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Full Case Details
Facts
- The patient (Anuradha) and her husband Dr. Kunal Saha (for short, “Kunal”) were settled in the United States of America. Anuradha, a child Psychologist by profession, was a recent graduate from a prestigious Ivy League School (`Columbia University’ in the New York State). Although a doctor by profession, Kunal has been engaged in research on H.I.V/ AIDS for the past 15 years.
- They left U.S.A. for a vacation to India on 24th March, 1998. They arrived in Calcutta on 1st April, 1998. While in Calcutta, Anuradha developed fever along with skin rash on 25th April, 1998.
- On 26th April, Dr. Sukumar Mukherjee, Respondent No. 1 herein attended and examined Anuradha at her parental residence on a professional call. Dr. Mukherjee assured the patient and her husband of a quick recovery and advised her to take rest but did not prescribe her any specific medicine.
- However, two weeks thereafter, i.e., on 7th May, 1998, the skin rash reappeared more aggressively. Dr. Mukherjee was again contacted and as per his instructions, Anuradha was taken to his chamber.
- After examining Anuradha, Dr. Mukherjee prescribed Depomedrol injection 80 mg twice daily for the next three days.
- Despite administration of the said injection twice daily, Anuradha’s condition deteriorated rapidly from bad to worse over the next few days.
- Accordingly, she was admitted at the Advanced Medicare Research Institute (AMRI) in the morning of 11th May, 1998 under Dr. Mukherjee’s supervision. Anuradha was also examined by Dr. Baidyanath Halder, Respondent No. 2 herein. Dr. Halder found that she had been suffering from Erithima plus blisters. Her condition, however, continued to deteriorate further. Dr. Abani Roy Chowdhury, Consultant, Respondent No. 3 was also consulted on 12th May, 1998.
- On or about 17th May, 1998, Anuradha was shifted to Breach Candy Hospital, Mumbai as her condition further deteriorated severely. She breathed her last on 28th May, 1998.
Principles
- National commission judgement
- Doctor only promises to use fair, reasonable and competent degree of skill.
- Error of judgement in the process of diagnosis does not amount to deficiency in service.
- Bolam V. Friern Hospital Management Committee
- A man need not to possess the highest expert skill
- Not guilty if a body of opinion which takes a contrary view.
- Bolitho V. City & Hackney health authority [(1997) 4 All ER 771( HL)]
- Responsible Reasonable and Respectable − opinion of expert must past the 3R test
- Civil liability under tort law as also under consumer protection act
- Right of the patient to be informed − risk − reaction − consent
- Individual liability of the doctors
- Fair , reasonable & competent degree of skill − not highest skill
- Failure to use due skill in diagnosis with the result that wrong treatment is given would be negligence.
- In complicated cases – slow in doctor negligence
- Assessing criminal culpability under section 304−A
- The doctrine of cumulative effect is not available in criminal law
- Burden of proof in medical negligence will lie on hospital that they were in line with standard medical practice that is fair , reasonable, competent degree of skill.
- Non feasance − malfeasance
- Cumulative−Effects Doctrine an effect produced by something happening over a long period of time the cumulative effect(s) of smoking on the body.•
- Judgement
- Dr mukherjee & others were negligent , but not guilty under section 304−A of IPC
- Negligence on the part of each of the treating doctors as also the hospital may have been contributing factors to the ultimate death of the patient.
- After coming to know that the patient is suffering from TEN, Dr. Abani Roy Chowdhury ought to have ensured that supportive therapy had been given.
- Dr. Kaushik Nandy has done whatever was possible to be done and his line of treatment meets with the treatment protocol of one of the experts, viz. Prof. Jean Claude Roujeau although there may be otherwise difference of opinion, that he cannot be held to be guilty of negligence.
- Apart from using the steroids, aggressive supportive therapy that is considered to be rudimentary for TEN patients was not provided by Dr. Halder.
Further `vitalsigns’ of a patient such as temperature, pulse, intake− output and blood pressure were not monitored. All these factors are considered to be the very basic necessary amenities to be provided to any patient, who is critically ill. The failure of Dr. Halder to ensure that these factors are monitored regularly is certainly an act of negligence.
