Wrong diagnosis or error cannot amount to medical negligence: Consumer Forum absolves Pediatrician

Justice S P Tavade, President and A Z Khwaja, Judicial Member, while pronouncing the verdict has set aside an order issued by the District Consumer Disputes Redressal Commission, Satara that directed the doctor to pay a compensation of Rs 1 lakh for the alleged medical negligence.

The case concerns a resident of Satara district, who visited Phade Hospital with his son in 2001 due to fever. The pediatrician examined the patient, prescribed medicines, and charged a fee. After a few days, they revisited and the doctor once again examined the child, took urine and blood samples, and prescribed more medicines with a follow-up. However, the patient's condition hadn't improved, so the doctor prescribed medicines for another seven days. Further, with no improvement, more medicines were prescribed for 9 to 10 days. Thereafter, the doctor conducted tests as the fever continued to worsen, but refused to admit the patient. Ultimately, the patient passed away.

Aggrieved, the complainant moved the District Forum alleging negligence and mental agony, seeking Rs 2,00,000 in compensation from the doctor. It was the case of the complainant that the paediatrician had not properly diagnosed the condition of his son and therefore, had not admitted him as indoor patient nor had provided necessary and adequate medical treatment and therefore, there was medical negligence on the part of the doctor which resulted into unfortunate death of his son.

After receiving the notice, the paediatrician acknowledged providing treatment to the complainant's son but vehemently denied any negligence or lack of proper treatment. The doctor refuted the allegation that she had not admitted the complainant's son, stating that it was the complainant who refused admission. It was submitted that when the complainant's son visited, he only complained of leg pain, and medications were provided accordingly. Later, the doctor advised admission, but the complainant declined.

Further contending that she was working as child specialist with well known hospitals and her treatment was not only proper but on correct line, the doctor maintained that there was no negligence and deemed the complaint malicious and legally unsustainable, requesting its dismissal.

The District Consumer Commission in Satara, after reviewing the evidence presented by both the complainant and the opponent, Dr Phade, along with the relevant documents and arguments, determined that the doctor's actions constituted medical negligence and amounted to deficient service. Consequently, the District Consumer Commission ruled in favor of the complainant and ordered the pediatrician and the insurance company (opponent No. 2), to pay Rs 95,000 as compensation along with Rs 5,000 in costs.

However, the pediatrician moved an appeal against the judgment and order issued by the District Consumer Commission in Satara, raising several grounds for her challenge.

The doctor's counsel argued that the District Consumer Commission in Satara failed to properly evaluate the evidence and erroneously relied on the complainant's testimony without expert evidence. It was submitted that on the day of the incident in 2001, the patient was examined and found not to have a fever. His elevated heart rate at 130 per minute, above the normal range, prompted the doctor to conduct ASO titer and RA factor tests and a chest x-ray, all of which yielded negative results. The doctor then prescribed Tablet Lasix (40 mg) to lower the heart rate and Tablet Enderal (10 mg) to stabilize it. She also recommended the complainant admit his son as an indoor patient, but the complainant declined. The pediatrician relied on case papers, provided in the record, which support these claims and confirmed that the patient was indeed directed to be admitted. The counsel contended that the District Consumer Commission failed to scrutinize this aspect adequately.

Secondly, the doctor's counsel argued that the District Consumer Commission did not consider the affidavits of two experts, Dr. Madhav Abaji Pol and Dr. Sukumar Surchand Vora, both of which are part of the record. Upon reviewing these affidavits, it came to light that both experts, who are medical practitioners themselves, stated that the doctor had conducted a proper investigation of patient, advised his admission for observation, and provided appropriate diagnosis and treatment. They also noted that while patient's death had occurred, no Post Mortem Report had been submitted to establish the exact cause of death. The complainant alleged that patient died in 2001 but failed to provide a Post Mortem Report or other medical documents to ascertain the precise cause of death.

Furthermore, the counsel strongly contended that despite the complainant's specific claim of improper diagnosis and insufficient medical care for his son, no substantial evidence supported these allegations. Conversely, the doctor presented expert testimony from two medical practitioners, supported by affidavits, demonstrating that appropriate and attentive care was provided to the patient, including the administration of necessary medicines.

During arguments, the doctor's counsel cited a relevant Supreme Court judgment, Civil Appeal No. 2024 of 2019, titled 'Vinod Jain Vs. Santokba Durlabhji Memorial Hospital & Anr.,' decided on 25th February 2019. The case contained similar observations to the present matter.

After hearing the contentions and perusing the records, the Commission observed that the complainant has not provided any expert testimony to establish a lack of proper medical care or diligence on the part of the doctor. It further said, "The testimony of these two witnesses is clearly falsified by the medical papers maintained by appellant/opponent hospital and the same clearly shows that on 24/02/2001 the appellant (doctor) had advised admission and the same is clearly written in the medical papers."

The Commission found it significant to note that the complainant has not provided any explanation for why he did not seek treatment at another hospital on 24/02/2001 when his son's condition worsened, nor has he presented evidence of consulting another doctor that night. Additionally, he has not submitted any documents, including a Post Mortem Report, to determine the precise cause of his son death.

In contrast, the pediatrician (appellant/opponent) has relied on the affidavits of two medical practitioners, Dr Madhav Pol and Dr Sukumar Vora, who unequivocally affirmed that the patient received appropriate medication after a proper diagnosis. They further attested that the treatment given was highly suitable for the patient's condition.

In light of this, the Commission noted;

"It was the duty of the complainant to adduce positive evidence to show that the line of treatment given or the medicines prescribed were not adequate or proper for the condition of his Son and the same amounted to medical negligence. But no such evidence is led by the Complainant."

Based on the evidence and materials presented, the commission noted that;

"It is very much clear that the Son of the complainant died on 24/02/2001, after he was taken back from the hospital of the appellant doctor. Complainant has alleged that his Son was suffering from high fever and leg pain and thereafter he collapsed, but, surprisingly, the complainant has not placed on record any papers which could show the exact cause of death of the Son of the complainant. But the medical papers filed by the appellant show that on 24/02/2001 the appellant had given all the necessary medicines and had also conducted the tests taking into consideration the health of the patient. There is also no material to show that the death of the patient had taken place due to consumption of the said tablets prescribed by the appellant in wrong manner."

Coming now to the position of law, the Commission further said;

"It is well settled principle of law that wrong diagnosis or error cannot amount to medical negligence. It is well settled that to establish liability on the medical practitioner it must be shown by positive evidence that the medical practitioner had not exercised necessary skill and caution as required by the medical practitioner."

It referred to the landmark case of Jacob Mathew Vs. State of Punjab & Anr., reported in 2005(3) CPR 70 (SC) that a person is not liable in negligence because someone else of greater skill and knowledge would have prescribed different treatment or operated in a different way. It is also observed by the Hon’ble Supreme Court that a mere deviation from normal professional practice is not necessary evidence of negligence.

Subsequently, the Commission set aside the order passed by the District Consumer Disputes Redressal Commission, Satara, and dismissed the complaint filed by the complainant against the pediatrician. It held;

"In the present case the Complainant has made allegations relating to medical negligence on the part of Dr Phade stating that the pediatrician had not at all given proper medical treatment to his Son and the same amounted to deficiency in service. But, as discussed earlier the Complainant has not adduced any independent positive evidence of any medical expert to show that the treatment given by the appellant Dr Phade was not on proper lines or was wrong or that the treatment given by the appellant led to a cause of death of his Son . There is no material to connect the death of with the treatment given by the appellant. At this stage it is also necessary to mention that even the learned District Consumer Commission has also not made any efforts to call for any independent report of any independent body like medical board. However, in absence of such positive evidence, the learned District Consumer Commission has arrived at findings of medical negligence on the basis of evidence of two witnesses and has also given findings that there was an error in the diagnosis by the appellant Dr Phade."

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