Medical professional cannot assure that patient will overcome medical crisis: Supreme Court

A medical professional cannot assure that a patient will successfully overcome medical crisis and all that doctors are expected to do is to take reasonable care in discharge of their duties, the Supreme Court observed on Wednesday [Dr Chanda Rani Akhouri vs Dr M A Methusethupathi]. .The Court said that a doctor will be liable only if he did not possess the requisite skills which he claimed he had or he did not exercise the skill he possessed, with reasonable competence.A bench of Justices Ajay Rastogi and Abhay Oka, therefore, upheld orders of the National Consumer Disputes Redressal Commission (NCDRC) which refused to hold two doctors guilty in a medical negligence case.The Court was hearing a petition filed by a widow, whose husband had died on February 3, 1996 after undergoing a kidney transplant surgery. She alleged that her husband died due to the post operative medical negligence and follow-up care."The doctors are expected to take reasonable care, but no professional can assure that the patient will come back home after overcoming the crisis. At the same time, no evidence has come on record at the behest of the appellants which, in any manner, could demonstrate that it was a case of post-operative medical negligence or follow up care on the part of treating doctors. At the same time, the respondents - treating doctors are indeed experts and qualified Nephrologists and this fact has been admitted by the appellant that the patient was under treatment of the best medical professionals and qualifie Nephrologists, but those treating doctors could not save the patient and that in itself could not be considered to be a case of post operative medical negligence," the bench held..According to the plea, Chanda Rani Akhouri's husband had developed hypertension and despite continuous treatment there wasn't any progress at Delhi's hospital, after which he was suggested to undergo a kidney transplant at Dr Methusethupathi's clinic at Chennai.Subsequently, after taking opinions from doctors at Delhi, the family took the deceased Naveen Kant to Chennai and he underwent a successful transplant in November 1995 by a team of 12 experts. The surgery was conducted within the provisions of the Transplantation of Human Organs and Tissues Act, 1994. He was discharged after 12 days.Naveen's family claimed that he continuously complained of severe pain in his left forearm where intravenous drugs were injected and at the given time, he was assured that the pain would subside in due course of time. However, despite follow-up care, he died in February 1996. The NCRDC after going through the material on record including the evidence led by the parties, arrived at a conclusion that it was not a case of post operative medical negligence as alleged by the deceased's family and dismissed their complaint by a judgment dated July 31, 2009..The bench led by Justice Rastogi noted that Naveen's family agreed to the fact that the doctors who treated him, were experts in the field. "Any individual approaching such a skilled person would have a reasonable expectation under the duty of care and caution but there could be no assurance of the result. No doctor would assure a full recovery in every case. At the relevant time, only assurance given by implication is that he possessed the requisite skills in the branch of the profession and while undertaking the performance of his task, he would exercise his skills to the best of his ability and with reasonable competence," the bench said, while referring to the top court's decision in Jacob Mathew v. State of Punjab and Another. The judges further said that the liability would arise only if (a) either a person (doctor) did not possess the requisite skills which he professed to have possessed; or (b) he did not exercise with reasonable competence in given case the skill which he did possess. The bench then referred to various case laws dealing with medical negligence and said, "It clearly emerges from the exposition of law that a medical practitioner is not to be held liable simply because things went wrong from mischance or misadventure or through an error of judgment in choosing one reasonable course of treatment in preference to another. In the practice of medicine, there could be varying approaches of treatment. There could be a genuine difference of opinion. However, while adopting a course of treatment, the duty cast upon the medical practitioner is that he must ensure that the medical protocol being followed by him is to the best of his skill and with competence at his command. At the given time, medical practitioner would be liable only where his conduct fell below that of the standards of a reasonably competent practitioner in his field."The judges, further noted that the team that operated Naveen had already conducted 900 to 1000 successful renal transplant surgeries. "Even as per the case sheet of the patient, doctors have treated him to the best of their medical knowledge and administered the best medical care which was possible. Although the complaint of the patient which remained persistent could not be ruled out despite medically approved drugs being administered to him and if he could not be finally saved, that in itself could not be considered to be a case of post operative medical negligence," the Court held..[Read Judgment]