SC exonerates Andhra doctor, hospital, holds Every Death in Hospital is not medical negligence

New Delhi: Considering medical negligence allegations against Visakhapatnam-based Care hospital and its doctors, the Supreme Court recently stated that "every death in an institutionalized environment of a hospital does not necessarily amount to medical negligence on a hypothetical assumption of lack of due medical care."

Although the plea claimed that the doctors and the hospital were negligent while providing treatment to the patient and there was also delay in treatment, the Supreme Court bench comprising of Justice D. Y. Chandrachud, Justice A. S. Bopanna and Justice J. B. Pardiwala dismissed the plea after referring to the NCDRC judgment. 

"Unless the appellants are able to establish before this Court any specific course of conduct suggesting a lack of due medical attention and care, it would not be possible for the Court to second-guess the medical judgment of the doctors on the line of medical treatment which was administered to the spouse of the first appellant," noted the Supreme Court bench.

In the main case concerned, the complainant had filed a complaint before the top consumer court alleging medical negligence during the treatment of her husband, who lost his life. The patient had been vomiting and was taken to the casualty of Care Hospital. After being taken to the casualty, the patient started complaining about breathlessness 

It was alleged by the complainant that after giving one injection to the patient, he started developing convulsions and cramps and became unconscious. One of the assisting doctors had allegedly informed about 70% of blockage of arteries of heart and the doctors had also demanded costly medicines as well. Although the patient was shifted to the ICU, he could not be saved.

The complainant had alleged that precious time was wasted in casualty for non-administration of initial injection, non-supply of the oxygen mask and not shifting the patient to the ICU on time. Further, the complainant claimed that despite requests for entire medical record, the hospital supplied only three documents. Therefore, the complainant had approached the NCDRC bench and prayed for a compensation of Rs 7 crores with 18% interest and Rs. 3 crores for mental agony from the hospital and doctors.

On the other hand, the Director of the Care Hospital denied all the allegations of medical negligence. It was submitted that the patient and his wife did not disclose the fact that the patient was suffering from diabetes for the last 20 years and was on insulin injections. The Hospital submitted that the patient had been given injection Zofar commonly used for nausea and vomiting and Pantocid injection for acidity.

When the ECG was taken it showed subtle changes, and after that the Cardiologist Dr G.S.R Murthy was informed. As the patient developed severe breathlessness followed by respiratory arrest, Code Blue was announced and immediately, as per ACLS (algorithms for Advanced Cardiac Life Support) guidelines, CPR was started with Ambuventilation. Apart from this, the patient was given injections of Adrenaline and Inotropes. The Cardiologist attended the patient and after 20 minutes of CPR, the patient regained rhythm and the second ECG was taken. It showed the patient had suffered massive heart-attack. The relatives had been informed about this and immediately the patient was taken to mechanical ventilator. The doctors and the hospital submitted that despite shifting the patient to ICCU and taking all the measures, the patient could not be revived.

After perusing the entire medical record, the bench had observed, "The record revealed that the Cardiology resident doctor (Opposite Party No. 3) was present on duty and regularly briefing the relatives of the patient about the health status of the patient. We do not accept that the patient was not admitted in ICU till arrival of the Cardiologist or that Oxygen was not given and there was delay in the treatment of the patient."

Exonerating the Hospital and the doctors, the top consumer court had further noted,

"We note that the doctors made all efforts to resuscitate the patient from the cardiac arrest but could not revive the patient. In our view, they performed their duty with reasonable standard of care. We do not find any deficiency either from the hospital or the treating doctors."

In the order dated 24 March, 2021, the NCDRC bench had also clarified that "It should be borne in mind that simply proving the suffering of ailment by the patient does not amount to medical negligence."

However, challenging the top consumer court's order, the Hospital and the doctors approached the Supreme Court. While considering the plea, the top court bench noted that the NCDRC had considered the evidentiary material produced in support of the complaint alleging medical negligence and the NCDRC had not found any act of negligence.

Referring to this, the Supreme Court bench noted that

"Unless the appellants are able to establish before this Court any specific course of conduct suggesting a lack of due medical attention and care, it would not be possible for the Court to second-guess the medical judgment of the doctors on the line of medical treatment which was administered to the spouse of the first appellant. In the absence of any such material disclosing medical negligence, we find no justification to form a view at variance with the view which was taken by the NCDRC."

"Every death in an institutionalized environment of a hospital does not necessarily amount to medical negligence on a hypothetical assumption of lack of due medical care," it further observed.

Therefore, dismissing the plea, the Supreme Court bench mentioned in the order, "In the circumstances and having due regard to the test which has been laid down by this Court in its decisions governing medical negligence, we see no reason to entertain the appeal. The appeal is accordingly dismissed."

To read the Supreme Court order, click on the link below.

https://medicaldialogues.in/pdf_upload/supreme-court-medical-negligence-185427.pdf

To read the NCDRC order, click on the link below.

https://medicaldialogues.in/pdf_upload/ncdrc-no-medical-negligence-185428.pdf

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