Medical Profession is one of the oldest profession and most humanitarian one. Doctors in India are treated as second life savers after God. The standard of care from doctors and hospital authority is expected to be more in comparison with other cases of negligence. So proper care must be taken by the authorities and the doctors side to avoid medical negligence. The Black law dictionary definition of negligence “ conduct, whether of action or omission, which may be declared and treated as negligence without any argument or proof as to the particular surrounding circumstances, either because it is in violation of statue or valid municipal ordinance or because it is so palpably opposed to the dictates of common prudence that it can be said without hesitation or doubt that no careful person would have been guilty of it. As a general rule, the violation of a public duty, enjoined by law for the protection of person or property, so constitutes”.
The basic elements of Negligence are (a) Duty of Care (b) Breach of Duty (c)Cause in fact (d)Proximate Cause and (e) Damage. These are the basic elements of negligence, to prove the case of negligence all these criteria must be satisfied and in cases of medical negligence in India, the ambit of duty of care and proximate cause increases, as there are life involve in this situation.
When there is civil wrong (right in rem) against a contractual obligation (right in persona), with a breach of duty which invites the intervention of judges to grant certain remedy for the damages then the tortious liability arises but the standard of care is more in medical cases as compared to general cases.
Principle of Standard of care was laid down by Supreme Court in the case of Dr. Laxman Balakrishna Joshi vs. Dr. Trimbark Babu Godbole AIR 1969,SC 128 and A.S Mittal .v. State of U.P, AIR 1989 SC 1570 . In these cases, different kind of negligence were introduced which were further question of qualification for application in other cases.
There is an exception for medical negligence that if a doctor does not charge fees for his act then he cannot be sued for medical negligence under Tort as per the definition of service which is mentioned in sec 2(1) of Consumer protection Act 1986.
Vicarious liability of hospitals
The principle of vicarious liability is based on a latin maxim “qui facit per alium facit per se” which describes that the one who acts through another act in his or her own interest. The patient only requires diligent and proper care, if any of the staff of the hospital is negligent in the performance of their prescribed work, the hospital will be held liable on the negligent conduct of even borrowed doctors for specific performance of certain operations. This principle was established in the case of Aparna Dutt .V. Apollo Hospital Enterprises Ltd. (2002 ACJ 954 (Mad. HC).
Hospitals have been also held liable for not providing adequate medical facility as it was held in Paschim Bengal Khet Mazdoor Samity and Ors. v. State of Bengal(1996(4)SC260).
Hospitals are also held vicariously held liable if they are not able to provide proper sanitation facility, as it happened in Mr. M Ramesh Reddy .V. State of Andra Pradesh [2003 (1) CLD 81 (APSCDRC).
Medical negligence and ethics
In some cases of medical negligence, the compensation to the victim has given looking on the ethical values related to humanitarian basis as we can infer with the case of Pravat Kumar Mukherjee Vs. Ruby General Hospital and ors 2005 CPJ 35 (NC). In this case National Commission of India delivered a land mark judgment for treating of accident victim, what happened in this case the complainant were the parents of deceased boy named Samanate Mukherjee a 2nd year B.tech boy who studied in Netaji Subhas Chandra Bose Engineering College , the complaint was filed in National Commission of India. The boy was hit by a Calcutta transport bus and rushed to the hospital which was 1 km from the accident spot. The boy was conscious when he was taken to hospital and he showed his medical insurance card, which clearly says that the boy will be given Rs.65,000 by the Insurance company in case of accident, relying on it hospital started treating boy but after giving some initial treatment hospital demanded Rs15,000 and on the non- payment of the demanded money hospital discontinued treatment of the boy and the boy was rushed to another hospital in the way the boy died. This was the case and in this case the National Commission held Ruby hospital liable and provided Rs. 10 lakhs as compensation to the parents. So, in this case the court looked on humanitarian basis and compensation was awarded to the complainant.
Landmark Judgment on Medical Negligence
When we think about landmark judgment in medical negligence cases the first judgment that comes into our mind is one of the high profile and most talked case with the highest amount of compensation granted till date. Kunal Saha Vs AMRI (Advanced Medical Research institute ) famously known as Anuradha Saha Case, this case was filed in 1998 with the allegation of medical negligence on Kolkata based AMRI Hospital and three doctors namely Dr. Sukumar Mukherjee, Dr. Baidyanath Halder and Dr. Balram Prasad. In simple layman term, the wife was suffering from drug allergy and the doctors were negligent in prescribing medicine which further aggravated the condition of patient and finally led to death. In brief this was the facts and circumstances of the case, in this case the final verdict was given by the Supreme court on 24th October 2013 and a compensation of around 6.08 crore for the death of his wife.
In the case of V.Krishan Rao Vs Nikhil Super Speciality Hospital 2010, Krishna Rao, an officer in malaria department filed a complaint against the hospital for negligent conduct in treating his wife. His wife was wrongly treated for typhoid fever instead of malaria fever, due to the wrong medication provided by the hospital. Finally, the verdict was given and Rao was awarded a compensation of Rs 2 lakhs. In this case, the principle of res ipsa loquitor (thing speak for itself) was applied and the compensation was given to the plaintiff.
Defense of Medical Profession
In defense of medical profession Supreme court in Kusum Sharma & Ors vs. Batra Hospital and Medical Research case held that the law of negligence has to be applied according to facts and circumstances of individual case. No one can ignore that medicine is an evolving science, and there is no precise outcome of effect for every person. The operations involve certain calculated risk which cannot be denied because of complication in the operation if some risk is done, the doctors cannot be held liable for negligence as the patient himself has consented to the risk involved in the operation.
In another case of Jacob Mathew .V. State of Punjab, the Supreme court held that in some cases of medical profession the doctors are equipped in certain situation where they have to make choices between a devil and the deep sea. Sometimes in certain situation there must be greater risk in the operation but higher chances of success and in another move there would be lesser risk but higher chances of failure. So the decision, that which course would be follow will depend on facts and circumstances of case.
Conclusion
On the scrutiny of leading medical negligence cases of India, certain principles should be taken into consideration while pronouncing the judgment in medical negligence cases.
Negligence should be guided upon the principle of reasonableness of common man prudence and negligence must be established in order to give the compensation in certain cases.
Medical profession requires certain degree of skill and knowledge, so the standard of care in cases of medical professional is generally high and should also be taken into account while giving the judgment.
A medical professional can be only held liable, when the standard of care is reasonably is less than the reasonable care that should be taken from a competent practitioner in that field.
When a choice has to be made between certain circumstance when there is higher risk involved and greater success is involved and lesser risk with higher chances of failure, the facts and circumstances of the individual case should be taken into the consideration.
No negligence will apply on medical professional, when he performs his duty with the utmost care that should be taken, and he had taken all the precaution.
Medical professional should not be harassed unreasonably and unwanted apprehension and fear should not be created on the medical fraternity that they can give their best in certain cases where it is required, they should be given some liberty in certain peculiar situation where they need to make their judgment without any apprehension freely. So that it can be beneficial for the society.
The basic elements of Negligence are (a) Duty of Care (b) Breach of Duty (c)Cause in fact (d)Proximate Cause and (e) Damage. These are the basic elements of negligence, to prove the case of negligence all these criteria must be satisfied and in cases of medical negligence in India, the ambit of duty of care and proximate cause increases, as there are life involve in this situation.
When there is civil wrong (right in rem) against a contractual obligation (right in persona), with a breach of duty which invites the intervention of judges to grant certain remedy for the damages then the tortious liability arises but the standard of care is more in medical cases as compared to general cases.
Principle of Standard of care was laid down by Supreme Court in the case of Dr. Laxman Balakrishna Joshi vs. Dr. Trimbark Babu Godbole AIR 1969,SC 128 and A.S Mittal .v. State of U.P, AIR 1989 SC 1570 . In these cases, different kind of negligence were introduced which were further question of qualification for application in other cases.
There is an exception for medical negligence that if a doctor does not charge fees for his act then he cannot be sued for medical negligence under Tort as per the definition of service which is mentioned in sec 2(1) of Consumer protection Act 1986.
Vicarious liability of hospitals
The principle of vicarious liability is based on a latin maxim “qui facit per alium facit per se” which describes that the one who acts through another act in his or her own interest. The patient only requires diligent and proper care, if any of the staff of the hospital is negligent in the performance of their prescribed work, the hospital will be held liable on the negligent conduct of even borrowed doctors for specific performance of certain operations. This principle was established in the case of Aparna Dutt .V. Apollo Hospital Enterprises Ltd. (2002 ACJ 954 (Mad. HC).
Hospitals have been also held liable for not providing adequate medical facility as it was held in Paschim Bengal Khet Mazdoor Samity and Ors. v. State of Bengal(1996(4)SC260).
Hospitals are also held vicariously held liable if they are not able to provide proper sanitation facility, as it happened in Mr. M Ramesh Reddy .V. State of Andra Pradesh [2003 (1) CLD 81 (APSCDRC).
Medical negligence and ethics
In some cases of medical negligence, the compensation to the victim has given looking on the ethical values related to humanitarian basis as we can infer with the case of Pravat Kumar Mukherjee Vs. Ruby General Hospital and ors 2005 CPJ 35 (NC). In this case National Commission of India delivered a land mark judgment for treating of accident victim, what happened in this case the complainant were the parents of deceased boy named Samanate Mukherjee a 2nd year B.tech boy who studied in Netaji Subhas Chandra Bose Engineering College , the complaint was filed in National Commission of India. The boy was hit by a Calcutta transport bus and rushed to the hospital which was 1 km from the accident spot. The boy was conscious when he was taken to hospital and he showed his medical insurance card, which clearly says that the boy will be given Rs.65,000 by the Insurance company in case of accident, relying on it hospital started treating boy but after giving some initial treatment hospital demanded Rs15,000 and on the non- payment of the demanded money hospital discontinued treatment of the boy and the boy was rushed to another hospital in the way the boy died. This was the case and in this case the National Commission held Ruby hospital liable and provided Rs. 10 lakhs as compensation to the parents. So, in this case the court looked on humanitarian basis and compensation was awarded to the complainant.
Landmark Judgment on Medical Negligence
When we think about landmark judgment in medical negligence cases the first judgment that comes into our mind is one of the high profile and most talked case with the highest amount of compensation granted till date. Kunal Saha Vs AMRI (Advanced Medical Research institute ) famously known as Anuradha Saha Case, this case was filed in 1998 with the allegation of medical negligence on Kolkata based AMRI Hospital and three doctors namely Dr. Sukumar Mukherjee, Dr. Baidyanath Halder and Dr. Balram Prasad. In simple layman term, the wife was suffering from drug allergy and the doctors were negligent in prescribing medicine which further aggravated the condition of patient and finally led to death. In brief this was the facts and circumstances of the case, in this case the final verdict was given by the Supreme court on 24th October 2013 and a compensation of around 6.08 crore for the death of his wife.
In the case of V.Krishan Rao Vs Nikhil Super Speciality Hospital 2010, Krishna Rao, an officer in malaria department filed a complaint against the hospital for negligent conduct in treating his wife. His wife was wrongly treated for typhoid fever instead of malaria fever, due to the wrong medication provided by the hospital. Finally, the verdict was given and Rao was awarded a compensation of Rs 2 lakhs. In this case, the principle of res ipsa loquitor (thing speak for itself) was applied and the compensation was given to the plaintiff.
Defense of Medical Profession
In defense of medical profession Supreme court in Kusum Sharma & Ors vs. Batra Hospital and Medical Research case held that the law of negligence has to be applied according to facts and circumstances of individual case. No one can ignore that medicine is an evolving science, and there is no precise outcome of effect for every person. The operations involve certain calculated risk which cannot be denied because of complication in the operation if some risk is done, the doctors cannot be held liable for negligence as the patient himself has consented to the risk involved in the operation.
In another case of Jacob Mathew .V. State of Punjab, the Supreme court held that in some cases of medical profession the doctors are equipped in certain situation where they have to make choices between a devil and the deep sea. Sometimes in certain situation there must be greater risk in the operation but higher chances of success and in another move there would be lesser risk but higher chances of failure. So the decision, that which course would be follow will depend on facts and circumstances of case.
Conclusion
On the scrutiny of leading medical negligence cases of India, certain principles should be taken into consideration while pronouncing the judgment in medical negligence cases.
Negligence should be guided upon the principle of reasonableness of common man prudence and negligence must be established in order to give the compensation in certain cases.
Medical profession requires certain degree of skill and knowledge, so the standard of care in cases of medical professional is generally high and should also be taken into account while giving the judgment.
A medical professional can be only held liable, when the standard of care is reasonably is less than the reasonable care that should be taken from a competent practitioner in that field.
When a choice has to be made between certain circumstance when there is higher risk involved and greater success is involved and lesser risk with higher chances of failure, the facts and circumstances of the individual case should be taken into the consideration.
No negligence will apply on medical professional, when he performs his duty with the utmost care that should be taken, and he had taken all the precaution.
Medical professional should not be harassed unreasonably and unwanted apprehension and fear should not be created on the medical fraternity that they can give their best in certain cases where it is required, they should be given some liberty in certain peculiar situation where they need to make their judgment without any apprehension freely. So that it can be beneficial for the society.
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