Court quashes Medical Council order against Cardio, warns against Compensation Culture

The bench comprising of Justice Krishna S Dixit further opined that doctors like public servants should be legally protected from bonafide errors in their actions.

Such observations came from the bench while it noted that in many cases patients and their relatives are recklessly suing the doctors at the slightest opportunity either to make fast money or to get an acceptance of their guilt.

"It does not need research to show that more often than not, the cases of medical negligence are launched recklessly by the patients and their relatives; 'compensation culture' which obtains in other jurisdictions is gradually gaining entry to the field of medical services in our society affecting a healthy relationship of doctor & patient; it is tritely said "faith heals and not the medicine"; faith here means the one reposed in the treating doctor; courts have been nowadays observing that an unscrupulous section of the people are prone to use the slightest opportunity to sue the doctors and hospitals, in the hope of making fast buck," observed the court.

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While determining the motivation of people for such actions, the bench opined, "the motivation of people bringing actions for medical negligence are more complicated: some sue for money; others sue for getting an acceptance of guilt; some others do it to ensure that errors would not be repeated; but a large chunk of cases does not involve bonafide claims, cannot be much disputed; the 'compensation culture' be it truth or a myth in varying degrees, has given rise to risk aversion; medical professionals having a complaint made against them gather an impression that there is an unjustifiable attack on their professional integrity and reputation; this may lead to a defensive response of the medicos ultimately resulting into enormous cost escalation in medical services.

These observations came from the bench while it was considering the plea by a doctor "who was administered the punishment of 'warning' by Karnataka Medical Council by an order dated 07.05.2009. The council had passed such an order for the alleged occupational lapse by the doctor, to be more specific for alleged procedural breach in accomplishing angioplasty to an aged & ailing pattient.

Challenging this order of the Council, the doctor filed a petition before the High Court and sought quashing of the order.

The council for the petitioner doctor submitted before the court that the concerned patient was suffering from multiple ailments including diabetes, Neuropathy, Nephropathy, etc., and she was being treated by several other doctors in different hospitals at different times.

At this outset, the court opined that the first error on the face of record was that even though the patient was treated by many other doctors, the allegation was made only against the petitioner doctor and the other doctors were not even issued with a show-cause notice.

After perusing the medical record, the bench further noted that the patient was already aged 65 years and she was suffering from ailments natural to declining age of life. "it is a common knowledge that the evening of life, some diseases come and stay with beings, be it humans or other, as inevitable guests; an aged person suffering from ailments of the kind, is visited by yet another disease more particularly affecting the functioning of heart, the degree of mortality increases," noted the court.

Referring to the records, the bench observed that "the patient had some significant problem with Cardio Vascular Vein since long and therefore, she had undergone angiogram at the hands of the petitioner; however, the medical records including the impugned order prima facie show that the cause of death is the serious bacterial infection later contracted; there is huge time gap between accomplishment of angioplasty by the petitioner and the demise of the patient; there is nothing on record to show that the alleged deficiency in professional service accelerated the process of health deterioration that eventually resulted into her death."

"Some positive evidentiary material was necessary to eliminate the possible nova causa interveniens; therefore, there is no reasonable connect or nexus between the medical procedure done by the petitioner and death of the patient," the court held.

Further noting that the realm of medicine is an ever growing branch of uncertain medicine, the court then referred to William Osler, a Canadian Physician, who more than a century ago had held that "medicine is a science of uncertainty and an art of probability".

At this outset, the bench also added, "the advancement of science & technology has to some extent reduced the level of such uncertainty and enhanced the degree of probability, is also true; however, it cannot be disputed that the medical field is still in a fluid state."

The judgment further added,

"Even if it is shown that a drug or a procedure did cause an injury, it is difficult to ascertain whether this is because of the drug or the procedure; for example, it might be that the drug or the procedure is not defective if it provides a cure for the vast majority of people, although it has undesirable consequences for a small number of people; if a patient is of the unlucky few, there will be difficulty in concluding that the drug or the procedure was actionably defective; this is only to highlight the uncertain causation obtaining in the realm of medical liability; this aspect ought to have animated the decision making process that culminated into the impugned order of penalty; however, that having not happened, the impugned order suffers from another legal infirmity."

Finally, the bench referred to Vedic literature which lauded medical practitioner and medicine as 'vaidyo naaraayano harihi', which means that a true doctor as a healer is God. In this context, the High Court bench also pointed out how during COVID pandemic, the doctors and paramedics served the society.

"Society has to gratefully appreciate the valuable services rendered by the medicos; however, at times, being the victims, the medicos are made to apologize to the attackers and this led to the State enacting the Prevention of Violence Against Doctors, Medical Professionals, and Medical Institutions Act, 2018; having said all this, this court hastens to add that the doctors' is a profession wherein service ought to be the motto and not the profit; as any professionals, they too are not immuned from legal action for medical negligence," clarified the Court while it absolved the petitioner doctor from all allegations.

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