Case Law: Vinod Jain v. Santokba Durlabhji Memorial Hospital & Anr. (Civil Appeal No. 2024 of 2019 (Supreme Court)

ORDER DATED: 25.02.2019

Holding that a case of the wrong diagnosis cannot be equated to medical negligence, the Supreme Court has recently upheld the decision of National Consumer Disputes Redressal Commission for quashing the State Commission’s decision of holding a doctor and hospital guilty for alleged medical negligence. The Supreme Court also exonerated the doctor from the allegations.

The case concerns a female patient, with a previous history of oesophageal cancer (colon and breast Cancer), hypertension and type 2 diabetes, who was admitted to Santokba Durlabhji Memorial Hospital (SDMH) Jaipur on 15.10.2011 under Dr. Anurag Govil with complaints of chills and fever. A nasal feed tube was inserted on the same day, stated to be dislodged due to severe dysphagia. Few other tests were prescribed.

One of the tests was a Complete Blood Count Report, which found that the WBC was high, indicative of infection. She had also running temperature of 104 degrees Fahrenheit, and her medical treatment commenced with intravenous administration of injection Magnex of 1.5 mg.

As per the medical reports, the cannula used for intravenous treatment stopped functioning and the doctor prescribed a further antibiotic tablet, Polypod to be orally administered through the nasal tube.

The patient was discharged from the hospital on 18.10.2011. The patient had her WBC count high and she was prescribed to continue taking her medicines for a period of 5 days post discharge, which apparently was administered to her, as per the appellant. The complainant in his complaint informed that on 23.10.2011, and had to be admitted to a nearby Heart and General Hospital, where she was put on life-support ventilation system. The WBC count of the wife of the appellant had risen even further and the systolic BP was only 40. Her health continued to deteriorate and she was required to be shifted to the Fortis Escorts Hospital, where she died on 31.10.2011.

A case of medical negligence was filed against a doctor and hospital with the Rajasthan Medical Council which dismissed the complaint holding no case of medical negligence was found in the given facts of the case. The process of coming to this conclusion included the response of the treating doctor to a panel of eleven doctors which scrutinized the complaint and the material placed before the panel, by the appellant.

The further appeal of the appellant, before the Medical Council of India was rejected as time barred on 8.03.2013. The appellant then moved to the State Consumer Disputes Redressal Commission, Rajasthan which held its judgment in favour of the complainant by ruling compensation of over Rs. 15 lakh. The Respondents then filed an appeal at NCRDC which exonerated the doctor and the hospital. The Complainant moved to the Supreme Court against the reasoning of NCDRC.

The appellant sought to make out a case of inappropriate and ineffective medication, failure to restart the cannula for IV medication, premature discharge of the deceased despite her condition warranting treatment in the ICU, oral administration of Polypod antibiotic, despite her critical condition, which actually required intravenous administration of the medicine.

The doctor in their defence informed that when the patient was discharged, she was fine, her vitals were normal and she was well-hydrated, with no infection in her chest or urinary tract. She was stated to be clinically stable from 15.10.2011 to 17.10.2011 and that is why she was so discharged on 18.10.2011, with proper medical prescriptions for the next 5 days.

The Apex Court after going through the matter dismissed the complaint, stating that the case can be termed as that of wrong diagnosis, not of medical negligence. The Court also noted that the hospital promptly attended to the wife of the appellant. The treating doctor, physician, also attended to her promptly, and started her on antibiotic treatment. The nasal feed tube was re-inserted promptly. However, in the early hours on the next day on 16.10.2011, the cannula stopped functioning and instead of re-cannulating the patient, oral administration of the antibiotic Polypod was found justified. It is this aspect, which according to the appellant, amounts to medical negligence. The explanation offered by Respondent treating doctor was that when he attended the patient at 11 a.m. on 16.10.2011, he found that the drip had been disconnected on account of all peripheral veins being blocked due to past chemotherapies, and that the drip had been stopped, the night before itself, at the instance of the appellant. Taking into consideration the fact that the atient was normal, well hydrated and displayed normal vitals, the oral administration of the tablet was prescribed.

The Court upheld the decision of the NCRDC and dismissed the complaint, absolving the doctor of any medical negligence.