NCDRC Reiterates The 3 Duties A Doctor Owes To The Patient: Whether To Undertake The Case; What Treatment To Give; And, Administration Of That Treatment

Brief facts of the case:

On, 03.07.2011, Santosh Kumar (“patient”) sustained electric burn injuries in his arms, legs and abdomen due to electrocution and two days after the incident, he was admitted in the appellant hospital, Dhanvantri Hospital & Research Centre. On 09.07.2011 and 11.07.2011, two operations were performed in the patient’s left hand. The patient alleged that the delay in performing the operation and the subsequent operation led to ‘gangrene’ of the left arm which was later amputated at another hospital.

The respondent (patient) alleged that due to the doctor’s negligence while operating at the hospital, the patient suffered from infection and gangrene. This resulted in the patient becoming completely handicapped and suffering from 80% disability. Thus, a consumer complaint was filed against the doctor and the appellant hospital before the State Commission, Jaipur. The State Commission decided in favour of the patient since it appeared that all the complications started only after getting admitted in Dhanvantri Hospital, after operation and the bleeding.

On the contrary, the appellants denied all allegations. They submitted that the patient himself absconded from S.M.S. Jaipur (hospital of first instance) and then approached them in a very serious condition. Before the treatment started, a High Risk Informed Consent was obtained from the patient’s uncle. Further, they submitted that a “CT Angiography” was performed just a day after the patient approached the appellant hospital and then the flap surgery was performed on 09.07.2011 to prevent further damage and infection. All the allegations of the medical negligence were explicitly denied by the appellants. The appellants also contended that the patient concealed several facts and manipulated the record and the flap surgery was very important to prevent damage. Aggrieved by the order of the State Commission, the appellants filed this first appeal in the NCDRC.

Observations of the Commission:

NCDRC relied on the Handbook of Burns Volume 1: Acute Burn Case, Textbook of Plastic, Reconstructive, and Aesthetic Surgery and few articles on the subject to determine that it was actually the severity of burns which led to the damage of muscles, nerved and blood vessels of the patient’s arm and the Flap Surgery was an acceptable procedure performed with reasonable care by the doctor. The amputation of the arm was somewhat inevitable given the intensity of the injury. However, the NCDRC went ahead to remark that the doctor who performed the surgery was an Orthopedic Surgeon and even though he might possess skills to perform the surgery, the surgery being a complex procedure fell under the domain of an expert plastic surgeon and not an Orthopedic Surgeon. Thus, the doctor should have taken plastic surgeon’s assistance or opinion during the flap procedure.

Relying on the Hon’ble Supreme Court’s case of Dr. Laxman Balakrishna Joshi vs Dr. Trimbak Bapu Godbole & Anr. AIR 1969 SC 128, the commission reiterated the following 3 duties that the doctor owes to his patient:

“(a) a duty of care in deciding whether to undertake the case;

(b) a duty of care in deciding what treatment to give; and

(c) a duty of care in the administration of that treatment.”

As per the commission, in the present case, the doctor failed to undertake all the aforementioned duties and thus paved way for negligence. The doctor was not held liable for all the injuries sustained by the patient, but liable to limited extent of performing the Flap Surgery. The Commission expounded that it was his “act of commission” i.e., doing something which he was not supposed to do. With the aforementioned observations, a compensation of 20 Lakh Rupees was awarded to the patient which was to be given by the appellants within 6 days and hence the appeal was partly allowed.

Case:

Dhanvantri Hospital & Research Centre and anr. vs Santosh Kumar Sharma & 3 others

Case No.:

First Appeal No. 925 of 2019

Counsel for the Appellant:

Mr. Sanjay Kr. Ghosh, Ms. Rupali S. Ghosh and Mr. Pawan Kr. Ray

Counsel for the Respondent/Opposite Party:

Mr. Vizzy Agarwal (for R1, R2, R3) and Ms Suchi Singh (for R4)

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