Summary of the Judgment
Case Name: Neeraj Sud & Anr. vs. Jaswinder Singh (Minor) & Anr.
Date of Judgment: 25th October 2024
Court: Supreme Court of India
Bench: Honorable Justice Pamidighantam Sri Narasimha and Honorable Justice Pankaj Mithal
Cited Judgments: Bolam v. Friern Hospital Management Committee, Jacob Mathew v. State of Punjab
Introduction
The Supreme Court of India, in its recent judgment, provided a comprehensive interpretation of medical negligence principles in a case involving Dr. Neeraj Sud, who was accused of negligence in performing surgery on a minor, Jaswinder Singh. This landmark judgment reinforces the standards of medical negligence and highlights the importance of evidence-based assessment before attributing liability to medical professionals.
The crux of the case revolves around the surgery performed by Dr. Neeraj Sud, a qualified ophthalmologist, at the Post Graduate Institute of Medical Education & Research (PGI), Chandigarh. The complainants, the parents of the minor, alleged that the surgery intended to correct a congenital drooping eyelid, or ptosis, resulted in the deterioration of the child’s vision and onset of double vision. Dissatisfied with the initial dismissal of their complaint by the State Commission, they approached the National Consumer Disputes Redressal Commission (NCDRC), which subsequently ruled in their favour, holding Dr. Sud and PGI jointly and severally liable for compensation.
Facts and Findings of the Case
The Supreme Court meticulously examined the sequence of events and the evidence presented. The surgery, performed on 26th June 1996, was intended to correct moderate ptosis without affecting the child’s vision. Post-surgery, however, the child’s visual acuity decreased from 6/9 to 6/18, accompanied by complaints of double vision. This unforeseen outcome led the complainants to allege negligence, claiming a compensation amount that was ultimately partly awarded by the NCDRC.
However, the Honorable Bench, led by Justice Pankaj Mithal, observed that:
“Deterioration of the condition of the patient post-surgery is not necessarily indicative or suggestive of the fact that the surgery performed or the treatment given to the patient was not proper or inappropriate or that there was some negligence in administering the same.”
The Court emphasised that the mere deterioration of the patient's condition post-treatment does not automatically infer negligence.
Analysis of Medical Negligence
The Court applied the well-established Bolam Test, originating from the case Bolam v. Friern Hospital Management Committee, which serves as a gold standard for determining negligence in the medical profession. According to this test, a medical professional is not considered negligent if they act in accordance with practices accepted as proper by a responsible body of medical opinion.
“A doctor is not negligent if he is acting in accordance with the acceptable norms of practice unless there is evidence of a medical body of skilled persons in the field opining that the accepted principles/procedure were not followed.”
The application of this test to the current case revealed no deviation from the accepted medical practices. Justice Mithal opined that a practitioner with the required qualifications and competence, such as Dr. Sud, cannot be deemed negligent simply because the outcome was not favourable to the patient. Instead, negligence is only established if there is a direct breach of duty or failure to apply reasonable skill and diligence.
Reversal of the NCDRC's Decision
The NCDRC’s decision to award compensation was primarily based on the observation that the child's condition had worsened post-surgery. The NCDRC held that the surgery resulted in a visual decline, which indicated a lack of due care on the part of the surgeon. However, the Supreme Court found this conclusion lacking in substantiation, stating:
“In cases of surgery or such treatment, it is not necessary that in every case the condition of the patient would improve and the surgery is successful to the satisfaction of the patient. It is very much possible that in some rare cases complications of such nature arise, but that by itself does not establish any actionable negligence on part of the medical expert.”
By overturning the NCDRC’s decision, the Court restored the State Commission’s initial judgment that absolved Dr. Sud and PGI of liability. This reversal is significant, as it underscores the Court’s stance that the judiciary should not readily attribute fault to medical professionals without compelling evidence.
Importance of Evidence in Establishing Negligence
Throughout its judgment, the Supreme Court stressed the importance of evidentiary support in cases of alleged medical negligence. The complainants did not present any expert testimony or concrete evidence suggesting that Dr. Sud deviated from the standard of care expected in his field. The medical records, while indicative of the patient’s worsened condition, did not substantiate any claim of malpractice or negligence.
Justice Narasimha highlighted this by observing:
“Simply for the reason that the patient has not responded favourably to the surgery or the treatment administered by a doctor or that the surgery has failed, the doctor cannot be held liable for medical negligence straightway by applying the doctrine of Res Ipsa Loquitor unless it is established by evidence that the doctor failed to exercise the due skill possessed by him in discharging his duties.”
This quote encapsulates the Court’s assertion that negative outcomes in medical treatments are not always reflective of negligence, especially when the professional in question has adhered to accepted standards of practice.
Conclusion
The Supreme Court’s decision in the case of Neeraj Sud & Anr. vs. Jaswinder Singh (Minor) & Anr. reiterates the principle that medical professionals should not be held liable for unforeseen complications arising from treatments or surgeries. The judgment elucidates that without clear evidence demonstrating a breach of duty or deviation from established medical practices, allegations of negligence cannot stand.
By emphasising the requirement for solid evidence and expert testimony, the Court has provided a much-needed clarification on the standards of medical negligence. This ruling should serve as a guidepost for both the legal and medical communities in India, fostering a balanced approach to protecting patient rights without discouraging healthcare practitioners from performing their duties.
Justice Mithal aptly concluded that:
“When reasonable care, expected of the medical professional, is extended or rendered to the patient, unless contrary is proved, it would not be a case for actionable negligence.”
This case serves as a landmark ruling, setting a clear precedent for how medical negligence claims should be approached in the future.
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