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Study On: Medical Negligence

Lately, Indian society is pursuing an awareness towards a patient's right. Let us first analyze the concept of negligence in general.

An action for negligence proceeds upon the idea of an obligation or duty on the part of the defendant to use care, a breach which results in the plaintiff's injury. The duty may arise by a statute or otherwise.

Now, as we proceed towards Medical Negligence, a fragment of Torts. In cases of medical negligence, a claimant shall be seeking damages for physical injury. The term 'medical negligence' is an omnibus one, which refers to wrongful actions in professional field of medicine, during the pursuit of their profession while dealing with patients. Currently medical negligence has become a major concerning issue which is one of the most praised professions.

This article outlines the basic structure of medical negligence with some legal phrase and also focuses on explaining malpractices in medical profession and law made for it.

The consequences of medical negligence can broadly be put into 2 categories which shall be described further:
  1. Monetary Liability
  2. Disciplinary Actions
A monetary damages award paid to the plaintiff by the hospital or medical provider serves as the legal remedy in the majority of cases of medical negligence. This can be used to pay for additional medical expenses, hospital fees, and therapies. In some places, the number of damages that the plaintiff may receive is occasionally limited to situations involving medical malpractice or medical negligence. Awards for medical negligence have been limited in order to stop frivolous lawsuits and demands for excessive compensation.

Disciplinary Actions:
Another consequence of medical negligence might be the imposition of fines and subsequent disciplinary action. The Indian Medical Council (IMC) (Professional Conduct, Etiquette and Ethics) Regulations, 2002, created in accordance with the IMC Act, 1956, govern professional misconduct by medical practitioners.

A medical practitioner's name may be permanently removed or he may be suspended if the Medical Council of India (MCI) and the appropriate State Medical Councils decide to take disciplinary action.

Negligence can be diverted into many fragments out of which we now discuss the segment of Medical Negligence. It is an offence under Tort, IPC, Indian contract act and consumer protection act. Medical malpractice, sometimes referred to as medical negligence, is when a doctor, dentist, nurse, pharmacist, or other health care provider treats a patient improperly, carelessly, or negligently.

When a healthcare professional deviates from the accepted "standard of care" when treating a patient, it is considered medical malpractice. Mistakes in the medical matters can result into minor injuries, serious injuries or sometimes resulting into the death of a person. We shall consider the fact that no human is actually perfect in any profession but a situation which could have been defined yet neglected and resulting to damage to the plaintiff should be held wrongful.

Such as Failure to provide a safe and suitable situation as promised, as it relates to inappropriate or broken equipment, improper accommodations or any medical professional, including a doctor, nurse, hospital staff, or other, who has violated their responsibility.

Unless there is documented proof to the contrary, it is difficult to ascertain if the institution engaged in medical negligence. Not every patient death may be attributed to medical malpractice in and of itself.

Based on either of these two conclusions, the hospital or the doctors working there may be held liable for negligence:
  • They either lacked the necessary expertise they claimed to have,
  • or they failed to use the talent they did have in the situation with reasonable competence.
The standard for judging whether the defendant engaged in negligence would be that of a typical competent person utilizing a typical level of ability in that industry. No expert may legitimately assert that they are the most skilled or experienced in their particular industry. Even if a skilled professional might possess superior qualities, this cannot serve as a foundation for evaluating the work of a professional accused of negligence. The following explanations provide the key components needed to prepare medical negligence.

Right to life is a fundamental right defined under Article 21 of Constitution of India which if damaged then the plaintiff is entitled for some compensation by the wrongdoer i.e., the defendant. In recent judgements where the court has ordered the defendant to pay large compensation amount to the plaintiff.

This action by the court will ensure that medical practitioners are not neglect ant. The Indian government is also obligated to ensure public health region universal access to healthcare. Therefore, it is the responsibility of the court to balance the rights and interests of all parties considerably involved. If the damage is done by the defendant to the plaintiff, then the complainant may seek monetary compensation before the Civil Courts, High Court or the Consumer Dispute Redressal Forum under the Constitutional Law, Law of Torts/Law of Contract and the Consumer Protection Act.
  1. Breach of Duty in Medical Negligence
    ยท When a doctor's practice doesn't live up to the standards, this is proven. For the majority of tort cases, the test of the "reasonable man" or the infamous "guy on the Clapham omnibus," who is claimed to be an ordinary person placed in the identical circumstances, is used.

    The criterion of comparable professional practice is instead applied where there has been a probable breach of professional obligation. The most famous instance of this professional standard is Bolam v. Friern Hospital Trust. It centered on a patient who suffered fractures while receiving ECT therapy and claimed that his anesthetic care was inadequate in part because he was not given muscular relaxation for the procedure, restrained, or informed of the risk of fracture.

    However, it was determined that carelessness could not be proven because it was demonstrated that it was not common practice to administer muscle relaxants at the time, and because conflicting views on the advantages of muscular relaxation and the increased hazards of the relaxant existed. It was maintained that it was sufficient for a doctor to behave in accordance with a procedure that was approved by a trustworthy group of medical professionals.

    No reasonable doctor would have acted in that way under the identical conditions, the claimant must demonstrate. However, this is the same test as for other professional groups where negligence is under consideration. It has been argued that the existence of a body of opinion that supports a doctor's actions is in favor of the medical profession, handing responsibility for deterring other doctors from engaging in the allegedly negligent behavior to the medical profession.
     
  2. Causation and harm in medical negligence
    In medical negligence cases, proving causation basically entails demonstrating that carelessness occurred as a result of an obligation not being met or a duty not being upheld, which ultimately resulted in a harm. Establishing causality is the process of proving the aforementioned. In medical malpractice lawsuits, it can be very challenging to demonstrate medical negligence. In other words, it is very difficult to establish causation in such circumstances. In general, it is assumed that there may be potential problems that could have an impact on the therapy's outcome while someone is receiving treatment or any surgery for the same.
     
  3. Case laws in medical negligence
    The complainant, a malaria department officer, brought a lawsuit against the hospital in V. Krishan Rao v. Nikhil Super Specialty Hospital for treating his wife in a negligent manner. The fact that the hospital administered the incorrect drug, causing his wife to receive treatment for typhoid fever rather than malaria fever, was sufficient to prove causation. According to the res ipsa loquitor principle, which states that things should speak for themselves, in this case the complaint was compensated for the harm they had endured.

A second-year engineering student was struck by a bus and sent to a hospital for treatment in Pravat Kumar Mukherjee Vs. Ruby General Hospital and Ors. The hospital began treating the youngster since he had a medical insurance card that stated the insurance provider would pay him Rs. 65,000 in the event of an accident. When they didn't receive the requested payment of Rs. 15,000 after a while, the hospital stopped treating the youngster and sent him to another facility, where he passed on en route. In this case, the defendants were found responsible for medical malpractice on the basis of humanitarian considerations, and the plaintiff was given compensation.

In the case of Ms. Neha Kumari and Anr v. Apollo Hospital and Ors (2003), the National Consumer Disputes Redressal Commission had determined that the alleged medical negligence had not been proven because the complainant had complicated congenital abnormalities of the spine and the entire body, as shown by a pre-operative CT scan.

The Hon'ble Commission, relying on the decision in Basant Seth v. Regency Hospital O P (1994), rejected the hospital's argument and held that the hospital is vicariously liable for any wrongdoing alleged by the consultants. This was in regards to the hospital's vicarious liability for the consultants' negligence.

For the sake of diagnosis, treatment, organ transplant, research, disclosure of medical information, and educational and medico-legal objectives, there is a legal obligation to get prior agreement (from living patients) on the part of the hospitals and doctors. Hospitals will be held responsible for medical negligence if prior consent of the parties has not been taken before undertaking any kind of medical practices on the patient.

In the case of Spring Meadows Hospital and Anr. v. Harjol Ahluwalia from 1998, the parents of a child who was left permanently crippled received a payment of Rs. 5 lacs for their mental anguish in addition to a Rs. 12 lacs settlement for the child. The hospital was meant to cover the remaining Rs. 12 lacs after the insurance paid its portion.

Although the insurance provider intervened because the nurse who administered the child's adult dose of Lariago injection was ineligible, the Apex Court made no mention of this matter when deciding on negligent cases. Therefore, it's crucial to keep in mind that medical professionals and institutions shouldn't just get a Professional Indemnity Insurance Policy but also ensure that the nurses and other hospital personnel who are hired as a result of it are qualified.

Conclusion
Medical negligence is a complex category of tort that cannot be categorized as simple. Medical malpractice has a different form and character. Given the doctor's training and expertise in the field, there is a very high standard of care that must be provided to the patient in the case of medical negligence.

There has been a rapid increase in the number of medical negligence cases in India, raising the question of whether victims should be compensated in accordance with the Consumer Act of 1986 or whether it is time to enact legislation specifically for these situations, where patients suffered as a result of the carelessness of doctors and other medical professionals who owed them a duty of care and breached it.

In most cases, the hospital management is responsible for any negligence on the part of such employees. Patients visit the hospital and frequently end up staying there since they rely on it to provide them with expensive medical treatments. In exchange, the hospital is expected to provide these kinds of secured medical services, and in the event of a service gap or in cases where the procedure was carried out without the necessary care and caution, the hospital must be held accountable.

Several criteria should be taken into account while handing down judgments in medical negligence cases, according to an examination of the most prominent medical negligence cases in India. Given their experience in that sector and the always evolving nature of medical practices, doctors just need to behave with the utmost care, abstain from negligence, and constantly think of innovative ways to treat their patients. The interests of patients and physicians must be balanced. It is now time to create new avenues for protecting both patients' and doctors' rights.

Written By: Aditi Dawange

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