InCivil Appeal No. 10347 of 2010 -SC- Doctors cannot be held liable for medical negligence solely because a patient did not respond favourably to treatment or a surgery has failed:Supreme Court rejects medical negligence claim against Delhi’s Indraprastha Apollo Hospital
Justice A.S. Bopanna & Justice Prashant Kumar Mishra [17-10-2023]

Read Order:Mrs. Kalyani Rajan V. Indraprastha Apollo Hospital &Ors

Chahat Varma

New Delhi, October 18, 2023: In a recent decision, the Supreme Court has upheld an order passed by the National Consumer Disputes Redressal Commission (NCDRC), dismissing a medical negligence case against Indraprastha Apollo Hospital and its doctors.

The present appeal was directed against the order passed by the NCDRC dated 03.08.2010, whereby the complaint filed by the appellant under Section 2 (c)(iii) of the Consumer Protection Act, 1986, was rejected.

The case revolved around a complainant who was the wife of a deceased patient. The patient, a 37-year-old individual, had passed away on 06.11.1998 at Indraprastha Apollo Hospital. He had undergone major neurosurgery and was receiving follow-up care. The complainant alleged that no doctor from the neurosurgery team attended to her husband after he was shifted to a private room. She contended that, following major surgery, the deceased should have been transferred to the Intensive Care Unit (ICU) instead of a private room.

The NCDRC had found that the primary allegation was related to the lack of medical care from the time the deceased was moved to the private room until he suffered a cardiac arrest. However, the appellant had failed to establish any connection between the heart attack suffered by the deceased and the operation or the quality of post-operative care. As a result, the NCDRC concluded that there was no proven case of medical negligence, and the hospital and doctors were not held liable for it.

The division bench of Justice A.S. Bopanna and Justice Prashant Kumar Mishra noted that the complainant had never questioned the diagnosis and surgical treatment provided by the doctor. The case focused solely on the lack of appropriate post-operative medical care.

The bench noted that the material available on the record demonstrated that, as per standard practice, all patients who showed no signs of complications in the recovery room and had no post or pre-operative complications were sent to their rooms. In the present case, the symptoms that emerged after the deceased was discharged from the operation theatre were not typical symptoms that precede a cardiac arrest. Furthermore, since the patient did not have a history of heart ailments, it was unreasonable to expect the doctors to predict a cardiac problem after successful surgery.

The bench further observed that the patient had no history of diabetes, hypertension, or any cardiac problem. Therefore, it was challenging for the treating doctors, including the duty doctor and the hospital, to anticipate that the patient might suffer a cardiac arrest.

The bench referred to Jacob Mathew v. State of Punjab and Another [LQ/SC/2005/768] and observed that a professional could be held liable for negligence based on one of two findings: either they were not possessed of the requisite skill which they professed to have possessed, or they did not exercise, with reasonable competence in the given case, the skill which they did possess.

The bench also examined the decision rendered in Martin F.D'Souza v. Mohd. Ishfaq, [LQ/SC/2009/365], wherein it is stated that simply because the patient has not favourably responded to a treatment given by a doctor or a surgery has failed, the doctor cannot be held directly liable for medical negligence by applying the doctrine of Res Ipsa Loquitor.

Insofar as the applicability of the principles of Res Ipsa Loquitur, in the facts and circumstances of the case, the bench held that it was essential to bear in mind that the principles are only invoked when circumstances strongly suggest involvement in negligent behaviour by the person against whom an accusation of negligence is made. To apply the principles of Res Ipsa Loquitur, it is necessary that there is a 'Res' to establish the allegation of negligence. Strong incriminating circumstantial or documentary evidence is required for the application of the doctrine.

Based on the above considerations, the court was of the view that the appellant had failed to establish negligence on the part of the hospital and doctors in providing post-operative care. The findings of the NCDRC in this regard were upheld as legally sound and not perverse.