No doctor does negligence knowingly: NCDRC refuses patient's kin plea to enhance compensation

Stressing on the State Commission's remark that, 'No doctor does negligence knowingly and nor his objective are that he will give wrong treatment', Presiding Member of NCDRC, Dr S M Kantikar observed that the death of the patient, as alleged by the patient's kin, should not be attributed to the Anti Tubercular Treatment (ATT) advised by the doctor, adding that the State Commission awarded just and proper compensation, considering the peculiar facts and the known complication of ATT.

The case is that in 1998, a patient was taken to the doctor for respiratory problems. It was diagnosed as pleural effusion of left lung and he was admitted in the doctor’s nursing home. The effusion fluid was removed and he was discharged. It was alleged that due to consumption of medicines prescribed by the doctor, the patient lost his appetite and developed jaundice. The patient visited the doctor repeatedly, but he allegedly ignored the patient. And again, the doctor himself admitted the mistake and did not stop Anti Tubercular Treatment (ATT), alleged the patient's kin. For jaundice, he referred the patient immediately to RML Hospital, New Delhi.

Thereafter, the patient got admitted in Safdarjung Hospital, New Delhi and diagnosed as Drug induced hepatitis. The patient was in the Safdarjung Hospital for some time. He developed kidney problems (loss of urine) and dry gangrene of both foot. Therefore, for dialysis, he was shifted to Batra Hospital. Unfortunately, the patient eventually died.

Being aggrieved by the alleged negligent treatment causing death of the patient, the patient's son filed a complaint before the District Forum to claim Rs 4,40,000/-.

In response, the medical practitioner filed written version and submitted that he diagnosed the case as tubercular pleural effusion and started the best available treatment for TB. He further submitted that in the Safdarjung Hospital, the same diagnosis was made and the same medicines were given. Thereafter, it was diagnosed as drug induced hepatitis.

The District Forum, allowed the Complaint and directed the doctor to pay compensation of Rs. 50,000/- and Rs. 5,000/- for mental agony with cost of litigation amounting to Rs. 2,500/-.

Being aggrieved at the amount of compensation, the Complainant filed the First Appeal before the U.P. State Commission for the enhancement of compensation. The Appeal was dismissed with the following observation:

“The appellant reiterated that the amount of compensation in passing judgement should be having enough ground to increased and must be grant the compensation, as prayed in the plaint. No doctor does negligence knowingly and nor his objective are that he will give wrong treatment. Hon'ble District forum found Doctor guilty and by self-discretion compensation has also been appliqued. In such situation we came to the conclusion that there is no need to interfere in the decision and order taken by the Hon'ble District Forum regarding the question and the order is reasonable and lawful. The appeal deserves to be rejected.”

Aggrieved, the Complainant filed the instant Revision Petition against the Order passed by U.P. State Consumer Disputes Redressal Commission in 2022.

On careful perusal of the medical record of RML Hospital, Safdarjung Hospital, Batra Hospital and the prescriptions of the doctor, the Commission concluded that the patient was properly investigated by the doctor and thereafter, he started ATT for tuberculosis. The patient took ATT for one month and he was under regular follow-up of the doctor. As the patient developed jaundice, due to drug induced hepatitis, on 21.11.1998, the doctor referred him to RML Hospital. From there, the patient went to Safdarjung Hospital for further treatment, wherein he was investigated. The X-ray revealed pulmonary Koch’s and the ATT was continued. The patient further developed Anuria (renal problems) and dry gangrene of right foot. The surgical opinion was also taken.

The apex consumer body noted;

"In the instant case, the diagnosis and ATT treatment was necessary. The doctor treated the patient with appropriate ATT regime. I find it as reasonable standard of care. From the standard textbook on medicine (Harrison’s Internal Medicine), it is known complication that ATT drugs cause hepatotoxicity, and it is reversible."

Subsequently, the Commission dismissed the revision petition. It held;

"In the instant case, as the patient developed jaundice, he was immediately referred to higher centres for further management. In my view, the renal problem and gangrene of foot, both are not related or resulted due to ATT treatment. Therefore, the death of the patient shall not be attributed to the ATT treatment advised by the doctor. However, the State Commission awarded just and proper compensation, considering the peculiar facts and the known complication of ATT. The same is affirmed. Based on the discussion above, there is no merit in the instant Revision Petition, same is dismissed."

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