctrine of res ipsa loquitur. No sensible professional would intentionally commit an act or omission which would result in harm or injury to the patient since the professional reputation of the professional would be at stake. A single failure may cost him dear in his lapse. It was also observed in this case that a medical practitioner is not liable to be held negligent simply because things went wrong from mischance or misadventure or through an error of judgment in choosing one reasonable course of treatment in preference to another. He would be liable only where his conduct fell below that of the standards of a reasonably competent practitioner in his field."

The Commission stated that the issue which needed consideration was whether the hospital committed any medical negligence during the treatment of the patient. 

The Commission agreed with the findings of the State Commission that the patient was suffering from Stage 5 Chronic Kidney Disease at the time she was admitted to Apollo Hospitals.

"The appellant has made only vague allegations in the complaint and the patient was got discharged from the respondent against medical advice. The State Commission rightly observed that the appellant could not point out any incident of negligence and no negligence could be attributed against the respondent. There is no convincing and cogent evidence which can establish any incident of negligence on the part of the doctors of the respondent in treatment of the patient which should not be expected from a medical professional doctor. 

The burden to prove negligence was on the appellant but the appellant could not discharge said burden by placing appropriate material on record. We are not convinced by the arguments of the appellant as detailed herein above. The mere bald allegations of medical negligence on the part of the respondent are not tenable as each and every allegation must be substantiated through medical documents and expert opinion which the appellant could not do. The appellant filed an application in the present complaint before the State Commission for seeking permission to obtain an expert opinion regarding the treatment given to his wife in the opposite party hospital but the State Commission vide its Order dated 28.06.2022 dismissed the said application," noted the Commission. 

Stating that the appellant failed to clearly explain how the hospital was negligent in treating the patient, the Commission said, 

"The appellant pleaded negligence in treatment of the patient and deficiency in service but the appellant except mentioning that the respondent was negligent in treatment of the patient did not state that how the respondent was negligent in treatment of the patient. The patient was given appropriate treatment to the patient. The respondent has acted like a reasonable man on considerations which ordinarily regulate the conduct of human affairs. There was no apparent or noticeable omission on the part of the respondent in the treatment of the patient. The respondent has taken appropriate care in the treatment of the patient. There is no evidence against the respondent that the respondent ever breached an ethical protocol in the treatment of the patient."

Applying the Bolam principle, the Commission held that the hospital had exercised the ordinary skill and care expected from a competent medical professional. There was nothing to show that the doctors failed to act with due diligence or reasonable competence.

The Commission further said, "The respondent cannot be held liable for medical negligence due to mere fact that the patient has not responded favourably to the treatment and unfortunately died. The respondent cannot be levelled with negligence in performance of its duty with reasonable skill and competence. There is no much force in the written arguments submitted by the appellant that the patient was died due to medical negligence on the part of the respondent as the patient was having a severe history of chronic kidney disease at fifth stage and undergoing dialysis thrice in a week besides other complications before approaching the respondent for second opinion."

Holding that the complainant failed to prove a deficiency in service, the NCDRC dismissed the appeal and upheld the earlier order absolving Apollo Hospitals of medical negligence charges.

To view the order, click on the link below: 

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