Supreme Court Decision – Doctors are best judges to decide the line of treatment based on their skill, knowledge and experience

माननीय सुप्रीम कोर्ट ने एक नेग्लिजेंस के केस को ख़ारिज करते हुए यह फैसला सुनाया की इलाज के दौरान डॉक्टर अपने स्किल, नॉलेज और अनुभव के आधार पर सबसे बड़े जज होते हैं, सो उन पर कोई सवाल नहीं उठाया जा सकता ।

केस की जानकारी –
Dr. S. K. Jhunjhunwala v/s Mrs. Dhanwantri Kumari & Anr.
Civil Appeal No.3971/2011., decided on 01/10/2018.

Judges Bench – Hon. Abhay Manohar Sapre & Hon. Vineet Saran, JJ.

मुख्य बिंदु –

वर्ष 1996 में श्रीमती धन्वन्तरी कुमारी, निवासी कोलकाता को पेट दर्द की शिकायत हुई तो, उन्होंने पहले सामान्य इलाज लिया फिर डॉ. बसु को दिखाया जिन्होंने जांच आदि करने के बाद बताया की आपके गाल ब्लेडर में दो स्टोन हैं जिनके लिए लेपेरोस्कोपिक सर्जरी होगी, इसलिए आप सर्जन को दिखाइए |
ऐसी स्थिति में मरीज ने डॉ. झुनझुनवाला के यहाँ लेपेरोस्कोपिक सर्जरी करवाई लेकिन बीच ओपरेशन डॉक्टर को गाल ब्लेडर में सूजन, इन्फ्लामेशन और अढेसन दिखे तो उन्होंने तुरंत बाहर जाकर मरीज के पति को स्थिति बताई और उनसे अनुमति लेकर कन्वेंशनल ओपन सर्जरी करके गाल ब्लेडर निकाल दिया, दस दिन बाद मरीज को छुट्टी दे दी गयी |

करीब डेढ़ साल बाद डॉक्टर के खिलाफ कंज्यूमर कंप्लेंट दर्ज करी गयी की डॉक्टर ने बिना मरीज की कंसेंट लिए उनकी ओपन सर्जरी कर दी जिसमें भी ढंग से नहीं की और केयर भी नहीं की जिससे मरीज को मानसिक, शारीरिक पेन हुआ और उनके शरीर पर टांके लगे व स्कार बन गया, कुछ दिन तक डिसेंट्री, वजन कम हुआ, पीलिया हुआ साथ ही ओपरेशन के छह महीने बाद दुबारा से दिल्ली में सर्जरी करवानी पड़ी क्यूंकि डॉक्टर की गलती से CBD में कुछ स्टोन स्लिप हो गए थे |
डॉक्टर ने अपने पक्ष में तर्क दिया कि लेपेरोस्कोपिक सर्जरी के लिए पूरी कंसेंट ली थी, हालात के अनुसार उन्हें ओपन सर्जरी करनी पड़ी, मरीज की बेहोशी की स्थिति में उसके पति से कंसेंट ली थी तथा इलाज में किसी तरह की लापरवाही नहीं बरती गयी |

स्टेट कमिशन ने मरीज की कम्प्लेंट डिसमिस करदी तो मरीज नेशनल कमिशन में गयी जहाँ पर डॉक्टर को दोषी मानते हुए दो लाख का जुर्माना लगा दिया जिसके खिलाफ डॉक्टर सुप्रीम कोर्ट पहुंचे |

सुप्रीम कोर्ट डिस्कशन –

• how to decide the negligence of Doctors and placed its reliance on the celebrated judgment of UK Court in the year 1957, in the case of  Bolam V/s. Friern Hospital. In the said case it was held that “Where you get a situation which involves the use of some special skill or competence, then the test as to whether there has been negligence or not is not the test of the man on the top of a Clapham omnibus, because he has not got this special skill. The test is the standard of the ordinary skilled man exercising and professing to have that special skill. A man need not possess the highest expert skill. It is well established law that it is sufficient if he exercises the ordinary skill of an ordinary competent man exercising that particular art”
• It also relied on the famous 3 judges bench Supreme Court Judgment in the case of Jacob Mathew V/s. State of Punjab (2005) 6 SCC 1. In that case it was held that a Physician would not assure the patient of full recovery in every case. A surgeon cannot and does not guarantee that the result of surgery would invariably be beneficial, much less to surgery would invariably be beneficial, much less to extent of 100% for the person operated on. The only assurance which such a professional can give or can be understood to have given by implication is that he is possessed of the requisite skill in that branch of profession which he is practicing and while undertaking the performance of the task entrusted to him he would be exercising his skill with reasonable competence. This is what the entire person approaching the professional can expect. Judged by this standard, a professional may be held liable for negligence on one of two findings: either he 14 was not possessed of the requisite skill which he professed to have possessed, or, he did not exercise, with reasonable competence in the given case, the skill which he did not possess.
• It also relied on another landmark judgment in the case of Hucks V/s. Cole wherein it was observed that “a medical practitioner was not be 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 of another. A medical practitioner would be held liable only where his conduct fell below that of the standards of a reasonably competent practitioner in his field.”
• These principles were applied to the case in the hand. The Court discussed the degrees and experience of the Doctor Jhunjhunwala. He was practicing since 1969 in Kolkata and obtained FRCS from London in the year 1976. Thus he was a well-qualified Surgeon and having requisite experience in the filed, the Court further Observed.
• The Court did not accept the allegation of the patient that she gave consent only for Laparoscopic surgery and not for the Open Surgery. The Court relied upon the terms of consent form itself, which gave every authority to the Appellant Doctor to perform open conventional surgery on the same organ if there would have been some abnormalities and thus the Court held that there was no need for having separate consent as alleged by the Complainant-patient.
• The Court agreed to the evidence on record which proved that the Doctor chose or shifted to Open surgery as he noticed that there was some inflammation, adhesion and swelling on Gall Bladder and therefor he came out of operation theater and informed respondent’s husband and explained him everything and only after her husband gave consent, the conventional surgery was performed. Thus it was not the case of unauthorized act of the Doctor. Moreover, it was the clear case of emergency and it was done to save the life of the patient and there was no time for Doctors to wait till the patient would gain consciousness to take decision on her own, as envisaged in the landmark judgment on Informed Consent in the case of Samira Kohli V/s. Prabha Manchanda (2008) 2 SCC 1. Most importantly, their Lordships called it as the most natural conduct and behavior of any prudent doctor. The Hon. Court further observed as it was surprising that the patient never raised the issue of Consent to the Doctor of the Hospital, nor did her husband raise the issue after operation.
• The Court categorically further observed that even the National Commission has held that the Patient has failed to prove any kind of negligence that can be attributed to the Doctor nor any medical expert opinion has been placed on record in support of her claim. The Court also relied upon the observations of National Commission that the Complainant failed to prove with the help of medical evidence that the stones which were removed in Sir Gangaram Hospital were the same which the Appellant failed to remove.
• Regarding allegations of subsequent ailments of the patient as a result of the operation, their Lordships held that negligence. Suffering of ailment by the patient after surgery is one thing. It may be due to myriad reasons known in medical jurisprudence.  Whereas suffering of any such ailment   as a result of improper performance of the surgery and that too with the degree of negligence on the part of Doctor is another thing.  To prove the case of negligence of a doctor, the medical evidence of experts in field to prove the latter is required. Simply proving the former is not sufficient. The patient failed to prove the same.

साफ़ शब्दों में कहा गया की डॉक्टर अपने काम का उस्ताद है वो अपने स्किल, नॉलेज और अनुभव के आधार पर जो डिसीजन लेता है उसे गलत नहीं ठहराया जा सकता |
सावधानी – कंसेंट लें और डॉक्यूमेंट पूर्ण रखें |

शेयर करें, सतर्क करें |