Summary
The Supreme Court restored dismissal of the patient’s medical-negligence complaint and set aside the National Commission’s compensation award. On the particular consent form and evidence, conversion from laparoscopic to conventional gall-bladder surgery was authorised when abnormalities were discovered; the surgeon had also informed and obtained consent from the attending husband. The patient did not establish a specific negligent act or a causal connection between the operation and her later ailments. An adverse outcome alone did not prove departure from reasonable professional competence.
Issues
- Whether the surgeon’s conversion to conventional surgery lacked consent on the evidence.
- Whether the patient proved negligent treatment and a causal connection with the later ailments.
- What professional standard governed the assessment of the surgeon’s conduct.
Held
- The governing standard was the ordinary competent practitioner exercising reasonable skill in the relevant field, assessed with knowledge available at the time. A surgeon did not guarantee recovery, and an adverse result or choice between reasonable treatments did not itself establish negligence. (¶¶ 17, 18, 19, 21, 22, 23)
- The surgeon possessed the relevant qualifications and experience. The patient’s signed consent form authorised the additional or substitute procedure in the stated circumstances, and the conventional operation concerned the same organ after inflammation, adhesion and swelling made continuation of laparoscopy unsuitable. On those facts another consent form was unnecessary. (¶¶ 25, 26, 27, 30, 31, 32)
- The Court accepted the surgeon’s evidence that he informed the attending husband of the discovered condition and obtained his consent before proceeding. The original authorisation and this further consent supported the conclusion that the substituted procedure was authorised; the Court also applied the cited exception concerning necessary protection of life or health. (¶¶ 33, 34, 35, 36, 37, 38)
- The record did not establish specific negligent surgery or postoperative care. Nor did it establish that the stones removed during the later treatment were the same stones negligently left during the first operation. The causal link between the surgeon’s conduct and the later ailments lacked the necessary medical evidence in this case. (¶¶ 40, 41, 42, 43, 44, 45)
- The patient’s suffering and the discharge-certificate argument did not overcome the findings on consent and proof of negligence. The compensation award was set aside and the State Commission’s dismissal restored. (¶¶ 46, 47, 48, 49, 50)
Result
Appeal allowed; National Commission’s order set aside and State Commission’s order dismissing the medical-negligence complaint restored.