Medical Negligence is a malpractice wherein medical professionals fail to exercise a duty of care towards the patients and fulfill their professional obligations.[1] The definition of 'Medical Negligence' has remained unchanged over the time- "Failure to exercise reasonable skill as per the general standards and the prevalent situation is termed as medical negligence."

Medical Negligence is the tort which takes cognizance of the following:

1. A legal duty either express or implied to treat the patient must exist.
2. Breach of such legal duty, if any, in comparison to the expected conduct and performance of the people from the same profession.
3. Presence of damage caused by such breach which must result in injury which needs to be compensated.

Medical profession is a noble profession but in recent years we see a rise in cases of medical negligence wherein doctors as well as hospitals are taking undue benefits from people who come to hospitals for their treatment. They take benefit of patient's condition by charging exorbitant prices for the services provided, failure to exercise due care by misdiagnosis, surgical errors, wrong drug prescription. Medical Community is required to adopt standard skills and owe a duty of care towards the patients.

The basic principle relating to medical negligence is known as the Bolam Rule and has been accepted by the Supreme Court as the standard test for medical negligence in Jacob Mathew V. State of Punjab[2]. This was laid down in the judgment in Bolam V. Friern Hospital Management Committee[3] as under: medical negligence arises from an act or omission by a medical practitioner, which no reasonably competent and careful medical practitioner would have committed. Therefore, a medical practitioner while attending to the patient is expected to adopt reasonably skillful behavior and follow the ordinary skills and practices of the medical profession with ordinary care.[4]

While deliberating on the absence of basic qualifications of a homeopathic doctor to practice allopathy in Poonam Verma vs. Ashwin Patel and Ors.[5], the Supreme Court ruled that anyone who practices a particular system of medicine without having knowledge of it can be held guilty of medical negligence.

This principle emphasizes that a lack of qualifications or understanding in a specific field can lead to negligence, and no further proof is required in such cases. In the case of the Indian Medical Association vs. V.P. Shanta and Ors[6]., the Supreme Court decided on the issue of coverage of medical profession within the ambit of the Consumer Protection Act. The act of medical practitioner concerning medical negligence will be considered a deficiency under the CPA.

In the case of Springs Meadows Hospital v. Harjol Ahluwalia[7], the Supreme Court of India held that both parents and a minor can claim compensation under the Consumer Protection Act. The case originated at the National Consumer Disputes Redressal Commission (NCDRC). The central question was whether the case fell under the Consumer Protection Act, 1986.The issue revolved around medical negligence. The facts were, Harjot Ahluwalia, a minor, was admitted to Spring Meadows Hospital by his parents. The child was diagnosed with typhoid and received an injection from a nurse. Unfortunately, his condition deteriorated after the injection. The Commission found negligence on the part of both the nurse and Dr. Dhananjay. Since the doctor and nurse were hospital employees, the hospital was held vicariously liable for their negligence.

In the case of Kunal Saha v. AMRI Hospital[8], the Supreme Court of India addressed medical negligence and awarded significant compensation. The case involves Kunal Saha, an Indian-American doctor, filed a case against Advanced Medicare & Research Institute (AMRI), a Kolkata-based hospital, and three doctors. He sought compensation for deficiency in medical services provided by them, which led to the untimely demise of his wife, Anuradha Saha. The Supreme Court ordered AMRI Hospital and the three doctors to pay ₹6 crores plus interest to Kunal Saha.This landmark judgment emphasizes the importance of accountability in medical care.

In other case of NIMS V. Prasanth S. Dhananka[9], a 20-year-old student was suffering from chest pain and was admitted to NIMS. After conducting several tests, she was advised to undergo surgery as it revealed there was a tumor. The patient condition worsened after the surgery and family of the patient held NIMS vicariously liable and state of Andhra Pradesh statutorily liable for the medical negligence. The issue in the case was whether the consent of the patient will dissolve the liability of doctors in medical negligence and whether the compensation awarded in the case was suffice or not? The court held that it was a case of medical negligence and awarded 1 crore exemplary compensation for the same.

In the case of Jyoti Devi v. Suket Hospital & Ors.[10], the Supreme Court of India addressed medical negligence and compensation. The background of case is Jyoti Devi underwent an appendicitis removal surgery at Suket Hospital in Himachal Pradesh in June 2005. Despite assurances by doctors, she continued to suffer pain for four years after the procedure. A Chandigarh hospital later discovered a needle had been left in her abdomen during the initial surgery.

Jyoti Devi sought ₹19.8 lakh as compensation. The District Consumer Disputes Redressal Forum ordered Suket Hospital to pay ₹5 lakh as compensation. The State Commission reduced the compensation to ₹1 lakh, but the National Consumer Disputes Redressal Commission (NCDRC) increased it to ₹2 lakh. Jyoti Devi appealed to the Supreme Court. The Supreme Court upheld the NCDRC's decision, granting Jyoti Devi ₹5 lakh as compensation. The Court emphasized that the "Eggshell Skull rule" (where the victim's pre-existing vulnerability is considered) should apply only under specific conditions.

Suggestions and Solutions
Patients can take several steps to protect themselves from medical errors such as being informed about their health condition by understanding the medical condition, treatment options, and potential risks and by asking questions and seeking clarification from the healthcare provider, by choosing the right provider selecting a qualified and experienced healthcare professional, checking their credentials, reviews, and track record. Consider seeking a second opinion for major diagnoses or treatments. Clearly communicating the symptoms, medical history, and any allergies. Maintaining a personal health record with details of the medical history, test results, and treatments. Requesting copies of the medical records from providers. Being an active participant in the healthcare can significantly reduce the risk of medical errors.

Conclusion
As long as doctor follows a practice which is acceptable to the medical profession, he cannot be held liable for negligence merely because a better alternative course or method of treatment was available. This also includes a scenario where just because a more skilled doctor would not have chosen to follow a practice or procedure which the accused followed. The conduct needs to be judged based on the day of the operation, and not on trial. There are many cases where doctors do act negligently and a person loses his life and is awarded compensation but this compensation is not equivalent to human life lost so it is duty of medical professionals to possess certain standard skills and to exercise a duty of care of which is acceptable to the medical community.

End-Notes:

1. https://www.forbes.com/advisor/legal/medical-malpractice/medical-negligence/
2. (2005) 6 SCC 1
3. [1957] 1 WLR 582
4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2779963/
5. 1996 SCC (4)
6. 1995 SCC (6)
7. 1998 (4) SCC 39
8. SSC 384 (2014)
9. 2010 ACJ 38
10. 2024 INSC 330

Written By:  Priya Singal first year law student from Vivekananda Institute of Professional Studies which is affiliated to Indraprastha University.