{"id":254109,"date":"2021-09-13T13:00:48","date_gmt":"2021-09-13T07:30:48","guid":{"rendered":"https:\/\/www.scconline.com\/blog\/?p=254109"},"modified":"2021-09-17T11:28:21","modified_gmt":"2021-09-17T05:58:21","slug":"medical-negligence-3","status":"publish","type":"post","link":"https:\/\/www.scconline.com\/blog\/post\/2021\/09\/13\/medical-negligence-3\/","title":{"rendered":"Mere legal principles not sufficient in medical negligence cases: SC absolves doctor and hospital of liability for medical negligence"},"content":{"rendered":"<p style=\"text-align: justify;\"><strong>Supreme Court:<\/strong> A Division Bench comprising of Hemant Gupta and A.S. Bopanna, JJ. absolved a doctor and a hospital of liability for medical negligence. The Supreme Court said that failure of treatment cannot automatically make the medical professional liable for medical negligence. It was observed:<\/p>\n<blockquote>\n<p style=\"text-align: justify;\"><span style=\"color: #0000ff;\">&#8220;Every death of a patient cannot on the face of it be considered as death due to medical negligence unless there is material on record to suggest to that effect.&#8221;<\/span><\/p>\n<\/blockquote>\n<p style=\"text-align: justify;\">Further, explaining that such cases may involve highly technical medical issues, the Court said that mere legal principles and general standard of assessment may not be sufficient. Additionally, the Court considered when can the principle of <em>res ipsa loquitur <\/em>be invoked in cases of medical negligence.<\/p>\n<p style=\"text-align: justify;\">The instant was a case where the patient, set to undergo a surgery, suffered cardiac arrest after she was administered anaesthesia. Following is a comprehensive report of Supreme Court&#8217;s opinion on medical jurisprudence.<\/p>\n<h3 style=\"text-align: justify;\"><span style=\"color: #008000;\"><strong>Facts and Appeal<\/strong><\/span><\/h3>\n<p style=\"text-align: justify;\">One Jasbeer Kaur was admitted in Sun Flag Hospital, Faridabad, to undergo surgery. She was diagnosed with hydronephrosis, her right kidney was severely damaged and left kidney was also diagnosed with stone. On being declared fit for surgery, it was decided that both kidneys could not be operated simultaneously and the less affected, i.e. left kidney, would be operated first. An informed consent of high-risk surgery was obtained from the patient as well as her husband. The surgery on left kidney was a successful operation and patient&#8217;s condition improved.<\/p>\n<p style=\"text-align: justify;\">Thereafter, the patient was taken for second surgery. Dr Harish Kumar Khurana administered Pentothal Sodium and Scolin as per the medical practice. An endotracheal tube was inserted in the trachea to give nitrous oxide and oxygen. This standard procedure was also followed during the first surgery but on this occasion, patient&#8217;s condition deteriorated, her blood pressure fell and pulse became feeble, cardiac respiratory arrest was noticed, she was put on Boyle&#8217;s machine and automatic ventilator. Despite this, the patient passed away.<\/p>\n<p style=\"text-align: justify;\">Patient&#8217;s husband and children filed a complaint before the National Consumer Disputes Redressal Commission (&#8220;NCDRC&#8221;) alleging medical negligence. NCDRC found Dr Khurana and the hospital guilty and directed payment of Rs 17 lakh as compensation. Aggrieved, Dr Khurana and the hospital approached the Supreme Court.<\/p>\n<h3 style=\"text-align: justify;\"><span style=\"color: #008000;\"><strong>Analysis and Observations<\/strong><\/span><\/h3>\n<p style=\"text-align: justify;\">Summarising\u00a0 judicial opinion on the subject, including the decision in <em>Jacob Mathew <\/em>v.<em> State of Punjab<\/em>,<a href=\"http:\/\/www.scconline.com\/DocumentLink\/vr22j2Gb\"> (2005) 6 SCC 1<\/a> which laid down the &#8216;test&#8217; for establishing medical negligence, the Supreme Court observed that:<\/p>\n<blockquote>\n<p style=\"text-align: justify;\">&#8220;[It] is clear that in every case where the treatment is not successful or the patient dies during surgery, it cannot be automatically assumed that the medical professional was negligent.&#8221;<\/p>\n<\/blockquote>\n<p style=\"text-align: justify;\">The Court said that to indicate negligence, there should be material available on record or else appropriate medical evidence should be tendered. In the instant case, apart from the allegations made by the claimants before NCDRC, no medical evidence was tendered to indicate negligence on the part of the doctor, who in fact explained his position relating to medical process to assert that there was no medical negligence. The Court said that conclusion reached by NCDRC appeared to be assumptive without the backing of medical evidence. Whether the manner in which Dr Khurana proceeded to administer anaesthesia amounted to negligence could have been determined only if there was medical evidence on record.<\/p>\n<p style=\"text-align: justify;\"><span style=\"color: #993300;\"><strong><em>Informed consent of patient<\/em><\/strong><\/span><\/p>\n<p style=\"text-align: justify;\">The Court considered the aspect regarding consent for second surgery being taken only of patient&#8217;s husband and not the patient herself. On this, the Court noted that during the first surgery, consent of the patient as well her husband was taken. During the second surgery, the patient was recovering from the first surgery and the requirement for second surgery was informed to her. In that circumstance, informed consent was obtained from her husband.<\/p>\n<p style=\"text-align: justify;\"><span style=\"color: #993300;\"><strong><em>Noting in case sheet<\/em><\/strong><\/span><\/p>\n<p style=\"text-align: justify;\">Rejecting NCDRC&#8217;s conclusion that Dr Khurana was negligent in not taking care of the noting in the case sheet regarding patient&#8217;s poor tolerance to anaesthesia, the Court noted that Dr Khurana was the anaesthetist during the first surgery as well and was thus aware about details of the patient to whom he had administered anaesthesia for the first surgery. The Court held that when it is shown that the earlier surgery was uneventful, in the absence of any medical evidence brought on record to the contrary regarding Dr Khurana&#8217;s failure in taking any steps while administering anaesthesia for the second surgery, the observation of poor tolerance in the case sheet by itself could not be assumed as negligence. It was observed:<\/p>\n<blockquote>\n<p style=\"text-align: justify;\"><span style=\"color: #0000ff;\">&#8220;To arrive at the conclusion that there was negligence, the medical evidence to point out negligence in administering anaesthesia even in that situation was required to be tendered since the adjudicating authority is not an expert in the field of medicine to record an independent opinion.&#8221;<\/span><\/p>\n<\/blockquote>\n<p style=\"text-align: justify;\"><span style=\"color: #993300;\"><strong><em>Res ipsa loquitur<\/em><\/strong><\/span><\/p>\n<p style=\"text-align: justify;\">Considering the applicability of the principle of <em>res ipsa loquitur<\/em> (things speak for themselves) to cases of medical negligence, the Court observed:<\/p>\n<blockquote>\n<p style=\"text-align: justify;\"><span style=\"color: #0000ff;\">&#8220;The negligence alleged should be so glaring, in which event the principle of <em>res ipsa loquitur <\/em>could be made applicable and not based on perception. \u00a0&#8230;<\/span><\/p>\n<p style=\"text-align: justify;\"><span style=\"color: #0000ff;\">Principle of <em>res ipsa loquitur<\/em> is invoked only in cases the negligence is so obvious.&#8221;<\/span><\/p>\n<\/blockquote>\n<p style=\"text-align: justify;\">The Court felt that observations contained in NCDRC&#8217;s order were in the nature of accepting every allegation made by the claimants as the only version and it was not weighed with the version put forth by the doctors. It was noted that the patient had undergone the same process of being administered anaesthesia for the first surgery which was successful. Though in the second surgery, the patient suffered a cardiac arrest, the subsequent processes with the help of Boyle\u2019s apparatus were conducted and the patient was moved to Critical Care Unit, whereafter subsequent efforts failed. The patient breathed her last after few days. There was no contrary medical evidence placed on record to establish that the situation had arisen due to the medical negligence on the part of the doctors.<\/p>\n<p style=\"text-align: justify;\"><span style=\"color: #993300;\"><strong><em>Mere legal principles not sufficient<\/em><\/strong><\/span><\/p>\n<p style=\"text-align: justify;\">The Court noted that NCDRC reached the conclusion that the appellants failed to clear the Bolam test purely on applying the legal principles, without having any contra medical evidence on record despite observing that the surgeon was a qualified and experienced doctor and also that the anaesthetist had administered anaesthesia to 25,000 patients.<\/p>\n<p style=\"text-align: justify;\">The Court opined that the aspect of poor tolerance to anaesthesia and what should be the gap between the two surgeries was a highly technical medical issue which was also dependant on the condition of the patient in a particular case, which required opinion of an expert in the field. There was no medical evidence based on which conclusion was reached with regard to medical negligence. The Supreme Court observed:<\/p>\n<blockquote>\n<p style=\"text-align: justify;\"><span style=\"color: #0000ff;\">&#8220;[M]ere legal principles and the general standard of assessment was not sufficient in a matter of the present nature when the very same patient in the same set up had undergone a successful operation conducted by the same team of doctors.&#8221;<\/span><\/p>\n<\/blockquote>\n<p style=\"text-align: justify;\"><span style=\"color: #993300;\"><strong><em>Magisterial enquiry report<\/em><\/strong><\/span><\/p>\n<p style=\"text-align: justify;\">The claimants had also filed a criminal complaint against the appellants, pursuant to which a magisterial enquiry was conducted. NCDRC placed much reliance on this enquiry report, which according to the Court could not be treated as contra medical evidence as compared to the evidence tendered by the appellants. \u00a0It was observed:<\/p>\n<blockquote>\n<p style=\"text-align: justify;\"><span style=\"color: #0000ff;\">&#8220;Though the opinion of the civil surgeon who was a member of the committee is contained in the report, the same cannot be taken as conclusive since such report does not have the statutory flavour nor was the civil surgeon who had tendered his opinion available for cross-examination or seeking answers by way of interrogatories on the medical aspects.<\/span><\/p>\n<\/blockquote>\n<h3 style=\"text-align: justify;\"><span style=\"color: #008000;\"><strong>Decision<\/strong><\/span><\/h3>\n<p style=\"text-align: justify;\">In such view of the matter, the Supreme Court held that NCDRC&#8217;s decision could not be sustained. The appeal was accordingly allowed. [Harish Kumar Khurana v. Joginder Singh, <a href=\"http:\/\/www.scconline.com\/DocumentLink\/8AHQp9o0\"><b>2021 SCC OnLine SC 673<\/b><\/a>, decided on 7-9-2021]<\/p>\n<hr \/>\n<h3 style=\"text-align: justify;\"><span style=\"color: #ff0000;\">Tejaswi Pandit, Senior Editorial Assistant has reported this brief.<\/span><\/h3>\n","protected":false},"excerpt":{"rendered":"<p>Supreme Court: A Division Bench comprising of Hemant Gupta and A.S. Bopanna, JJ. absolved a doctor and a hospital of liability for <\/p>\n","protected":false},"author":67011,"featured_media":154914,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_jetpack_memberships_contains_paid_content":false,"footnotes":""},"categories":[3,9],"tags":[47016,29785,3485,5363],"class_list":["post-254109","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-casebriefs","category-supremecourt","tag-doctor-and-hospital-liability","tag-law","tag-medical_negligence","tag-supreme-court"],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v26.4 (Yoast SEO v26.4) - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Mere legal principles not sufficient in medical negligence cases: SC absolves doctor and hospital of liability for medical negligence | SCC Times<\/title>\n<meta name=\"description\" content=\"Medical Negligence\" \/>\n<meta name=\"robots\" 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deterioration not automatically indicative of medical negligence; Supreme Court overturns NCDRC order","author":"Apoorva","date":"October 28, 2024","format":false,"excerpt":"\u201cWhen reasonable care, expected of the medical professional, is extended or rendered to the patient unless the contrary is proved, it would not be a case for actionable negligence.\u201d","rel":"","context":"In &quot;Case Briefs&quot;","block_context":{"text":"Case Briefs","link":"https:\/\/www.scconline.com\/blog\/post\/category\/casebriefs\/"},"img":{"alt_text":"Medical negligence","src":"https:\/\/i0.wp.com\/www.scconline.com\/blog\/wp-content\/uploads\/2024\/10\/Medical-negligence.webp?resize=350%2C200&ssl=1","width":350,"height":200,"srcset":"https:\/\/i0.wp.com\/www.scconline.com\/blog\/wp-content\/uploads\/2024\/10\/Medical-negligence.webp?resize=350%2C200&ssl=1 1x, https:\/\/i0.wp.com\/www.scconline.com\/blog\/wp-content\/uploads\/2024\/10\/Medical-negligence.webp?resize=525%2C300&ssl=1 1.5x, 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case","author":"Editor","date":"February 14, 2023","format":false,"excerpt":"Kerala High Court acquitted the medical staff convicted by the Trial Court in medical negligence case and held that sufficient evidence is needed to prove death due to medical negligence, and that a medical professional cannot be held liable for mischance or misfortune.","rel":"","context":"In &quot;Case Briefs&quot;","block_context":{"text":"Case Briefs","link":"https:\/\/www.scconline.com\/blog\/post\/category\/casebriefs\/"},"img":{"alt_text":"Kerala High 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Briefs","link":"https:\/\/www.scconline.com\/blog\/post\/category\/casebriefs\/"},"img":{"alt_text":"Rajasthan High Court","src":"https:\/\/i0.wp.com\/www.scconline.com\/blog\/wp-content\/uploads\/2024\/02\/Rajasthan-High-Court.webp?resize=350%2C200&ssl=1","width":350,"height":200,"srcset":"https:\/\/i0.wp.com\/www.scconline.com\/blog\/wp-content\/uploads\/2024\/02\/Rajasthan-High-Court.webp?resize=350%2C200&ssl=1 1x, https:\/\/i0.wp.com\/www.scconline.com\/blog\/wp-content\/uploads\/2024\/02\/Rajasthan-High-Court.webp?resize=525%2C300&ssl=1 1.5x, https:\/\/i0.wp.com\/www.scconline.com\/blog\/wp-content\/uploads\/2024\/02\/Rajasthan-High-Court.webp?resize=700%2C400&ssl=1 2x"},"classes":[]},{"id":356934,"url":"https:\/\/www.scconline.com\/blog\/post\/2025\/08\/18\/ker-hc-s-304a-ipc-applies-only-if-doctor-negligence-directly-causes-death\/","url_meta":{"origin":254109,"position":4},"title":"S. 304-A IPC attracted only when death is direct or proximate result of doctor\u2019s rash or negligent act: Kerala HC","author":"Editor","date":"August 18, 2025","format":false,"excerpt":"\u201cWhile negligence was an omission to do something which a reasonable man would do, or the doing of something which a prudent and reasonable man would not do, medical negligence occurred when a healthcare professional breached his duty of care, causing harm to a patient.\u201d","rel":"","context":"In &quot;Case Briefs&quot;","block_context":{"text":"Case Briefs","link":"https:\/\/www.scconline.com\/blog\/post\/category\/casebriefs\/"},"img":{"alt_text":"doctor's negligence directly causes death","src":"https:\/\/i0.wp.com\/www.scconline.com\/blog\/wp-content\/uploads\/2025\/08\/doctors-negligence-directly-causes-death.webp?resize=350%2C200&ssl=1","width":350,"height":200,"srcset":"https:\/\/i0.wp.com\/www.scconline.com\/blog\/wp-content\/uploads\/2025\/08\/doctors-negligence-directly-causes-death.webp?resize=350%2C200&ssl=1 1x, 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