Negligence Is Not Present If Complications Arise From Non-Medical Procedures: Supreme Court

The statement was made by a panel of Justice AS Bopanna and Justice Prashant Kumar Mishra in support of a consumer commission order that did not provide relief to a lady.

According to a recent ruling by the Supreme Court, in order to apply the principles of Res Ipsa Loquitur, there must be a “Res” in order to support the claim of medical negligence.

The Latin phrase “the thing speaks for itself” is Res Ipsa Loquitur.

The court noted that no case of negligence is made out if complications suffered by the patients are not related to the medical process.

“In so far as the applicability of principles of Res Ipsa Loquitur, in the fact and circumstances of the case, it is to bear in mind that the principles get attracted where circumstances strongly suggest partaking in negligent behaviour by the person against whom an accusation of negligence is made. For applying the principles of Res Ipsa Loquitur, it is necessary that a ‘Res’ is present to establish the allegation of negligence. Strong incriminating circumstantial or documentary evidence is required for application of the doctrine,” the court said in its October 17 order.

A woman whose husband had died from cardiac arrest was testifying in court. From the moment her husband was moved to the private room until he had a cardiac arrest, the widow has claimed that the hospital failed to provide her with adequate care.

On August 3, 2010, the National Consumer Disputes Redressal Commission ruled that the petitioner had not produced any convincing evidence or material on file demonstrating that the patient’s heart attack was caused by inadequate post-operative care or had anything to do with the operation in question.

In the Supreme Court, the woman contested the Consumer Commission’s ruling.

Despite the fact that the deceased had no cardiac issues, the appellant claimed that cardiac arrest was the cause of death. The woman’s attorney also claimed that the patient was told upon admission that he would be sent to the intensive care unit following the procedure.

However, he was shifted from the recovery room directly to a private room and not to the ICU, the appellant argued. Refuting the appellant’s submission, the lawyer representing the Hospital submitted that the patient had made an excellent recovery after neurosurgery and there were no postoperative complications, therefore, he was shifted to the recovery room and thereafter to a private room.

“It is significant to notice that the patient did not have any history of diabetes or hypertension or any cardiac problem. Therefore, it was difficult for treating doctors including the duty doctor or the hospital to assume that the patient may suffer cardiac arrest moreover, the patient had also not complained of pain in any other part of the body except the neck region,” the court noted.

“The case in handstands on a better footing, in as much as there was no mistake in diagnosis or a negligent diagnosis by Respondent no. 2 (doctor). In the absence of the patient having any history of diabetes, hypertension, or cardiac problems, it is difficult to foresee a possible cardiac problem only because the patient had suffered pain in the neck region,” the court said.

The Supreme Court has recently said that to apply the principles of Res Ipsa Loquitur, it is necessary that a ‘Res’ is present to establish the allegation of medical negligence.

Res Ipsa Loquitur is a Latin word that means “the thing speaks for itself”.

A bench of justices AS Bopanna and Prashant Kumar Mishra’s remark came while upholding a consumer commission order that did not give relief to a woman.

The court noted that no case of negligence is made out if complications suffered by the patients are not related to the medical process.

“In so far as the applicability of principles of Res Ipsa Loquitur, in the fact and circumstances of the case, it is to bear in mind that the principles get attracted where circumstances strongly suggest partaking in negligent behaviour by the person against whom an accusation of negligence is made. For applying the principles of Res Ipsa Loquitur, it is necessary that a ‘Res’ is present to establish the allegation of negligence. Strong incriminating circumstantial or documentary evidence is required for application of the doctrine,” the court said in its October 17 order.

The court was hearing a woman whose husband died after suffering cardiac arrest. The woman has alleged that the hospital has not taken proper care of her husband from the time he was shifted to the Private room till he suffered a cardiac arrest.

The National Consumer Disputes Redressal Commission on Aug 3 2010 held that the petitioner has not been able to establish by any cogent evidence or material on record that the heart attack suffered by the person had any connection with the operation in question or on account of lack of post-operative care.

The woman challenged the Consumer Commission order in the Supreme Court.

The appellant submitted that the person died due to cardiac arrest, albeit, admittedly, he had no cardiac problems. The woman’s lawyer further submitted that at the time of admission, the person was informed that after the surgery he would be shifted to the ICU.

However, he was shifted from the recovery room directly to a private room and not to the ICU, the appellant argued. Refuting the appellant’s submission, the lawyer representing the Hospital submitted that the patient had made an excellent recovery after neurosurgery and there were no postoperative complications, therefore, he was shifted to the recovery room and thereafter to a private room.

“It is significant to notice that the patient did not have any history of diabetes or hypertension or any cardiac problem. Therefore, it was difficult for treating doctors including the duty doctor or the hospital to assume that the patient may suffer cardiac arrest moreover, the patient had also not complained of pain in any other part of the body except the neck region,” the court noted.

“The case in handstands on a better footing, in as much as there was no mistake in diagnosis or a negligent diagnosis by Respondent no. 2 (doctor). In the absence of the patient having any history of diabetes, hypertension, or cardiac problems, it is difficult to foresee a possible cardiac problem only because the patient had suffered pain in the neck region,” the court said.

“For the foregoing, this Court is of the considered view that the appellant has failed to establish negligence on the part of Respondents in taking post-operative care and the findings in this regard recorded by the Commission does not suffer from any illegality or perversity,” the court said.