No negligence of Doctors in case of LAMA Patients: National Commmission

In case of Patient leaving the Hospital against the Medical Advice (LAMA), no negligence can be attributed to Doctors"

This was the observation made by the National Consumer Disputes Redressal Commission in a recent judgement pronounced on 31st January, 2017. (Patient)Leaving Against Medical Advise, popularly also known as LAMA, is the scenario which might be seen in various hospitals routinely. This Judgment is a lesson for patients and for Doctors as well, as it yet again emphasises the importance of proper treatment and maintaining the record.

Case details - TARLOK CHAND MATTU V/s. M/S. VASAL HOSPITAL & ANR.
REVISION PETITION NO. 2369 OF 2016.
Decided on 31 Jan 2017

Allegations of the Complainant in short :

1. The Patient in this case i.e. the wife of the complainant, was admitted in the Hospital and was shifted to ICU. Certain tests worth Rs.1900/- were conducted, but the complainant alleged that reports were not shown to the Complainant nor the ailment details were shared with him. The complainant, who is a handicapped, stated that he had to run from pillar to post for seeking medical assistance.
2. The Complainant and the Patient were pushed out from the Hospital in a very inhuman manner. The Ambulance was also arranged by the Complaint at his expense and not by the Hospital and on way the Patient passed away.
3. Hence the Complaint was filed for Rs. 10,50,000/-

Defense of Hospital :

1. The patient with symptoms of fever, nausea, body ache, vomiting and weakness was admitted in ER and was attended by the emergency doctors and was treated properly.

2. After certain tests, it was diagnosed that the Patient had Leucopenia (Low White Cells), Thrombocytopenia (Low Platelets Count), High SGOT, SGPT (Liver Enzymes) and viral fever with hepatitis.

3. Due to then existing epidemic of dengue fever in the city, a provisional diagnosis of dengue fever was made.

4. However after few hours, the patient’s condition started worsening, may be due to Dengue Shock Syndrome (DSS). The patient’s attendants were also informed about her condition and the treatment given. In this course, the patient left against the Medical Advice.
However, both the lower forums on evidence, dismissed the Complaint and hence the Revision was filed in national Commission.

Held :
The National Commission after perusing the evidence on record and after hearing of the parties on merits and relying upon landmark judgments of Hon. Supreme Court, dismissed the Revision and observed as :

1. The Complainant failed to establish as to exactly what the Doctor ought to have done. There was no iota of evidence to buttresses the allegation that the patient was not given proper treatment.

2. All the necessary treatment to prevent the Dengue Shock Syndrome (DSS), which is a common complication of such viral fever, was given.

3. Quoting the observations of the district forum, the court stated that Vide Ex. R-3, the history sheet prepared by OPs, it is recorded that at about 5 PM, the complainant stated that he wantd to take his wife to DMC Hospital Ludhiana and patient left the hospital against medical advice.

4.If the Patient had left against medical advice and there is no material on record to establish that the care, which ought to have been taken, has not been taken, no negligence can be attributed to Doctors.

The court dismissing the revision petition, clearly observed,

If the Patient had left against medical advice and there is no material on record to establish that the care, which ought to have been taken, has not been taken, as laid down by the Hon’ble Supreme Court in Jacob Mathew v. State of Punjab & Anr., (2005) 6 SCC 1 and several other judgments, no negligence can be attributed to the Opposite Parties.   

The Doctors colleagues must have faced such situation at least once in their practice. As it is said “Nor record is no defense and poor record is poor defense”, this case exactly emphasises this aspect. If the patient is not satisfied with the treatment, he has every right to change the Doctor / Hospital and in such cases, proper documentation, consents are essential, that may in turn protect Doctors if the cases are filed.

Thanks and Regards,

Adv. Rohit Erande
Pune. ©

http://cms.nic.in/ncdrcusersWeb/GetJudgement.do?method=GetJudgement&caseidin=0/0/RP/2369/2016&dtofhearing=2017-01-31