SC: Doctor Can’t Be Held Liable for Medical Negligence, If Patient Doesn’t Favourably Respond to Surgery or Treatment

The apex court said that medical negligence needs to be established by evidence that the doctor failed to exercise the due skill possessed by him.

New Delhi:The Supreme Court has said that if a patient has not responded favourably to the surgery or the treatment administered by a doctor or that the surgery has failed, the doctor cannot be held liable for medical negligence straightway. The apex court has made it clear that a simple lack of care, an error of judgment or an accident is not sufficient proof of negligence on part of the medical professional so long as the doctor follows the acceptable practice of the medical profession in discharge of his duties.

A bench comprising justices P S Narasimha and Pankaj Mithal, in judgment delivered on Friday, said: “simply for the reason that the patient has not responded favourably to the surgery or the treatment administered by a doctor or that the surgery has failed, the doctor cannot be held liable for medical negligence straightway by applying the doctrine of Res Ipsa Loquitor unless it is established by evidence that the doctor failed to exercise the due skill possessed by him in discharging of his duties”.

The bench said deterioration of the condition of the patient post-surgery is not necessarily indicative or suggestive of the fact that the surgery performed or the treatment given to the patient was not proper or inappropriate or that there was some negligence in administering the same. “In case of surgery or such treatment it is not necessary that in every case the condition of the patient would improve and the surgery is successful to the satisfaction of the patient”, said Justice Mithal, who authored the judgment on behalf of the bench.

The apex court allowed an appeal filed by Dr Neeraj Sud and the Postgraduate Institute of Medical Sciences, Chandigarh against the 2011 order of the National Consumer Disputes Redressal Commission (NCDRC). The commission had directed them to pay Rs three lakh as compensation and Rs 50,000 as cost to complainant Jaswinder Singh and his father for negligence.

Justice Mithal said the complainants have not adduced any evidence to establish any negligence in the performance of surgery or treatment on part of Dr. Neeraj Sud or the PGI. Justice Mithal said the complainants mainly relied upon the medical records of the PGI which were obtained and considered by the state commission.

“Deterioration of the condition of the patient post-surgery is not necessarily indicative or suggestive of the fact that the surgery performed or the treatment given to the patient was not proper or inappropriate or that there was some negligence in administering the same”, said Justice Mithal.

Justice Mithal said in case of surgery or such treatment it is not necessary that in every case the condition of the patient would improve and the surgery is successful to the satisfaction of the patient. “It is very much possible that in some rare cases complications of such nature arise but that by itself does not establish any actionable negligence on part of the medical expert”, said the bench.

The bench said it is well recognized that actionable negligence in the context of the medical profession involves three constituents (i) duty to exercise due care; (ii) breach of duty and (iii) consequential damage. “However, a simple lack of care, an error of judgment or an accident is not sufficient proof of negligence on part of the medical professional so long as the doctor follows the acceptable practice of the medical profession in discharge of his duties”, said the bench.

Justice Mithal said a doctor cannot be held liable for negligence merely because a better alternative treatment or course of treatment was available or that more skilled doctors were there who could have administered better treatment.

The apex court, while junking the petition by the complainant, said that no evidence was produced of any expert body in the medical field to prove that requisite skill possessed by Dr Sud was not exercised by him in discharge of his duties.

The bench said a medical professional may be held liable for negligence only when he is not possessed with the requisite qualification or skill or when he fails to exercise reasonable skill which he possesses in giving the treatment. “None of the above two essential conditions for establishing negligence stand satisfied in the case at hand as no evidence was brought on record to prove that Dr. Neeraj Sud had not exercised due diligence, care or skill which he possessed in operating the patient and giving treatment to him”, said the bench.

The bench said when reasonable care, expected of the medical professional, is extended or rendered to the patient unless contrary is proved, it would not be a case for actionable negligence.

The apex court said Dr. Neeraj Sud was a competent and a skilled doctor possessing requisite qualification to perform PTOSIS surgery and to administer the requisite treatment and that he had followed the accepted mode of practice in performing the surgery and that there was no material to establish any overt act or omission to prove negligence on his part. “As stated earlier, no evidence was adduced to prove that he had not exercised sufficient care or has failed to exercise due skill in performing the surgery”, said the bench.

It was alleged that in June 1996, a surgery was performed on the 6-year-old boy for the physical deformity diagnosed as PTOSIS (drooping eyelid) by Dr. Neeraj Sud at PGI. However, instead of any improvement the condition of the eye further deteriorated post-surgery.

The complainants’, thus through the complaint made to the state commission claimed compensation of Rs.15,00,000/- for the sufferings due to negligence of the doctor and a further sum of Rs.4,55,000/- towards the cost of the treatment, loss of studies etc. The appellants’, doctor and the institute, said the complainant was given proper treatment with due care during operation and that the correction and reoccurrence of PTOSIS is a common complication of congenital ptosis which could have been set right by repeat surgery. The patient was not examined by Dr Sud after January, 1997 as he was taken for treatment to Guru Nanak Eye Centre, Delhi and Dr Daljit Singh Hospital, Amritsar.

The appellants’, in their defence, said: “Dr. Neeraj Sud and the PGI admitted that the surgery was performed by Dr. Neeraj Sud who is a qualified post-graduate in ophthalmology. He had three years of experience in eye surgeries including surgery of PTOSIS. During the period 1994-1996 when Dr. Neeraj Sud was a senior resident at PGI, he was associated with about 74 PTOSIS operations”.