Underlining that a doctor can’t be framed as guilty of medical negligence just because a patient did not survive, the Supreme Court on Tuesday said that doctors can only attempt to treat the patient by applying their best abilities and skills and cannot assure life to the ill.
A bench comprising justices Hemant Gupta and V Ramasubramania, said: “There is a tendency to blame the doctor when a patient dies or suffers some mishap. This is intolerant conduct of the family members to not accept the death in such cases. The increased cases of manhandling of medical professionals who worked day and night without their comfort have been very well seen in this pandemic.”
“Despite the treatment, if the patient had not survived, the doctors cannot be blamed as even the doctors with the best of their abilities cannot prevent the inevitable,” the bench said. Further, it said that it is expected from doctors to take reasonable care but none of the professionals can assure that the patient can defeat the surgical procedures or disease.
The court further remarked that sufficient material or medical evidence should be placed before the deeming authority to decide that the death was caused due to medical negligence.
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“Every death of a patient cannot on the face of it be considered to be medical negligence,” added the bench.
The top court noted this as it allowed a plea submitted by Bombay Hospital and Medical Research Centre against the National Consumer Disputes Redressal Commission’s order that asked the former to pay Rs 14.18 lakh to the family of Dinesh Jaiswal, who died in June 1998 after a failed surgeries of his gangrene in his limbs.
Jaiswal’s family blamed the facility’s negligence in conducting surgeries. They further accused the absence of the treating senior doctor in the hospital, lack of operation theatre, and a broken-down angiography machine. However, all these allegations were denied by the hospital asserting that the patient was provided with the best possible treatment by the medical professionals who were on duty and all resources available with them was utilised.
The national consumer commission had in its 2010 judgement called in for the principle of “res ipsa loquitur” (mere occurrence of certain events can lead to an inference of negligence of the other side) where the hospital will be held guilty of medical negligence.
The apex court on Tuesday rejected the commission's verdict and noted that the order had legal as well as factual deficiencies.
“It is a case where the patient was in serious condition threatening gangrene even before admission to the hospital but even after surgery and re-exploration, if the patient does not survive, the fault cannot be fastened on the doctors as a case of medical negligence,” the court said.
Expecting the doctors to remain beside the patient throughout his stay in the hospital is irrational, the court remarked, saying that it is expected from the doctor to provide reasonable care, the bench held that in the present case the proper medical care was not lacking in any manner.
The court also stressed that the patient was never left unattended at any point and the fact that the main treating doctor was out of the country cannot be linked to medical negligence as there were 20 specialists in the hospital in multi-faculties. “The patient was in a critical condition and if he could not survive even after surgery, the blame cannot be passed on to the hospital, '' the court said.
The patient was provided with all possible treatment by the doctors within their means and capacity, noted the bench.
Speaking on the delay in re-exploration after the primary surgery caused complications saying that it was due to the non-availability of an operation theatre, the court said that it was a coincidence that all the available four operation theatres in the hospital were occupied when the deceased patient was supposed to undergo surgery.
The bench further stated: “We do not find that the expectation of the patient to have an emergency operation theatre is reasonable as the hospital can provide only as many operation theatres as the patient load warrants. If the operation theatres were occupied at the time when the operation of the patient was contemplated, it cannot be said that there is negligence on the part of the hospital.”
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The patient was attended by a team of specialist doctors, the court said adding that “unfortunately, nature had the last word” and the patient breathed his last.
“The family may not have coped with the loss of their loved one, but the hospital and the doctor cannot be blamed as they provided the requisite care at all given times,” it declared.
In March 2010, the deceased’s family was paid Rs 5 lakh as interim compensation by the Supreme court following the agreement to evaluate the hospital’s appeal. The court added that the given compensation shall be taken as ex gratia payment to Jaiswal’s family and the hospital cannot recover it.