Summary
The Supreme Court set aside the NCDRC's finding of medical negligence against a PGI surgeon who operated on a child for congenital ptosis, holding that deterioration after surgery does not by itself prove negligence and that the complainants had led no evidence that the doctor failed to exercise the skill he possessed. The State Commission's dismissal of the complaint was restored.
Issues
- Whether a doctor and hospital can be held liable for medical negligence merely because the patient's condition worsened after surgery.
- Whether the NCDRC was justified in reversing the State Commission's finding of no negligence when the complainants led no evidence beyond the hospital's own medical records.
- Whether the complainants were entitled to enhancement of the compensation awarded by the NCDRC.
Held
- A worsening of the patient's condition after surgery is not, by itself, indicative of improper treatment or negligence; surgery need not succeed to the patient's satisfaction in every case, and complications arising in some cases do not establish actionable negligence. (¶¶ 11, 13)
- Actionable medical negligence requires a duty of care, its breach and consequential damage. A simple lack of care, an error of judgment or an accident does not prove negligence so long as the doctor follows accepted medical practice, and a doctor is not liable merely because a better alternative treatment or a more skilled doctor was available. (¶ 14)
- A medical professional may be held negligent only where he lacks the requisite qualification or skill, or fails to exercise with reasonable competence the skill he possesses. Applying the Bolam test as approved in Jacob Mathew, a doctor acting according to accepted norms is not negligent absent evidence, such as the opinion of a body of skilled medical persons, that accepted procedure was not followed. (¶¶ 15, 16, 17)
- The NCDRC's finding was based on no evidence: the complainants produced no expert or other evidence of lack of skill or care and relied only on the PGI records, which showed deterioration but not negligence. A doctor cannot be held liable straightaway by applying res ipsa loquitur merely because the surgery failed or the patient did not respond favourably. (¶¶ 8, 12, 13, 16, 17, 18)
- Since no negligence was proved against the doctor or the PGI, the complainants were not entitled to any compensation and no question of enhancement arose. The Court deprecated the casual drafting of the complainants' appeal but considered it on merits. (¶¶ 5, 19, 20)
Result
Civil Appeal No. 272 of 2012 by the doctor and PGI allowed; the NCDRC judgment dated 24.08.2011 set aside and the State Commission's order dismissing the complaint restored. Civil Appeal No. 5526 of 2012 by the complainants dismissed.