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Medical Negligence in Tort Law


Medical Negligence in Tort Law
Medical Negligence in Tort Law

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Individuals immersed in a specific profession are expected to possess the necessary expertise and competence required for their role. Moreover, they bear a responsibility to execute their duties with a reasonable level of care.


The standard of care requisite in any given scenario hinges upon the professional proficiency anticipated from members of a specific group. 


For instance, the performance of a surgeon or an anaesthetist is evaluated against the benchmark set by an average practitioner within their respective sphere or the one they present themselves to be affiliated with. Furthermore, specialists are held to an even higher standard, necessitating a heightened degree of skill.



Doctor’s Duty to Attend to a Patient


If a specialist doctor neglects to provide care to a patient admitted in the emergency ward of a hospital, resulting in the patient's demise, the doctor may be held accountable for compensation. In the case of Sishir Rajan Saha v. The State of Tripura, the petitioner's son, Ashim Saha, was involved in an accident while travelling from Agartala to Udaipur on a scooter. 



Upon admission to the emergency ward of G.B. Hospital in Agartala, the Senior Specialist Doctor, Dr. P. Roy, was unavailable. Despite repeated calls for his attention to the patient, Dr. P. Roy prioritised his private patients and neglected to attend to the accident victim.



Tragically, Ashim Saha succumbed to his injuries. As a result of his negligence, Dr. P. Roy was found liable to pay Rs. 1,25,000 as compensation for the deceased's death. Additionally, directives were issued to all Government hospitals to enhance their medical services.

 
 

Doctor’s Duty of Care


In medical practice, a healthcare provider owes their patient a series of essential duties of care:


(i) A duty of care in determining whether to undertake the case;


(ii) A duty of care in determining the appropriate treatment to administer; and


(iii) A duty of care in the execution of the treatment.


Any breach of these aforementioned duties grants the patient the right to pursue legal action for negligence.



Elaborating on the nature of the duty of care within the medical profession, the Supreme Court deliberated in Dr. Lakshman Balkrishna Joshi v. Trimbak Bapu Godbole:



"The petitioner must bring to their task a reasonable degree of skill and knowledge and must exercise a reasonable degree of care. The law neither demands the utmost nor the minimal level of care and competence, rather it evaluates the circumstances of each case. The physician possesses discretion in selecting the proposed treatment for the patient, which is notably broader in emergency situations."



In the cited case, the respondent's son, approximately 20 years old, suffered an accident on a sea beach, resulting in a fracture of the femur of his left leg. He was admitted to the appellant's hospital for treatment.



The appellant's actions involved reducing the fracture without administering anaesthesia to the patient but instead opting for a single dose of morphia injection. Excessive force was exerted during the procedure, with three attendants employed to manipulate the injured leg. 



Subsequently, the leg was encased in plaster of Paris splints. Unfortunately, this treatment induced shock, ultimately leading to the patient's demise. The Supreme Court found the doctor guilty of negligence.



In the State of Gujarat v. Laxmiben Jayantilal Sikligar, the plaintiff sought treatment for discomfort and swallowing difficulties at Civil Hospital, Godhra. The Civil Surgeon performed surgery on her thyroid gland.



However, due to negligence during the operation, she sustained permanent partial paralysis of the larynx (voice box) resulting from damage to or severance of the recurrent laryngeal nerve. The surgeon confessed to neglecting to identify and separate the nerve during the procedure.



Although only one of the two nerves was damaged, rendering the plaintiff partially impaired, negligence was established on the surgeon's part for failing to take appropriate precautions before and during the surgery.



In the case of A.H. Khodwa v. State of Maharashtra, a sterilisation procedure was conducted on a patient after childbirth. Regrettably, the surgeon inadvertently left a mop inside the patient's abdomen.



This oversight led to the development of peritonitis, ultimately resulting in the patient's demise. The operating doctor was presumed to be negligent, and consequently, the State, responsible for the hospital's management, was deemed vicariously liable.



In Indian Medical Association v. V.P. Shantha, the Supreme Court acknowledged medical practitioners' liability for negligence, emphasising that their professional status and accountability to the Medical Council did not absolve them from the responsibility to compensate for negligence. 



This ruling overturned the decision of the Madras High Court in Dr. C. Subramaniam v. Kumaraswamy, asserting that the services provided by medical practitioners fall under Sec. 2(1)(o) of the Consumer Protection Act, 1986. Accordingly, such cases are actionable within the forums established under the Consumer Protection Act, 1986.

 
 

Unsuccessful Sterilisation Operation


In the case of State of Haryana v. Smt. Santra, Smt. Santra, a financially disadvantaged labourer with seven children, sought sterilisation under the State-sponsored Family Planning program in 1988. She approached the Chief Medical Officer in Gurgaon for the procedure.



Unfortunately, despite the operation being performed, she later discovered that she was pregnant and subsequently gave birth to a female child. This failure was attributed to the negligence of the attending doctor.



In this instance, the negligence of the doctor was self-evident, as the unsuccessful sterilisation operation demonstrated a clear breach of professional duty. Therefore, no further evidence of negligence was required. The unexpected birth placed an additional economic strain on the already struggling individual who had opted for the procedure.



Both the doctor and the State were deemed liable to compensate the plaintiff for the damages incurred as a result of the failed sterilisation procedure.




Uterus Removed Without Justification


In the case of Lakshmi Rajan v. Malar Hospital Ltd., the plaintiff, a married woman aged 40, discovered a painful lump in her breast. While undergoing treatment for the lump at the hospital in question, her uterus was removed without medical justification.



This incident was deemed a case of service deficiency, and the hospital was directed to compensate the plaintiff with Rs. 2,00,000 for the ordeal.



In a similar case, M. Sobha v. Dr. Mrs. Rajkumari Unithan, the plaintiff, M. Sobha, aged 35 and a mother of an 8-year-old son, consulted the defendant gynaecologist at a renowned Nursing Home in Cochin on 17.6.1988.



The gynaecologist suggested a procedure to clear potential obstructions in the fallopian tube hindering ovum delivery into the uterus, which was carried out on 18.6.1988 through a simple procedure involving controlled air pressure applied through an apparatus into the vagina.



Following the procedure, the plaintiff developed an infection in her reproductive system, resulting in the need for removal. However, it couldn't be conclusively established that the infection stemmed from negligence on the part of the defendant. Due to the lack of evidence linking the infection to negligence, the defendant was not held liable for the plaintiff's suffering.

 
 

Foreign Matter Left in Body During Operation


In Aparna Dutta v. Apollo Hospital Enterprises Ltd., Madras, the plaintiff, an Indian citizen residing in Saudi Arabia after marriage, encountered gynaecological issues in 1986, resulting in the diagnosis of a cyst in one of her ovaries.



She opted to undergo surgery, specifically a hysterectomy, in India for which she relied on the assistance of friends and relatives during her recovery. The operation took place at Apollo Hospital, Madras, on 21-6-1991, under general anaesthesia.



Following the surgery, the plaintiff experienced discomfort due to a palpable lump in her abdominal region. Despite notifying hospital authorities, no significant action was taken.



It was later discovered that a foreign object, specifically an abdominal pack, had been negligently left inside her abdomen by the operating doctor. Subsequent surgery was required to remove the foreign object.



In this case, the doctrine of res ipsa loquitur, meaning "the thing speaks for itself," was invoked, holding the doctor and the hospital accountable for negligence. The plaintiff was awarded damages totaling Rs. 5,80,000 for the suffering, pain, and mental anguish endured.



Death Due to Transfusion of Blood of a Wrong Group


In R.P. Sharma v. State of Rajasthan, the petitioner's wife, Smt. Kamla Sharma, underwent gallstone removal surgery at S.M.S. Hospital, Jaipur. Due to a critical error by hospital staff, she received a transfusion of blood from the wrong group, leading to a rapid deterioration in her condition, including loss of eyesight, and ultimately resulting in her death.



The State, responsible for the hospital's management, was held vicariously liable for the death resulting from the negligence of its staff.



Doctor’s Duty to Maintain Secrecy


In Dr. Tokugha v. Apollo Hospital Enterprises Ltd., the appellant, a doctor scheduled to marry Ms. Akli, had his engagement called off when Apollo Hospital disclosed to Ms. Akli that he was HIV positive. The appellant sought damages, arguing that the hospital breached medical ethics by revealing his health status.



The court acknowledged the confidentiality rule but emphasised exceptions when disclosure is necessary in the public interest, particularly to prevent harm to others.



In this case, the right to privacy was weighed against the potential risk to Ms. Akli's life if she married the appellant without knowledge of his HIV status. The appeal was dismissed, affirming the hospital's action as warranted under the circumstances.

 
 



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