Delhi: "Just because a person suffers from a bad outcome of medical treatment, does not accrue an automatic right to sue the hospital or doctor for compensation," making this observationon the NCDRC dismissed the charges of medical negligence against a private doctor.
The case concerns a patient who developed uro-sepsis and passed away later during treatment. The petitioner, son of the deceased patient approached the forum alleging medical negligence against the doctor and clinic.
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The petitioner submitted that her father was admitted to a Kolkata-based private facility for weakness and pain in the left groin. The Ultrasonography (USG) and few blood tests were done and it was a suspected case of cancer in the liver and lungs. Then a CT-guided FNAC was performed. It was very painful and the patient suffered a suffocating experience. Bedsore was noted on the back.
2 days later, the patient did not pass urine for a long time and the doctor inserted a catheter in the bladder. It was alleged that the spread of lung cancer takes time to reach liver and it spreads locally in the chest.
It was submitted that the patient was 84 years old with chronic medical ailments but the doctor failed to co-relate the raised blood levels of fibrinogen, D-dimer and PSA, which would have been helpful for proper management with the help of Oncologist, Hematologist and Urologist. The treating doctor failed to exercise a reasonable degree of care to diagnose and control the urinary infection which was present at the time of admission at Belle-Vue Clinic. The patient developed uro-sepsis and died on 06.06.2007. After that, the petitioner approached the district consumer forum alleging negligence against the doctor and the facility.
The District Forum dismissed the complaint and the State Commission also upheld the decision. Being aggrieved, the complainant filed the instant Revision Petition.
The learned counsel for the complainant submitted that both the commissions failed to consider the dereliction of duty by the accused doctor, which precipitated the sepsis leading to the death of the 84 years old patient within six days of his admission.
It was further alleged that the doctor at the earlier stage did not examine or investigated the patient for simple tests like a plain Chest X-ray, USG abdomen, and a few blood tests. The learned counsel for the doctor argued that the medical record showed that the patient was admitted with severe weakness, general debility, and malnutrition. There were low hemoglobin and low albumin level in the blood. The patient was suffering from comorbidities like Hypertension and Prostrate problem. On 05.06.2007, by FNAC of the liver, the diagnosis was confirmed as metastatic adenocarcinoma. The X-ray chest and blood tumour makers (CEA, PSA), raised CRP, D-dimer and fibrinogen were suggestive of primary cancer of colon or lung.
The doctor referred the patient to a renowned Oncologist, the Head of the Department of Oncology and Radiotherapy Unit at SSKM Hospital. After examination, he also opined it as "malignancy – primary ? GI? Lung" and the same was explained to the patient's wife also and she was told about the limited therapeutic options because of the poor condition of the patient.
On pursual of the arguments of both the parties, the apex commission stated, "It was diagnosed as lung cancer with liver metastasis and urinary sepsis. Because of poor prognosis there was no scope of chemotherapy or radiotherapy. Therefore, the doctor suggested supportive care and suggested to try with an oral drug called Gefitinib, if the infection was controlled."
The commission also noted that the patient's condition started deteriorating very fast in spite of the patient being under cover of two antibiotics. The patient developed cardiac arrest and though resuscitative measures were taken but the patient passed away at 10.35 a.m.
The commission further added, "We note that the complainant filed the instant complaint based on the report of the expert, the ex-Professor of Forensic Medicine at Govt. Medical College. However, he was neither a subject expert nor qualified in Oncology and Urology. Under Section 45 of Evidence Act, he cannot be construed as an expert."
Moreover, the commission took note of the fact that the patient was kept under the treatment of a team of doctors including two Oncologists.
The commission clarified that as common practice the Oncologists initially assess the stage of the disease and the condition of the patient.
The bench observed that the patient's hematological values D-Dimer, plasma fibrinogen and FDP were marginally increased. Such changes are usually seen in advanced liver cancer, which can be treated without the help of Hematologist. The patient was suffering from chronic comorbidities like – Hypertension and Prostatic hyperplasia.
Following the observation, the commission stated,
Therefore the active management of cancer was not advised and life expectancy despite the treatment was drastically restricted. Such patients with general debility are prone for urinary complications. In our considered view, the death of the patient was due to advanced cancer with lung and liver metastasis; it was neither due to negligence nor deficiency in service during the treatment from the Opposite Parties. It should be borne in mind that " No cure is not negligence of doctors".
The commission referred to the supreme court's verdict of the Jacob Mathew's case and dismissed the revision petition stating
The condition of the patient did not improve despite proper treatment. It resulted into the death of the patient. Therefore, just because a person suffers from a bad outcome of medical treatment, does not accrue an automatic right to sue the hospital or doctor for compensation. We do not find any medical error to be considered as negligent in the instant case. It was the reasonable care exercised by the doctor.
To view the order, click on the following link:
https://.in/pdf_upload/judgement2021-03-05-150163.pdf