No deficiency in not Shifting Critical Patient to Higher Center: NCDRC absolves Orthopaedic Surgeon, General Surgeon, Anaesthetist, hospital

Dismissing the complaint, the top consumer court noted, "The patient was critical and unless his condition gets stabilized, shifting the patient to higher center was not advisable. We do not find there was deficiency in treatment, the treating doctors followed the reasonable standard of practice."

The issue concerned whether non-referral of the patient to the Specialist or higher center amounts to deficiency in service or medical negligence of the treating doctor/hospital.

The history of the case goes back to 2011 when the son of the complainant, about 17 years of age, had been hit by a train and was taken to the treating hospital. It was alleged that the doctors in the hospital didn't carefully attend the fatal head injuries. There was no neurosurgeon at the hospital and the patient was not referred to a higher center as well. Ultimately, the patient died.

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On the other hand, the hospital and doctors denied negligence during treatment and they treated the patients with all precautions.

When the complainants approached the District Forum, the Consumer Court allowed the complaint and awarded a sum of Rs 12 lakh to the complainants. However, the State Commission allowed the appeal and dismissed the complaint.

Being aggrieved by the order passed by the State Commission, the complainants approached the NCDRC.

After hearing the case details from both the parties and perusing the material on record, the medical record, the Post-Mortem Report and the opinion of CMO, the top consumer court noted that when the patient was taken to the hospital, he was in the state of haemorrhagic shock and sustained multiple fractures and head injury. Immediately, after conducting relevant investigations and X-rays, he was shifted to ICU and was kept under observation. The patient was initially managed in casualty.

The NCDRC also noted that the Post-Mortem report confirmed that the cause of death was fatal head injury and hemorrhagic shock. The report further stated that such ante mortem injuries are sufficient to cause death of the person and moreover, those injuries were sustained due to railway accident.

The top consumer court further perused the Medical Board's inquiry report, which mentioned that as per the treatment record injured was in critical state with hypotension (BP 70 systolic) and altered sensorium. It was further mentioned in the report that the specialist doctors at the hospital treated the patient as per their available facilities and their acumen. The report also mentioned that the patient suffered massive multiple organ Trauma in the rail accident and died because of it.

It was further informed that such types of injured patients need tertiary care facility treatment like CT Scan, blood transfusion and evaluation by Neurosurgeon. So, this patient should have been referred to a higher institute after the initial management.

After taking note of all the relevant documents, the consumer court opined that the patient after being evaluated by specialist doctors including an Orthopaedic Surgeon, General Surgeon and Anaesthetist, was treated as per their reasonable skills and standard of practice.

"We do not find any failure of duty of care or negligence from the Opposite Parties to refer the patient at higher centre, because it was a serious accident and the patient was in critical stage. It was the duty of the attending doctors to treat the emergency and stabilize the patient before referring to the higher centre for further management. We find the doctors took the required care as under standard of practice to deal with the emergency situation," observed NCDRC.

At this outset, the top consumer court further referred to Supreme Court judgment in the case of Jacob Mathew v State of Punjab (2005), wherein the Apex Court had noted that a mere deviation from normal professional practice is not necessarily evidence of negligence. So long as it can be found that the procedure which was in fact adopted was one which was acceptable to medical science as on that date, the medical practitioner cannot be held negligent merely because he chose to follow one procedure and not another and the result was a failure.

Referring to the Supreme Court judgment, the NCDRC noted,

"The patient was critical and unless his condition gets stabilized, shifting the patient to higher center was not advisable. We do not find there was deficiency in treatment, the treating doctors followed the reasonable standard of practice."

Dismissing the revised petition, the top consumer court noted,

"Based on the foregoing discussion, there is no merit in the instant Revision Petition. We concur with the Order of the State Commission. The Revision Petition is dismissed. There shall be no order as to costs."