The Supreme Court today ruled that a doctor cannot be held guilty of medical negligence only because a patient suffers ailment after a surgery..A patient has to prove specific negligence on the part of the doctor while performing the surgery and also that the ailment was a result of improper performance of surgery, to succeed in the case..The judgment was delivered by a Bench of Justices AM Sapre and Vineet Saran in an appeal filed by a doctor against an order of the National Consumer Disputes Redressal Commission (National Commission)..The appellant doctor was initially slated to perform a laparoscopic surgery on the respondent’s gallbladder. However, during the surgery, the appellant noticed swelling, inflammation, and adhesion on the respondent’s gallbladder. He, therefore, came out of the Operation Theater and disclosed these facts to respondent’s husband and told him that in such a situation it would not be possible to perform laparoscopic surgery and only conventional procedure of surgery is the option to remove the malady. The husband of respondent agreed to the option suggested by the appellant and the appellant accordingly performed conventional surgery of removal of gall bladder..The respondent, thereafter, suffered various ailments, such as dysentery, loss of appetite, reduction of weight, jaundice etc..It was alleged that all these ailments were incurred due to the negligence of the appellant, who performed the surgery carelessly leaving behind the respondent with mental agony, pain, harassment, and money loss. Hence, she filed a complaint to claim compensation..The State Commission dismissed her complaint but the National Commission ruled in her favour. Thereupon, the doctor-appellant appealed to the Supreme Court..The Supreme Court proceeded to rely on the Bolam’s Test laid down by the Queen’s Bench in the case of Bolam v. Friern Hospital Management Committee..As per the law laid down in Bolam’s case, a Physician would not assure the patient of full recovery in every case. A surgeon cannot and does not guarantee that the result of surgery would invariably be beneficial, much less to the extent of 100 percent for the person operated on. The only assurance which such a professional can give or can be understood to have given by implication is that he is possessed of the requisite skill in that branch of the profession which he is practicing and while undertaking the performance of the task entrusted to him he would be exercising his skill with reasonable competence. This is what a person approaching the professional can expect..Judged by this standard laid down in Bolam’s case, a professional may be held liable for negligence on one of two findings: either he was not possessed of the requisite skill which he professed to have possessed, or, he did not exercise, with reasonable competence in the given case, the skill which he did not possess..The Court, then proceeded to apply the test laid down in Bolam’s case to the facts of this case. It noted that the appellant was a qualified senior doctor with experience in the field and had also possessed the requisite knowledge and skill in the subject to perform the surgery of gallbladder..It was also not in dispute that initially he proceeded to perform the laparoscopic surgery of the gallbladder of respondent as advised but while so performing he noticed some inflammation, adhesion, and swelling on the gallbladder and, therefore, decided to perform the conventional surgery..The Court noted that clause 4 of the Consent Form empowered the performing doctor to perform such additional operation or procedure including the administration of a blood transfusion or blood plasma as they or he may consider necessary or proper in the event of any emergency or if any anticipated condition is discovered during the course of the operation..Further, as per clause 4 of the Consent Form, the appellant was entitled to perform the conventional surgery as a substitute to the former on having noticed some abnormalities at the time of performing Laparoscopy..Moreover, the appellant had informed the respondent’s husband of the change in the surgery plan and had obtained his consent for the same..“In our opinion, there is no reason to disbelieve this fact stated by the appellant in his evidence. It is, in our opinion, a natural conduct and the behavior of any prudent doctor, who is performing the operation to apprise the attending persons of what he noticed in the patient and then go ahead accordingly to complete the operation”, the Court said..The Court, therefore, concluded that there was no negligence on the part of the appellant while performing the surgery..On the subsequent ailments suffered by her, the Court noted that the same was not as a result of any negligence by the appellant..There has to be a specific kind of negligence on the part of the doctor and the ailments suffered by the patient should be as a result of the negligence. There has to be a direct nexus with these two factors to sue a doctor for negligence, the Court held..“Suffering of ailment by the patient after surgery is one thing. It may be due to myriad reasons known in medical jurisprudence. Whereas suffering of any such ailment as a result of improper performance of the surgery and that too with the degree of negligence on the part of Doctor is another thing. To prove the case of negligence of a doctor, the medical evidence of experts in field to prove the latter is required. Simply proving the former is not sufficient.” .Hence, the court allowed the appeal and overturned the decision of the National Commission..Read the judgment below.
The Supreme Court today ruled that a doctor cannot be held guilty of medical negligence only because a patient suffers ailment after a surgery..A patient has to prove specific negligence on the part of the doctor while performing the surgery and also that the ailment was a result of improper performance of surgery, to succeed in the case..The judgment was delivered by a Bench of Justices AM Sapre and Vineet Saran in an appeal filed by a doctor against an order of the National Consumer Disputes Redressal Commission (National Commission)..The appellant doctor was initially slated to perform a laparoscopic surgery on the respondent’s gallbladder. However, during the surgery, the appellant noticed swelling, inflammation, and adhesion on the respondent’s gallbladder. He, therefore, came out of the Operation Theater and disclosed these facts to respondent’s husband and told him that in such a situation it would not be possible to perform laparoscopic surgery and only conventional procedure of surgery is the option to remove the malady. The husband of respondent agreed to the option suggested by the appellant and the appellant accordingly performed conventional surgery of removal of gall bladder..The respondent, thereafter, suffered various ailments, such as dysentery, loss of appetite, reduction of weight, jaundice etc..It was alleged that all these ailments were incurred due to the negligence of the appellant, who performed the surgery carelessly leaving behind the respondent with mental agony, pain, harassment, and money loss. Hence, she filed a complaint to claim compensation..The State Commission dismissed her complaint but the National Commission ruled in her favour. Thereupon, the doctor-appellant appealed to the Supreme Court..The Supreme Court proceeded to rely on the Bolam’s Test laid down by the Queen’s Bench in the case of Bolam v. Friern Hospital Management Committee..As per the law laid down in Bolam’s case, a Physician would not assure the patient of full recovery in every case. A surgeon cannot and does not guarantee that the result of surgery would invariably be beneficial, much less to the extent of 100 percent for the person operated on. The only assurance which such a professional can give or can be understood to have given by implication is that he is possessed of the requisite skill in that branch of the profession which he is practicing and while undertaking the performance of the task entrusted to him he would be exercising his skill with reasonable competence. This is what a person approaching the professional can expect..Judged by this standard laid down in Bolam’s case, a professional may be held liable for negligence on one of two findings: either he was not possessed of the requisite skill which he professed to have possessed, or, he did not exercise, with reasonable competence in the given case, the skill which he did not possess..The Court, then proceeded to apply the test laid down in Bolam’s case to the facts of this case. It noted that the appellant was a qualified senior doctor with experience in the field and had also possessed the requisite knowledge and skill in the subject to perform the surgery of gallbladder..It was also not in dispute that initially he proceeded to perform the laparoscopic surgery of the gallbladder of respondent as advised but while so performing he noticed some inflammation, adhesion, and swelling on the gallbladder and, therefore, decided to perform the conventional surgery..The Court noted that clause 4 of the Consent Form empowered the performing doctor to perform such additional operation or procedure including the administration of a blood transfusion or blood plasma as they or he may consider necessary or proper in the event of any emergency or if any anticipated condition is discovered during the course of the operation..Further, as per clause 4 of the Consent Form, the appellant was entitled to perform the conventional surgery as a substitute to the former on having noticed some abnormalities at the time of performing Laparoscopy..Moreover, the appellant had informed the respondent’s husband of the change in the surgery plan and had obtained his consent for the same..“In our opinion, there is no reason to disbelieve this fact stated by the appellant in his evidence. It is, in our opinion, a natural conduct and the behavior of any prudent doctor, who is performing the operation to apprise the attending persons of what he noticed in the patient and then go ahead accordingly to complete the operation”, the Court said..The Court, therefore, concluded that there was no negligence on the part of the appellant while performing the surgery..On the subsequent ailments suffered by her, the Court noted that the same was not as a result of any negligence by the appellant..There has to be a specific kind of negligence on the part of the doctor and the ailments suffered by the patient should be as a result of the negligence. There has to be a direct nexus with these two factors to sue a doctor for negligence, the Court held..“Suffering of ailment by the patient after surgery is one thing. It may be due to myriad reasons known in medical jurisprudence. Whereas suffering of any such ailment as a result of improper performance of the surgery and that too with the degree of negligence on the part of Doctor is another thing. To prove the case of negligence of a doctor, the medical evidence of experts in field to prove the latter is required. Simply proving the former is not sufficient.” .Hence, the court allowed the appeal and overturned the decision of the National Commission..Read the judgment below.
