Medical Negligence: Can Hospitals escape liability simply because treatment was provided at no cost?

Ahmedabad: The State Consumer Disputes Redressal Commission (SCDRC), Gujarat, recently held that even when the treating hospital has not charged any fees from the patient, the service provided by the hospital would fall within the definition of service and the patient would be considered as a consumer under the Consumer Protection Act, 1986.

Such an observation was made by the Gujarat State Consumer Court while considering the appeal filed by the family of a patient, who died while receiving post-operative treatment at a hospital after undergoing kidney-stone surgery.

The District Commission had dismissed the complaint filed by the patient's family on the ground that the deceased was not a consumer under the Consumer Protection Act, as the hospital provided free treatment.

However, the State Consumer Court relied on a Supreme Court order and quashed the District Commission's order and remanded the case back to the District Commission, Bhavnagar, to consider it afresh on merits.

The history of the case goes back to 2013, when the patient was admitted to Akshar Surgical Hospital of Dr. Ghelani of Bitad for the treatment of a kidney stone. Based on the doctor's advice, an operation for the removal of the stone was performed in the hospital. Even though the operation was successful and there was no difficulty, allegedly, at the time of discharge, the hospital administered an antiseptic injection in the patient's vein, which directly affected the patient's heart, and the condition of the patient deteriorated, leading to his death.

Consequently, the legal heirs of the deceased filed the consumer complaint before the District Consumer Court and alleged that the patient died on account of medical negligence on the part of the treating hospital and doctor.

The District Consumer Court dismissed the complaint on the ground that the Complainant was not a consumer as defined in the Consumer Protection Act, since the hospital did not charge the patient doctor for the treatment and the surgery.

Being aggrieved and dissatisfied with the said order, the complainant filed an appeal before the State Consumer Commission. The counsel for the complainants relied on the Supreme Court order in the case of Indian Medical Association vs V. P. Shantha and noted that service rendered at a Government hospital/nursing home where services are rendered on payment of charges and also rendered free of charge to other persons availing such services would fall within the ambit of the expression 'service' as defined in Section 2(1)(o) of the Act irrespective of the fact that the service is rendered free of charge to persons who do not pay for such service.

Free service would also be "service" and the recipient a "consumer" under the Act. Therefore, the impugned Order passed by the learned District Forum requires to be quashed and set aside, and the matter requires to be remanded back to the learned District Commission to decide the case on merits in respect of medical negligence on the part of the Hospital, argued the counsel for the complainants.

On the other hand, the counsel for the Insurance Company submitted that the order passed by the District Forum was just and proper and as per the Supreme Court's decision in the case of Indian Medical Association versus V. Р. Shantha, service rendered at a non-Government hospital/Nursing home where no charge whatsoever is made from any person availing the service and all patients (rich and poor) are given free service - is outside the .purview of the expression 'service' as defined in Section 2(1)(o) of the Act. The payment of token amount for registration purpose only at the hospital/Nursing home would not alter the position.

While considering the matter, the State Commission perused the conclusion arrived by the Supreme Court and observed that the Apex Court in the judgment in question concluded that the service rendered at a non-governmental hospital or a nursing home, where no charge is made from any person availing the service and all parties (rich and poor) are given free service outside the purview of expression "service" as defined in section 2(1)(o) of the Act.

"But.. the conclusion service rendered at non-government hospital or nursing home where charges are required to be paid by persons who are in a position to pay and persons who cannot afford to pay are rendered service free of charge, would fall within the ambit of expression "service" as defined in Section 2(1)(o) of the Act, irrespective of fact that the service is rendered free of charge to persons who are not in a position to pay for service. Free service would also be service and the recipient is Consumer under the Act," the consumer court noted.

Accordingly, the State Commission decided to remand the matter back to the District Consumer Court and ordered,

"So according to our considered opinion, looking to the facts of the present case, the conclusion arrived at by the Hon'ble Supreme Court in Para No. 8 of Page No. 17 of the Judgment would be applicable in this case and accordingly, even when the Opponent No. 1- Hospital has not charged any fees from the Deceased - Patient, the service provided by the hospital would fall within the definition of service and the deceased is said to be consumer as defined in Consumer Protection Act, 1986 and therefore, the impugned Order passed by the learned District Forum dismissing Complaint on the ground that deceased is not a Consumer is not just and proper and the same is erroneous and perverse and against the Judgment of the Hon'ble Apex Court and hence, the impugned Order passed by the learned District Forum dismissing Complaint requires to be quashed and set aside and Case No. 44 of 2014 filed by the legal heirs of the deceased *** before the learned District Forum, Bhavnagar requires to be remanded back to the learned District Forum for deciding the case afresh on merits in respect of the medical negligence on the part of the hospital after giving sufficient opportunity to produce the evidence of all the parties of the case."

"The learned District Commission, Bhavnagar is hereby directed to decide the Case No. 44 of 2014 filed by the legal heirs of the deceased *** against the Akshar Surgical Hospital and Oriental Insurance Company Limited afresh on merits in respect of the medical negligence of the hospital by giving sufficient opportunity to lead evidence of all the parties...Since the matter is of year 2014, learned District Commission is hereby requested to decide the matter, preferably within a period of six months from the date of the Order of this Appeal. Parties are also directed to extend their fullest cooperation to the learned Commission to dispose of the matter as per the direction given by this Commission as aforesaid," ordered the Court.

To view the order, click on the link below:

https://medicaldialogues.in/pdf_upload/gujarat-scdrc-303227.pdf

Also Read: Doctors Liability Under Consumer Protection Act: Review petition filed in SC