Ruby Hall Clinic held Liable for hiring an Unqualified Anaesthetist

Pune : Experience cannot count as a replacement for a specialized qualification. The Maharashtra State Consumer Forum has made this amply clear in a medical negligence case pointing out that an MBBS doctor not having a PG in Anesthesia, despite having an experience in the field, cannot be considered as an Anesthetist

The case is that of a five year old child, who was admitted to the Grant Medical Foundation Ruby Hall Clinic, Pune for the purpose of removal of Kidney stones under the care of Dr.Balwant Singh Ratta, a qualified Euro Surgeon. She was operated upon by the Dr Ratta, with Dr.Rusi Nariman Marolia, the anaesthetist attached the hospital, administering pre-operative anesthesia to the patient. On the day of operation, in the evening the patient became critical as the heart beats were reduced though put on ventilator. Unfortunately,soon after the child( patient) died. The family, alleging medical negligence by doctors filed a case with the Consumer Court.

The court summarized the core issues of the complaint as follows

(i) Whether opponent no.2 i.e. Dr.Balwant Singh Ratta exercised due caution while carrying out the operation for removal of the kidney stones of the patient?
(ii) Whether informed and valid consent was obtained prior to carrying out operation for removal of kidney stones?
(iii) Whether Opponent No.3. Dr.Rusi Nariman Marolia is qualified and authorized to claim himself as a Anesthetist to administer anesthesia to the patient?

Expert committee of the doctors from Sassoon hospital was appointed to go into the root of the incident. It is reported that while both the expert Committee and the hon'ble court found no negligence on the first two points, but it was the qualification of Dr Marolia that came under question.

The Committee arrived at the conclusion that Dr.Rusy Marolia though he may not be having degree in anesthesia but he has the basic qualifications. Since 1st August, 1966 to 31st January, 1969 he worked as Resident Doctor in Sassoon General Hospital who has obtained knowledge and expertise in surgical anesthesia. From the year 1975 he has been practicing as anesthetist in the opponent no.1 hospital and Committee expressed its opinion that the training and experience gained by Dr.Rusy Marolia i.e. opponent no.2 is sufficient qualification to work as anesthetist.

The court however, did not agree with the committee pointing out that hiring a doctor with an MBBS qualification to the post of anesthetist was in violation of the Medical Council (Professional Conduct, Etiquette and Ethics) Regulations 2002, which prohibit an unqualified person from practicing in a field in which he had not have the requisite qualification. It was also in contravention of the law as interpreted by the Supreme Court in the case of Poonam Verma v/s Dr Ashwini Patel where unqualified persons were held to be quacks and charlatans

We are of the opinion that the Medical Counsel of India and Maharashtra Medical Council dealing with modern medicines and the practitioners registered with them shall take cognizance of the fact that the unqualified person viz. Dr. Rusy Marolia has been there in the opponent no.1 hospital for years practicing as anesthetist on the basis of some certificate and elementary training at his command jeopardizing lives of patients.

Owing to the above fact, the court held both the hospital and the doctor liable for negligence

... Dr. Marolia without there being requisite qualification as required under the statute rules and regulations has been working as Anesthetist since 1975 with the Opponent no.1 hospital which per se establishes guilty of negligence against him and also warrants action by competent authorities, i.e. Indian Medical Council and Maharashtra Medical Council. It is unassuming that the opponent no.1 A public Trust running the hospital to render services to the patient has employed opponent no.3 – Dr. Marolia as Anesthetist, even though, he does not possess the required qualification as per the norms and standards laid down for the post of Anesthetist. In view of this both Dr. Marolia and the opponent no.1 are liable for negligence per se in rendering services to the patient. We on this background are convinced to hold deficiency in service against opponent nos.1 and 3 for serious medical negligence.

With this the court ordered the hospital as well as Dr Marolia to pay a lumpsum compensation of Rs 10 lakhs to the parents of the deceased child, and an additional amount of Rs 80,000/ for expenses and litigation costs. It was directed that compliance of the order should be made within 45 days, else the amounts awarded would carry interest at 9% for the period of delay. A copy of the judgement has been forwarded to the Medical Council of India for disciplinary action