A failed surgery alone does not imply medical negligence: SC | Latest news India

The Supreme Court has emphasized that medical professionals cannot be held liable for negligence solely because surgery or treatment does not produce the expected results, stating that doctors’ culpability must arise from clear evidence pointing to a deviation from medical practices. accepted.

In a ruling that underscored the protection of medical professionals against allegations of negligence, the court stressed that complications, even unexpected ones, do not necessarily mean that a doctor has not performed his or her duties with due diligence and skill.

“Just because the patient has not responded favorably to surgery or treatment administered by a doctor or the surgery has failed, the doctor cannot be immediately held liable for medical negligence applying the doctrine of ‘Res Ipsa Loquitur’. ‘ (Latin term meaning ‘the thing speaks for itself’) unless it is established by evidence that the doctor did not exercise due skill possessed by him in the performance of his duties,” said a bench of Justices PS Narasimha and Pankaj Mithal.

The principle of “Res Ipsa Loquitur” implies that negligence is so obvious that it does not need further proof.

The court held that a bad result does not necessarily amount to negligence. Rejecting the assumption that a botched surgery or an unsatisfactory medical outcome inherently points to negligence, the court stressed that medical procedures carry inherent risks and that the unpredictability of outcomes should not automatically lead to a conclusion of negligence.

The case in question revolved around a complaint of medical negligence in minor eye surgery on a child diagnosed with congenital ptosis, a condition characterized by the drooping of the upper eyelid. The surgery was performed by a qualified ophthalmologist at the Post Graduate Institute of Medical Education and Research (PGI) in Chandigarh in June 1996. When the surgery did not produce the expected improvement and the child’s condition appeared to deteriorate, the patient’s family filed a complaint. complaint, asking for compensation for what they alleged was substandard medical care.

Initially, the state consumer commission dismissed the complaint after finding no evidence of negligence. The National Consumer Disputes Redressal Commission (NCDRC) reversed the decision and awarded compensation of $3.5 lakh to the complainants and hold the doctor and the PGI jointly and severally liable. The case eventually reached the Supreme Court, which took a different stance and ultimately exonerated the doctor and the medical institution.

A key aspect of the court’s analysis was the reaffirmation of the Bolam Test, a long-recognized standard in medical negligence cases. Originating from the 1957 English case Bolam Vs Friern Hospital Management Committee, this test establishes that a doctor is not negligent if he acts in accordance with a practice accepted by a responsible body of medical professionals. In the Indian context, the court endorsed the Bolam test in Jacob Mathews v. State of Punjab (2005), holding that only if a doctor lacks the necessary skills or fails to exercise reasonable competence should liability be imposed on him.

In the present case, the court applied this well-established benchmark and concluded that the treating physician had the necessary qualifications and experience to perform the surgery. He added that there is no evidence to suggest the doctor failed to exercise due care or deviated from acceptable medical standards. The court concluded that the postoperative complications were not indicative of any medical negligence.

The ruling clarified the three essential components necessary to establish medical negligence: a duty of care that the medical professional owes to the patient; a violation of that in which the doctor’s actions do not meet the expected standard and the consequent harm directly related to it.

In the absence of clear evidence of negligence, the court said the failed outcome could not be construed as a breach of duty. He recognized that complications could arise even with the best medical practices and that a doctor should not be unfairly penalized for rare or unfortunate results.

“The deterioration of the patient’s condition post-surgery is not necessarily indicative or suggestive that the surgery performed, or the treatment given to the patient was not adequate or inappropriate, or that there was any negligence in its administration. In the case of surgery or said treatment, it is not necessary that in all cases the patient’s condition improves and that the surgery be a success to the patient’s satisfaction,” the ruling says.

When reasonable patient care is or is given, the court said, contrary evidence must be proven to charge medical professionals with actionable negligence.

The verdict has significant implications for medical professionals, offering them protection from unjustified liability if they have followed established medical practices and exercised reasonable care, even as it seeks to balance patients’ rights with protecting doctors from undue harassment.