Medical Professionals Not Liable For Reasonable Errors, But Pacemaker Should Have Shown To Patient : NCDRC

Brief Facts of the Case

The complainant's wife was admitted to Paras Hospital due to severe respiratory and cardiac issues. Under a doctor's care, she was diagnosed with multiple severe conditions and discharged with incomplete treatment. After a brief readmission, she suffered a cardiac arrest but was revived and placed on a ventilator. Despite her severe infection, a CRT-D device was implanted by the doctor with questionable motives, leading to her transfer to another doctor. The complainant's request to transfer her to another hospital was denied. The patient's condition worsened, and she died shortly after. The complainant claims the pacemaker caused her death due to medical negligence and was overcharged for the procedure and doctor's fees. He filed a complaint before the District Forum seeking Rs. 13,00,000 in compensation. The District Forum allowed the complaint and held the hospital liable for deficiency in service, directing them to refund the amount of the CRT-D device and pay Rs. 25,000 for compensation. Aggrieved by the District Forum's order, the hospital appealed to the State Commission of Haryana, which was dismissed. Consequently, the hospital filed a revision petition before the National Commission

Contentions of the hospital

The hospital argued that the complainant was compensated by insurance and that the patient received optimal treatment without negligence. The patient, suffering from severe heart issues, was treated by a doctor with decongestive therapy who recommended a CRT-D pacemaker, which was implanted after consultation. Despite stabilization efforts, the patient suffered arrhythmia and cardiac arrest but was transferred to another doctor. Necessary tests and treatments, including anti-tuberculosis therapy, were provided. The doctors asserted there was no negligence, and the patient passed away despite their efforts. They maintained the device was properly handled and not liable for her death.

Observations by the National Commission

The National Commission observed that, according to the Supreme Court, in medical negligence cases, it is not sufficient to blame a doctor for an unfortunate event without specific evidence of negligence. Citing cases such as Kusum Sharma v. Batra Hospital (2010) 3 SCC 480, S. K. Jhunjhunwala vs. Dhanwanti Kaur and Another (2019) 2 SCC 282 and Devarakonda Suryasesha Mani v Care Hospital, Institute of Medical Sciences IV (2022) CPJ 7 (SC) the Commission emphasized that unsuccessful treatment or patient death does not automatically imply medical negligence. It was stated that a medical professional is not liable simply because of an error in judgment if the chosen treatment was reasonable. The Commission referenced Jacob Mathew v. State of Punjab (2005) SSC (Crl) 1369 and Dr. Laxman Balkrishan Joshi Vs. Dr. Trimbak Bapu Godbole and Anr., AIR 1969 SC 128 which, underscored that doctors owe a duty of care to their patients and are expected to exercise a reasonable degree of skill and knowledge. In this case, there was no specific evidence or expert opinion challenging the decision to implant the pacemaker, the procedure used, or whether the device was infected and contributed to the patient's death. The hospital maintained that the CRT-D pacemaker was implanted after consultation with specialists and obtaining the patient's consent, and there was no indication the device was defective. The Commission found that although the pacemaker, a high-value item, was not shown to the complainant before implantation, which constituted a deficiency in service, there was no evidence of an ulterior motive or pre-existing infection in the device.

The Commission allowed the petition and modified the District Commission's order. It directed the hospital to pay Rs. 2,00,000 as compensation for the deficiency in service within one month, with a 12% per annum interest applicable in case of delay.

Case Title: Paras Hospital Vs. Rishi Kumar Jain

Case Number: R.P. No. 2379/2023