Medico Legal

CAN DOCTOR CHOOSE HIS PATIENTS ?

Yes in usual cold pt.s, EXCEPT IN EMERGENCY Pt. Parmanand Katara v Union of India, 1989 ACJ 1000 Road accident victim was denied treatment and had to be taken from one hospital to other.

Paschim Bang Ket Mazdoor Samity v. State of W.B. AIR 1996 SC 2424

Hakim Sheikh fell from train 8/7/92 and had head injuries, taken to PHC. Referred to state hosp, no bed. Taken to Calcutta medical college, no bed, Shabhu Nath Pandit hosp. referred to National Medical college to SSKM Hosp to Bangur int of Neuro to Calcutta Medical research Centre on 9/7.

CROSS-PATHY PRACTICE

Poonam Verma V. Dr. Ashwin Patel, 1996 (2) CPJ 1 (SC)

Dr. Ashwin Patel BHMS, a Homeopath gave Ampicillin and paracetamol for viral fever. Later patient became serious and admitted to a local nursing home and transferred to Hinduja Hospital, Mumbai and dies of diabetic keto-acidosis AIIMS, Delhi said that giving Ampicillin and Paracetamol were appropriate but supreme court held, since Dr. Ashwin Patel did not study pharmacology and did not qualify himself to be an allopath and hence not entitled to give these medicines, so principles of negligence per se was applied and asked to pay Rs. 3,30,000/-.

AYURVEDIC DOING ALLOPATHY

Dr. Mukhtiar Chand V State of Punjab, 1998 (5) SCALE 501.

Supreme Court observed that an Ayurvedic doctor prescribing alloapathic medicines is permitted if particular state allows them under Rule 2(ee) (iii) of Drugs and cosmetics Rules 1945, as effective from 14-5-1960 and notifications issued there under would be available from 16.6.1964, in such cases section 15(2)(b) of Indian Medical Council Act 1956 will not apply. But they can not operate and can only give essential allopathic medicines.

STATE DOES NOT PERMIT ALLOPAHY PRACTICE

Dr. S.N. Namboodiri V. Haneefa, 1998 (1) CPJ 389 Kerala SCDRC.

where an Ayurvedic doctor gave treatment for jaundice to 4 & ½ years Haneefa's daughter with allopathic and ayurvedic drugs. There was no improvement. So he referred patient to Medical College and Hospital, but ultimately she expired. Dr. Namboodiri DAM and DMS in Ayurvedic system so Consumer Court said he was not competent to prescribe allopathic medicines. Therefore held negligent for prescribing allopathic medicines, with out having studied and acquiring the degree in allopathic system. Asked to pay Rs. 40,000/-

AYURVEDIC DOCTOR DOING D&C

K. Mahabala Bhatt v. K Krishna, 2001 (3) CPR 137 NC Ayurvedic doctors with GCIM qualifications, not studied obstetric and gynecology, no dire emergency but conducted D and C, resulted in death of patient. They are not suppose to D and C and therefore held liable, pay 2.01 lakh.

FAILURE TO MONITOR A PATIENT

Guru Tegbhadur Hospital v. D.K. Nayyar 2002 (1) CPR 442 Pun. SC

Old diabetic patient came with vomiting and diarrhea for which she was treated on OPD basis with anti diarrheals and anti diabetic medicines. Initial blood sugar was 80mg/dl, next day she lapsed in to hypoglycaemic coma and died, at the time blood sugar was 38 mg / dl. such patient needed admission and monitoring of blood sugar when she had persistent vomiting, negligence and deficiency of service, pay Rs. 50,000/-

NON-ANTICIPATION OF A COMMON COMPLICATION

Devi Rani v. Dr. N. Prakash Rao Andhra Pradesh S.C.D.R.C. III (2002) CPJ, 123.

Patient had fever with chills "Amalar" 2 tablets prescribed with out asking for history of allergy to sulpha and with out confirming diagnosis of chloroquin resistant malaria. Doctor then failed to diagnose SJS due to sulpha in this patient, kept on treating the patent with B-complex and glycerine, anthical lotion for next 5 dyas, no treatment given for SJS, Total vision lost in both eyes due dry eyes due to severe reaction of medicine (SJS), Negligence of doctor proved for failure to diagnose and waste time of patient with unnecessary treatment and treat SJS or refer to specialist. Complainant entitled to compensation of 2 lakhs with interest @ 12% p.a.

FAILURE TO RECORD DISSENT

Dr. T.T. Thomas v. Elisa AIR 1987 Ker. 52

Doctor did not perform appendectomy for want of consent and also did not record dissent of patient, appendix burst, patient died. Burden of proof that patient did not consent lies on doctor, Rs. 37,000/- awarded.

FAILURE TO GIVE ANESTHESIA FOR SEETHING OF BONE CAUSE PAIN, SHOCK, DEATH

Dr. Laxman Balkrishan Joshi v. Dr. Trimbak Bapu Godbole, 1969 ACJ 193.

20 yrs old Andanda, son of doctor had fractured left side of femur on 6-5-1963 on palshet breach of Ratnagiri. Local doctor treated him and on 8-5-63 moved to Dr. Joshi at Pune on 9-5-63. After giving Morphea injection his fracture was set right with out anesthesia and plaster was given. Boy became serious and died post procedure, held liable for setting fracture without giving anesthesia causing severe pain, shock and death. Rs. 3000/- awarded by HC upheld.

FAILURE TO OPERATE WITHIN CONSENT

Rambiharilal v Dr. J.N. Shrivastav, AIR 1985 MP HC 150 (DB)

On 27.9.58, wife was taken for operation with consent for appendectomy. Doctor finds appendix normal proceeds to remove gall bladder with out consent. Patient died of hepatorenal failure due to 2 hours prolonged chloroform anesthesia in a known case of bad kidneys. No preventive steps to protect liver and kidneys taken by giving glucose and vitamins, no consent, no infrastructure to do such operation, held liable Rs. 1000/- asked were awarded.

FAILURE TO ADVISE PREOPERATIVE INVESTIGATION

Sourindra Mohan Ghosh v. Dr. D.V. Pahwa 2002 (2) CPJ 243 WB SC

Before doing cataract operation doctor advised B-scan of eye. No proof of such advise on case sheet. Without getting the B-scan report operated on eye. Had he done B-scan before operation and found retinal detachment, patient could have sought 2nd opining or deferred operation. When everything was over then post operative did B-scan found retinal detachment, patient became blind, liable to pay Rs. 1,00,000/-.

CONSENT CAN NOT SUBSTITUTE FOR SHORT COMING OF INFRASTRUCTURE

Devendra Kumar Sharma v. PGI Chandigarh, 2002 (1) CPJ.

Taken for clipping of aneursm in a vessel in brain, drill not found working, abadnond operation, says patient consented to take all kinds of risks. Court said the consent is for the inherent outcome of operative complications and not for deficiencies in infrastructure, diligence and care, pay Rs. 2.05 lakh.

FAILURE TO KEEP RARE BLOOD GROUP READY PRIOR TO OPERATION

Dr. Rashim B. Fadnvis v. MGP 1998 (1) CPJ 49 NC

Operated on AB neg/ 124 for hysterectomy for multiple fibroids with out even keeping one bottle of AB neg ready. Operations lasted for more than 7 hours. Patient bled profusely. Could not arrange for blood during operation patient died, held negligent, pay 2,60,355/-. Anesthetist which was exonerated was reversed by NC but on merits found her not negligent.

FAILURE TO GET SPECIALIST CARE FROM BEGINNING

Prasanth S Dhanaka v. Nizam Institute of medical sciences 1999 (1) CPJ 43 NC.

After undergoing operation of intrathoracic tumor benign shwnnoma patient became paraplegic. Preoperative MRI and Myelogram were not done inspite of rib vertebral erosion and therefore could not involve neurosugreon from beginning. Negligence, Pay 15.75 lakhs.

VICARIOUS LIABILITY

Doctor Responsible for Unqualified Professionals Likes Nurses, Componders, Assistant Doctors.

Spring Meadows Hospitals V. Harjot Singh Ahluwalia 1998 (3) Cpr 1 Sc.

Nurse Gave Intavenous Chloroquin Instead of Chloramphenicol Resulted in Cardiorespoiratory Arrest Revived But Brain Damage Due to Anoxia in Child Occurred. Highest Claim Amount of 17.5 Lakhs Given.

Can Misleading Signs Boards Amount to Negligence ?

Yes

Dr. Sr. Louie v. Kannolil Pathumma, 1993 (1) CPR 422 NC

Dr. Sr. Louie was MD from Germany which is equiavlent to MBBS in India. Her Sign board showed DM gyn. Whch gave a misleading impression to patient that she is MD in gyne i.e. PG in Gyn. She is not entitled to claim MD gyn. in India. Not qualified to undertake complicated cases of delivery so pay compensation of Rs. 77,000/-

ILLEGIBLE PRESCRIPTION

Pendergast V. Sam and Dee Ltd. (1988) Independent, 17th March (Queen's bench divisions AULD J.).

This decision is affirmed on appeal (1989) Times, 14th March, CA.

Instead of antibiotic Amoxil in Asthma patient recieved diabetes medicine, daonil causing hypoglycemia and brain damage, negligence held. Doctor to pay 25% and chemist 75% of awarded amount.

WRONG PATHOLOGICAL REPORT

Chandrasagar D. Rajput v. Dr. Dinesh J Shah 1999 (1) CPJ 434 Mah. SC.

In ANC path reports positive report for VDRL given Patient got report done in other lab. Found Negative No mention that there is some chance of false positive in the report. State commission Mah. Awarded Rs. 50,000 for negligence and deficiency of service.

WRONG BLOOD GROUP REPORT

Hilarious Institute and Clinical Lab. vs. Mohan Das Appeal No. 497/95.

decided on 20.4.95 by Kerlala SC Bharat. Path. Lab. V. Mangilal Vyas 2003(3) CPJ 94 NC.

Complainant was given wrong blood group report. On the basis of the report he traveled from Madurai to Calicut to donate blood to his sister-in-law to find his blood group was different from mentioned in report, State commission upheld decision of District forum and ordered compensation of Rs. 1000/- 2nd case Rs. 5000/- awarded.

RELYING ONLY ON REPORTS NOT JUSTIFIED

Rahul Sinha v. Dr. Alok Mitra 1995 (2) CPJ 227 CT scan reported everything is normal and there was no trace of cancer in a treate4d case of cancer, which subsequently turned out to be recurrence of cancer. Relying totally on the impression of radiologist is not correct, particularly when medical history creates suspicion of recurrence.

UNHYGIENIC CONDITIONS IN HOSPITAL

M. Ramesh Reddy, State of Andhra Pradesh, 2003 CLD 81 AP SC.

Hospital authorities were held negligent for not keeping bathroom clean, in this case bathroom was covered with fungus and became slippery, where maternity patient slipped and died. Compensation of Rs. 1 lakh awarded.

PROFESSIONAL SECRECY AND CONFIDENTIALITY

Mr. X v. Hospital Z 2003(1) SCC 500 under s. 20 A of Indian Medical council Act 1956 prohibits docotors from disclosing secrets except under order of court of law HIV positive person wants to marry and HIV negative will person with out disclosing his positive status. Positive status is disclosed by hospital. Has hospital doctors violated s. 20 A SC said one had to weigh right to privacy with fiance right to life and be lead healthy u/art. 21, right to life shall be superior Whether liable under s. 269/270 of IPC.