Top Court Says Doctors are Not Always Liable for Patient's Death

On Tuesday, the Supreme Court reaffirmed that a doctor is not liable for his patient’s death. The doctor may only treat his patients to the best of his ability. When a patient dies or has an accident, it’s easy to point fingers at the doctor. Refusing to accept death is an intolerant act on the part of family members. A bench of judges, Hemant Gupta and V. Ramasubramanian, criticized the increase in incidents of manhandling of medical personnel who worked day and night without considering their comfort during the pandemic.

It was further stated by the panel: “Despite the therapy, if the patient had not lived, the physicians could not be responsible as even the best-trained doctors cannot prevent the inevitable.

Although patients can expect their doctors to use due caution throughout treatments, no medical expert can guarantee that their client will make a full recovery.

It emphasized that the deciding authority should have access to adequate material or medical evidence before reaching the decision that death was the result of medical negligence.“A patient’s death cannot on the face of it be construed to constitute medical negligence,”the panel said.

This was stated while the court was upholding the appeal of Bombay Hospital and Medical Research Centre against the National Consumer Disputes Redressal Commission’s decision to award 14.18 lakh to the heirs of one Dinesh Jaiswal, who passed away in June 1998 after unsuccessful surgeries to treat the gangrene in his limbs.

The family believes that the lack of an operating room and a malfunctioning angiography machine contributed to Jaiswal’s death. The hospital, however, has denied any wrongdoing, saying that patients received the highest quality care feasible given the available personnel and budget.

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The National Consumer Commission found the hospital negligent in 2010 based on "res ipsa loquitur," which states that "the mere existence of an event may lead to an inference of negligence on the other side."

The supreme court, however, reversed this verdict on Tuesday, citing legal and factual flaws in the original ruling as reasons for its decision.

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Even if the patient has surgery and re-exploration and still does not make it, it cannot be considered medical negligence because the patient was in a grave state with imminent gangrene before admission to the hospital. The complaint here was unreasonable in expecting the doctor to stay at his bedside for the entirety of the patient’s hospitalization. The bench ruled that there was no evidence that the doctor in question had provided substandard care.

The court emphasized that the patient was never left unattended and that the absence of the primary treating physician during the time the patient was hospitalized did not constitute medical negligence because the patient was treated by 20 specialists across many departments.

According to the document, “the hospital and the doctor who offered all necessary therapy within their resources and ability cannot be held responsible if the patient did not live even after surgery.”

When discussing the issue of the patient’s delayed re-exploration after the initial surgery revealed complications due to the lack of an available operation theatre, the bench pointed out that it was purely coincidental that all four of the hospital’s operation theaters were occupied on the day the patient was scheduled to undergo surgery. Since the hospital only has so many operating rooms available at any one time, we do not think it is realistic for the patient to demand access to an emergency operating room. Nothing can be asserted about hospital carelessness if all available operating rooms were in use when the patient’s surgery was scheduled.

There was a team of specialists ready to care for the patient, and they did so, the court said; nonetheless, “sadly, nature had the final word,” and the man passed away. The hospital and the doctor “cannot be faulted since they provided the essential treatment at all given times,” it argued, even if the family “may not have coped with the death of their loved one.”

In March 2010, when it decided to review the hospita’’s appeal, the highest court awarded Rs.5 lakh in interim compensation to the deceased’s relatives. This sum will be considered an ex gratia payment to Jaiswal’s family, the bench said, and will not be sought back from the medical facility.

References:

1. Hindustan times - https://www.hindustantimes.com/india-news/doctor-can-t-be-held-guilty-of-negligence-just-because-a-patient-died-supreme-court-101638298774413.html
2. Medical Dialogues - https://medicaldialogues.in/news/health/medico-legal/doctors-cant-be-held-liable-for-negligence-merely-because-better-alternative-course-of-treatment-was-available-ncdrc-101162

Source-Medindia