Summary
The Supreme Court set aside a medical-negligence compensation award, finding that the challenged airway procedure was a medically accepted alternative chosen after consideration and that no breach or causal connection to later complications was proved. An unsuccessful outcome alone did not establish negligence. The hospital’s non-joinder objection was nevertheless rejected: it had to account for treatment by its engaged doctors and could produce them to explain the care provided.
Issues
- Whether choosing nasotracheal intubation in the patient’s condition fell below reasonable professional standards.
- Whether the later injuries were causally attributable to that procedure.
- Whether omission of another treating doctor required rejection of the complaint.
Held
- Actionable medical negligence required a duty, breach measured against reasonable professional competence and resulting injury attributable to that breach. A poor outcome or a different available accepted treatment did not by itself establish liability. (¶ 34–39)
- The evidence supported the procedure as an accepted temporary response after difficulties in removing the existing airway tube. The Commission had not adequately considered that clinical explanation or identified the specific breach. (¶¶ 40–45, 53–56)
- The record did not establish a causal link between the procedure and later voice loss or respiratory deformity, given the initial trauma, repeated procedures, prolonged intubation and treatment at several places. The Court did not fix a different definitive cause. (¶¶ 46–48, 50–55)
- The other allegations concerning vision, platelet management and the diagnostic test had also not been proved; the Commission’s rejection of them was sustained. (¶ 30–32)
- Non-impleadment of an additional treating doctor was not a threshold ground to reject these factual allegations. The hospital remained accountable for its doctors’ services and could produce the concerned practitioner to establish due care. (¶ 49)
- The doctors and hospital succeeded because negligence was not established on the evidence, and the patient’s enhancement appeal consequently failed. (¶ 56–57)
Result
Doctors’ and hospital’s appeals allowed to the specified extent; negligence compensation award set aside. Patient’s appeal for enhancement dismissed. Parties to bear their own costs.