SC: Doctor cannot be held guilty of negligence just because a patient died

The Supreme Court declared on Tuesday that no doctor can guarantee a patient’s life, but can only try to treat everyone to the best of his or her abilities, reiterating that a doctor cannot be held liable for medical malpractice just because a patient does not survive.

“There is a tendency to blame the doctor when a patient dies or suffers some mishap. This is an intolerant conduct of the family members to not accept the death in such cases. The increased cases of manhandling of medical professionals who worked day and night without their comfort has been very well seen in this pandemic,” lamented a bench of justices Hemant Gupta and V Ramasubramanian.

The bench added: “In spite of the treatment, if the patient had not survived, the doctors cannot be blamed as even the doctors with the best of their abilities cannot prevent the inevitable…The doctors are expected to take reasonable care but none of the professionals can assure that the patient would overcome the surgical procedures.”

It underlined that there must be sufficient material or medical evidence should be available before the adjudicating authority to arrive at the conclusion that death is due to medical negligence. “Every death of a patient cannot on the face of it be considered to be medical negligence,” said the bench.

The court said this while allowing an appeal filed by Bombay Hospital and Medical Research Centre against the National Consumer Disputes Redressal Commission’s order to pay ₹14.18 lakh to the family of one Dinesh Jaiswal, who died in June 1998 following unsuccessful surgeries of his gangrene in his limbs.

The family attributed Jaiswal’s demise to negligence in conducting surgeries, absence of the treating senior doctor, lack of operation theater, and a broken-down angiography machine. The hospital, however, refuted all allegations, stating the best possible treatment by present medical professionals and within the resources available was provided.

In its 2010 judgment, the national consumer commission invoked the principle of “res ipsa loquitur” (mere occurrence of certain event can lead to an inference of negligence of the other side) to hold the hospital guilty of medical negligence.

But the top court on Tuesday set aside this judgment, noting the order suffered from legal as well as factual infirmities.

“It is a case where the patient was in serious condition impending gangrene even before admission to the hospital but even after surgery and re-exploration, if the patient does not survive, the fault cannot be fastened on the doctors as a case of medical negligence. It is too much to expect from a doctor to remain on the bed side of the patient throughout his stay in the hospital which was being expected by the complainant here. A doctor is expected to provide reasonable care which is not proved to be lacking in any manner in the present case,” held the bench.

The court underlined that there was never a stage when the patient was left unattended and mere fact that the main treating doctor had gone abroad cannot lead to an inference of medical negligence because the patient was admitted in a hospital having 20 specialists in multi-faculties.

“The patient was in a critical condition and if he could not survive even after surgery, the blame cannot be passed on to the hospital and the doctor who provided all possible treatment within their means and capacity,” it said.

On the aspect of delay in re-exploration after the initial surgery threw up complications due to non-availability of an operation theater, the bench noted that it was only a matter of chance that all the four operation theatres of the hospital were occupied when the patient was to undergo surgery.

“We do not find that the expectation of the patient to have an emergency operation theatre is reasonable as the hospital can provide only as many operation theatres as the patient load warrants. If the operation theatres were occupied at the time when the operation of the patient was contemplated, it cannot be said that there is negligence on the part of the hospital,” it said.

The court added that a team of specialist doctors was available and also attended to the patient but “unfortunately, nature had the last word” and the patient breathed his last. “The family may not have coped with the loss of their loved one, but the hospital and the doctor cannot be blamed as they provided the requisite care at all given times,” it maintained.

The deceased’s family was paid ₹5 lakh as interim compensation by the top court in March 2010 when it had agreed to examine the hospital’s appeal. The bench said that this amount shall be treated as ex gratia payment to Jaiswal’s family and will not be recovered by the hospital.