Medical Negligence: Bombay High Court Upholds Doctor's Conviction For Patient's Death 40 Yrs Ago

The Bombay High Court recently upheld the conviction of a septuagenarian doctor for his negligence by not taking immediate steps to deal with a complication during a surgery, leading to the death of a patient in 1984.

Justice Bharati Dangre increased the fine imposed on Dr. Anil Pinto from Rs. 5,000 to Rs. 5 lakh. Out of this sum, Rs. 4.9 lakh is directed to be paid to the family of the victim.

“An error of judgment on part of the professional is also not negligence per se, but when an expert surgeon like Dr. Pinto leave the patient waiting, with a spasm of a vital artery and which subsequently resulted in formation of clots, definitely amounts to negligence. The most relevant period of 12 hours was allowed to pass with no serious steps being taken, with a just wait and watch policy adopted by him”, the court observed.

Prakash Parekh, a 30-year-old businessman, sought treatment for hyperhidrosis, or excessive sweating of his palms from Dr. Pinto. A surgery was performed on him, and complications arose during the procedure as Dr. Pinto accidentally damaged a nerve, leading to a critical spasm in a vital artery. After 12 hours, Prakash was transferred to the KEM Hospital for further treatment due to the unavailability of modern equipment at Dr. Pinto's facility. Despite efforts to stabilize his condition, he did not show signs of improvement and passed away on February 20, 1984.

His father filed a complaint under Section 304-A of the IPC against Dr. Anil Pinto. The complaint alleged negligence on the part of Dr. Pinto, asserting that the surgery was unnecessary and that Prakash had not been adequately informed of its risks.

After examining witnesses such as the family members of the deceased as well as doctors as expert witnesses, the Metropolitan Magistrate held that Dr. Pinto had been culpably negligent, emphasizing his failure to inform the family about the surgery. The trial court further held that Dr. Pinto hastily conducted the procedure without taking necessary precaution and conducting preliminary tests. It imposed a fine of Rs. 5000 on Dr. Pinto.

The complainant filed a revision application seeking the doctor's incarceration, the state filed a criminal appeal seeking enhancement of the sentence, and Dr. Pinto filed an appeal against his conviction.

The court opined that Dr. Pinto's failure to inform Prakash's relatives about the surgery did not constitute negligence. Since Prakash, a consenting adult, willingly signed the consent form after being informed of the risks, Dr. Pinto had no obligation to seek familial consent.

Expert testimony highlighted the typical response to artery spasms during sympathectomy and the treatment options for clot formation. Prompt intervention with local anesthesia or vasodilator drugs is typically effective in resolving arterial spasms are not uncommon during, it was testified.

The court held that while Dr. Pinto's decision to perform the surgery may not have been inherently faulty, his negligence lay in the delayed response to the arterial spasm and subsequent complications.

The court disagreed with the magistrate's finding regarding Dr. Pinto's obligation to inform relatives about the surgery. It also rejected finding of negligence in conducting preliminary tests, citing evidence of prior consultations and evaluations.

Testimony revealed delays in administering Lemodex, a medication aimed at addressing the arterial spasm. and seeking expert consultation, exacerbating the patient's condition. Thus, the court concurred with the magistrate's assessment of negligence in Dr. Pinto's delayed response to complications during surgery.

The court concluded that Dr. Pinto's actions deviated from acceptable norms of standard of care expected of a medical professional.

Dr. Pinto' was found guilty negligent act not amounting to culpable homicide under Section 304A of the IPC. Given his medical ailments and contributions to society, the court opted to enhance the fine imposed by the magistrate rather than impose a custodial sentence.

Case no. – Criminal Appeal No. 395 of 1995

Case Title – State of Maharashtra v. Dr. Anil Pinto

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