To Hold A Medical Practitioner Liable For Negligence, A Higher Threshold Limit Must Be Met: Supreme Court

The Supreme Court, while hearing a set of appeals pertaining to the medical negligence matter, observed that to hold a medical practitioner liable for negligence, a higher threshold limit must be met. This is to ensure that these doctors are focused on deciding the best course of treatment as per their assessment rather than being concerned about possible persecution or harassment that they may be subjected to in high-risk medical situations.“Therefore, to safeguard these medical practitioners and to ensure that they are able to freely discharge their medical duty, a higher proof of burden must be fulfilled by the complainant. The complainant should be able to prove a breach of duty and the subsequent injury being attributable to the aforesaid breach as well, in order to hold a doctor liable for medical negligence.,” Justices Hrishikesh Roy and Manoj Misra.The Bench was hearing the appeals filed under the Consumer Protection Act, 1986, (Act) assailing the impugned decision passed on February 16, 2018, by the National Consumer Disputes Redressal Commission (NCDRC) in a Consumer Case filed by Mrs. Sunita Parvate. In the same she had alleged that medical negligence in her treatment at Suretech Hospital which resulted in permanent damage to her respiratory tract and permanent voice-loss.As per the complaint, the main claim of negligence was the unnecessitated and forcefully-conducted Nasotracheal Intubation (‘NI’) procedure which was the only reason she suffered from voice-loss and permanent deformity in her respiratory tract. The ‘NI’ procedure was carried out, despite multiple failures in decannulating the ‘TT’. It may be noted that the ‘NI’ procedure entails inserting an endotracheal tube through the patient’s nose, to assist in breathing. The NCDRC directed Suretech Hospital and Research Centre Private Limited, a Hospital in Nagpur, Dr. Nirmal Jaiswal, Chief Consultant and Intensive Care Unit In-charge, at Suretech Hospital, Dr. Madhusudan Shendre, ENT Surgeon at Suretech Hospital, and Dr. M. A. Biviji, Radiologist at Suretech Hospital to jointly and severally pay Rs. 6,11,638/- . The medical negligence was proved on account of the unjustifiable and forceful performance of ‘NI’ procedure on Mrs. Sunita on May 13, 2004, at Suretech Hospital. In a set of three appeals, one appeal was filed by Dr. M.A. Biviji denying any role in the alleged medical negligence during treatment of Mrs. Sunita at Suretech Hospital. Second was filed by Suretech Hospital and other doctors completely denying that any negligence was committed during Mrs. Sunita’s treatment in Suretech Hospital. Last one was filed by Mrs. Sunita seeking enhancement of compensation ordered for medical negligence during her treatment.Inter-alia, the Court observed that the medical team at Suretech Hospital was able to successfully prove that due medical consideration was given before choosing the ‘NI’ procedure. Therefore, it was held that no negligence was committed in opting for and/or conducting the aforesaid procedure.Court’s Observations At the outset, the Court addressed whether the act of conducting the ‘NI’ procedure on Mrs. Sunita on 13.05.2004 at Suretech hospital, while removing the existing ‘TT’ after the Bronchoscopy report indicated normalcy in Mrs. Sunita’s airways, amounted to negligence or not.Deriving its strength from the landmark pronouncements of Jacob Mathew vs. State of Punjab, (2005) 6 SCC 1 and Kusum Sharma vs. Batra Hospital (2010) 3 SCC 480, the Court penned down the three essential ingredients in determining an act of medical negligence. Those were: (1) a duty of care extended to the complainant, (2) breach of that duty of care, and (3) resulting damage, injury or harm caused to the complainant attributable to the said breach of duty. However, a medical practitioner will be held liable for negligence only in circumstances when their conduct falls below the standards of a reasonably competent practitioner., the Bench recorded. The Court went on to elucidate this further and stated that due to the unique circumstances and complications that arise in different individual cases, coupled with the constant advancement in the medical field and its practices, it is natural that there shall always be different opinions, including contesting views regarding the chosen line of treatment, or the course of action to be undertaken. In such circumstances, just because a doctor opts for a particular line of treatment but does not achieve the desired result, they cannot be held liable for negligence, provided that the said course of action undertaken was recognized as sound and relevant medical practice. This may include a procedure entailing a higher risk element as well, which was opted for after due consideration and deliberation by the doctor. Therefore, a line of treatment undertaken should not be of a discarded or obsolete category in any circumstance. Addressing the impugned judgment, the Court observed that though it held that the...

To Hold A Medical Practitioner Liable For Negligence, A Higher Threshold Limit Must Be Met: Supreme Court

Gyanvi Khanna

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