Doctor liable for shortfall in standard of duty

The National Commission noted the evidence revealed a breach of the required standard of duty and care, as also established in the hospital's internal inquiry report

Jatinder Kumar, a 40-year-old school teacher, was diagnosed to be suffering from end-stage Non-Hodgkin’s Lymphoma (NHL). He was admitted to Dayanand Medical College and Hospital, Ludhiana, from May 30 to June 20, 2011. He was told that chemotherapy could cure his ailment.

On July 29, after the third chemotherapy session, an attempt to change the catheter failed. Kumar was told there was a urinary infection, so a catheter would have to be connected to the bladder directly through minor surgery. He was sent to the emergency ward where Dr Anju Bansal, a junior doctor, was on duty. Kumar requested her to call a senior doctor to perform the procedure, but Dr Bansal refused and instead carried out the procedure on her own. The patient was discharged at 10.30 PM.

Kumar experienced extreme discomfort the same night due to his inability to pass urine. He returned to the hospital at 5 AM the next morning where the same junior doctor made multiple unsuccessful attempts to reconnect the catheter to the bladder.

A sonography revealed a significant hole in the bladder. The injury to the bladder was considered critical. Kumar was informed he would have to undergo another minor surgery. Dr P S Nain performed surgery for about two hours, after which Kumar was put on a ventilator as his condition continued to deteriorate. He expired on October 4, 2011.

Shallu, Kumar’s widow, filed a consumer complaint before the Ludhiana District Consumer Commission against the hospital and both the doctors. The District Commission relied on the hospital’s internal inquiry report, which had concluded that the doctors had been negligent. It held the hospital and the doctors jointly and severally liable to pay Rs 3 lakh along with 9 per cent interest, and awarded Rs 7,000 towards litigation expenses.

The order was challenged in appeal. The hospital wanted to be exonerated of liability, while Shallu wanted the compensation enhanced. The Punjab State Commission dismissed Shallu’s appeal. It allowed the hospital’s appeal and set aside the order.

Shallu challenged the orders passed in both appeals by filing two revision petitions before the National Commission. She pointed out that Dr Anju Bansal was a second-year medical student who was well aware of Kumar’s immuno-suppressed condition, yet she recklessly carried out the first surgery without supervision. 

Shallu also pointed out that the second surgery for the hole in the bladder, caused during the first surgery, ought to have been performed by a urologist but was performed by Dr P S Nain, who was a general surgeon and not a specialist.

Shallu pointed out that merely because the patient was certified as having died due to non-Hodgkin’s Lymphoma did not absolve the hospital and its doctors of negligence with respect to suprapubic cystostomy required to connect the catheter to the bladder.

The National Commission refused to accept the hospital’s contention that it could not be held negligent in the absence of a post-mortem report. It noted that the evidence revealed a breach of the required standard of duty and care, as also established in the hospital’s internal inquiry report. 

It concluded that the doctors were guilty of negligence and that the hospital, too, would be vicariously liable for deficiency in service.

Accordingly, by its order of October 12, 2023, delivered by Dr Inder Jit Singh, the National Commission allowed Shallu’s revision, set aside the orders of the State Commission, and restored the District Commission’s decision awarding compensation of Rs 3 lakh along with 9 per cent interest, and Rs 7,000 towards litigation expenses. Two months were granted for compliance.

The writer is a consumer activist