Know why NCDRC rejected claim of medical negligence in Justice Verma’s death

National Consumer Disputes Redressal Commission: In a complaint by the wife, and children of Justice J.S. Verma, Former CJI seeking directions to the three hospitals and treating doctors to pay exemplary damages and compensation of Rs 10 Crores alleging medical negligence in Justice Verma’s treatment resulting in his death, the Presiding member, Dr S.M. Kantikar and two members namely, Ram Surat Ram Maurya and Dr Inder Jit Singh dismissed the complaint holding that there was no negligence on the part of the doctors who treated Justice Verma.

It was stated that the instant complaint was filed pursuing the principles of Justice J.S. Verma – “to ensure that the guilty do not go unpunished.” It was stated that Justice Verma was diagnosed with asymptomatic coronary artery disease in 1993, managed well by a healthy lifestyle. Following a complete executive check-up in 2012, significant abnormal liver function was revealed, but no further investigation or medication was recommended. After a swelling developed in his left leg, Justice Verma was admitted to the Nursing home (Opposite party) wherein, he underwent treatment from 12-03-2013 to 14-03-2013 and diagnosed with irregular heart rhythm, followed by several tests clearly showing significantly deranged liver function and very significantly abnormal blood clotting. After prescribing suitable medication, he was discharged on 14-03-2013 and continued medicines for 3 months. He experienced bleeding in April, which was informed to the doctor concerned, but did not get any further instructions and told to continue the prescribed medicines.

A few days later, he felt unwell with significant gastrointestinal bleeding during his visit to Mumbai, had several blood vomiting while travelling, immediately got admitted and six units of blood and plasma was transfused to cover blood loss. Endoscopy at Fortis Escorts Hospital revealed bleeding from ulcer and not oesophageal varices. Multiple transfusions created fluid overload in lungs which caused acute breathing problem and citrate in transfusion bound blood calcium. It was alleged that the attending doctors failed to properly manage the complications and Justice Verma was shifted to Medanta Hospital, and worsening of fluid overload and a deteriorating cardiac status due to multiple transfusions was revealed. Complaining about the suboptimal management of Medanta Hospital, it was stated that cardiac arrest after few hours of admission could not be reversed, Justice Verma was intubated and ventilated, but could not survive and passed away on 22-04-2013.

Complaint of Medical Negligence

The instant complaint points fingers at negligence on part of doctors in treating liver dysfunction, prescription of combination of drugs while ignoring Justice Verma’s condition, ignorance of going through test reports before prescribing medicines, delay in endoscopy, negligent transfusion of blood and plasma not followed by methods to flush out excess body fluid, shifting to Medanta hospital without pre-consultation, poor management at Medanta hospital in treating a critical patient, etc.

Further allegations were made against the Chairman and Managing Director of Medanta who allegedly caused ‘severe mental trauma and distress’ to the family by breaching patient privacy, divulging detailed medical history of Justice Verma on national TV.

Complaint was filed before the Medical Council of India against erring doctors for negligence and professional misconduct, eventually referred to and dismissed by Delhi Medical Council on 10-06-2014. The same was appealed before MCI on 23-06-2014, while the instant complaint was filed on 10-04-2015. Appeal before MCI was also dismissed on 21-09-2015, which was challenged before Delhi High Court and disposed of vide order dated 11-10-2017 directing MCI to constitute an Expert Committee. The said Committee also exonerated the treating doctors.

The Commission noted the Expert Opinion by Delhi Medical Council and MCI, which found absence of negligence on part of treating doctors at the three hospitals at any stage.

The Commission relied on Jacob Mathew v. State of Punjab, (2005) 6 SCC 1, Malay Kumar Ganguly v. Dr. Sukumar Mukherjee, (2009) 9 SCC 221 and Kusum Sharma v. Batra Hospital, (2010) 3 SCC 480 denying doctors’ liability if the patient does not favourably respond to the treatment.

The Commission required proof of ‘four D’s’ for a successful claim of medical negligence:

• Duty
• Dereliction or Deviation
• Direct (Proximate) Cause

• Damages

It further said that ‘dereliction of duty of care from treating doctors’ could not be proved in the instant case, and the same was not a proximate cause of death of Justice Verma.

The Commission noted the critical medical condition at 75 years of age with diabetes mellitus and Justice Verma’s high risk of stroke. The Commission rejected negligence and viewed that “prescribing two anticoagulants to the instant patient was an accepted reasonable standard.” The Commission relied on Achutrao Haribhau Khodwa v. State of Maharashtra, (1996) 2 SCC 634 wherein, the Court had acknowledged the difference of medical practitioners’ skill from doctor to doctor. Further in Chanda Rani Akhouri v. M.A. Methusethupathi, 2022 SCC OnLine SC 481 it was held that “a medical practitioner is not tobe held liable simply because things went wrong from mischance or misadventure or through an error of judgment in choosing one reasonable course of treatment in preference to another.”

The Commission said that standard medical protocols were followed by all the doctors in the instant case, and that “The death of Justice J.S. Verma was not attributable to the act of Opposite Parties. We have deep sympathies with the death of Justice Verma, but it cannot be ground for liability.” Thus, the Commission dismissed the instant matter.

[Pushpa Verma v. Bhardwaj Nursing and Maternity Home Pvt. Ltd., 2023 SCC OnLine NCDRC 208, decided on 12-06-2023]

Advocates who appeared in this case :

For Complainant: Senior Advocate Prashant Bhushan, Advocate Abhimanue Shrestha, Senior Advocate Satish Tamta, Advocate Shariq Iqbal, Advocate Dhruv Tamta;

For Opposite Party: Advocate Rohit Puri, Advocate Aditya Awasthi, Advocate Sangeeta, Advocate Shyel Trehan, Advocate Raghav Anand.