Obligation To Provide Medical Care Includes Both Ethical And Legal Aspects: NCDRC

Brief Facts of the Case

The complainant's mother was admitted to Life Line Nursing Home for gallbladder surgery. The surgery performed allegedly resulted in the patient's death due to medical negligence, including broken teeth and anaesthesia failure. The complainant accused the nursing home and doctors of deception by transferring the patient to the ICU posthumously and filing a false criminal case against him and his brothers. A complaint led to the patient's body being exhumed for a post-mortem examination. The complainant further claimed the surgery was illegal under the West Bengal Clinical Establishments Act as the nursing home was unlicensed. It was also alleged that no proper consent was obtained, and the risks were not adequately explained. Complaints were filed with medical authorities, and the complainant sought compensation from the District Forum for treatment costs, mental agony, and litigation expenses. The district forum dismissed the complaint, following which the complainant appealed to the State Commission of West Bengal which allowed the appeal. It directed the nursing home to pay a compensation of Rs. 7 lakhs along with Rs. 50,000 as litigation costs. Consequently, the nursing home filed a revision petition before the National Commission.

Contentions of the Nursing Home

The nursing home argued that the complainant lacked any cause of action, stating that all necessary formalities under the WBCE Rules, 2003, were followed and requisite permissions were obtained. It clarified that the complainant's mother was admitted based on the recommendation of the surgeon, who directed the operation and enlisted the anaesthetist. Despite comprehensive treatment efforts, the patient, who suffered from various ailments, died the following day. The nursing home emphasized its limited role and compliance with medical advice, denying any deficiency in service or negligence and asserting that all necessary treatments were provided in pursuit of the patient's recovery.

Observations by the National Commission

The National Commission observed that informed consent requires patients or their families to understand the risks, complications, and nature of the treatment. The Supreme Court in Samira Kohli v. Dr. Prabha Manchanda emphasized that a patient has an inviolable right to decide on treatment, and a doctor cannot proceed without consent unless it's life-saving and urgent. In this case, while the complainant claimed that informed consent was not obtained, the nursing home and doctors argued that detailed information was provided in Bengali and acknowledged by signatures. The Commission found no deficiency in service regarding consent. Regarding duty of care, the Supreme Court in Dr. Laxman Balakrishna Joshi v. Dr. Trimbak Babu Godbole established that doctors must provide care with reasonable skill, knowledge, and diligence. Failure to do so constitutes medical negligence. The Court in P.B. Desai v. State of Maharashtra clarified that the duty to treat acquires both ethical and legal dimensions. The West Bengal Medical Council's investigation found the nursing home and doctors liable for lapses in treatment. Despite the patient's death shortly after surgery, efforts to conceal the facts were noted. The Commission upheld the State Commission's findings of negligence but modified the suspension of the anaesthetist's registration.

The National Commission upheld the State Commission's order and dismissed the revision petition.

Case Title: Lifeline Nursing Home & Polyclinic Vs. Mohd. Nasim

Case Number: R.P. No. 1171/2022