Expert Evidence Crucial In Medical Negligence Cases: NCDRC

The National Consumer Disputes Redressal Commission, presided by AVM J. Rajendra, held that expert evidence is crucial in medical negligence cases to determine fault.

Brief Facts of the Case

The complainant suffered a snake bite on her right thumb and was taken to Nehru Satabdi Central Hospital, where she was treated as a paying patient. Admitted to the pediatric ward and under the care of the doctors, she alleged that the doctors failed to provide proper treatment, resulting in gangrene and the subsequent amputation of her thumb. Discharged in an incomplete state of recovery, she required further treatment elsewhere, incurring significant expenses. The amputation adversely affected her daily life, ability to write, body image, and marriage prospects. The complainant filed a complaint before the District Commission prompting her to seek Rs. 5,00,000 in compensation for the negligence and loss suffered. The District Commission allowed the complaint and directed the Hospital to pay Rs.3,00,000 as compensation along with Rs.1,000 towards cost of litigation. Aggrieved, the hospital appealed to the State Commission of Orissa which dismissed the appeal. Consequently, the hospital filed a revision petition before the National Commission.

Contentions of the Hospital

The hospital argued that upon the complainant's admission, a black thread was tightly tied around the root of her right thumb, which caused significant discoloration and was recorded by the Casualty Medical Officer. They stated that the thread had restricted blood flow, leading to the bluish appearance of the thumb. After removing the thread, the hospital staff provided immediate treatment, including IV fluids and anti-snake venom, and transferred her to the ICU for further observation. Despite their efforts, the complainant's thumb had to be amputated due to gangrene. The hospital contended that the gangrene developed due to the complainant's parents' negligence in tying the thread too tightly, rather than any fault in their treatment. They claimed she was discharged only after her condition stabilized and accused her of not attending follow-up appointments. Asserting there was no negligence on their part, the hospital requested dismissal of the complaint and sought Rs. 5,00,000 in damages for reputational harm.

Observations by the National Commission

The National Commission observed that the primary issue was whether there was negligence or deficiency in service by the hospital in treating the complainant for a neurotoxic snake bite, which later led to gangrene and thumb amputation, and if so, to what extent the hospital was liable. It was noted that the hospital argued that the thread caused the gangrene by restricting blood supply, and that it had been tied by the complainant's parents, not the hospital. However, no expert medical evidence was presented to support the claim of negligence. The commission observed that in medical negligence cases, expert evidence is crucial, as noted by the Supreme Court in S.K. Jhunjhunwala v. Dhanwanti Kau & Anr., where such evidence helps determine fault. It was further highlighted that the the complainant claimed the thread was not recorded in the Medical Record Department (MRD) Sheet, but the commission found this irrelevant as the MRD is not meant to capture every minor detail. The commission emphasized that the hospital provided the appropriate anti-venom treatment, and medical literature supported the protocol followed. The argument that the wrong dosage was administered was dismissed, as the treatment given was within accepted standards of care. Citing Jacob Mathew vs. State of Punjab, the commission noted that medical professionals are not liable for negligence if they follow practices acceptable at the time, even if alternative treatments existed. The commission concluded that it was undisputed that the complainant was admitted and treated for a snake bite, but the gangrene and subsequent thumb amputation occurred due to the thread tied by the complainant's parents. Since the thread was not tied by the hospital and no expert opinion established negligence, the hospital could not be held responsible.

The National Commisison allowed the revision petition and set aside the orders by the District and State Commission.

Case Title: Chief Medical Officer Nehru Satabdicentral Hospital Vs. Puja Sahu

Case Number: R.P. No. 1353/2022