Medical Negligence: NCDRC Holds Doctors Of Fortis Hospital Liable

Brief Facts of the Case

The complainant's son suffered from a spinal condition, AAD, caused by a childhood injury. This left him wheelchair-bound and progressively deteriorating neurologically. The patient was admitted to SMS Hospital for surgery but left without permission, later consulting a doctor from the hospital and getting admitted to Fortis Hospital for surgery. Surgeries were performed, but complications arose, including a collapsed lung and quadriplegia. He remained on a ventilator and eventually died. The complainant argued the hospital was negligent, as post-surgery scans showed bone fragments compressing the spinal cord, which were not present in earlier scans. The hospital did not deny these findings. It was also alleged that the patient's lung collapse and high steroid use without consent contributed to his death. The complainant filed a complaint before the State Commission of Rajasthan, which allowed the complaint. It directed the hospital and the doctor to pay Rs. 50,00,000 as compensation with 9% interest rate. Consequently, the hospital filed an appeal before the National Commission.

Contentions of the Opposite Party

The hospital claimed the disease, Mobile Atlanto Axial Dislocation (AAD), was caused by a neck fracture from a fall. They argued that informed consent was obtained, surgeries were performed as per protocols, and the patient's condition post-surgery was expected in such complex cases. They stated that proper treatment was provided, and the complainant failed to prove negligence. Medical literature was cited to support that risks in medical procedures do not imply negligence if conducted with reasonable skill.

Observations by the National Commission

The National Commission observed that the definition of “service” under Section 2(1)(d) of the Act must be understood broadly and includes services rendered by medical practitioners. The principles of medical negligence, as established in Jacob Mathew (based on the Bolam Test), highlight that negligence is determined by deviations from standard medical practice. Negligence must involve failure to meet the expected standard of care, resulting in harm to the complainant. Key elements are duty, breach, and damage.The Hon'ble Supreme Court in V. Kishan Rao vs. Nikhil Super Speciality Hospital applied the doctrine of res ipsa loquitur in medical negligence cases. This principle shifts the burden of proof to the hospital to show they were not negligent when negligence is evident. Expert evidence must be judged case by case, as ruled in Dr. J.J. Merchant and Indian Medical Association vs. V.P. Shantha. In the present case, the hospital performed surgeries on the complainant's son without adequate pre-operative tests or proper informed consent. The patient's condition worsened post-surgery, leading to his transfer in critical condition. Evidence showed that the hospital did not meet the required standard of care. The complainant established negligence, as per the principles in Jacob Mathew. The Commission observed that the State Commission correctly held the hospital liable for medical negligence under res ipsa loquitur. However, the specific liability of the hospital (appellant no. 1) and another doctor (appellant no. 2) was not sufficiently proven. The findings regarding other doctors (appellants 3 and 4) were upheld, as they failed to justify their actions. The order of the State Commission was upheld in part. Appellants 3 and 4 were jointly and severally liable for compensation to the complainant. However, the appeal of appellants 1 and 2 was allowed due to lack of sufficient evidence of negligence against them.

Case Title: Fortis Health Care (India) Ltd. Vs. Bhagchand Meena

Case Number: F.A. No. 1093/2018

Click Here To Read/Download The Order